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A Multi-detection Assay for Malaria Transmitting Mosquitoes

A Multi-detection Assay for Malaria Transmitting Mosquitoes

Published on: February 28, 2015

Evaluation of malaria outbreak detection methods, Uganda, 2022.

Marie Gorreti Zalwango¹, Jane F Zalwango², Daniel Kadobera²

¹Uganda Public Health Fellowship Programme-Uganda National Institute of Public Health, Kampala, Uganda. mzalwango@musph.ac.ug.

Malaria Journal

|January 13, 2024

Summary

Malaria outbreak detection in Uganda using district data showed the 75th percentile method is effective across all transmission levels. This approach, alongside mean + 2SD for prioritization, can improve malaria surveillance.

Keywords:

Epidemic thresholds Malaria Malaria outbreak Uganda

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Area of Science:

Epidemiology
Public Health
Infectious Disease Surveillance

Background:

Malaria outbreak detection relies on World Health Organization (WHO)-recommended thresholds, varying by transmission intensity.
In 2022, over 50% of Ugandan districts reported epidemics using the 75th percentile method, necessitating a focused response.
Evaluating different threshold methods is crucial for appropriate malaria surveillance and prioritization.

Purpose of the Study:

To compare the outbreak-signaling performance of three WHO-recommended malaria surveillance threshold methods.
To assess the appropriateness of different threshold methods across varying malaria transmission intensities in Uganda.
To inform malaria control strategies through improved outbreak detection and prioritization.

Main Methods:

Applied and adjusted three threshold methods (75th percentile, mean + 2SD, C-SUM) to weekly data from 16 Ugandan districts in 2022.
Selected districts represented very low, low, medium, and high transmission zones.
Recalculated district-specific thresholds using 2017-2021 data for accurate categorization.

Main Results:

District-level data re-categorized transmission levels for 8 out of 16 analyzed districts.
The 75th percentile method detected significantly more outbreak weeks than the mean + 2SD method (p < 0.001).
Cumulative sum (C-SUM) and 75th percentile methods showed similar sensitivity in very low and low-transmission areas.

Conclusions:

District-level data provides a more accurate basis for malaria transmission categorization and threshold selection.
The 75th percentile method demonstrates effectiveness across all transmission levels, comparable to C-SUM in low-transmission settings.
Recommends using the 75th percentile for general outbreak detection and mean + 2SD for prioritizing medium- to high-transmission areas.