Reactive case detection could be a powerful tool in malaria elimination, as it selectively targets transmission pockets. However, field operations have yet to demonstrate under which conditions, if any, reactive case detection is best poised to push a region to elimination. This study uses mathematical modelling to assess how baseline transmission intensity and local interconnectedness affect the impact of reactive activities in the context of other possible intervention packages.
This paper summarizes a framework for evaluating the costs of malaria elimination interventions and applies this approach to one key component of the elimination strategy—reactive case detection (RCD)—implemented through 173 health facilities across 10 districts in Southern Province of Zambia during 2014.
This review highlights the importance of a community surveillance system like RCD in shaping Zambia’s malaria elimination campaign by identifying community-based infections that might otherwise remain undetected. Results from this review will be used to plan programme scale-up into other parts of Zambia.
In 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia.
The primary aim of this study is to quantify the relative effectiveness of MDA and fMDA with DHAp against no mass treatment (standard of care) for reducing Plasmodium falciparum prevalence and incidence. Strengths of this trial include: a robust study design (CRCT); cross-sectional parasite surveys as well as a longitudinal cohort; and stratification of high and low transmission areas. Primary limitations include: statistical power to detect only a 50 % reduction in primary outcomes within high and low transmission strata; potential for contamination; and potential for misclassification of exposure.
The intervention [mass testing and treatment, MTAT] appears to be highly cost-effective relative to World Health Organization thresholds for malaria burden reduction in Zambia as compared to no MTAT. However, it was estimated that population-wide mass drug administration is likely to be more cost-effective for burden reduction and for transmission reduction compared to MTAT.
The findings [of this study] highlight the importance of increased community sensitization as part of mass treatment campaigns for improving campaign coverage and acceptance. Further, they suggest that communication channels between the Zambia Ministry of Health, National Malaria Control Centre and Medical Stores Limited may need to be improved so as to ensure there is consistent supply and management of commodities. Continued capacity building of CHWs and health facility supervisors is critical for a more effective programme and sustained progress towards malaria elimination.
When improved through comprehensive parasitologically confirmed case reporting, HMIS data can become a valuable tool for evaluating malaria program scale-up. Using this approach, this article provides further evidence that increased ITN coverage is associated with decreased malaria morbidity and use of health services for malaria illness in Zambia.
Author: Bennett A, Eisele TP, Hamainza B, Ingwe MM, Kamuliwo M, Keating J, Miller JM, Moonga HB, Smith TA, Steketee R, Vounatsou P, Yukich J
Publication date: November 2014
Source: Population health metrics
Timeliness, completeness, and accuracy are key requirements for any surveillance system to reliably monitor disease burden and guide efficient resource prioritization. Evidence that electronic reporting of malaria cases by CHWs meet these requirements remains limited. This study describes and evaluates a prototype mobile phone reporting platform for a CBSS in rural Zambia that was initially established as a programme implemented by CHWs for community-wide passive and active testing with RDTs and treatment of all confirmed cases with AL, which also allowed monitoring of malaria parasite infection burden as a secondary objective