Extending and transitioning the China-Tanzania pilot project on malaria control
The goal of this project is to sustain the key interventions of a Phase I pilot program implemented in southern Tanzania, including validation of the 1,7–mRCTR approach and demonstration of a further reduction in the disease burden (mortality and morbidity) towards 1% malaria prevalence in the study communities. This will be achieved by strengthening malaria surveillance and control capacity at the local level, by the implementation of the adopted Chinese and Tanzania malaria control strategy and other existing strategies in the intervention areas.
Through the joint efforts of the Chinese and Tanzanian teams a new approach for malaria control was developed, termed as the 1-7 malaria Reactive Community based Testing and Response (1-7 mRCTR). The approach utilized the existing health facility data combined with the vector surveillance results to decide which priority clusters to conduct community testing and treatment on weekly basis (1-7 mRCTR). A Phase I pilot program conducted between 2015-2018 demonstrated the feasibility to translate and adapt the Chinese experience on malaria control and prevention in high-burdened areas. By the end of June 2018, the parasite prevalence was reduced in intervention and control sites by 81% and 52%, respectively. However, different challenges were identified at the conclusion of the pilot project: (i) lack of sustainability of key intervention communities; (ii) the pilot project was not fully integrated with NMCP; and (iii) lack of plan for an exit strategy.
The Phase II study will include the following activities:
1. Authenticate the Phase I results and complete the assessment of feasibility by maintaining the key interventions in previous intervention areas to reduce malaria burden in these communities. Introduce the intervention in new areas to see if the same impact can be achieved.
2. Prepare for the exit strategy (based on the final results).
3. Address remaining issues and prepare for national scale-up through a multi-district demonstration program followed by a national roll-out in Tanzania.
4. Explore an effective cooperation mechanism between China and Tanzania as the case of the south-south cooperation and China-Africa health cooperation model.
This extension phase will be implemented in the ten wards (representing four catchment populations) with the moderate-highest malaria incidence from Rufiji, Kibiti, and Kilwa districts in the southeastern of Tanzania covering an approximated 243,449 people.