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4 Results for Health Topics

4.1 Communicable disease control

4.1.2 Malaria

  • Over half (55%, 62/151) of the 151 CD interventions that met the inclusion criteria of this review were conducted against malaria.
  • Nearly half (>45%) of these studies were randomized-controlled trials, most (>80%) of high quality, indicating a higher degree of confidence in their results compared to other less rigorous designs.
  • All (100%) malarial interventions in this review occurred in populations displaced as a result of armed conflict.
  • 20 vector control interventions met the inclusion criteria of this review.
  • Insecticide-treated nets (ITNs) (N=7) were the most frequently studied intervention in these settings, followed by insecticide spraying (IS) and a variety of insecticide-treated surfaces (clothes, tents, sheeting, cattle).
  • Nearly half of the vector control interventions (8/20, 40%) were conducted in northwestern Pakistan among Pakistani natives, Afghan residents, and Afghan refugees living in camp and non camp settings; the remaining research was equally split between Southeast Asia (6/20) and Africa (6/20).
  • Half (50%) of the 20 vector control interventions were RCTs, with the majority of these (80%) graded as high quality.
  • 42 human-targeted interventions met the inclusion criteria of this review.
  • Anti-malarials (N=61) were the most frequently studied intervention in these settings, although one study of a malaria vaccine was included.
  • Three quarters of the human targeted interventions (32/42, 76%) were conducted in Southeast Asia, with over 90% (30/32) of research conducted in these areas by research groups on the Thai Burmese or Thai-Cambodian borders.
  • Three quarters (76%) of the 42 interventions were RCTs of some design, with the majority of these (75%) graded as high quality.
  • In terms of effectiveness, insecticide treated nets, tents, and clothes were found to be significantly more effective than their untreated counterparts (See Malaria vector table). However, these findings varied by region and over time, likely related to changes in vector and host parasite patterns over the inclusion years of this review.
  • This review included 14 studies that included some component of genetic testing for resistance genes to various therapies (e.g. chloroquine), the majority (75%) of which were conducted in Thailand. The majority of studies (65%) included supervised treatment, which provided significantly better ACPR outcomes than non-supervised treatment.

 

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