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.
The optimal implementation strategy for mass test and treat or mass drug administration malaria parasite clearance strategies will vary by background level of prevalence, by rate of infections imported to the area, and by ability to operationally achieve high population coverage.
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.
Enhanced surveillance and implementation of a data feedback loop have substantially increased malaria testing rates and decreased the number of unconfirmed malaria cases and courses of ACT consumed in Lusaka District within just two years.
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.
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