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Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015–2017

Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015–2017
Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015–2017
Background: surveillance is a core component of an effective system to support malaria elimination. Poor surveillance data will prevent countries from monitoring progress towards elimination and targeting interventions to the last remaining at-risk places. An evaluation of the performance of surveillance systems in 16 countries was conducted to identify key gaps which could be addressed to build effective systems for malaria elimination.

Methods: a standardized surveillance system landscaping was conducted between 2015 and 2017 in collaboration with governmental malaria programmes. Malaria surveillance guidelines from the World Health Organization and other technical bodies were used to identify the characteristics of an optimal surveillance system, against which systems of study countries were compared. Data collection was conducted through review of existing material and datasets, and interviews with key stakeholders, and the outcomes were summarized descriptively. Additionally, the cumulative fraction of incident infections reported through surveillance systems was estimated using surveillance data, government records, survey data, and other scientific sources.

Results: the landscaping identified common gaps across countries related to the lack of surveillance coverage in remote communities or in the private sector, the lack of adequate health information architecture to capture high quality case-based data, poor integration of data from other sources such as intervention information, poor visualization of generated information, and its lack of availability for making programmatic decisions. The median percentage of symptomatic cases captured by the surveillance systems in the 16 countries was estimated to be 37%, mostly driven by the lack of treatment-seeking in the public health sector (64%) or, in countries with large private sectors, the lack of integration of this sector within the surveillance system.

Conclusions: the landscaping analysis undertaken provides a clear framework through which to identify multiple gaps in current malaria surveillance systems. While perfect systems are not required to eliminate malaria, closing the gaps identified will allow countries to deploy resources more efficiently, track progress, and accelerate towards malaria elimination. Since the landscaping undertaken here, several countries have addressed some of the identified gaps by improving coverage of surveillance, integrating case data with other information, and strengthening visualization and use of data.
1475-2875
Lourenco, Christopher
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Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Cohen, Justin M.
7de99049-a4c3-4fa1-8ff8-cc1bc5dcdfc9
Pindolia, Deepa
7acf501c-abb3-456e-ab64-a310dea401f3
Bhavnani, Darlene
72545b8a-b1b9-4c9f-ada8-d8587b678f39
Le Manach, Arnaud
dd586cd6-a08a-42b9-a643-bfe30003c2ad
Lourenco, Christopher
2bc7b120-e9ef-4db0-919c-299fe60d51a3
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Cohen, Justin M.
7de99049-a4c3-4fa1-8ff8-cc1bc5dcdfc9
Pindolia, Deepa
7acf501c-abb3-456e-ab64-a310dea401f3
Bhavnani, Darlene
72545b8a-b1b9-4c9f-ada8-d8587b678f39
Le Manach, Arnaud
dd586cd6-a08a-42b9-a643-bfe30003c2ad

Lourenco, Christopher, Tatem, Andrew, Cohen, Justin M., Pindolia, Deepa, Bhavnani, Darlene and Le Manach, Arnaud (2019) Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015–2017. Malaria Journal, 18, [315]. (doi:10.1186/s12936-019-2960-2).

Record type: Article

Abstract

Background: surveillance is a core component of an effective system to support malaria elimination. Poor surveillance data will prevent countries from monitoring progress towards elimination and targeting interventions to the last remaining at-risk places. An evaluation of the performance of surveillance systems in 16 countries was conducted to identify key gaps which could be addressed to build effective systems for malaria elimination.

Methods: a standardized surveillance system landscaping was conducted between 2015 and 2017 in collaboration with governmental malaria programmes. Malaria surveillance guidelines from the World Health Organization and other technical bodies were used to identify the characteristics of an optimal surveillance system, against which systems of study countries were compared. Data collection was conducted through review of existing material and datasets, and interviews with key stakeholders, and the outcomes were summarized descriptively. Additionally, the cumulative fraction of incident infections reported through surveillance systems was estimated using surveillance data, government records, survey data, and other scientific sources.

Results: the landscaping identified common gaps across countries related to the lack of surveillance coverage in remote communities or in the private sector, the lack of adequate health information architecture to capture high quality case-based data, poor integration of data from other sources such as intervention information, poor visualization of generated information, and its lack of availability for making programmatic decisions. The median percentage of symptomatic cases captured by the surveillance systems in the 16 countries was estimated to be 37%, mostly driven by the lack of treatment-seeking in the public health sector (64%) or, in countries with large private sectors, the lack of integration of this sector within the surveillance system.

Conclusions: the landscaping analysis undertaken provides a clear framework through which to identify multiple gaps in current malaria surveillance systems. While perfect systems are not required to eliminate malaria, closing the gaps identified will allow countries to deploy resources more efficiently, track progress, and accelerate towards malaria elimination. Since the landscaping undertaken here, several countries have addressed some of the identified gaps by improving coverage of surveillance, integrating case data with other information, and strengthening visualization and use of data.

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Accepted/In Press date: 11 September 2019
e-pub ahead of print date: 18 September 2019

Identifiers

Local EPrints ID: 434546
URI: http://eprints.soton.ac.uk/id/eprint/434546
ISSN: 1475-2875
PURE UUID: 7f8a437b-0b39-4558-95cd-d5ba36de7bcf
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

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Date deposited: 01 Oct 2019 16:30
Last modified: 12 Nov 2019 01:39

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