1 The PRIME trial: Improving health centres to reduce childhood malaria in Uganda
- 1.1 PROCESS: Evaluating how the PRIME intervention worked in practice
2 Use of rapid diagnostic tests to improve malaria treatment in the community in Uganda
3 Introducing rapid diagnostic tests in drug shops to improve the targeting of malaria treatment
- 3.1 Perceptions and impact of introducing rapid diagnostic tests in drug shops
4 IMPACT 2: Evaluating policies in Tanzania to improve malaria diagnosis and treatment
5.1 Cost-effectiveness of interventions to support the introduction of malaria rapid diagnostic tests in Cameroon
5.2 Costs and effects of strategies to improve malaria diagnosis and treatment in Nigeria
6 Strategies for expanding access to quality malaria diagnosis in south-central Asia where malaria incidence is low
7 Trusting rapid diagnostic tests in Zanzibar
- 7.1 Identifying causes of fever in children under five in Zanzibar
8 Restricting ACT drugs to patients with positive rapid diagnostic test results
9 Targeting ACT drugs: the TACT trial
10 InterACT: Interactions between malaria and HIV drugs in a malaria endemic area
- 10.1 Understanding perceptions of HIV-positive people taking malaria treatment
11 The ACTia trial: Safety of repeated drug use in children
- 11.1 How perceptions of malaria medication affect adherence
- 11.2 Malaria indicator survey to support national control programmes
12 Collating drug safety data from ACT Consortium studies
13 Interactions between malaria and HIV drugs in people living with HIV
- 13.1 Collecting safety data in antimalarial drug trials
14 Analysing the quality and authenticity of ACT drugs
15 How the use of rapid diagnostic tests influences clinicians decision to prescribe ACTs
16 Identifying non-malaria illnesses that cause fever
17 Access and quality of malaria diagnosis and treatment in South-East Asia

Malaria indicator survey to support national control programmes

[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.