An innovative three-layer strategy in response to a quartan malaria outbreak among forest goers in Hainan Island, China: a retrospective study

Table 1 Implementation of the three-layer strategy for epidemic response in 2015 outbreak and strengthened intervention from 2016 to 2018

Layer	No. of counties/cities	No. of towns	No. of villages	Epidemic response in 2015				Strengthened intervention from 2016 to 2018
				PCD		ACD		MPD			ACD in forest goer	Chemoprophylaxis
				No. of negative	No. of positive	No. of negative	No. of positive	2016	2017	2018	ACD in forest goer	n	Coverage rate, %*
First layer	2	2	10	496	0	1770	1^a	827	564	125	3126	2799	89.5
Second layer	4	11	–	6121	0	1710	0	6714	5788	5691	5118	3984	77.8
Third layer	13	–	–	77,555	0	17,795	0	99,586	176,943	97,630	10,364	9857	95.1
Total	–	–	–	84,172	0	21,275	1^a	107,127	183,295	103,446	18,608	16,640	89.4

ACD active case detection, PCD passive case detection, MPD malaria parasite detection by microscopy, TLS three-layer strategy, – not applicable
^aThis data showed the number of cases after implementation of TLS, not including five cases which depending on 1-3-7 approach by ACD plus PCD
*Significant difference among three layers (Chi-square value = 979.6, P < 0.01)

ISSN: 2049-9957