消除疟疾的检测和治疗：系统评价。
Testing and treatment for malaria elimination: a systematic review.
机构信息
Malaria Elimination Initiative, Institute for Global Health Sciences, University of California San Francisco (UCSF), 550 16th Street, San Francisco, CA, 94143, USA.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
出版信息
Malar J. 2023 Sep 3;22(1):254. doi: 10.1186/s12936-023-04670-8.
BACKGROUND
Global interest in malaria elimination has prompted research on active test and treat (TaT) strategies.
METHODS
A systematic review and meta-analysis were conducted to assess the effectiveness of TaT strategies to reduce malaria transmission.
RESULTS
A total of 72 empirical research and 24 modelling studies were identified, mainly focused on proactive mass TaT (MTaT) and reactive case detection (RACD) in higher and lower transmission settings, respectively. Ten intervention studies compared MTaT to no MTaT and the evidence for impact on malaria incidence was weak. No intervention studies compared RACD to no RACD. Compared to passive case detection (PCD) alone, PCD + RACD using standard diagnostics increased infection detection 52.7% and 11.3% in low and very low transmission settings, respectively. Using molecular methods increased this detection of infections by 1.4- and 1.1-fold, respectively.
CONCLUSION
Results suggest MTaT is not effective for reducing transmission. By increasing case detection, surveillance data provided by RACD may indirectly reduce transmission by informing coordinated responses of intervention targeting.
背景
全球对消除疟疾的关注促使人们研究主动检测和治疗（TaT）策略。
方法
进行了系统评价和荟萃分析，以评估 TaT 策略在减少疟疾传播方面的有效性。
结果
共确定了 72 项实证研究和 24 项建模研究，主要集中在高传播和低传播环境中的主动大规模 TaT（MTaT）和反应性病例检测（RACD）上。有 10 项干预研究将 MTaT 与无 MTaT 进行了比较，而 MTaT 对疟疾发病率影响的证据较弱。没有干预研究将 RACD 与无 RACD 进行比较。与单独的被动病例检测（PCD）相比，使用标准诊断方法的 PCD+RACD 在低传播和极低传播环境中分别将感染检测率提高了 52.7%和 11.3%。使用分子方法，感染检测率分别提高了 1.4 倍和 1.1 倍。
结论
结果表明，MTaT 对减少传播无效。通过增加病例检测，RACD 提供的监测数据可能通过为有针对性的干预措施提供协调响应，间接地减少传播。
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