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Malaria Burden through Routine Reporting: Relationship between Incidence and Test Positivity Rates
Simon P Kigozi1,2, Ruth N Kigozi3, Asadu Sserwanga1
1Infectious Diseases Research Collaboration, Kampala, Uganda.
Summary
Malaria surveillance indicators, test positivity rate (TPR) and incidence rate (IR), show similar monthly trends but complex spatial relationships. IR declines with distance from health centers, indicating differing roles in monitoring malaria burden.
Area of Science:
- Epidemiology
- Public Health
- Malaria Surveillance
Background:
- Test positivity rate (TPR) and incidence rate (IR) are key malaria surveillance indicators.
- Limited research exists on the spatiotemporal relationship between TPR and IR.
- Understanding these relationships is crucial for effective malaria control programs.
Purpose of the Study:
- To investigate the relationship between TPR and IR in children under 11 years in Uganda.
- To evaluate trends in TPR and IR over time and space.
- To explore associations using multivariable regression models.
Main Methods:
- Retrospective analysis of outpatient data from three health centers in Uganda (Oct 2011 - June 2016).
- Inclusion of 65,710 children presenting with suspected malaria.
- Statistical analysis including pairwise comparisons and multivariable regression models.
Main Results:
- Monthly TPR and IR showed similar trends, especially during low transmission seasons.
- Village-level analysis revealed a complex relationship: TPR remained constant, while IR decreased with distance from health centers.
- A significant nonlinear (cubic) relationship was found between TPR and IR.
Conclusions:
- TPR and IR are highly relevant for monitoring malaria burden but require distinct interpretations.
- TPR reflects demand for malaria treatment resources.
- IR indicates malaria risk within health facility catchment populations.
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