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Piloting a programme tool to evaluate malaria case investigation and reactive case detection activities: results from 3 settings in the Asia Pacific
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Univ Calif San Francisco, Global Hlth Grp, Malaria Eliminat Initiat, 550 16th St,3rd Floor, San Francisco, CA 94158 USA.
Minist Publ Hlth, Dept Dis Control, Bur Vector Borne Dis, Nonthaburi, Thailand.
UN Childrens Fund UNICEF, Aceh Field Off, Banda Aceh, Indonesia;Paritrana Asia Fdn, Jakarta, Indonesia.
Jiangsu Inst Parasit Dis, Jiangsu Prov Key Lab Parasite & Vector Control Te, Key Lab, Natl Hlth & Family Planning Commiss Parasit Dis C, Wuxi, Jiangsu, Peoples R China.
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2017 (English)In: Malaria Journal, ISSN 1475-2875, E-ISSN 1475-2875, Vol. 16, article id 347Article in journal (Refereed) Published
Abstract [en]

Background: Case investigation and reactive case detection (RACD) activities are widely-used in low transmission settings to determine the suspected origin of infection and identify and treat malaria infections nearby to the index patient household. Case investigation and RACD activities are time and resource intensive, include methodologies that vary across eliminating settings, and have no standardized metrics or tools available to monitor and evaluate them. Methods: In response to this gap, a simple programme tool was developed for monitoring and evaluating (M&E) RACD activities and piloted by national malaria programmes. During the development phase, four modules of the RACD M&E tool were created to assess and evaluate key case investigation and RACD activities and costs. A pilot phase was then carried out by programme implementers between 2013 and 2015, during which malaria surveillance teams in three different settings (China, Indonesia, Thailand) piloted the tool over a period of 3 months each. This study describes summary results of the pilots and feasibility and impact of the tool on programmes. Results: All three study areas implemented the RACD M&E tool modules, and pilot users reported the tool and evaluation process were helpful to identify gaps in RACD programme activities. In the 45 health facilities evaluated, 71.8% (97/135; min 35.3-max 100.0%) of the proper notification and reporting forms and 20.0% (27/135; min 0.0-max 100.0%) of standard operating procedures (SOPs) were available to support malaria elimination activities. The tool highlighted gaps in reporting key data indicators on the completeness for malaria case reporting (98.8%; min 93.3-max 100.0%), case investigations (65.6%; min 61.8-max 78.4%) and RACD activities (70.0%; min 64.7-max 100.0%). Evaluation of the SOPs showed that knowledge and practices of malaria personnel varied within and between study areas. Average monthly costs for conducting case investigation and RACD activities showed variation between study areas (min USD $844.80-max USD $2038.00) for the malaria personnel, commodities, services and other costs required to carry out the activities. Conclusion: The RACD M&E tool was implemented in the three pilot areas, identifying key gaps that led to impacts on programme decision making. Study findings support the need for routine M&E of malaria case reporting, case investigation and RACD activities. Scale-up of the RACD M&E tool in malaria-eliminating settings will contribute to improved programme performance to the high level that is required to reach elimination.

Place, publisher, year, edition, pages
2017. Vol. 16, article id 347
Keywords [en]
Monitoring and evaluation (M&E), Malaria, Elimination, Case investigation, Active case detection, Reactive case detection (RACD), Tool development, Programme performance, China, Indonesia, Thailand
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-359787DOI: 10.1186/s12936-017-1991-9ISI: 000408502000002PubMedID: 28830519OAI: oai:DiVA.org:uu-359787DiVA, id: diva2:1250493
Available from: 2018-09-24 Created: 2018-09-24 Last updated: 2018-09-24Bibliographically approved

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