强化疟疾控制项目对高疟疾流行区向低流行区过渡的影响评估：流行病学方面。

Impact assessment of Intensified Malaria Control Project in transitioning a high malaria-endemic district to a low-endemic district: an epidemiological aspect.

机构信息

National Vector Borne Disease Control Programme, Udalguri, Darrang, Assam, India.

Department of Parasite - Host Biology, ICMR - National Institute of Malaria Research, Dwarka, New Delhi, India.

出版信息

Pathog Glob Health. 2023 Jul;117(5):493-504. doi: 10.1080/20477724.2023.2194498. Epub 2023 Mar 24.

DOI:10.1080/20477724.2023.2194498

PMID:36960929

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10262807/

Abstract

Intensified Malaria Control Project (IMCP) was implemented in 2005 to control malaria in all North-Eastern and Odisha states of India. The present study aimed to investigate the impact of IMCP in reducing the malaria burden in Udalguri district, Assam state of North-East India. Malaria epidemiological data were obtained for IMCP intervention (Udalguri) and nonintervention district (West Singhbhumi, Jharkhand state). IMCP activities include introducing bi-valent rapid diagnostic kits (RDTs), Artemether-Lumefantrine drug in North-East India, long-lasting insecticidal nets (LLINs) distribution, and creating awareness programs about malaria in an intensified mode. The data revealed a significant decline in annual parasite incidence (API) from 14.94 (2005) to 2.61 (2018), -37% (95%CI: -57%, -19%, = 001) after using LLINs in 2009 and -64% (95%CI: -116%, -14%, = 013) after the introduction of RDTs in district Udalguri. Whereas control district showed a -28% (95%CI: -63%, 6.3%, = 0.051) decrease in API using LLINs and a 10% (95%CI: -7.6%, 28%, = 0.122) increase after the introduction of RDTs. () and () were the major malarial parasites in Udalguri. -malaria was much higher (71%) than -malaria (29%) during the study period. An increasing trend of cases was observed in Udalguri. Udalguri and Khoirabari BPHCs showed an overall reduction of 94% (95%CI: -143%, -45%, = 0.001) and 84% (95%CI: -126%, -39%, = 0.003), respectively; however, only a 10% (95%CI: -65%, -41%, = 0.360) reduction in API was observed in Orang BPHC. An overall decrease in malaria indicates the effective implementation of vector and disease control strategies in the Udalguri district.

摘要

强化疟疾控制项目（IMCP）于 2005 年实施，旨在控制印度东北部和奥里萨邦的疟疾。本研究旨在调查 IMCP 在减少印度东北部阿萨姆邦乌达尔古里地区疟疾负担方面的影响。疟疾流行病学数据来自 IMCP 干预（乌达尔古里）和非干预区（西辛格布姆，恰尔康德邦）。IMCP 活动包括在东北地区引入二价快速诊断试剂盒（RDT）、青蒿琥酯-咯萘啶药物、长效驱虫蚊帐（LLINs）分发以及以强化模式开展疟疾宣传活动。数据显示，在 2009 年使用 LLINs 后，年寄生虫发病率（API）从 2005 年的 14.94 降至 2018 年的 2.61，下降 37%（95%CI：-57%，-19%，=0.01），在乌达尔古里地区引入 RDT 后下降 64%（95%CI：-116%，-14%，=0.13）。而对照区使用 LLINs 后 API 下降 28%（95%CI：-63%，6.3%，=0.051），引入 RDT 后增加 10%（95%CI：-7.6%，28%，=0.122）。（）和（）是乌达尔古里的主要疟原虫。在研究期间，-疟疾病例（71%）明显高于-疟疾病例（29%）。乌达尔古里的病例呈上升趋势。乌达尔古里和科伊拉巴里 BPHC 分别显示出总体减少 94%（95%CI：-143%，-45%，=0.001）和 84%（95%CI：-126%，-39%，=0.003），而奥兰 BPHC 的 API 仅减少 10%（95%CI：-65%，-41%，=0.360）。疟疾的总体下降表明在乌达尔古里地区实施了有效的病媒和疾病控制策略。