Smart Surveillance and Micromanagement Using Information Technology for Malaria Elimination in Mangaluru, India – an Analysis of Five Years Data

2020 ◽  
Author(s):  
B. Shantharam Baliga ◽  
Shrikala Baliga ◽  
Animesh Jain ◽  
Naveen Kulal ◽  
Manu Kumar ◽  
...  
Keyword(s):  
Information Technology ◽  
Control System ◽  
Active Surveillance ◽  
Malaria Control ◽  
Malaria Elimination ◽  
Malaria Incidence ◽  
Control Measures ◽  
Smart Surveillance ◽  
Field Response ◽  
Complete Treatment

Abstract BackgroundMalaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case and data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence.MethodsIT system developed for robust malaria surveillance and field response is being continued in the 6th year. Protocol for surveillance control was followed as per the national programme guidilines mentioned earlier. Secondary data from the malaria control system is collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria map were also analysed.ResultsSmart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitizarion (DY) (p<0.001). Early reporting of new cases (within 48 hrs) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closure by 14 days. The best impact on reduction in incidence of malaria was recorded in pre-monsoon months (~85%) compared to lower impact in July-August months (~40%). ConclusionIT System helped to micromanage control activities such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.

scholarly journals Digitized smart surveillance and micromanagement using information technology for malaria elimination in Mangaluru, India: an analysis of five-year post-digitization data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
B. Shantharam Baliga ◽  
Shrikala Baliga ◽  
Animesh Jain ◽  
Naveen Kulal ◽  
Manu Kumar ◽  
...  
Keyword(s):  
Information Technology ◽  
Control System ◽  
Active Surveillance ◽  
Malaria Control ◽  
Malaria Elimination ◽  
Malaria Incidence ◽  
Control Measures ◽  
Smart Surveillance ◽  
Field Response ◽  
Complete Treatment

Abstract Background Malaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This has facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case, data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence. Methods IT system developed for robust malaria surveillance and field response is being continued in the sixth year. Protocol for surveillance control was followed as per the national programme guidelines mentioned in an earlier publication. Secondary data from the malaria control system was collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria maps were also analysed. Results Smart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitization (DY) (p < 0.001). Early reporting of new cases (within 48 h) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closures by 14 days. The best impact on reduction in incidence of malaria was recorded in the pre-monsoon months (~ 85%) compared to lower impact in July–August months (~ 40%). Conclusion MCS helped to micromanage control activities, such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.

scholarly journals Digitized smart surveillance in malaria elimination programme in Mangaluru city, Karnataka, India - a detailed account of operationalization in post-digitization years

2020 ◽  
Author(s):  
B Shantharam Baliga ◽  
Shrikala Baliga ◽  
Animesh Jain ◽  
Naveen Kulal ◽  
Manu Kumar ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Malaria Elimination ◽  
Secondary Data ◽  
Control Measures ◽  
Detailed Account ◽  
Geographical Information ◽  
Malaria Surveillance ◽  
Smart Surveillance ◽  
Complete Treatment ◽  
Elimination Programme

Background An indigenously developed digital handheld Android-based geographical information system (GIS)-tagged tablets (TABs) device has been deployed in Mangaluru city, Karnataka, India for smart surveillance in malaria elimination programme from October 2014. Here a detailed account is enumerated in the post-digitization years. The study was aimed to assess the effectiveness of the digitized surveillance system under the ongoing health system in Mangaluru city. Methods A software developed for digitization of malaria surveillance was continued in the post-digitization years (PDY). The same digitization year (DY) protocol was followed in the post-digitization periods also. Secondary data from the malaria control software, total nunber of cases, active surveillance, malaria indices, and feedback from stakeholders were looked at and analyzed. Results Digital surveillance was sustained and the performance improved in the 5th year with participation of all stakeholders. Malaria indices significantly reduced to about 65% in the digitization years compared with digitization year (p<0.001). Slide positivity rate (SPR) decreased from 10.36 (DY) to 4.3 (PDY4). Annual parasite incidence (API) decreased from 16.17 (DY) to 5.4 (PDY4). There was a tempo-spatial correlation between closure of cases on 14th day and incidence of malaria. There was a negative correlation between contact smears and incidence of malaria (r = -0.907). Good impact was recorded in the pre-monsoon months (~85%) and low impact in July and August months (~40%). Conclusion Software helped to improve incidence-centric active surveillance, complete treatment with documentation of elimination of parasite, targeted vector control measures. The learnings and analytical output from the data helped to modify strategies for local control of both disease and the vector.

