基于马德拉邦曼德拉区消除疟疾示范项目的经验建立消除疟疾模型。
A model for malaria elimination based on learnings from the Malaria Elimination Demonstration Project, Mandla district, Madhya Pradesh.
机构信息
Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India.
Indian Council of Medical Research-National Institute of Research in Tribal Health (ICMR- NIRTH), Jabalpur, Madhya Pradesh, India.
出版信息
Malar J. 2021 Feb 16;20(1):98. doi: 10.1186/s12936-021-03607-3.
BACKGROUND
Malaria Elimination Demonstration Project (MEDP) was started as a Public-Private-Partnership between the Indian Council of Medical Research through National Institute of Research in Tribal Health, Govt. of Madhya Pradesh and Foundation of Disease Elimination and Control of India, which is a Corporate Social Responsibility (CSR) initiative of the Sun Pharmaceutical Industries Limited. The project's goal was to demonstrate that malaria can be eliminated from a high malaria endemic district along with prevention of re-establishment of malaria and to develop a model for malaria elimination using the lessons learned and knowledge acquired from the demonstration project.
METHODS
The project employed tested protocols of robust surveillance, case management, vector control, and capacity building through continuous evaluation and training. The model was developed using the learnings from the operational plan, surveillance and case management, monitoring and feedback, entomological investigations and vector control, IEC and capacity building, supply chain management, mobile application (SOCH), and independent reviews of MEDP.
RESULTS
The MEDP has been operational since April 2017 with field operations from August 2017, and has observed: (1) reduction in indigenous cases of malaria by about 91 %; (2) need for training and capacity building of field staff for diagnosis and treatment of malaria; (3) need for improvement insecticide spraying and for distribution and usage of bed-nets; (4) need for robust surveillance system that captures and documents information on febrile cases, RDT positive individuals, and treatments provided; (5) need for effective supervision of field staff based on advance tour plan; (6) accountability and controls from the highest level to field workers; and (7) need for context-specific IEC.
CONCLUSIONS
Malaria elimination is a high-priority public health goal of the Indian Government with a committed deadline of 2030. In order to achieve this goal, built-in systems of accountability, ownership, effective management, operational, technical, and financial controls will be crucial components for malaria elimination in India. This manuscript presents a model for malaria elimination with district as an operational unit, which may be considered for malaria elimination in India and other countries with similar geography, topography, climate, endemicity, health infrastructure, and socio-economic characteristics.
背景
消除疟疾示范项目(MEDP)是印度医学研究理事会通过国家部落健康研究所、印度马哈拉施特拉邦政府和疾病消除与控制基金会之间的公私合作伙伴关系启动的,这是太阳制药工业有限公司企业社会责任(CSR)倡议。该项目的目标是证明在疟疾高度流行的地区可以消除疟疾,同时防止疟疾再次出现,并利用从示范项目中获得的经验和知识制定消除疟疾的模式。
方法
该项目采用经过测试的稳健监测、病例管理、病媒控制和能力建设方案,并通过持续评估和培训加以实施。该模式是利用从操作计划、监测和病例管理、监测和反馈、昆虫学调查和病媒控制、IEC 和能力建设、供应链管理、移动应用程序(SOCH)以及 MEDP 的独立审查中获得的经验教训制定的。
结果
自 2017 年 4 月开始运营以来,MEDP 已开展了实地工作,从 2017 年 8 月开始,取得了以下成果:(1)疟疾本地病例减少约 91%;(2)需要培训和建设现场工作人员诊断和治疗疟疾的能力;(3)需要改进杀虫剂喷洒和驱虫蚊帐的分发和使用;(4)需要建立一个强大的监测系统,以捕获和记录发热病例、RDT 阳性个体和提供的治疗信息;(5)需要根据预先制定的考察计划对现场工作人员进行有效的监督;(6)从最高层到基层工作人员的问责制和控制;(7)需要有针对性的 IEC。
结论
消除疟疾是印度政府的一个高度优先的公共卫生目标,其承诺的截止日期是 2030 年。为了实现这一目标,建立问责制、所有权、有效管理、业务、技术和财务控制等内置系统将是印度消除疟疾的关键组成部分。本文介绍了一种以县为行动单位的消除疟疾模式,该模式可能会被考虑用于印度和其他具有类似地理、地形、气候、流行程度、卫生基础设施和社会经济特征的国家消除疟疾。
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