A framework for Malaria Surveillance Systems in elimination settings with geospatial applications in the Greater Mekong Subregion

Abstract

There has been a restored global push for malaria elimination in recent years and to achieve their malaria elimination goals, countries will require a well-designed and effective surveillance system. This is particularly true for the Greater Mekong Subregion where there is global pressure from the threat of artemisinin resistance to accelerate surveillance system revisions. Analysis of surveillance systems in countries that have successfully eliminated malaria reveals that each country invested substantially in disease notification, analysis, and rapid response. The main purpose of this thesis is to develop a novel framework for assessing surveillance systems to help countries identify gaps, prioritize solutions, and build systems sufficient for malaria elimination. The framework is applied to 16 countries committed to elimination and overarching recommendations to strengthen surveillance systems are generated. These recommendations are assembled into four thematic areas: expanding the surveillance system’s coverage of remote areas by increasing geographical access to care; designing improved architectures that integrate electronic data collection and reporting systems; defining core data analysis needs and how data will be used for response; and increasing malaria program capacity to deploy and maintain data collection and reporting platforms. The thesis concludes with a demonstration of how geospatial solutions can address each of these thematic surveillance gaps, specifically in the settings of Vietnam and Cambodia. As countries continue to revise and scale-up their malaria surveillance to reach elimination standards, sustained political will and strong financial commitments are necessary to support effective and enduring systems. These findings will help governments that pursue malaria elimination use best practices for generating key data to support surveillance strengthening.

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Identifiers

ORCID for Andrew Tatem: orcid.org/0000-0002-7270-941X

ORCID for Peter Atkinson: orcid.org/0000-0002-5489-6880

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