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Wang Y, Li C, Mao Y, Liu Y, Mao Y, Shao J, Chen J, Yang K. Development and evaluation of a health literacy scale for parasitic diseases. BMC Infect Dis 2024; 24:971. [PMID: 39271983 PMCID: PMC11395214 DOI: 10.1186/s12879-024-09857-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Parasitic diseases remain a serious public health problem in China. Health education aimed at disseminating health-related knowledge and promoting healthy behaviours, plays a crucial role in the prevention and control of parasitic diseases. This study aims to develop a tool to measure the parasitic disease health literacy of residents in China. METHODS Scale development was based on qualitative and quantitative methods. Qualitative method included focus group discussions and Delphi consultations. A methodological design with multistage sampling and a pilot study was used to evaluate the questionnaire. The scale's reliability was tested using Cronbach's α and split-half reliability, while its construct validity was assessed using confirmatory factor analysis. The scale's passing score was determined using the receiver operating characteristic curve. A cross-sectional survey was conducted in six districts of the prefecture of Jiangsu and residents aged 14-69 years in the participating townships were randomly selected based on their location. RESULTS The health literacy indicator system for parasitic diseases included 3 first-level, 9 s-level and 23 third-level indicators. The 23-item questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.774) and split-half reliability (Spearman-Brown coefficient = 0.778). The questionnaire's passing score was 60. A total of 990 valid questionnaires were collected from participants in three cities. The percentage of participants with health literacy regarding parasitic diseases was 15.8%. Their scores were influenced by age, income, employment, and educational level. CONCLUSIONS Health literacy of parasitic diseases is an integrated indicator rather than just knowledge or behavior information. The correlation between knowledge and behavior is weak. The capacity for healthy behavior of parasitic disease is associated with the location and culture of the city. For neglected diseases, it is important for people to talk positively about their behaviors with a doctor.
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Affiliation(s)
- Yi Wang
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, People's Republic of China
| | - Chengyuan Li
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, People's Republic of China
| | - Yuanchun Mao
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, People's Republic of China
| | - Yaobao Liu
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, People's Republic of China
| | - Yanmin Mao
- Lianyungang Center for Disease Control and Prevention, Lianyungang, Jiangsu Province, 222006, People's Republic of China
| | - Jie Shao
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, 214125, People's Republic of China
| | - Jianfeng Chen
- Taizhou Center for Disease Control and Prevention, Taizhou, Jiangsu Province, 225309, People's Republic of China
| | - Kun Yang
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, People's Republic of China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Meiyuan 117 Yangxiang, Nanjing, Wuxi, Jiangsu, 214064, China.
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2
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Gu J, Cao Y, Chai L, Xu E, Liu K, Chong Z, Zhang Y, Zou D, Xu Y, Wang J, Müller O, Cao J, Zhu G, Lu G. Delayed care-seeking in international migrant workers with imported malaria in China. J Travel Med 2024; 31:taae021. [PMID: 38335249 DOI: 10.1093/jtm/taae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/12/2023] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Imported malaria cases continue to pose major challenges in China as well as in other countries that have achieved elimination. Early diagnosis and treatment of each imported malaria case is the key to successfully maintaining malaria elimination success. This study aimed to build an easy-to-use predictive nomogram to predict and intervene against delayed care-seeking among international migrant workers with imported malaria. METHODS A prediction model was built based on cases with imported malaria from 2012 to 2019, in Jiangsu Province, China. Routine surveillance information (e.g. sex, age, symptoms, origin country and length of stay abroad), data on the place of initial care-seeking and the gross domestic product (GDP) of the destination city were extracted. Multivariate logistic regression was performed to identify independent predictors and a nomogram was established to predict the risk of delayed care-seeking. The discrimination and calibration of the nomogram was performed using area under the curve and calibration plots. In addition, four machine learning models were used to make a comparison. RESULTS Of 2255 patients with imported malaria, 636 (28.2%) sought care within 24 h after symptom onset, and 577 (25.6%) sought care 3 days after symptom onset. Development of symptoms before entry into China, initial care-seeking from superior healthcare facilities and a higher GDP level of the destination city were significantly associated with delayed care-seeking among migrant workers with imported malaria. Based on these independent risk factors, an easy-to-use and intuitive nomogram was established. The calibration curves of the nomogram showed good consistency. CONCLUSIONS The tool provides public health practitioners with a method for the early detection of delayed care-seeking risk among international migrant workers with imported malaria, which may be of significance in improving post-travel healthcare for labour migrants, reducing the risk of severe malaria, preventing malaria reintroduction and sustaining achievements in malaria elimination.
