BackgroundUnder-reporting, delayed diagnosis, incomplete treatment and inadequate vector management are few among many factors responsible for uninterrupted transmission of malaria in India. Information technology (IT) and mobile apps can be utilized effectively to overcome these hurdles. Indigenously developed digital handheld geographic information system (GIS)-tagged Android-based tablets (TABs) has been designed especially for implementation of digitization protocol. This has changed the effectiveness of malaria surveillance and intervention strategies in a malaria endemic area of Mangaluru city, Karnataka, India.MethodsA software was developed and implemented for control measures to create a digital database of each malaria case. Secondary data analyses were carried out to determine and compare differences in malariometric indices between pre- and post-digitization years. With the introduction of this software active surveillance, information education and communication (IEC), and anti-vector measures were made ‘incidence-centric’. This means that the entire control measures were carried out in the houses where the malaria cases (index cases) were reported and also in surrounding houses.ResultsAnnual blood examination rate (ABER) increased from 13.82 to 32.8%. Prompt reporting of new cases had improved (36% within 24 h and 80% within 72 h). Complete treatment and parasite clearance time were documented in 98% of cases. In the second post-digitization year untraceable cases reduced from 11.3 to 2.7%; contact blood smears collection also increased significantly (p < 0.001); Slide Positivity Rate (SPR) decreased from 15.5 to 10.48%; malaria cases reduced by 30%.ConclusionsIT is very useful in translation of digitized surveillance to core interventions thereby effectively reduce incidence of malaria. This technology can be used effectively to translate smart surveillance to core interventions following the ‘1-3-7-14’ strategy.

Background Malaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This has facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case, data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence. Methods IT system developed for robust malaria surveillance and field response is being continued in the sixth year. Protocol for surveillance control was followed as per the national programme guidelines mentioned in an earlier publication. Secondary data from the malaria control system was collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria maps were also analysed. Results Smart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitization (DY) (p < 0.001). Early reporting of new cases (within 48 h) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closures by 14 days. The best impact on reduction in incidence of malaria was recorded in the pre-monsoon months (~ 85%) compared to lower impact in July–August months (~ 40%). Conclusion MCS helped to micromanage control activities, such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.

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Background An indigenously developed digital handheld Android-based geographical information system (GIS)-tagged tablets (TABs) device has been deployed in Mangaluru city, Karnataka, India for smart surveillance in malaria elimination programme from October 2014. Here a detailed account is enumerated in the post-digitization years. The study was aimed to assess the effectiveness of the digitized surveillance system under the ongoing health system in Mangaluru city. Methods A software developed for digitization of malaria surveillance was continued in the post-digitization years (PDY). The same digitization year (DY) protocol was followed in the post-digitization periods also. Secondary data from the malaria control software, total nunber of cases, active surveillance, malaria indices, and feedback from stakeholders were looked at and analyzed. Results Digital surveillance was sustained and the performance improved in the 5th year with participation of all stakeholders. Malaria indices significantly reduced to about 65% in the digitization years compared with digitization year (p<0.001). Slide positivity rate (SPR) decreased from 10.36 (DY) to 4.3 (PDY4). Annual parasite incidence (API) decreased from 16.17 (DY) to 5.4 (PDY4). There was a tempo-spatial correlation between closure of cases on 14th day and incidence of malaria. There was a negative correlation between contact smears and incidence of malaria (r = -0.907). Good impact was recorded in the pre-monsoon months (~85%) and low impact in July and August months (~40%). Conclusion Software helped to improve incidence-centric active surveillance, complete treatment with documentation of elimination of parasite, targeted vector control measures. The learnings and analytical output from the data helped to modify strategies for local control of both disease and the vector.

BackgroundMalaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This facilitated ‘smart surveillance’ followed by required field response within a timeline. The system facilitated data collection of individual case and data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence.MethodsIT system developed for robust malaria surveillance and field response is being continued in the 6th year. Protocol for surveillance control was followed as per the national programme guidilines mentioned earlier. Secondary data from the malaria control system is collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria map were also analysed.ResultsSmart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitizarion (DY) (p<0.001). Early reporting of new cases (within 48 hrs) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closure by 14 days. The best impact on reduction in incidence of malaria was recorded in pre-monsoon months (~85%) compared to lower impact in July-August months (~40%). ConclusionIT System helped to micromanage control activities such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.