Impact of 1,7-malaria reactive community-based testing and response(1,7-mRCTR)approach on malaria prevalence inTanzania

Background Progress in malaria control has stalled in recent years and innovative surveillance and response approaches are needed to accelerate malaria control and elimination eforts in endemic areas of Africa.Build‑ing on a previous China-UK-Tanzania pilot study on malaria control,this study aimed to assess the impact of the 1,7-malaria Reactive Community-Based Testing and Response(1,7-mRCTR)approach implemented over two years in three districts of Tanzania.Methods The 1,7-mRCTR approach provides community-based malaria testing via rapid diagnostic tests and treat‑ment in villages with the highest burden of malaria incidence based on surveillance data from health facilities.We used a diference-in-diferences quasi-experimental design with linear probability models and two waves of crosssectional household surveys to assess the impact of 1,7-mRCTR on malaria prevalence.We conducted sensitivity analyses to assess the robustness of our results,examined how intervention efects varied in subgroups,and explored alternative explanations for the observed results.Results Between October 2019 and September 2021,244,771 community-based malaria rapid tests were com‑pleted in intervention areas,and each intervention village received an average of 3.85 rounds of 1-7mRCTR.Malaria prevalence declined from 27.4%at baseline to 11.7%at endline in the intervention areas and from 26.0%to 16.0%in the control areas.1,7-mRCTR was associated with a 4.5-percentage-point decrease in malaria prevalence(95%confdence interval:−0.067,−0.023),equivalent to a 17%reduction from the baseline.In Rufji,a district characterized by lower prevalence and where larviciding was additionally provided,1,7-mRCTR was associated with a 63.9%decline in malaria prevalence.Conclusions The 1,7-mRCTR approach reduced malaria prevalence.Despite implementation interruptions due to the COVID-19 pandemic and supply chain challenges,the study provided novel evidence on the efectiveness of community-based reactive approaches in moderate-to high-endemicity areas and demonstrated the potential of South-South cooperation in tackling global health challenges.

Cost yield of different treatment strategies against Clonorchis sinensis infection

Background:Clonorchiasis is attributed to the ingestion of raw freshwater fsh harboring Clonorchis sinensis.Morbid‑ity control is targeted through the administration of antihelminthics.This study modelled the cost yield indicated by efectiveness and utility of diferent treatment strategies against clonorchiasis.Methods:About 1000 participants were enrolled from each of 14 counties selected from four provincial-level administrative divisions namely Guangxi,Guangdong,Heilongjiang and Jilin in 2017.Fecal examination was adopted to detect C.sinensis infection,while behavior of ingesting raw freshwater fsh was enquired.Counties were grouped into four categories based on prevalence,namely low prevalence group(<1%),moderate prevalence group(1–9.9%),high prevalence group(10–19.9%)and very high prevalence group(≥20%),while population were divided into three subgroups,namely children aged below 14 years old,adult female and adult male both aged over 14 years old.The average of cost efectiveness indicated by the cost to treat single infected cases with C.sinensis and of cost utility indicated by the cost to avoid per disability-adjusted life years(DALYs)caused by C.sinensis infection was calculated.Comparisons were performed between three treatment schedules,namely individual treatment,massive and selec‑tive chemotherapy,in which diferent endemic levels and populations were considered.Results:In selective chemotherapy strategy,the cost to treat single infected case in very high prevalence group was USD 10.6 in adult male,USD 11.6 in adult female,and USD 13.2 in children.The cost increased followed the decrease of endemic level.In massive chemotherapy strategy,the cost per infected case in very high prevalence group was USD 14.0 in adult male,USD 17.1 in adult female,USD 45.8 in children,which were also increased when the endemic level decreased.In individual treatment strategy,the cost was USD 12.2 in adult male,USD 15.0 in adult female and USD 41.5 in children in very high prevalence group;USD 19.2 in adult male,USD 34.0 in adult female,and USD 90.1 in children in high prevalence group;USD 30.4 in adult male,USD 50.5 in adult female and over USD 100 in children in moderate prevalence group;and over USD 400 in any population in low prevalence group.As to cost utility,the difer‑ences by treatment strategies,populations and endemic levels were similar to those in cost efectiveness.Conclusions:Both cost efectiveness and cost utility indicators are highly impacted by the prevalence and popula‑tion,as well as the treatment schedules.Adults especially men in the areas with a prevalence over 10%should be prioritized,in which selective chemotherapy was best and massive chemotherapy was also cost efective.In moderate endemic areas,the yield is not ideal,but selective chemotherapy for adult male may also be adopted.In low endemic areas,all strategies were high costly and new strategies need to be developed.

