Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System.

Area of Science:

• Public Health
• Epidemiology
• Health Systems Research

Background:

• Malaria elimination programs increasingly depend on surveillance-response systems.
• Timeliness is a critical metric for evaluating the effectiveness of these systems.
• Mobile and web-based tools support reporting in many malaria surveillance efforts.

Purpose of the Study:

• To investigate the response time of Zanzibar's Malaria Case Notification (MCN) system.
• To identify factors influencing response time within the surveillance-response system.
• To assess the operational efficiency of malaria case investigation.

Main Methods:

• A mixed-methods approach was employed.
• Quantitative analysis of response time data from Zanzibar Malaria Elimination Program (ZAMEP).
• Qualitative data from surveys and focus groups with health workers and surveillance officers.

Main Results:

• Response time in Zanzibar districts ranged from 0.6 to 6.05 days.
• Response time did not show association with calendar time or the number of reported malaria cases.
• Operational challenges, including incomplete records and transport issues, were identified, linked to program management deficiencies.

Conclusions:

• Effective program management is essential for timely malaria case response, even with automated tools.
• Technological solutions alone are insufficient for optimal surveillance-response system performance.
• Malaria programs must prioritize robust management practices to support elimination goals.