Predictors of local malaria outbreaks: an approach to the development of an early warning system in Colombia

Mateus, Julio César; Carrasquilla, Gabriel

doi:10.1590/s0074-02762011000900014

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…Each country is exposed to particular and different ecological circumstances; challenges are more apparent at local level when using similar indicators to predict malaria occurrence [ 16 ]. A limited number of studies focus on a comprehensive approach for early warning, which considers predictive factors rather than meteorological variables [ 17 ]. This is a crucial issue in pre-elimination and elimination settings where variables other than meteorological are more important.…”

Section: Introductionmentioning

confidence: 99%

Predicting factors for malaria re-introduction: an applied model in an elimination setting to prevent malaria outbreaks

Ranjbar

Shoghli

Kolifarhood

et al. 2016

Malar J

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BackgroundMalaria re-introduction is a challenge in elimination settings. To prevent re-introduction, receptivity, vulnerability, and health system capacity of foci should be monitored using appropriate tools. This study aimed to design an applicable model to monitor predicting factors of re-introduction of malaria in highly prone areas.MethodsThis exploratory, descriptive study was conducted in a pre-elimination setting with a high-risk of malaria transmission re-introduction. By using nominal group technique and literature review, a list of predicting indicators for malaria re-introduction and outbreak was defined. Accordingly, a checklist was developed and completed in the field for foci affected by re-introduction and for cleared-up foci as a control group, for a period of 12 weeks before re-introduction and for the same period in the previous year. Using field data and analytic hierarchical process (AHP), each variable and its sub-categories were weighted, and by calculating geometric means for each sub-category, score of corresponding cells of interaction matrices, lower and upper threshold of different risks strata, including low and mild risk of re-introduction and moderate and high risk of malaria outbreaks, were determined. The developed predictive model was calibrated through resampling with different sets of explanatory variables using R software. Sensitivity and specificity of the model were calculated based on new samples.ResultsTwenty explanatory predictive variables of malaria re-introduction were identified and a predictive model was developed. Unpermitted immigrants from endemic neighbouring countries were determined as a pivotal factor (AHP score: 0.181). Moreover, quality of population movement (0.114), following malaria transmission season (0.088), average daily minimum temperature in the previous 8 weeks (0.062), an outdoor resting shelter for vectors (0.045), and rainfall (0.042) were determined. Positive and negative predictive values of the model were 81.8 and 100 %, respectively.ConclusionsThis study introduced a new, simple, yet reliable model to forecast malaria re-introduction and outbreaks eight weeks in advance in pre-elimination and elimination settings. The model incorporates comprehensive deterministic factors that can easily be measured in the field, thereby facilitating preventive measures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1192-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Predicting factors for malaria re-introduction: an applied model in an elimination setting to prevent malaria outbreaks

Ranjbar

Shoghli

Kolifarhood

et al. 2016

Malar J

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“…Estos hallazgos son similares a los reportados por Mateus y Carrasquilla (33), quienes encontraron que los municipios con mayor proporción de habitantes mayores de 45 años tienen un riesgo significativamente menor de presentar brotes de malaria. Otros autores han explicado este hallazgo porque al incrementar la edad disminuye la frecuencia de infecciones y la parasitemia en áreas endémicas (34).…”

Section: Resultsunclassified

“…En el estudio de Mateus y Carrasquilla (33), tampoco se evidenció una asociación entre las variables de tipo financiero y los brotes de malaria; esto podría deberse a que los municipios no contaban con las capacidades técnicas y administrativas para gestionar los recursos de las transferencias nacionales o a que los efectos de la descentralización probablemente requieren de más tiempo para mostrar resultados.…”

Section: Resultsunclassified

Decentralization and health system reform: What is their impact on malaria incidence in Colombian municipalities?