scholarly journals Digitized smart surveillance in malaria elimination programme in Mangaluru city, Karnataka, India ― a detailed account of operationalization in post-digitization years

2020 ◽  
Author(s):  
Susanta Kumar Ghosh ◽  
B. Shantharam Baliga ◽  
Shrikala Baliga ◽  
Animesh Jain ◽  
Naveen Kulal ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Malaria Elimination ◽  
Secondary Data ◽  
Control Measures ◽  
Detailed Account ◽  
Geographical Information ◽  
Malaria Surveillance ◽  
Smart Surveillance ◽  
Complete Treatment ◽  
Elimination Programme

Abstract Background An indigenously developed digital handheld Android-based geographical information system (GIS)-tagged tablets (TABs) device has been deployed in Mangaluru city, Karnataka, India for smart surveillance in malaria elimination programme from October 2014. Here a detailed account is enumerated in the post-digitization years. The study was aimed to assess the effectiveness of the digitized surveillance system under the ongoing health system in Mangaluru city. Methods A software developed for digitization of malaria surveillance was continued in the post-digitization years (PDY). The same digitization year (DY) protocol was followed in the post-digitization periods also. Secondary data from the malaria control software, total nunber of cases, active surveillance, malaria indices, and feedback from stakeholders were looked at and analyzed. Results Digital surveillance was sustained and the performance improved in the 5 th year with participation of all stakeholders. Malaria indices significantly reduced to about 65% in the digitization years compared with digitization year ( p <0.001). Slide positivity rate (SPR) decreased from 10.36 (DY) to 4.3 (PDY4). Annual parasite incidence (API) decreased from 16.17 (DY) to 5.4 (PDY4). There was a tempo-spatial correlation between closure of cases on 14 th day and incidence of malaria. There was a negative correlation between contact smears and incidence of malaria ( r = - 0.907). Good impact was recorded in the pre-monsoon months (~85%) and low impact in July and August months (~40%).Conclusion Software helped to improve incidence-centric active surveillance, complete treatment with documentation of elimination of parasite, targeted vector control measures. The learnings and analytical output from the data helped to modify strategies for local control of both disease and the vector.

scholarly journals Selective sweep suggests transcriptional regulation may underlie Plasmodium vivax resilience to malaria control measures in Cambodia

2016 ◽  
Vol 113 (50) ◽  
pp. E8096-E8105 ◽  
Author(s):  
Christian M. Parobek ◽  
Jessica T. Lin ◽  
David L. Saunders ◽  
Eric J. Barnett ◽  
Chanthap Lon ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Malaria Control ◽  
Histone Deacetylases ◽  
Transcriptional Control ◽  
Selective Sweep ◽  
Malaria Incidence ◽  
Population Level ◽  
Control Measures ◽  
Effective Population ◽  
Species Specific

