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Principles of Disease Surveillance

Principles of Disease Surveillance

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Updated: Aug 6, 2025

Measuring Naturally Acquired Phagocytosis-Inducing Antibodies to Plasmodium falciparum Parasites by a Flow Cytometry-Based Assay

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Using antenatal care as a platform for malaria surveillance data collection: study protocol.

Julie R Gutman¹, Julia Nanteza Mwesigwa², Kyra Arnett³

¹Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA. fff2@cdc.gov.

Malaria Journal

|March 18, 2023

Summary

Antenatal care (ANC1) testing can offer a cost-effective way to monitor malaria prevalence and intervention coverage. This study evaluates ANC-based surveillance as a tool for tracking monthly malaria trends and improving public health strategies.

Keywords:

ANC-based surveillance Benin Burkina Faso Malaria Mozambique Nigeria Tanzania Zambia

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Area of Science:

Public Health
Infectious Disease Epidemiology
Health Systems Research

Background:

Routine health information systems have limitations in timely malaria trend reporting.
Community surveys for malaria prevalence are resource-intensive and lack geographic detail.
Integrating malaria testing into the first antenatal care visit (ANC1) offers a potential for more timely and granular data.

Purpose of the Study:

To assess the feasibility and utility of ANC1-based surveillance for monitoring malaria burden and intervention coverage.
To validate ANC data against traditional household survey methods.
To evaluate the representativeness and cost-effectiveness of ANC1 surveillance.

Main Methods:

An observational, cross-sectional study across six malaria-endemic countries (Benin, Burkina Faso, Mozambique, Nigeria, Tanzania, Zambia).
Pregnant women at ANC1 were tested for malaria and completed a questionnaire on intervention coverage and care-seeking.
Correlations between ANC1 data and contemporaneous household survey data were analyzed.

Main Results:

Malaria prevalence at ANC1 will be assessed at facility and district levels, stratified by gravidity.
Monthly trends in ANC1 malaria prevalence will be reported.
Correlations between ANC1 and household survey estimates for malaria prevalence, bed net use, and care-seeking will be evaluated.

Conclusions:

ANC1-based surveillance shows potential for cost-effective, localized malaria monitoring.
It can provide timely data on parasite prevalence and intervention coverage representative of the general population.
Further evaluation will focus on operational feasibility, programmatic utility, and scalability.