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Measuring effectiveness of malaria control: a simplified method for primary health care. Preliminary report
1Tropical Health Epidemiology Unit, London School of Hygiene and Tropical Medicine, UK.
Insights
A new malaria evaluation tool uses infant parasite rates to measure intervention effectiveness. This method analyzes blood slides and transmission patterns in seasonal and non-seasonal areas.
Area of Science:
- Malariology
- Epidemiology
- Public Health
Background:
- Malaria control programs require effective evaluation tools.
- Existing methods may not be suitable for all epidemiological settings, particularly those with distinct seasonal transmission patterns.
Purpose of the Study:
- To develop and validate a novel measure for assessing malaria intervention effectiveness.
- To create a tool applicable to both seasonal and non-seasonal malaria transmission areas.
Main Methods:
- Utilizing infant parasite rates and surveillance blood slides at the onset of the malaria transmission season.
- Plotting fortnightly parasite case detection (PCD) returns on log-log paper to determine slope angles.
- Comparing slope angles from intervention areas with control or baseline data.
Main Results:
- The difference in slope angles between intervention and control groups quantifies intervention effectiveness.
- The method is adaptable for seasonal malaria patterns across all age groups.
- In areas with significant immunity, focusing on positive-testing children improves accuracy.
Conclusions:
- The developed measure offers a flexible and effective means of evaluating malaria interventions.
- It provides an alternative indicator for non-seasonal malaria by focusing on infection acquisition rates.
- The tool is undergoing trials in diverse global settings to confirm its utility.
Abstract:
Based on the infant parasite rate where an increasing number of infants become positive for each month of age (until a plateau is reached) a measure is developed using surveillance blood slides of all cases of malaria at the start of the transmission season. The fortnightly PCD returns from the beginning of the malaria transmission season are plotted on log-log paper and the angle the slope of the line makes with the axis is compared with similar results obtained from the intervention. The difference between the angles measures the effectiveness. The measure can be used in places that have a marked seasonal pattern (for all ages). Where immunity is shown to be a factor, only positive children should be utilized. In areas where malaria is not seasonal, the infant parasite rate, using the rate of acquiring infection rather than the overall value, will provide an alternative indicator. This evaluation tool is being tried in seasonal and non-seasonal parts of the world.