Cambodia, in which both Plasmodium vivax and Plasmodium falciparum are endemic, has been the focus of numerous malaria-control interventions, resulting in a marked decline in overall malaria incidence. Despite this decline, the number of P. vivax cases has actually increased. To understand better the factors underlying this resilience, we compared the genetic responses of the two species to recent selective pressures. We sequenced and studied the genomes of 70 P. vivax and 80 P. falciparum isolates collected between 2009 and 2013. We found that although P. falciparum has undergone population fracturing, the coendemic P. vivax population has grown undisrupted, resulting in a larger effective population size, no discernable population structure, and frequent multiclonal infections. Signatures of selection suggest recent, species-specific evolutionary differences. Particularly, in contrast to P. falciparum, P. vivax transcription factors, chromatin modifiers, and histone deacetylases have undergone strong directional selection, including a particularly strong selective sweep at an AP2 transcription factor. Together, our findings point to different population-level adaptive mechanisms used by P. vivax and P. falciparum parasites. Although population substructuring in P. falciparum has resulted in clonal outgrowths of resistant parasites, P. vivax may use a nuanced transcriptional regulatory approach to population maintenance, enabling it to preserve a larger, more diverse population better suited to facing selective threats. We conclude that transcriptional control may underlie P. vivax’s resilience to malaria control measures. Novel strategies to target such processes are likely required to eradicate P. vivax and achieve malaria elimination.

scholarly journals Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

2020 ◽  
Author(s):  
Timothy Awine ◽  
Sheetal P Silal
Keyword(s):  
Malaria Control ◽  
Malaria Incidence ◽  
Protective Efficacy ◽  
Indoor Residual Spraying ◽  
Information Management System ◽  
Control Measures ◽  
Bed Nets ◽  
Model Parameters ◽  
Insecticide Treated Bed Nets ◽  
The Impact

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana have been investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation model with its associated rate parameters was developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Model parameters were estimated using data captured on the District Health Information Management System in Ghana from 2008 to 2017.The impact of insecticide treated bed nets and indoor residual spraying on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone. To fit the model, Approximate Bayesian Computational sampling approach was adopted. Results Increasing the coverage levels of both long lasting insecticide treated bed nets or indoor residual spraying activities without a corresponding increase in their proper use or patronage does not impact highly on averting predicted incidence of malaria in Ghana. Improving on the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones. Conclusions Projected goals set in the National Strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high efficacy.

HUMAN RESOURCE CAPACITY TO EFFECTIVELY IMPLEMENT MALARIA ELIMINATION: A POLICY BRIEF FOR ETHIOPIA

2013 ◽  
Vol 29 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Adugna Woyessa ◽  
Mamuye Hadis ◽  
Amha Kebede
Keyword(s):  
Human Resource ◽  
Malaria Control ◽  
Health Workforce ◽  
Malaria Elimination ◽  
Health Personnel ◽  
Career Guidance ◽  
Health Workers ◽  
Malaria Incidence ◽  
Audit And Feedback ◽  
Educational Outreach

Objective: The aim of this study was to investigate malaria elimination in Ethiopia. Ethiopia has planned to eliminate malaria by 2015 in areas of unstable malaria transmission and in the entire country by 2020. However, there is a shortage and maldistribution of the health workforce in general and malaria experts in particular. Training, motivating, and retaining the health workforce involved in malaria control is one strategy to address the shortage and maldistribution of the health workforce to achieve the goal of elimination.Methods: Policy options include the following: (i) in-service training (educational outreach visits, continuing education meetings and workshops, audit and feedback, tailored interventions, and guideline dissemination) may improve professional practice; (ii) recruiting and training malaria specialists together with academic support, career guidance, and social support may increase the number of malaria experts; and (iii) motivation and retention packages (such as financial, educational, personal, and professional support incentives) may help motivate and retain malaria professionals.Results: Implementation strategies include the following: (i) massive training of health personnel involved in malaria elimination and malaria experts (requiring special training) at different levels (national, sub-national, District & community levels), and (ii) recruiting highly qualified health personnel and retention and motivation mechanisms are needed.Conclusions: The lack of adequately trained human resources and personnel attrition are major challenges to effectively implement the planned multi-faceted malaria elimination by 2020 strategy in Ethiopia. Although a reduction in malaria incidence has been observed in the last 3-4 years, maintaining this success and achieving the malaria elimination goal with the present human resource profile will be impossible. A clear strategy for developing the capacity of the health workers in general, and malaria experts in particular, and retaining and motivating staff are crucial for malaria control and elimination.

