Shrinking the Malaria Map

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

Surveillance

A man in Kenya enters malaria monitoring data into a ledger. Bonnie Gillespie 2007 Courtesy of Photoshare

Strong surveillance is integral to every malaria elimination program. Elimination programs need to know where and when individual cases are occurring so that appropriate interventions, such as active case detection or targeted parasite elimination, can rapidly reduce residual transmission and prevent further spreading of malaria.

Programs need to have a mechanism for rapidly reporting cases, along with a rapid feedback loop and the capacity to mount a precise response to stamp out transmission. In addition to responding reactively to cases, some programs choose to screen proactively or treat high-risk populations or communities that could harbor malaria transmission.

Malaria elimination surveillance comes in many forms, but typically includes passive case detection and active case detection.

The MEI’s Work on Surveillance for Malaria Elimination includes:

  • Developing tools and methods for countries to identify the high risk areas (hotspots, or geographical areas with relatively high transmission) and incorporate evidence to improve targeting of interventions in particular geographic areas. This work includes decision-support systems such as geospatial modeling and malaria risk mapping.
  • Developing tools and strategies to identify high risk populations (hotpops, or populations that are at relatively higher risk for transmission) and work closely with national malaria programs to incorporate these strategies in order to improve targeting of interventions among higher risk populations. This work includes using social networks to identify groups of friends, workers or family members who may all be at an increased risk for malaria.
  • Assisting countries in implementing practical MEI-developed tools which monitor and evaluate active surveillance efforts and inform countries of the gaps and weaknesses in their programs, as well as approaches to make improvements.
  • Conducting research in countries to understand and improve collaboration on malaria elimination surveillance between the private sector and national programs.
  • Partnering with countries to document and disseminate unique and successful surveillance strategies so that other countries can learn from these approaches and adopt them. This work includes the MEI documenting China’s innovative 1-3-7 surveillance strategy.
  • Playing a pivotal role in advocating for coordinated or multi-country surveillance efforts, particularly within the context of regional collaborations.
  • Coordinating surveillance-focused working groups and meetings and making recommendations to the WHO as a result of these consensus-building meetings. This work includes the MEI coordinating the APMEN Surveillance and Response Working Group, which supported the development of new malaria elimination indicators.