2012

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Introducción. Colombia es uno de los países de América Latina con mayor incidencia de malaria. El control de la malaria en el país se lleva a cabo en el marco de un programa descentralizado de seguridad social en salud, bajo la responsabilidad de departamentos y municipios. Objetivo. Evaluar el efecto de la descentralización en el contexto del Sistema General de Seguridad Social en Salud, sobre la incidencia de malaria en municipios colombianos. Materiales y métodos. Se realizó un estudio ecológico de tendencia en municipios que notificaron, al menos, cinco casos anuales de malaria en cinco de los siete años del periodo 1998 a 2004, en el cual se solicitó información sobre indicadores de descentralización, afiliación a la seguridad social en salud y casos de malaria a entidades nacionales y a secretarías departamentales y municipales de salud. Se evaluó el comportamiento de las tasas de malaria teniendo en cuenta si el municipio era certificado o no. Se analizaron las medidas repetidas utilizando la ecuación estimada generalizada. Resultados. La certificación (Incidence Rate Ratio, IRR=2,36; IC 95% 1,57-3,56), la proporción de población con necesidades básicas insatisfechas (IRR=9,35; IC 95% 3,66-23,89) y la proporción de población menor de 40 años (IRR=1,18; IC 95% 1,13-1,23) fueron factores asociados con el incremento de la incidencia de malaria en municipios colombianos. Conclusiones. Los factores socioeconómicos y demográficos, además del estado de certificación, se presentan como factores de riesgo para malaria en los municipios colombianos.Palabras clave: malaria, descentralización, sistema de salud, factores de riesgo, Colombia. Decentralization and health system reform: What is their impact on malaria incidence in Colombian municipalities?Introduction. Colombia is one of the Latin-American countries with higher malaria incidence and its control is the responsibility of the departments and municipalities. Objective. To assess the effect of decentralization within the context of the Social Security Health System on the incidence of malaria in Colombian municipalities. Materials and methods. An ecological trend study was carried out in municipalities which reported at least five cases of malaria in 5 of the 7 years between 1998 and 2004. Information on indicators of decentralization of the municipalities, population with health insurance in either the subsidized or contributive regimes as well as incidence of malaria was requested from the health authorities of the departments and municipalities. Socioeconomic and demographic variables were also collected. The behavior of the malaria rates was assessed in relation to the decentralization status of the municipalities. A repeated measure analysis was performed using the generalized estimating equation. Results. The decentralization status of the municipality (IRR=2.36; 95%CI: 1.57-3.56), its proportion of unmet basic needs (IRR=9.35; 95%CI: 3.66-23.89) and of population younger than 40 years of age (IRR=1.8; 95%CI: 1.13-1.23) were associated with malaria inci...

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“…Malaria has declined in all other countries sharing the Amazon Basin. Brazil and Colombia together report more than one-half of the malaria cases in the Americas and have shown efforts in identifying and successfully targeting at-risk populations 13,34–36. A project for malaria in the Andean region across international boundaries was successful in reduction of the disease and reinforced the need for such efforts 37…”

Section: Discussionmentioning

confidence: 99%

Malaria in the Americas: Trends from 1959 to 2011

Carter¹,

Singh²,

Mújica³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Malaria has declined in recent years in countries of the American continents. In 2011, 12 of 21 endemic countries had already met their 2015 Millennium Development Goal. However, this declining trend has not been adequately evaluated. An analysis of the number of cases per 100,000 people (annual parasite index [API]) and the percentage of positive blood slides (slide positivity rate [SPR]) during the period of 1959–2011 in 21 endemic countries was done using the joinpoint regression methodology. During 1960–1979, API and SPR increased significantly and peaked in the 1980s. Since the 1990s, there have been significant declining trends in both API and SPR. Additionally, both Plasmodium vivax and P. falciparum species-specific incidence have declined. With the exception of two countries, such a collectively declining malaria trend was not observed in previous decades. This presents a unique opportunity for the Americas to seriously consider malaria elimination as a final goal.

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Predictors of local malaria outbreaks: an approach to the development of an early warning system in Colombia

Cited by 13 publications

References 23 publications

Predicting factors for malaria re-introduction: an applied model in an elimination setting to prevent malaria outbreaks

Predicting factors for malaria re-introduction: an applied model in an elimination setting to prevent malaria outbreaks

Decentralization and health system reform: What is their impact on malaria incidence in Colombian municipalities?

Malaria in the Americas: Trends from 1959 to 2011

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