Establishment of an indicator framework for global One Health Intrinsic Drivers index based on the grounded theory and fuzzy analytical hierarchy-entropy weight method

Background:One Health has become a global consensus to deal with complex health problems.However,the pro‑gress of One Health implementation in many countries is still relatively slow,and there is a lack of systematic evalua‑tion index.The purpose of this study was to establish an indicator framework for global One Health Intrinsic Drivers index(GOH-IDI)to evaluate human,animal and environmental health development process globally.Method:First,82 studies were deeply analyzed by a grounded theory(GT)method,including open coding,axial coding,and selective coding,to establish a three-level indicator framework,which was composed of three selective codes,19 axial codes,and 79 open codes.Then,through semi-structured interviews with 28 health-related experts,the indicators were further integrated and simplifed according to the inclusion criteria of the indicators.Finally,the fuzzy analytical hierarchy process combined with the entropy weight method was used to assign weights to the indi‑cators,thus,forming the evaluation indicator framework of human,animal and environmental health development process.Results:An indicator framework for GOH-IDI was formed consisting of three selective codes,15 axial codes and 61 open codes.There were six axial codes for“Human Health”,of which“Infectious Diseases”had the highest weight(19.76%)and“Injuries and Violence”had the lowest weight(11.72%).There were four axial codes for“Animal Health”,of which“Animal Epidemic Disease”had the highest weight(39.28%)and“Animal Nutritional Status”had the low‑est weight(11.59%).Five axial codes were set under“Environmental Health”,among which,“Air Quality and Climate Change”had the highest weight(22.63%)and“Hazardous Chemicals”had the lowest weight(17.82%).Conclusions:An indicator framework for GOH-IDI was established in this study.The framework were universal,balanced,and scientifc,which hopefully to be a tool for evaluation of the joint development of human,animal and environmental health in diferent regions globally.

Children education for sustainable control of liverfluke infections

Significant disease burden is caused by infections with human liver flukes, includingClonorchis sinensis,Opisthorchis viverrini andO. felineus. Epidemiology is characterized by high burden in the male than the female, and in the elder than the younger. Chemotherapy is the mainstream for morbidity control, but it could not prevent re-infection. Mean-while, behavioral change on the dietary habit of ingesting raw freshwater fish is challenging. In this opinion, we argue why it is important to educate children for sustainable control of liver fluke infections. Then, the design, development and key messages of an educational cartoon for preventing liver fluke infections is introduced. Technical focuses are emphasized based on a pilot using the education cartoon for preventing clonorchiasis in China. Finally, how to further develop and verify this education strategy is discussed.

A decade of innovation to deepen the understanding of infectious diseases of poverty and foster their control and elimination

Exactly 10 years ago,on 25 October 2012,a group of scientists,policy-makers,and practitioners undertook an ambitious project to launch a new open-access journal,named Infectious Diseases of Poverty[1].The idea had originated from a think-tank put forth by the Special Programme for Research and Training in Tropical Diseases(TDR),an organisation co-sponsored by the United Nations Children’s Fund(UNICEF),the United Nations Development Programme(UNDP),the World Bank,and the World Health Organization(WHO).Indeed,this think-tank published a comprehensive Global Report for Research on Infectious Diseases of Poverty[2]that guided the scope and remit of Infectious Diseases of Poverty.