Implementation Science to Optimize Malaria Vector Control and Disease Management

优化疟疾病媒控制和疾病管理的科学实施

• 批准号: 8473155
• 负责人: Randall A Kramer
• 金额: $ 40.62万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8473155
• 关键词: Accounting; Acute; Affect; Africa; Africa South of the Sahara; African; Area; Cessation of life; Child; Country; Data; Decision Support Model; Diagnostic; Disease Management; Disease Vectors; Effectiveness; Environmental Health; Experimental Designs; Facilities and Administrative Costs; Filarial Elephantiases; Future; Health; Income; Insecticides; Intervention; Joints; Malaria; Malaria prevention; Outcome; Pharmacotherapy; Process; Productivity; Prophylactic treatment; Randomized; Reporting; Research; Research Infrastructure; Residual state; Schistosomiasis; Science; Services; Side; Site; System; Tanzania; Testing; Therapeutic Intervention; Time; Translational Research; Vector-transmitted infectious disease; Work; World Health Organization; base; cost; design; evidence base; flexibility; health care delivery; implementation science; improved; insight; killings; mortality; neglect; prevent; public health relevance; research study; tool; vector; vector control

DESCRIPTION (provided by applicant): Malaria is one of the greatest health challenges facing the developing world. World Health Organization data indicate that malaria causes over 1 million deaths per year, with over 90% of those deaths occurring in sub-Saharan Africa. A number of strategies are available to prevent malaria, including the use of insecticide treated nets and indoor residual spraying for vector control and a variety of diagnostic strategies and drug therapies for both prophylaxis and treatment. However, it is often difficult for decision-makers to determine the best combination of interventions, given the constraints within local health care delivery systems, as well as in vector control infrastructure. Thus, the central objective of this proposal is to improve malaria control outcomes through an implementation science approach that integrates health delivery experiments and decision support modeling to promote joint optimization of vector control and disease management strategies. We propose three specific aims: (1) perform randomized experiments of vector control and disease management strategies in Tanzania to elucidate which intervention strategy combinations are most effective in real world settings, using an implementation science approach; (2) use analytical insights from the health delivery experiments to refine an existing decision support model that includes both vector control and disease management; and (3) develop approaches for replicating the decision support tool in other parts of Tanzania and other countries in sub-Saharan Africa. Accomplishing these combined specific aims will provide a framework for designing and implementing multi-pronged malaria control strategies that have the best chances for sustained effectiveness in an operational setting. We will test the effectiveness of different combinations of vector and disease management interventions over time based on field experiments. We will then use the experimental results in conjunction with decision support modeling to improve a new tool that will allow decision-makers to jointly optimize vector and disease management strategies. The tool is flexible enough to incorporate new therapies and interventions as they are developed. This proposal has been developed in a collaborative process with critical partners in Tanzania and, thus, leverages an active and vibrant set of professional relationships. Through these in-country partnerships, we have direct access to key decision-makers at both the local and national levels. In addition, our previous work across Africa provides a strong platform from which to launch future replication in areas beyond the primary study site.

描述（由申请人提供）：疟疾是发展中国家面临的最大健康挑战之一。世界卫生组织的数据表明，疟疾每年造成100多万人死亡，其中90%以上发生在撒哈拉以南非洲。有一些预防疟疾的战略，包括使用驱虫蚊帐和室内滞留喷洒来控制病媒，以及各种诊断战略和药物疗法来预防和治疗。然而，由于地方保健提供系统以及病媒控制基础设施的制约因素，决策者往往难以确定最佳的干预组合。因此，该提案的中心目标是通过实施科学方法来改善疟疾控制成果，该方法将卫生服务实验和决策支持建模相结合，以促进病媒控制和疾病管理战略的联合优化。我们提出了三个具体目标：（1）在坦桑尼亚进行病媒控制和疾病管理策略的随机实验，以阐明哪种干预策略组合在真实的世界环境中最有效，使用实施科学方法;（2）使用健康交付实验的分析见解来完善现有的决策支持模型，包括病媒控制和疾病管理;以及（3）制定在坦桑尼亚其他地区和撒哈拉以南非洲其他国家推广决策支持工具的方法。实现这些综合具体目标将为设计和执行多管齐下的疟疾控制战略提供一个框架，这些战略最有可能在业务环境中保持效力。我们将在实地实验的基础上，随着时间的推移，测试不同的病媒和疾病管理干预措施组合的有效性。然后，我们将使用实验结果与决策支持模型相结合，以改进一种新的工具，使决策者能够共同优化病媒和疾病管理策略。该工具足够灵活，可以在开发新的治疗和干预措施时纳入其中。该提案是在与坦桑尼亚关键合作伙伴的协作过程中制定的，因此利用了一系列积极和充满活力的专业关系。通过这些国内伙伴关系，我们可以直接接触到地方和国家一级的关键决策者。此外，我们以前在非洲各地的工作提供了一个强有力的平台，可以在主要研究地点以外的地区开展今后的复制工作。

项目成果

Process Evaluation of a Community-Based Microbial Larviciding Intervention for Malaria Control in Rural Tanzania.

• DOI: 10.3390/ijerph17197309
• 发表时间: 2020-10-07
• 期刊: International journal of environmental research and public health
• 作者: Berlin Rubin N;Mboera LEG;Lesser A;Miranda ML;Kramer R
• 通讯作者: Kramer R

The Value of Information in Decision-Analytic Modeling for Malaria Vector Control in East Africa.

信息在东非疟疾病媒控制决策分析模型中的价值。

• DOI: 10.1111/risa.12606
• 发表时间: 2017
• 期刊: Risk analysis : an official publication of the Society for Risk Analysis
• 作者: Kim,Dohyeong;Brown,Zachary;Anderson,Richard;Mutero,Clifford;Miranda,MarieLynn;Wiener,Jonathan;Kramer,Randall
• 通讯作者: Kramer,Randall