scholarly journals Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

2020 ◽  
Author(s):  
Timothy Awine ◽  
Sheetal P Silal
Keyword(s):  
Malaria Control ◽  
Malaria Incidence ◽  
Protective Efficacy ◽  
Indoor Residual Spraying ◽  
Information Management System ◽  
Control Measures ◽  
Bed Nets ◽  
Model Parameters ◽  
Insecticide Treated Bed Nets ◽  
The Impact

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana were investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation models with their associated rate parameters were developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Models were fitted using data from the District Health Information Management System in Ghana from 2008 to 2017 and historical intervention coverage levels. To calibrate the models, Approximate Bayesian Computational sampling approach with a distance based rejection criteria was adopted. A leave-one-out approach was used to validate model parameters and the most sensitive evaluated using a multivariate regression sensitivity analysis. The impact of insecticide treated bed nets and their usage and indoor residual spraying as well as their protective efficacy on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the malaria control strategy for 2014-2020. Results Increasing the coverage levels of both long lasting insecticide treated bed nets and indoor residual spraying activities without a corresponding increase in their recommended usage does not impact highly on averting predicted incidence of malaria. Improving upon the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones.Conclusions Projected goals set in the national strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely to be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy. Key words: model, malaria, interventions, long lasting insecticide bednets, indoor residual spraying

scholarly journals The decline of malaria in Vietnam, 1991-2014

2017 ◽  
Author(s):  
Sandra M Goldlust ◽  
Phung Duc Thuan ◽  
Dang Duy Hoang Giang ◽  
Ngo Duc Thang ◽  
Guy E Thwaites ◽  
...  
Keyword(s):  
Case Management ◽  
Vector Control ◽  
Malaria Control ◽  
Malaria Incidence ◽  
Population Level ◽  
Control Measures ◽  
Central Component ◽  
Annual Data ◽  
Combination Therapies ◽  
Insecticide Treated Nets

AbstractA central component of malaria control initiatives throughout the world is the use of artemisinin-based combination therapies (ACTs) for treatment of uncomplicated P. falciparium malaria. Despite the well-documented clinical efficacy of ACTs, the population-level effects of ACT case management on malaria transmission have not been studied thoroughly until recently. An ideal case study for the population-level effects of artemisinin use can be found in Vietnam, where a major increase of malaria cases in the 1980s was followed by the gradual adoption of artemisinin-based clinical case management. We assembled annual data from Vietnam’s National Institutes for Malariology, Parasitology, and Entomology showing the degree to which artemisinin therapies were adopted in different provinces, the effort placed on vector control, and the funding available to provincial malaria control programs, from 1991 to 2014. Data on urbanization were also collected for this period. We found that a 10% increase in the artemisinin proportion of treatments procured by a provincial control program corresponded to a 32.8% (95% CI: 27.7 – 37.5%) decline in estimated malaria cases; the association persisted and the effect size was nearly unchanged if confirmed cases or suspected cases were used. There was no consistent effect of vector control on malaria cases in Vietnam as a whole, nor was any effect found when the data were broken up regionally. The association between urbanization and malaria was generally negative and sometimes statistically significant. This was most pronounced in the central region of Vietnam, where a 10% increase in urbanization corresponded to a 43.3% (95% CI: 21.6 – 58.9%) decrease in suspected malaria incidence; this association was not statistically significant if confirmed cases or estimated cases were used. The decline of malaria in Vietnam from 1991 to 2014 can largely be attributed to the rapid adoption of artemisinin-based drugs. Recent analyses of aggregated data from Africa have shown that insecticide-treated nets have had the greatest effect on lowering malaria prevalence over the past fifteen years, suggesting that the success of different types of malaria interventions is region specific. Continuing global efforts on malaria elimination should focus on both vector control measures and increased access to artemisinin-combination therapies.

