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Malaria indicator survey to support national control programmes

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[Project summary in Français / Português]

Scientific title: Determining sub-national intervention coverage and malaria impact estimates in young children and older age groups using a continuous Malaria Indicator Survey in Chikhwawa district, Malawi

Latest on this research

[Français / Português]

The field work ended in June 2013, completing a full period of three years of a continuous Malaria Indicator Survey until the end of the ACTia trial. 

Preliminary findings show how low-cost continuous malaria surveys like these can be used to identify the variation in the coverage of both malaria transmission and interventions, and access to ACT across an area over time. By using the same indicators as national surveys, these provide complementary, timely, local data to inform more targeted control efforts and use of resources by local programme managers.

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What did we know before this research?

In areas where malaria transmission rates are moderate to high, the progress of malaria control is mainly evaluated using national household surveys such as Malaria Indicator Surveys (MIS), Demographic Health Surveys (DHS) or UNICEF Multiple Indicator Cluster Surveys (MICS). These are then complemented by data from Health Management Information Systems (HMIS).

Household surveys provide estimates of national and regional population every two to five years. However, this focus on average estimates does not take into account that the levels of transmission are very diverse within countries and districts. Also, control efforts include additional interventions - such as indoor residual spraying (IRS) - that target highly affected areas. 

It is widely recognised that more accurate estimates could help optimise the efforts to control malaria transmission at the national level, but there are no recommended standardised survey tools for monitoring and evaluation (M&E) at the district level. 

What does this study add?

There is increasing focus on reducing malaria transmission and using ACT drugs at population level. The use of ‘rolling’ household surveys - where data is collected over one or several years by small permanent teams - could become a complementary tool to national malaria surveys in selected settings, to determine the progress of malaria control. This includes disease transmission, disease burden, intervention coverage and access to ACT drugs within districts.

This is a complementary study to the ACTia trial that will determine the value and feasibility of using long-term local continuous Malaria Indicator Surveys to provide timely and local data that can inform more targeted control efforts. It will also determine the added value of expanding such surveys to children under five – to include older children and adults.

The research team

Principal Investigators

  • Dr Anja Terlouw, Liverpool School of Tropical Medicine


  • Prof David Lalloo, Liverpool School of Tropical Medicine


  • Dr. Sanie Sesay, Liverpool School of Tropical Medicine, UK and University of Malawi  


Other Investigators

  • Dr Kamija Phiri, Associate Professor, COM
  • Prof Peter Diggle, University of Liverpool/University of Lancaster
  • Emanuele Giorgi, PhD student, University of Lancaster

Related Publications

Short report : Rolling Malaria Indicator Surveys (rMIS): A Potential District-Level Malaria Monitoring and Evaluation (M&E) tool for program managers

Arantxa Roca-Feltrer, David G. Lalloo, Kamija Phiri, and Dianne J. Terlouw  |  Published
American Journal of Tropical Medicine and Hygiene

Combining data from multiple spatially referenced prevalence surveys using generalized linear geostatistical models

Emanuele Giorgi, Sanie S. S. Sesay, Dianne J. Terlouw, Peter J. Diggle  |  Published
Royal Statistical Society

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