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坦桑尼亚南部1,7-疟疾反应性社区检测与应对方法实施中断对疟疾防控工作的影响

Impact of Implementation Interruptions of 1,7-Malaria Reactive Community-Based Testing and Response Approach on Malaria Control Efforts - Southern Tanzania.

作者信息

Li Yuejin, Zheng Jinxin, Mlacha Yeromin P, Lu Shenning, Abdulla Salim, Li Qin, Yan Ge, Zhou Xiaonong, Xiao Ning, Githu Victoria, Gavana Tegemeo, Chaki Prosper, Bi Peng, Sui Yuan, Wang Yongbin, Wang Duoquan

机构信息

Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining City, Shandong Province, China.

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China.

出版信息

China CDC Wkly. 2025 May 2;7(18):628-634. doi: 10.46234/ccdcw2025.104.

DOI:10.46234/ccdcw2025.104

PMID:40376505

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12075446/

Abstract

INTRODUCTION

Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach significantly reduced malaria incidence rates. However, implementation was disrupted by security concerns, infectious disease outbreaks, and supply shortages. This study evaluates how these interruptions affected intervention effectiveness to inform future malaria control strategies.

METHODS

The study employed a two-phased design: Phase I (2016-2018) and Phase II (2019-2021). Weekly malaria incidence rates per 100 people were calculated from cases reported by local health facilities in the intervention areas during both phases. Seasonal and trend decomposition using loess (STL) and interrupted time series modeling with piecewise linear regression were used to evaluate the impact of disruptions on 1,7-mRCTR implementation effectiveness.

RESULTS

In Tanzania's 1,7-mRCTR areas, malaria incidence peaked during November-December and June-July. Phase I's 8-month interruption reversed the weekly trend from a 0.17% decline to a 0.58% increase (=0.001). After resumption, incidence dropped 8.96% (=0.039) and maintained a 0.39% long-term decline (=0.003). Even with seasonal adjustment, the interruption slowed the weekly decline from 0.08% to 0.07% (=0.003). Phase II showed a similar pattern: a one-week interruption caused a 0.70% drop (=0.007) but shifted the trend from a 0.02% decline to a 0.08% increase (=0.001). After resumption, interventions stabilized the decline at 0.11% weekly (=0.001).

CONCLUSIONS

This research demonstrates that Tanzania's malaria incidence is closely linked to seasonal patterns and consistent intervention efforts. Phase I's 8-month security-related interruption reduced 1,7-mRCTR effectiveness by 12.5%, while Phase II's 3-month pandemic-induced interruption caused only short-term fluctuations with minimal long-term impact. Rapid resumption of interventions after disruptions allowed for prompt recovery, highlighting the importance of adaptive strategies to maintain progress toward malaria control goals.

摘要

引言

中坦疟疾控制项目的调查表明，1-7岁疟疾反应性社区检测与应对（1-7-mRCTR）方法显著降低了疟疾发病率。然而，实施工作因安全问题、传染病暴发和供应短缺而中断。本研究评估了这些干扰如何影响干预效果，以为未来的疟疾控制策略提供参考。

方法

该研究采用两阶段设计：第一阶段（2016 - 2018年）和第二阶段（2019 - 2021年）。根据两个阶段干预地区当地卫生设施报告的病例计算每100人的每周疟疾发病率。使用局部加权回归的季节性和趋势分解（STL）以及带有分段线性回归的中断时间序列模型来评估干扰对1-7-mRCTR实施效果的影响。

结果

在坦桑尼亚的1-7-mRCTR地区，疟疾发病率在11月至12月以及6月至7月达到峰值。第一阶段8个月的中断使每周趋势从下降0.17%逆转至上升0.58%（=0.001）。恢复后，发病率下降了8.96%（=0.039），并保持每周0.39%的长期下降（=0.003）。即使进行了季节调整，中断也使每周下降速度从0.08%放缓至0.07%（=0.003）。第二阶段呈现出类似模式：一周的中断导致下降0.70%（=0.007），但趋势从下降0.02%转变为上升0.08%（=0.001）。恢复后，干预措施使每周下降稳定在0.11%（=0.001）。