scholarly journals An integrated malaria control program with community participation on the Pacific Coast of Colombia

2001 ◽  
Vol 17 (suppl) ◽  
pp. S103-S113 ◽  
Author(s):  
William Rojas ◽  
Sonia Botero ◽  
Hector Ivan Garcia
Keyword(s):  
Health Services ◽  
Vector Control ◽  
Community Participation ◽  
Malaria Control ◽  
Pacific Coast ◽  
Malaria Incidence ◽  
Control Program ◽  
Control Measures ◽  
Radio Communications ◽  
The Pacific

The study focuses on integrated malaria control in 23 communities on the Pacific Coast of Colombia, with several elements of an ecosystem approach to human health, including malaria-related sociopolitical, ecological, and economic factors. The program fostered community participation. The program presented here had 2 components: implementation and research. The first was conducted in 23 communities, 21 of which lacked adequate health services in terms of education, community participation, prompt diagnosis and complete treatment, and vector control. Research focused on specific vector control measures and the current national health services decentralization process. The project: 1) created a malaria prevention culture in the community; 2) avoided deaths from malaria (no fatal cases in the 3-year period, compared to 5-8 deaths a year previously); 3) avoided cases of cerebral malaria (no cases, as compared to 90-110 per year previously); 4) reduced malaria incidence by 45.36%; 5) decreased length of sick leave from 7.52 to 3.7 days; 6) established a permanent network of microscope technicians and 2-way radio communications; 7) integrated work by local, regional, and outside institutions; 8) demonstrated efficacy of insecticide-impregnated bednets to reduce malaria transmission.

scholarly journals A Systematic Review of the Evidence on the Effectiveness and Cost-Effectiveness of Mass Screen-and-Treat Interventions for Malaria Control

2021 ◽  
Author(s):  
Sooyoung Kim ◽  
Verah Nafula Luande ◽  
Joacim Rocklöv ◽  
Jane M. Carlton ◽  
Yesim Tozan
Keyword(s):  
Cost Effectiveness ◽  
Malaria Control ◽  
Malaria Elimination ◽  
Malaria Incidence ◽  
Economic Value ◽  
Experimental Studies ◽  
Control Program ◽  
Clinical Malaria ◽  
Malaria Prevalence ◽  
Sub Saharan Africa

Malaria elimination and eradication efforts have stalled globally. Further, asymptomatic infections as silent transmission reservoirs are considered a major challenge to malaria elimination efforts. There is increased interest in a mass screen-and-treat (MSAT) strategy as an alternative to mass drug administration to reduce malaria burden and transmission in endemic settings. This study systematically synthesized the existing evidence on MSAT, from both epidemiological and economic perspectives. Searches were conducted on six databases (PubMed, EMBASE, CINALH, Web of Science, Global Health, and Google Scholar) between October and December 2020. Only experimental and quasi-experimental studies assessing the effectiveness and/or cost-effectiveness of MSAT in reducing malaria prevalence or incidence were included. Of the 2,424 citation hits, 14 studies based on 11 intervention trials were eligible. Eight trials were conducted in sub-Saharan Africa and three trials in Asia. While five trials targeted the community as a whole, pregnant women were targeted in five trials, and school children in one trial. Transmission setting, frequency, and timing of MSAT rounds, and measured outcomes varied across studies. The pooled effect size of MSAT in reducing malaria incidence and prevalence was marginal and statistically nonsignificant. Only one study conducted an economic evaluation of the intervention and found it to be cost-effective when compared with the standard of care of no MSAT. We concluded that the evidence for implementing MSAT as part of a routine malaria control program is growing but limited. More research is necessary on its short- and longer-term impacts on clinical malaria and malaria transmission and its economic value.

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