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自2000年以来,在撒哈拉以南非洲地区的抗疟行动干预覆盖率达到前所未有的水平,了解其控制效果对指导下一步控制措施的制定至关重要。然而由于监测方法较为简单和缺乏可靠的监测数据,非洲不同流行模式下疟疾干预措施对疾病发病水平的影响仍然知之甚少。本研究根据疟疾现场调查的大量数据,重建从2000年至2015年的干预措施覆盖率变化趋势,并量化疟疾防控工作对其影响。研究结果显示从2000年至2015年,非洲恶性疟原虫带虫率减半,发病率下降了40%,自2000年以来干预措施已经避免了6.63(5.42~7.53可信区间)亿的临床病例。经杀虫剂处理过的蚊帐作为最广泛的干预措施,为降低疾病发病做出最大的贡献率(避免了68%的发病)。尽管干预措施的效果仍然低于预期水平,目前的疟疾干预措施已明显降低了整个非洲大陆的疟疾发病率。2015年之后的控制策略应以继续加强目前的干预措施,并保持杀虫剂有效性为基础。
Since 2000, the coverage of anti-malarial interventions in sub-Saharan Africa has reached an unprecedented level, and understanding its control effects is crucial to guide the development of next-step control measures. However, due to the simpler monitoring methods and lack of reliable monitoring data, the impact of malaria interventions on disease morbidity levels in different prevalence models in Africa is still poorly understood. Based on a large amount of data from malaria field surveys, this study reconstructed the trend of changes in coverage of interventions from 2000 to 2015 and quantified the impact of malaria prevention and control work. The study showed that from 2000 to 2015, the incidence of P. falciparum insects in Africa halved, with a 40% drop in incidence, and interventions since 2000 have avoided clinical cases of 6.63 (5.42-7.53 confidence intervals). Insecticide-treated mosquito nets are the most widely used interventions to make the largest contribution to reducing disease incidence (avoiding 68% of incidence). Although the effect of interventions is still below the expected level, the current malaria interventions have significantly reduced the incidence of malaria across the continent. Control strategies beyond 2015 should be based on continuing to strengthen current interventions and maintain pesticide effectiveness.