Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Malaria Elimination Initiative, Institute for Global Health Sciences, University of California-San Francisco, San Francisco, California.
Am J Trop Med Hyg. 2022 Sep 6;107(4):747-753. doi: 10.4269/ajtmh.22-0038. Print 2022 Oct 12.
International travel, a major risk factor for imported malaria, has emerged as an important challenge in sustaining malaria elimination and prevention of its reestablishment. To make travel and trade safe, the WHO adopted the International Health Regulations (IHR) which provides a legal framework for the prevention, detection, and containment of public health risks at source. We conducted a systematic review to assess the relevance and the extent of implementation of IHR practices that can play a role in reducing malaria transmission. Selected studies addressed control, elimination, and prevention of reestablishment of malaria. Study themes focused on appraisal of surveillance and response, updating national policies to facilitate malaria control and elimination, travel as a risk factor for malaria and risk mitigation methods, vector control, transfusion malaria, competing interests, malaria in border areas, and other challenges posed by emerging communicable diseases on malaria control and elimination efforts. Review results indicate that malaria has not been prioritized as part of the IHR nor has the IHR focused on vector-borne diseases such as malaria. The IHR framework in its current format can be applied to malaria and other vector-borne diseases to strengthen surveillance and response, overcome challenges at borders, and improve data sharing-especially among countries moving toward elimination-but additional guidelines are required. Application of the IHR in countries in the malaria control phase may not be effective until the disease burden is brought down to elimination levels. Considering existing global elimination goals, the application of IHR for malaria should be urgently reviewed and included as part of the IHR.
国际旅行是输入性疟疾的一个主要危险因素，已成为维持疟疾消除和防止其重新出现的一个重要挑战。为了确保旅行和贸易安全，世界卫生组织通过了《国际卫生条例》（IHR），为从源头预防、发现和控制公共卫生风险提供了法律框架。我们进行了系统评价，以评估可以发挥作用减少疟疾传播的 IHR 实践的相关性和实施程度。选定的研究涉及疟疾的控制、消除和防止重新出现。研究主题侧重于评估监测和应对、更新国家政策以促进疟疾控制和消除、旅行作为疟疾的危险因素和风险缓解方法、病媒控制、输血疟疾、利益冲突、边境地区疟疾以及新出现的传染病对疟疾控制和消除工作带来的其他挑战。审查结果表明，《国际卫生条例》没有将疟疾作为优先事项，也没有将疟疾作为重点关注的虫媒传染病。目前形式的《国际卫生条例》框架可以适用于疟疾和其他虫媒传染病，以加强监测和应对，克服边境挑战，改进数据共享，特别是在向消除迈进的国家之间，但需要额外的指导方针。在疟疾控制阶段的国家应用《国际卫生条例》可能不会有效，直到疾病负担降低到消除水平。考虑到现有的全球消除目标，应紧急审查《国际卫生条例》在疟疾方面的应用，并将其作为《国际卫生条例》的一部分。
