Malaria: How Are We Doing and How Can We Do Better?

Rosenthal, Philip J.; John, Chandy C.; Rabinovich, N. Regina

doi:10.4269/ajtmh.18-0997

Cited by 33 publications

(27 citation statements)

References 23 publications

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“…2 3 Knowing how to reduce malaria in the future clearly requires understanding of current epidemiology, and identification of changes that have already occurred. 4 …”

Section: Introductionmentioning

confidence: 99%

Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria

et al. 2021

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IntroductionGlobal progress in reducing malaria has stalled since 2015. Analysis of the situation is particularly needed in Nigeria, the country with by far the largest share of the burden, where approximately a quarter of all cases in the world are estimated to occur.MethodsWe analysed data from three nationwide surveys (Malaria Indicator Surveys in 2010 and 2015 and a National Demographic and Health Survey in 2018), with malaria parasite prevalence in children under 5 years of age determined by sampling from all 36 states of Nigeria, and blood slide microscopy performed in the same accredited laboratory for all samples. Changes over time were evaluated by calculating prevalence ratio (PR) values with 95% CIs for each state, together with Mantel-Haenszel-adjusted PRs (PRadj) for each of the six major geopolitical zones of the country.ResultsBetween 2010 and 2018, there were significant reductions in parasite prevalence in 25 states, but not in the remaining 11 states. Prevalence decreased most in southern zones of the country (South West PRadj=0.53; South East PRadj=0.59; South South PRadj=0.51) and the North Central zone (PRadj=0.36). Changes in the north were less marked, but were significant and indicated overall reductions by more than 20% (North-West PRadj=0.74; North East PRadj=0.70). Changes in the south occurred mostly between 2010 and 2015, whereas those in the north were more gradual and most continued after 2015. Recent changes were not correlated with survey-reported variation in use of preventive measures.ConclusionReductions in malaria infection in children under 5 have occurred in most individual states in Nigeria since 2010, but substantial geographical variation in the timing and extent indicate challenges to be overcome to enable global malaria reduction.

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“…2 3 Knowing how to reduce malaria in the future clearly requires understanding of current epidemiology, and identification of changes that have already occurred. 4 …”

Section: Introductionmentioning

confidence: 99%

Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria

et al. 2021

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“…However, multiple challenges are present, especially on the path to disease elimination, including, emerging resistances along the malaria-transmission cycle (vector and agent), TB antimicrobial resistance [2,3], weak implementation capacities, de cient drug supply systems, limited quality of care or fragmented approaches to health systems strengthening, urging the implementers of disease programmes to improve their e ciency. Operational research (OR) that is designed to increase both implementation e ciency and effectiveness provides evidence on elements that either enhance or impede the performance of established processes within, for instance, disease control activities [1,[4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Incorporating operational research in programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in four sub-Saharan African countries.

Camacho

Maher

Kamau

et al. 2020

Preprint

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Background: The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries. The objective of this follow-up study was to identify approaches and pathways to implement an OR component into grants to the Global Fund, in four sub-Saharan African countries. Special focus was given to the Structured Operational Research and Training IniTiative (SORT IT).Methods: The conceptual framework was based on an analysis to identify elements supporting and blocking the integration of OR, called force field analysis, and a behavioural change assessment covering aspects such as opportunity, motivation, capability and triggers to do the integration. Data were collected through online surveys and stakeholder interviews both via telephone/online conference tools and in person in four countries with a high burden of malaria and tuberculosis. These countries were Ghana, Sierra Leone, the United Republic of Tanzania and Zimbabwe. The stakeholders included programme managers, implementation partners, representatives from international organisations, academic and governmental research institutions and other individuals involved in the countries’ needs assessment and National Strategic Plan development. Results: We identified opportunities to integrate OR into the countries’ programmes during the funding process, the country’s needs assessment being the most important one, including the need of OR-related capacity. Both the force field analysis and the behavioural change assessment showed that the necessary elements to integrate OR were present in the countries. Motivation, capability and efficiency were found to be a managerial value omnipresent across stakeholders. However, those elements were influenced by the tendency to favour tangible assets over any abstract ones, such as increasing organisational capacity in OR.Conclusions: In each of the countries assessed, there is potential to integrating OR into the programmes supported by the Global Fund. However, given the relative lack of OR-related capacity and skills encountered, a capacity strengthening tool, such as SORT IT, would be of benefit helping to identify and carry forward OR activities sustainably.

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“…However, multiple challenges are present, especially on the path to disease elimination, including, emerging resistances along the malaria-transmission cycle (vector and agent), TB antimicrobial resistance [ 2 , 3 ], weak implementation capacities, deficient drug supply systems, limited quality of care or fragmented approaches to health systems strengthening, urging the implementers of disease programmes to improve their efficiency. Operational research (OR) that is designed to increase both implementation efficiency and effectiveness provides evidence on elements that either enhance or impede the performance of established processes within, for instance, disease control activities [ 1 , 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Incorporating operational research in programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in four sub-Saharan African countries

et al. 2020

View full text Add to dashboard Cite

Background: The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries. The objective of this follow-up study was to identify approaches and pathways to implement an OR component into grants to the Global Fund, in four sub-Saharan African countries. Special focus was given to the Structured Operational Research and Training IniTiative (SORT IT). Methods: The conceptual framework was based on an analysis to identify elements supporting and blocking the integration of OR, called force field analysis, and a behavioural change assessment covering aspects such as opportunity, motivation, capability and triggers to do the integration. Data were collected through online surveys and stakeholder interviews both via telephone/online conference tools and in person in four countries with a high burden of malaria and tuberculosis. These countries were Ghana, Sierra Leone, the United Republic of Tanzania and Zimbabwe. The stakeholders included programme managers, implementation partners, representatives from international organisations, academic and governmental research institutions and other individuals involved in the countries' needs assessment and National Strategic Plan development. Results: We identified opportunities to integrate OR into the countries' programmes during the funding process, the country's needs assessment being the most important one, including the need of OR-related capacity. Both the force field analysis and the behavioural change assessment showed that the necessary elements to integrate OR were present in the countries. Motivation, capability and efficiency were found to be a managerial value omnipresent across stakeholders. However, those elements were influenced by the tendency to favour tangible assets over any abstract ones, such as increasing organisational capacity in OR.

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Malaria: How Are We Doing and How Can We Do Better?

Cited by 33 publications

References 23 publications

Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria

Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria

Incorporating operational research in programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in four sub-Saharan African countries.

Incorporating operational research in programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in four sub-Saharan African countries

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