Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia
Malaria elimination using the 1-3-7 approach: lessons from Sampov Loun, Cambodia
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DOI：
10.1186/s12889-020-08634-4
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发表时间：
2020-04-22
影响因子：
4.5
通讯作者：
Kak, Neeraj
中科院分区：
文献类型：
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作者：
Kheang, Soy Ty;Sovannaroth, Siv;Kak, Neeraj
背景柬埔寨的目标是到2025年在其境内消灭疟疾，并正在制定旨在实现这一目标的一揽子消除战略和干预措施范本。方法柬埔寨从2015年7月开始在柬埔寨西部的Sampov Loun业务卫生区采用简化的1-3-7监测模式。1-3-7方法的目标是在一天内报告确诊病例，在三天内对特定病例进行调查，并采取有针对性的控制措施，以防止在七天内进一步传播。在Sampov Loun，应对措施包括反应性病例检测(对同旅行者、家庭接触者和家庭成员以及周围疑似疟疾病例的家庭进行检测)，以及提供健康教育和驱虫蚊帐。对所有确诊的恶性疟和恶性混合疟疾病例进行第28天的随访显微镜检查，以评估治疗效果。结果该区疟疾确诊病例由2015年的519例下降到2017年的181例，年寄生虫发病率由3.21/1000人下降到1.06/1000人。Sampov Loun最后一例本地传播的疟疾病例于2016年3月被发现。针对已确定的408例指示病例，对1377名接触者进行了筛查，从而确定了14例阳性病例。所有阳性病例都发生在指示病例的同机旅行者中。结论1-3-7方法在Sampov Loun的经验表明，基本消灭疟疾一揽子计划可以在行动区级实施，以实现柬埔寨消灭疟疾的目标，并为改进这一一揽子计划提供了必要的信息。
Background Cambodia has targeted malaria elimination within its territory by 2025 and is developing a model elimination package of strategies and interventions designed to achieve this goal. Methods Cambodia adopted a simplified 1-3-7 surveillance model in the Sampov Loun operational health district in western Cambodia beginning in July 2015. The 1-3-7 approach targets reporting of confirmed cases within one day, investigation of specific cases within three days, and targeted control measures to prevent further transmission within seven days. In Sampov Loun, response measures included reactive case detection (testing of co-travelers, household contacts and family members, and surrounding households with suspected malaria cases), and provision of health education, and insecticide-treated nets. Day 28 follow up microscopy was conducted for all confirmed P. falciparum and P. falciparum-mixed-species malaria cases to assess treatment efficacy. Results The number of confirmed malaria cases in the district fell from 519 in 2015 to 181 in 2017, and the annual parasite incidence (API) in the district fell from 3.21 per 1000 population to 1.06 per 1000 population. The last locally transmitted case of malaria in Sampov Loun was identified in March 2016. In response to the 408 index cases identified, 1377 contacts were screened, resulting in the identification of 14 positive cases. All positive cases occurred among index case co-travelers. Conclusion The experience of the 1-3-7 approach in Sampov Loun indicates that the basic essential malaria elimination package can be feasibly implemented at the operational district level to achieve the goal of malaria elimination in Cambodia and has provided essential information that has led to the refinement of this package.