Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, Republic of Korea.
Front Public Health. 2024 Aug 22;12:1423004. doi: 10.3389/fpubh.2024.1423004. eCollection 2024.
malaria has been one of the most troublesome diseases in the Democratic People's Republic of Korea (DPRK). Given that a majority of malaria cases are concentrated near the demilitarized zone, concerted elimination efforts from both the Republic of Korea (ROK) and DPRK are essential for a malaria-free Korean Peninsula. This study assessed the impact of rapid diagnostic tests (RDTs) and tafenoquine on malaria incidence in DPRK.
We patterned the current model structure from the previously developed malaria dynamic transmission model for ROK. Model parameters were adjusted using demographic and climate data from malaria-risk areas in DPRK, and the model was calibrated to annual malaria incidences from 2014 to 2018 in DPRK, as reported by the World Health Organization. Subsequently, we estimated the preventable malaria cases over a decade after introducing RDTs and tafenoquine compared to using microscopy alone and primaquine, respectively. Sensitivity analysis was performed to account for uncertainty in model parameters.
When comparing RDTs to microscopy, a one-day reduction in diagnostic time due to the introduction of RDTs led to a reduction in malaria incidence by 26,235 cases (65.6%) over the next decade. With a two-day reduction, incidences decreased by 33,635 (84.1%). When comparing a single dose of tafenoquine with a 14-day primaquine regimen, the former prevented 1,222 (77.5%) relapse cases and 4,530 (11.3%) total cases over the years.
The continuous and simultaneous implementation of RDTs and tafenoquine emerges as a potent strategy to considerably reduce malaria in DPRK.
疟疾一直是朝鲜民主主义人民共和国（朝鲜）最棘手的疾病之一。鉴于大多数疟疾病例集中在非军事区附近，韩国（韩国）和朝鲜需要共同努力才能实现朝鲜半岛无疟疾。本研究评估了快速诊断测试（RDT）和他非能对朝鲜疟疾发病率的影响。
我们从前开发的韩国疟疾动态传播模型中借鉴了当前模型结构。使用朝鲜疟疾风险地区的人口统计和气候数据调整模型参数，并根据世界卫生组织报告的 2014 年至 2018 年朝鲜的年度疟疾发病率对模型进行校准。随后，我们估计了在引入 RDT 和他非能后十年内可预防的疟疾病例数，与单独使用显微镜和伯氨喹相比。进行了敏感性分析以考虑模型参数的不确定性。
与显微镜相比，由于引入 RDT 可将诊断时间缩短一天，因此在未来十年中，疟疾发病率将减少 26,235 例（65.6%）。如果诊断时间缩短两天，发病率将减少 33,635 例（84.1%）。与 14 天伯氨喹方案相比，单次服用他非能可预防 1,222 例（77.5%）复发病例和 4,530 例（11.3%）总病例。
连续和同时实施 RDT 和他非能似乎是减少朝鲜疟疾的有效策略。