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Affiliation(s)
- Jiyue Gu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Liying Chai
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Enyu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Kaixuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Zeyin Chong
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Dandan Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuhui Xu
- Center for Disease Control and Prevention, Yangzhou, Jiangsu Province, 225007, China
| | - Jian Wang
- Yangzhou Schistosomiasis and Parasitic Disease Control Office, Yangzhou, Jiangsu Province, 225007, China
| | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, 69117, Germany
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Guangyu Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, 225009, China
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3
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Jia L, Chen X, Feng Z, Tang S, Feng D. Factors affecting delays in seeking treatment among malaria patients during the pre-certification phase in China. Malar J 2024; 23:73. [PMID: 38468296 DOI: 10.1186/s12936-024-04892-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/24/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Delays in malaria treatment can not only lead to severe and even life-threatening complications, but also foster transmission, putting more people at risk of infection. This study aimed to investigate the factors influencing treatment delays among malaria patients and their health-seeking behaviour. METHODS The medical records of 494 patients diagnosed with malaria from 6 different malaria-endemic provinces in China were analysed. A bivariate and multivariable regression model was used to investigate the association between delays in seeking treatment and various factors. A Sankey diagram was used to visualize the trajectories of malaria patients seeking medical care. Total treatment delays were categorized as patient delays and doctor delays. RESULTS The incidence of total delays in seeking malaria treatment was 81.6%, of which 28.4% were delayed by patients alone and 34.8% by doctors alone. The median time from the onset of symptoms to the initial healthcare consultation was 1 day. The median time from the initial healthcare consultation to the conclusive diagnosis was 2 day. After being subjected to multiple logistic regression analysis, living in central China was less likely to experience patient delays (OR = 0.43, 95% CI 0.24-0.78). The factors significantly associated with the lower likelihood of doctor delays included: age between 30 to 49 (OR = 0.43, 95% CI 0.23-0.81), being single/divorce/separated (OR = 0.48, 95% CI 0.24-0.95), first visiting a county-level health institution (OR = 0.25, 95% CI 0.14-0.45), first visiting a prefectural health institution (OR = 0.06, 95% CI 0.03-0.12) and first visiting a provincial health institution (OR = 0.05, 95%CI 0.02-0.12). Conversely, individuals with mixed infections (OR = 2.04, 95% CI 1.02-4.08) and those experiencing periodic symptoms (OR = 1.71, 95% CI 1.00-2.92) might face increased doctor delays. Furthermore, higher financial burden and complications were found to be associated with patient delays. Doctor delays, in addition to incurring these two consequences, were associated with longer hospital stays. CONCLUSION There was a substantial delay in access to health care for malaria patients before China was certified malaria free. Region, marital status, periodic symptoms and the level of health institutions were factors contributing to delays in treatment-seeking among malaria patients.
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Affiliation(s)
- Lianyu Jia
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiaoyu Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Manzoni G, Try R, Guintran JO, Christiansen-Jucht C, Jacoby E, Sovannaroth S, Zhang Z, Banouvong V, Shortus MS, Reyburn R, Chanthavisouk C, Linn NYY, Thapa B, Khine SK, Sudathip P, Gopinath D, Thieu NQ, Ngon MS, Cong DT, Hui L, Kelley J, Valecha NNK, Bustos MD, Rasmussen C, Tuseo L. Progress towards malaria elimination in the Greater Mekong Subregion: perspectives from the World Health Organization. Malar J 2024; 23:64. [PMID: 38429807 PMCID: PMC10908136 DOI: 10.1186/s12936-024-04851-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/11/2024] [Indexed: 03/03/2024] Open
Abstract
Malaria remains a global health challenge, disproportionately affecting vulnerable communities. Despite substantial progress, the emergence of anti-malarial drug resistance poses a constant threat. The Greater Mekong Subregion (GMS), which includes Cambodia, China's Yunnan province, Lao People's Democratic Republic, Myanmar, Thailand, and Viet Nam has been the epicentre for the emergence of resistance to successive generations of anti-malarial therapies. From the perspective of the World Health Organization (WHO), this article considers the collaborative efforts in the GMS, to contain Plasmodium falciparum artemisinin partial resistance and multi-drug resistance and to advance malaria elimination. The emergence of artemisinin partial resistance in the GMS necessitated urgent action and regional collaboration resulting in the Strategy for Malaria Elimination in the Greater Mekong Subregion (2015-2030), advocating for accelerated malaria elimination interventions tailored to country needs, co-ordinated and supported by the WHO Mekong malaria elimination programme. The strategy has delivered substantial reductions in malaria across all GMS countries, with a 77% reduction in malaria cases and a 97% reduction in malaria deaths across the GMS between 2012 and 2022. Notably, China was certified malaria-free by WHO in 2021. Countries' ownership and accountability have been pivotal, with each GMS country outlining its priorities in strategic and annual work plans. The development of strong networks for anti-malarial drug resistance surveillance and epidemiological surveillance was essential. Harmonization of policies and guidelines enhanced collaboration, ensuring that activities were driven by evidence. Challenges persist, particularly in Myanmar, where security concerns have limited recent progress, though an intensification and acceleration plan aims to regain momentum. Barriers to implementation can slow progress and continuing innovation is needed. Accessing mobile and migrant populations is key to addressing remaining transmission foci, requiring effective cross-border collaboration. In conclusion, the GMS has made significant progress towards malaria elimination, particularly in the east where several countries are close to P. falciparum elimination. New and persisting challenges require sustained efforts and continued close collaboration. The GMS countries have repeatedly risen to every obstacle presented, and now is the time to re-double efforts and achieve the 2030 goal of malaria elimination for the region.
