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Malaria
Surveillance, Information and Research
Strategies
- Establish
baseline and monitoring data on the malaria burden,
malaria transmission and socio-economic
and behavioural determinants by:
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Standardising
malaria definitions and indicators |
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Estimating
population at risk and specific risk groups |
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Mapping environmental, demographic, geographical, meteorological, entomological
and malaria data |
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Collecting malaria data as part of census, inter-census and Demographic
and Health Surveys |
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Conducting
malaria burden and KAP surveys |
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Estimating
the economic burden of malaria and cost of malaria
control |
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Preparing malaria country profiles |
- Establish
a sub-regional malaria information and surveillance network
- Support
countries in building sound surveillance and mapping systems
- Support
countries carry out regular monitoring and evaluation
of their programme and specific
activities
- Support operational research that is owned by NMCPs and relevant to their
work
- Provide NMCPs with up-to-date malaria texts and documents
- Develop
a network of researchers in Southern Africa that can support
NMCPs
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Posters
and Bulletins
Reference
Documents
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Malaria
Surveillance
Malaria
surveillance can be defined as the systematic collection
of information related to malaria such as number of
clinical cases, confirmed cases, malaria deaths, etc.
The rationale of malaria surveillance is to reveal malaria
trends and formulate malaria control interventions based
on evidence.
Functions of malaria surveillance:
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Evaluation of time trends |
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Identification and documentation of outbreaks |
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Evaluation of disease interventions |
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Determine effectiveness of epidemic control |
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Identification of populations at risk |
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Mobilize resources for epidemic disaster control
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The surveillance systems of countries covered by SAMC
is not the same throughout. For more information on
the surveillance system and information of a particular
country go to the country profiles.
SAMC operates a subregional surveillance and information
database. The information in the database comes from
the surveillance and routine information systems shown
in the table below.
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Country
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Surveillance
System
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Information
System
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Angola
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Quarterly
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Botswana
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Weekly
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Malawi
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Monthly
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Mozambique
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Weekly
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Namibia
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Weekly
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South
Africa
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Weekly
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Swaziland
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Weekly
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Tanzania
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Annual
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Zambia
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Quarterly
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Zimbabwe
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Weekly
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Currently all countries with surveillance systems submit surveillance
reports on a monthly basis and those with information
systems when the information is available. SAMC produces
Monthly Malaria Update giving an overview of the malaria
situation with the region.
Information
Information such as population at risk, drug policy,
sentinel sites, vector control initiatives and
meteorological data such as historical rainfall,
relative humidity, temperature, estimated rainfall derived
from satellite imagery and rainfall temperature forecasts are
available.
Geographical and Environmental Information Systems are
being used to integrate the information at our disposal
to analyse and strengthen malaria stratification, monitoring
and forecasting of epidemics. A malaria module of HealthMapper
is being used for this purpose. The software enables
NMCPs to create digital malaria thematic maps very easily.
Maps showing malaria free, unstable (epidemic prone)
and stable malaria areas have been produced. SAMC in
collaboration with HealthMap (WHO/HQ) and Malsat
(Liverpool School of Tropical Medicine) are supporting
countries to build their capacity in this area.
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Baseline
Data, Monitoring & Evaluation, and Operational Research
A
series of core impact, outcome and process RBM indicators
for Southern Africa are used for monitoring progress.
