A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania
A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania
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DOI：
10.3390/ijerph110505317
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发表时间：
2014-05-01
影响因子：
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通讯作者：
Miranda, Marie Lynn
中科院分区：
文献类型：
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作者：
Kramer, Randall A.;Mboera, Leonard E. G.;Miranda, Marie Lynn
由于地方卫生系统、基础设施、有限资源以及感染、疾病和治疗之间复杂的相互作用所造成的制约，优化疟疾控制战略变得复杂。本文的目的是描述一项随机因子研究的方案，旨在解决这一研究空白。该项目将评估坦桑尼亚mvmero区的两项疟疾控制干预措施：(1)一项疾病管理战略，涉及社区卫生工作者使用快速诊断技术进行早期发现和治疗；(2)通过社区支持的杀幼虫方法控制病媒生物。将6个研究村分为4组（对照组、早期发现和治疗组、杀幼虫组、早期发现和治疗加杀幼虫组）。研究的主要终点是在年度纵向横断面调查中测量的干预组中疟疾感染流行率的变化。反复进行的昆虫学调查、住户调查和焦点小组讨论将提供更多有价值的见解。在基线时，所有24个村庄的962户家庭参加了住户调查；其中720个家庭的2,884名成员参加了随后的疟疾计量调查。研究设计将允许我们估计不同干预组合的效应大小。我们研究方案的详细文件也可以为其他研究人员设计现场干预试验提供帮助。
The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.