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Affiliation(s)
- Giulia Manzoni
- WHO Mekong Malaria Elimination Programme, Phnom Penh, Cambodia.
- Independent Consultant, Antananarivo, Madagascar.
| | - Rady Try
- WHO Mekong Malaria Elimination Programme, Phnom Penh, Cambodia
| | - Jean Olivier Guintran
- World Health Organization Country Office, Phnom Penh, Cambodia
- Independent Consultant, Le Bar sur Loup, France
| | | | - Elodie Jacoby
- WHO Mekong Malaria Elimination Programme, Phnom Penh, Cambodia
- Independent Consultant, Ho Chi Minh, Viet Nam
| | - Siv Sovannaroth
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Zaixing Zhang
- World Health Organization Country Office, Phnom Penh, Cambodia
| | | | | | - Rita Reyburn
- World Health Organization Country Office, Vientiane, Lao PDR
| | | | - Nay Yi Yi Linn
- National Malaria Control Programme, Nay Pyi Taw, Myanmar
| | - Badri Thapa
- World Health Organization Country Office, Yangon, Myanmar
| | | | - Prayuth Sudathip
- Division of Vector Borne Diseases, Department of Disease Control, Bangkok, Thailand
| | - Deyer Gopinath
- World Health Organization Country Office, Bangkok, Thailand
| | - Nguyen Quang Thieu
- National Institute of Malariology, Parasitology and Entomology, Hanoi, Viet Nam
| | | | | | - Liu Hui
- Yunnan Institute of Parasitic Diseases, Yunnan, China
| | - James Kelley
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | | | - Maria Dorina Bustos
- World Health Organization, Regional Office for South-East Asia, New Delhi, India
| | | | - Luciano Tuseo
- WHO Mekong Malaria Elimination Programme, Phnom Penh, Cambodia
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
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Lu G, Zhao L, Chai L, Cao Y, Chong Z, Liu K, Lu Y, Zhu G, Xia P, Müller O, Zhu G, Cao J. Assessing the risk of malaria local transmission and re-introduction in China from pre-elimination to elimination: A systematic review. Acta Trop 2024; 249:107082. [PMID: 38008371 DOI: 10.1016/j.actatropica.2023.107082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 11/28/2023]
Abstract
Assessing the risk of malaria local transmission and re-introduction is crucial for the preparation and implementation of an effective elimination campaign and the prevention of malaria re-introduction in China. Therefore, this review aims to evaluate the risk factors for malaria local transmission and re-introduction in China over the period of pre-elimination to elimination. Data were obtained from six databases searched for studies that assessed malaria local transmission risk before malaria elimination and re-introduction risk after the achievement of malaria elimination in China since the launch of the NMEP in 2010, employing the keywords "malaria" AND ("transmission" OR "re-introduction") and their synonyms. A total of 8,124 articles were screened and 53 articles describing 55 malaria risk assessment models in China from 2010 to 2023, including 40 models assessing malaria local transmission risk (72.7%) and 15 models assessing malaria re-introduction risk (27.3%). Factors incorporated in the 55 models were extracted and classified into six categories, including environmental and meteorological factors (39/55, 70.9%), historical epidemiology (35/55, 63.6%), vectorial factors (32/55, 58.2%), socio-demographic information (15/26, 53.8%), factors related to surveillance and response capacity (18/55, 32.7%), and population migration aspects (13/55, 23.6%). Environmental and meteorological factors as well as vectorial factors were most commonly incorporated in models assessing malaria local transmission risk (29/40, 72.5% and 21/40, 52.5%) and re-introduction risk (10/15, 66.7% and 11/15, 73.3%). Factors related to surveillance and response capacity and population migration were also important in malaria re-introduction risk models (9/15, 60%, and 6/15, 40.0%). A total of 18 models (18/55, 32.7%) reported the modeling performance. Only six models were validated internally and five models were validated externally. Of 53 incorporated studies, 45 studies had a quality assessment score of seven and above. Environmental and meteorological factors as well as vectorial factors play a significant role in malaria local transmission and re-introduction risk assessment. The factors related to surveillance and response capacity and population migration are more important in assessing malaria re-introduction risk. The internal and external validation of the existing models needs to be strengthened in future studies.
