RTI International, Dar es Salaam, United Republic of Tanzania.
Zanzibar Malaria Elimination Programme, Ministry of Health, Zanzibar, United Republic of Tanzania.
Glob Health Sci Pract. 2023 Oct 30;11(5). doi: 10.9745/GHSP-D-22-00522.
Testing and treating asymptomatic populations have the potential to reduce the population's parasite reservoir and reduce malaria transmission. Zanzibar's malaria case notification (MCN) platform collects detailed sociodemographic and epidemiological data from all confirmed malaria cases to inform programmatic decision-making. We describe the design and operationalization process of the platform and other malaria surveillance resources that are enabling Zanzibar's progress toward malaria elimination.The MCN platform consists of an interactive short message service (SMS) system for case notification, a software application for Android mobile devices, a visual question set and workflow manager, a back-end database server, and a web browser-based application for data analytics, configuration, and management. Malaria case data were collected from August 2012 to December 2021 and reported via SMS from all public and private health facilities to a central database and then to district malaria surveillance officers' mobile devices. Data included patient names, shehia (administrative area), and date of diagnosis, enabling officers to track patients, ideally within 24 hours of reporting. Patients' household members were tested for malaria using conventional rapid diagnostic tests (RDTs). Treatment using artemisinin-based combination therapy was provided for persons testing positive.Between 2012 and 2021, a total of 48,899 index malaria cases were confirmed at health facilities, 22,152 (45.3%) within 24 hours of reporting; 41,886 (85.7%) cases were fully investigated and followed up to the household level. A total of 111,811 additional household members were tested with RDTs, of whom 10,602 (9.5%) were malaria positive.The MCN platform reports malaria case data in near real time, enabling prompt follow-up of index cases and prompt testing and treatment of members in index case households. Along with routine testing and treatment and other preventive interventions, the MCN platform is foundational to the programmatic efforts in further reducing malaria and ultimately eliminating autochthonous malaria transmission in Zanzibar.
对无症状人群进行检测和治疗有可能减少人群中的寄生虫储存量并降低疟疾传播率。桑给巴尔的疟疾病例通报（MCN）平台从所有确诊的疟疾病例中收集详细的社会人口学和流行病学数据，为规划决策提供信息。我们描述了平台的设计和运作过程以及其他疟疾监测资源，这些资源使桑给巴尔在消除疟疾方面取得了进展。
MCN 平台由一个用于病例通报的交互式短信服务（SMS）系统、一个用于 Android 移动设备的软件应用程序、一个可视化问题集和工作流管理器、一个后端数据库服务器以及一个基于网络浏览器的数据分析、配置和管理应用程序组成。从 2012 年 8 月到 2021 年 12 月，通过所有公共和私人卫生机构通过短信收集疟疾病例数据，并报告给中央数据库，然后报告给区疟疾监测官员的移动设备。数据包括患者姓名、shehia（行政区）和诊断日期，使官员能够跟踪患者，理想情况下在报告后 24 小时内进行跟踪。对患者的家庭成员使用常规快速诊断检测（RDT）进行疟疾检测。对检测呈阳性的人使用青蒿素为基础的联合疗法进行治疗。
在 2012 年至 2021 年期间，共有 48899 例索引疟疾病例在卫生机构确诊，其中 22152 例（45.3%）在报告后 24 小时内确诊；41886 例（85.7%）病例进行了全面调查并随访到家庭层面。总共对 111811 名额外的家庭成员进行了 RDT 检测，其中 10602 人（9.5%）呈疟疾阳性。MCN 平台几乎实时报告疟疾病例数据，使索引病例能够得到及时跟进，索引病例家庭中的成员也能得到及时检测和治疗。MCN 平台与常规检测和治疗以及其他预防干预措施一起，是该计划进一步减少疟疾并最终消除桑给巴尔本地疟疾传播的基础。
