Geography of Disease Burden: Case Studies in Namibia and Eritrea

Africa continues to experience the highest infectious disease burden despite an increase in investments. These include investments in malaria, HIV/AIDS, tuberculosis, as well as in communicable diseases. The global targets are to reduce the burden of these diseases through improved surveillance, prevention of outbreaks, effective case management, elimination and eventually, eradication. Achieving these targets, however, is limited by the poor geographic descriptions of the disease burden. Of the big five infectious disease burdens, malaria is the most advanced in terms of mapping its distribution. Malaria cartography has since formed the evidence-base for the design of many national malaria control programmes. This chapter focuses on malaria as an example, demonstrating its geographical descriptions. The availability of georeferenced malaria case data whether based on prevalence or incidence indicators has been used extensively in the mapping of geographical extents at national and sub-national scales. However, routine surveillance data is emerging as a valuable methodology of tracking burden in sub-Saharan Africa. A particular focus of this chapter is the use of routine national health systems surveillance data to describe, at a fine-scale, the distribution of malaria. However, routine data can be applied to the cartographic description of other diseases beyond malaria. The methodological aspects of burden estimation from routine surveillance platforms and cartography are highlighted.