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Affiliation(s)
- Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China; Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
| | - Li Zhao
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Liying Chai
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Zeyin Chong
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Kaixuan Liu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yan Lu
- Nanjing Health and Customs Quarantine Office, Nanjing, China
| | - Guoqiang Zhu
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China
| | - Pengpeng Xia
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China
| | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Germany
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Yi B, Zhang L, Yin J, Zhou S, Xia Z. 1-3-7 surveillance and response approach in malaria elimination: China's practice and global adaptions. Malar J 2023; 22:152. [PMID: 37161379 PMCID: PMC10169118 DOI: 10.1186/s12936-023-04580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
There has been a significant reduction in malaria morbidity and mortality worldwide from 2000 to 2019. However, the incidence and mortality increased again in 2020 due to the disruption to services during the COVID-19 pandemic. Surveillance to reduce the burden of malaria, eliminate the disease and prevent its retransmission is, therefore, crucial. The 1-3-7 approach proposed by China has played an important role in eliminating malaria, which has been internationally popularized and adopted in some countries to help eliminate malaria. This review summarizes the experience and lessons of 1-3-7 approach in China and its application in other malaria-endemic countries, so as to provide references for its role in eliminating malaria and preventing retransmission. This approach needs to be tailored and adapted according to the region condition, considering the completion, timeliness and limitation of case-based reactive surveillance and response. It is very important to popularize malaria knowledge, train staff, improve the capacity of health centres and monitor high-risk groups to improve the performance in eliminating settings. After all, remaining vigilance in detecting malaria cases and optimizing surveillance and response systems are critical to achieving and sustaining malaria elimination.
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Affiliation(s)
- Boyu Yi
- 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 Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Li Zhang
- 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 Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Jianhai Yin
- 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 Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Shuisen Zhou
- 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 Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China
| | - Zhigui Xia
- 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 Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, China.
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Lin H, Zhao S, Liu Y, Shao L, Ye Y, Jiang N, Yang K. Rapid Visual Detection of Plasmodium Using Recombinase-Aided Amplification With Lateral Flow Dipstick Assay. Front Cell Infect Microbiol 2022; 12:922146. [PMID: 35811679 PMCID: PMC9263184 DOI: 10.3389/fcimb.2022.922146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/24/2022] [Indexed: 12/14/2022] Open
Abstract
Background Malaria is a global public health problem. China has had no case of indigenous malaria since 2016. However, imported cases of malaria remain an issue among travelers, overseas workers, and foreign traders. Although these cases are always asymptomatic, if they donate blood, there is a great risk of transfusion transmitted-malaria (TTM). Therefore, blood banks need a rapid screening tool to detect Plasmodium species. Methods We designed an assay using recombinase-aided amplification (RAA) and a lateral-flow dipstick (LFD) (RAA-LFD) to detect the 18S ribosomal RNA gene of Plasmodium species. Sensitivity was evaluated using a recombinant plasmid and Plasmodium genomic DNA. Specificity was evaluated using DNA extracted from the blood of patients with malaria or other infectious parasites. For clinical assessment, blood samples from patients with malaria and blood donors were evaluated. Results The RAA-LFD assay was performed in an incubator block at 37°C for 15 min, and the amplicons were visible to the naked eye on the flow dipsticks within 3 min. The sensitivity was 1 copy/μL of recombinant plasmid. For genomic DNA from whole blood of malaria patients infected with P. falciparum, P. vivax, P. ovale, and P. malariae, the sensitivity was 0.1 pg/μL, 10 pg/μL, 10-100 pg/μL, and 100pg/μL, respectively. The sensitivity of this assay was 100pg/μL. No cross-reaction with other transfusion-transmissible parasites was detected. Conclusions The results demonstrated that this RAA-LFD assay was suitable for reliable field detection of Plasmodium species in low-resource settings with limited laboratory capabilities.
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Affiliation(s)
- Hong Lin
- Jiangsu Province Blood Center, Nanjing, China
- *Correspondence: Hong Lin, ; Kun Yang,
| | - Song Zhao
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Yanhong Liu
- Jiangsu Qitian Gene Technology Co., Ltd., Wuxi, China
| | - Lei Shao
- Jiangsu Province Blood Center, Nanjing, China
| | - Yuying Ye
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | | | - Kun Yang
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- *Correspondence: Hong Lin, ; Kun Yang,
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