These indicators are given below:
Core
RBM Indicators for Southern Africa
IMPACT
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SOURCE
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Under five mortality (all-cause) rate
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DHS, census, DSS, surveys
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Malaria mortality rate (under-fives, 5-14 year olds, 15+ years, pregnant women)
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HIS, DSS, surveys
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HIS, DSS, surveys
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Case fatality rate for malaria cases admitted to hospitals and health centres
with inpatient facilities (under-fives, 5-14 year
olds, 15+ years, pregnant women)
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HIS, sentinel sites
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Prevalence of malaria parasitaemia among 2-9 year olds
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Community surveys, DSS
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OUTCOME
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Percentage of people with a malaria attack receiving appropriate treatment
within 24 hours (under-fives, over-fives)
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Community surveys
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Percentage of people
with uncomplicated malaria properly managed at
health facilities (under-fives, over-fives)
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Health facility surveys
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Percentage of people
with severe malaria and correctly managed at health
facilities (under-fives, over-fives)
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Health facility surveys
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Percentage of children under-five sleeping under treated mosquito nets
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DHS, Community surveys
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Percentage of pregnant women sleeping under treated mosquito nets
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DHS, Community surveys
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Percentage of households owning at least one treated mosquito net
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DHS, Community surveys
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Percentage of pregnant women on antimalarial chemoprophylaxis or intermittent
presumptive treatment
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DHS, Community surveys
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Percentage of households in targeted areas that are sprayed
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HIS, records
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Percentage of all households in malarious areas that are sprayed
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HIS, records
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Percentage
of all households in malarious areas with malaria
prevention measures [1]
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Composite sources
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Percentage of malaria outbreaks detected within two weeks of onset
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IDS, HIS, records
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Percentage of detected malaria outbreaks properly controlled within two weeks
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IDS, HIS, records
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Percentage
of villages taking organised action on malaria
issues.
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Records
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PROCESS
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Percentage of health
facilities with no stock-outs of 1st,
2nd, 3rd -line antimalarial
drugs and essential items during the last 3 months.
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Health facility survey
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| Percentage
of facilities with adequate parasite detection services
[2] |
Health facility survey
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Percentage
of community health workers holders who have received
training in case management in last 24 months
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Records
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Percentage of clinicians who have received
training in case management in last 24 months
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Records
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Percentage of nurses who have received training
in case management in last 24 months
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Records
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Number
of national level financing, technical and other
partners
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NMCP
records
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Number
of district level financing, technical and other
partners
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DHMT
records
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[1] Use of treated mosquito nets, residual house
spraying, screens.
[2] Includes facilities, equipment, trained personnel
DHS:
Demographic and Health Survey
DSS: Demographic Surveillance Site
HIS: Health Information System
IDS: Integrated Disease Surveillance
Good
quality baseline data are essential if an evidence-base
is to be established and malaria control efforts properly
monitored and evaluated. Hence, using existing data
estimates of population at risk at national and provincial
levels, malaria mortality and morbidity, and coverage
of interventions have been calculated for the subregion.
POWERPOINT PRESENTATION Population
data and malaria control in Southern Africa,
WORD documents (click to view) -
However,
existing data are often insufficient and it is necessary
to conduct population-based surveys. To this end, quantitative
and qualitative protocols for population-based malaria
surveys are available. The protocols collect data
on malaria incidence, parasite prevalence and mortality
as well as malarias socio-economic and behavioural
determinants
Click to View -
Community-based surveys.doc
Operational
research protocols have also been develop for evaluation
malaria IEC materials and malaria interventions among
travellers and tourists with the Department of Community,
University of Zimbabwe, and the Department of Communication
Studies, University of Stirling, respectively.
Health
professionals working in malaria control often do not
have a access to up-to-date information on the disease
and its control. Consequently, SAMC together with the
Medical School Library of the University of Zimbabwe
launched the Malaria Red Reference Initiative in February
2000
Click to View
Malaria Red Reference Initiative
Partners
Blair
Research Institute
Central Statistical Offices
Department of Community Medicine, University of Zimbabwe
Department
of Communication Studies, University of Stirling
DHS/Macro
International
Drought
Monitoring Centre (SADC and WMO)
HealthMap Project, WHO/UNICEF
Malsat,
LSTM
Medical School Library, University of Zimbabwe
National Meteorological Services
National Oceanic and Atmospheric Administration (NOAA)
RBM Network on Mapping
SADC Health Desk
SADC Regional Remote Sensing Project
SARCOF
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