Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti
Abstract Background As in most eliminating countries, malaria transmission is highly focal in Haiti. More granular information, including identifying asymptomatic infections, is needed to inform programmatic efforts, monitor intervention effectiveness, and identify remaining foci. Easy access group...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-06-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12916-020-01611-z |
| _version_ | 1811206635485396992 |
|---|---|
| author | Thomas Druetz Gillian Stresman Ruth A. Ashton Lotus L. van den Hoogen Vena Joseph Carl Fayette Frank Monestime Karen E. Hamre Michelle A. Chang Jean F. Lemoine Chris Drakeley Thomas P. Eisele |
| author_facet | Thomas Druetz Gillian Stresman Ruth A. Ashton Lotus L. van den Hoogen Vena Joseph Carl Fayette Frank Monestime Karen E. Hamre Michelle A. Chang Jean F. Lemoine Chris Drakeley Thomas P. Eisele |
| author_sort | Thomas Druetz |
| collection | DOAJ |
| description | Abstract Background As in most eliminating countries, malaria transmission is highly focal in Haiti. More granular information, including identifying asymptomatic infections, is needed to inform programmatic efforts, monitor intervention effectiveness, and identify remaining foci. Easy access group (EAG) surveys can supplement routine surveillance with more granular information on malaria in a programmatically tractable way. This study assessed how and which type of venue for EAG surveys can improve understanding malaria epidemiology in two regions with different transmission profiles. Methods EAG surveys were conducted within the departments of Artibonite and Grand’Anse (Haiti), in regions with different levels of transmission intensity. Surveys were conducted in three venue types: primary schools, health facilities, and churches. The sampling approach varied accordingly. Individuals present at the venues at the time of the survey were eligible whether they presented malaria symptoms or not. The participants completed a questionnaire and were tested for Plasmodium falciparum by a highly sensitive rapid diagnostic test (hsRDT). Factors associated with hsRDT positivity were assessed by negative binomial random-effects regression models. Results Overall, 11,029 individuals were sampled across 39 venues in Artibonite and 41 in Grand’Anse. The targeted sample size per venue type (2100 in Artibonite and 2500 in Grand’Anse) was reached except for the churches in Artibonite, where some attendees left the venue before they could be approached or enrolled. Refusal rate and drop-out rate were < 1%. In total, 50/6003 (0.8%) and 355/5026 (7.1%) sampled individuals were hsRDT positive in Artibonite and Grand’Anse, respectively. Over half of all infections in both regions were identified at health facilities. Being male and having a current or reported fever in the previous 2 weeks were consistently identified with increased odds of being hsRDT positive. Conclusions Surveys in churches were problematic because of logistical and recruitment issues. However, EAG surveys in health facilities and primary schools provided granular information about malaria burden within two departments in Haiti. The EAG surveys were able to identify residual foci of transmission that were missed by recent national surveys. Non-care seeking and/or asymptomatic malaria infections can be identified in this alternative surveillance tool, facilitating data-driven decision-making for improved targeting of interventions. |
| first_indexed | 2024-04-12T03:51:30Z |
| format | Article |
| id | doaj.art-21aeee9cd25246b48aa9856ba36fd972 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-12T03:51:30Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-21aeee9cd25246b48aa9856ba36fd9722022-12-22T03:48:58ZengBMCBMC Medicine1741-70152020-06-0118111410.1186/s12916-020-01611-zProgrammatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in HaitiThomas Druetz0Gillian Stresman1Ruth A. Ashton2Lotus L. van den Hoogen3Vena Joseph4Carl Fayette5Frank Monestime6Karen E. Hamre7Michelle A. Chang8Jean F. Lemoine9Chris Drakeley10Thomas P. Eisele11Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical MedicineDepartment of Infection Biology, London School of Hygiene & Tropical MedicineCenter for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical MedicineCenter for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical MedicineCenter for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical MedicineIMA World HealthIMA World HealthMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and PreventionMalaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and PreventionProgramme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population (MSPP)Department of Infection Biology, London School of Hygiene & Tropical MedicineCenter for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical MedicineAbstract Background As in most eliminating countries, malaria transmission is highly focal in Haiti. More granular information, including identifying asymptomatic infections, is needed to inform programmatic efforts, monitor intervention effectiveness, and identify remaining foci. Easy access group (EAG) surveys can supplement routine surveillance with more granular information on malaria in a programmatically tractable way. This study assessed how and which type of venue for EAG surveys can improve understanding malaria epidemiology in two regions with different transmission profiles. Methods EAG surveys were conducted within the departments of Artibonite and Grand’Anse (Haiti), in regions with different levels of transmission intensity. Surveys were conducted in three venue types: primary schools, health facilities, and churches. The sampling approach varied accordingly. Individuals present at the venues at the time of the survey were eligible whether they presented malaria symptoms or not. The participants completed a questionnaire and were tested for Plasmodium falciparum by a highly sensitive rapid diagnostic test (hsRDT). Factors associated with hsRDT positivity were assessed by negative binomial random-effects regression models. Results Overall, 11,029 individuals were sampled across 39 venues in Artibonite and 41 in Grand’Anse. The targeted sample size per venue type (2100 in Artibonite and 2500 in Grand’Anse) was reached except for the churches in Artibonite, where some attendees left the venue before they could be approached or enrolled. Refusal rate and drop-out rate were < 1%. In total, 50/6003 (0.8%) and 355/5026 (7.1%) sampled individuals were hsRDT positive in Artibonite and Grand’Anse, respectively. Over half of all infections in both regions were identified at health facilities. Being male and having a current or reported fever in the previous 2 weeks were consistently identified with increased odds of being hsRDT positive. Conclusions Surveys in churches were problematic because of logistical and recruitment issues. However, EAG surveys in health facilities and primary schools provided granular information about malaria burden within two departments in Haiti. The EAG surveys were able to identify residual foci of transmission that were missed by recent national surveys. Non-care seeking and/or asymptomatic malaria infections can be identified in this alternative surveillance tool, facilitating data-driven decision-making for improved targeting of interventions.http://link.springer.com/article/10.1186/s12916-020-01611-zConvenience samplePlasmodium falciparumEpidemiologySurveillance |
| spellingShingle | Thomas Druetz Gillian Stresman Ruth A. Ashton Lotus L. van den Hoogen Vena Joseph Carl Fayette Frank Monestime Karen E. Hamre Michelle A. Chang Jean F. Lemoine Chris Drakeley Thomas P. Eisele Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti BMC Medicine Convenience sample Plasmodium falciparum Epidemiology Surveillance |
| title | Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti |
| title_full | Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti |
| title_fullStr | Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti |
| title_full_unstemmed | Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti |
| title_short | Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti |
| title_sort | programmatic options for monitoring malaria in elimination settings easy access group surveys to investigate plasmodium falciparum epidemiology in two regions with differing endemicity in haiti |
| topic | Convenience sample Plasmodium falciparum Epidemiology Surveillance |
| url | http://link.springer.com/article/10.1186/s12916-020-01611-z |
| work_keys_str_mv | AT thomasdruetz programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT gillianstresman programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT ruthaashton programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT lotuslvandenhoogen programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT venajoseph programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT carlfayette programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT frankmonestime programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT karenehamre programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT michelleachang programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT jeanflemoine programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT chrisdrakeley programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti AT thomaspeisele programmaticoptionsformonitoringmalariaineliminationsettingseasyaccessgroupsurveystoinvestigateplasmodiumfalciparumepidemiologyintworegionswithdifferingendemicityinhaiti |