Shrinking the Malaria Map

UCSF Global Health Group’s Malaria Elimination Initiative (MEI)

High Risk Populations Surveillance and Response Guide

Why is surveillance and response important in high-risk populations?

Decreasing and ultimately reducing transmissions to zero among high-risk populations (HRPs) is essential to achieving and sustaining malaria elimination. However, most malaria programs rely on passive case detection as the foundation of malaria surveillance, frequently missing specific HRPs who are less likely to present at health facilities or are mobile populations who may be absent at follow up. Targeted surveillance and response can help national malaria control programs (NMCPs) refine their understanding of HRPs, improve the targeting of interventions, and ultimately reduce malaria transmission.

What is the HRP Surveillance and Response Guide and why is it useful?

HRPs may be harder to reach and often require special approaches to ensure all malaria infections are detected and treated. The Malaria Elimination Initiative created the HRP Surveillance and Response Guide (HRP Guide), a set of four step-by-step modules, to help NMCPs build the epidemiological evidence and resources they need to determine the optimal selection and delivery of interventions for reducing malaria transmission among HRPs. The HRP Guide provides a set of approaches to review transmission patterns and surveillance gaps, gather detailed epidemiological evidence on risk factors and behaviors of populations likely at high-risk for malaria, track epidemiological trends in HRPs, and improve targeting of interventions.

Who should use this tool and how?

The HRP Guide is for NMCP program managers, M&E officers, and their implementing partners, including non-governmental organizations, and researchers in countries with low malaria transmission. The guide contains four modules, each of which provides instructions on the methods to gather and analyze the necessary information that will inform a more resilient surveillance and response platform. Not all countries will need to implement all modules.

The MEI requests that national malaria programs and implementing partners contact us when using any of the tools in the Malaria Elimination Toolkit. Support in implementing the tool may also be available. Please contact Laura Newman (laura.newman [at]

HRP Guide contents:
Module 1: Planning for Targeted HRP Surveillance and Response
Module 2: Identifying Risk Factors: Case-control Study
Module 3: Monitoring Malaria Transmission and Intervention Coverage
Module 4: Adapting Reactive Case Detection

Download the HRP Guide.

Malaria Elimination Toolkit

About Our Tools

The Malaria Elimination Toolkit offers approaches that address the challenges confronting national malaria control programs in low-transmission settings. The MEI has built this toolkit around key areas that enable successful malaria elimination and prevention of reintroduction: advocacy, financing, regional collaboration, surveillance and response, and vector control. By supplementing global malaria policy and guidance, these tools aim to accelerate elimination efforts in countries that are paving the way for malaria eradication.