Performance of passive case detection for malaria surveillance: results from nine countries in Mesoamerica and the Dominican Republic

• Published in: Malaria Journal
• Main Authors: Diego Rios-Zertuche, Keith H. Carter, Katie Panhorst Harris, Max Thom, Maria Paola Zúñiga-Brenes, Pedro Bernal-Lara, Álvaro González-Marmol, Casey K. Johanns, Bernardo Hernández, Erin Palmisano, Rebecca Cogen, Paulami Naik, Charbel El Bcheraoui, David L. Smith, Ali H. Mokdad, Emma Iriarte
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2021
• Subjects: Passive case detection; ABER; Annual blood examination rate; Malaria surveillance; Malaria elimination; Malaria indicators; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-021-03645-x; https://doaj.org/article/0890be9f8fb043259bd9ad11e138bc30

Abstract Background In malaria elimination settings, available metrics for malaria surveillance have been insufficient to measure the performance of passive case detection adequately. An indicator for malaria suspected cases with malaria test (MSCT) is proposed to measure the rate of testing on persons presenting to health facilities who satisfy the definition of a suspected malaria case. This metric does not rely on prior knowledge of fever prevalence, seasonality, or external denominators, and can be used to compare detection rates in suspected cases within and between countries, including across settings with different levels of transmission. Methods To compute the MSCT, an operational definition for suspected malaria cases was established, including clinical and epidemiological criteria. In general, suspected cases included: (1) persons with fever detected in areas with active malaria transmission; (2) persons with fever identified in areas with no active transmission and travel history to, or residence in areas with active transmission (either national or international); and (3) persons presenting with fever, chills and sweating from any area. Data was collected from 9 countries: Belize, Colombia (in areas with active transmission), Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama (September–March 2020). A sample of eligible medical records for 2018 was selected from a sample of health facilities in each country. An algorithm was constructed to assess if a malaria test was ordered or performed for cases that met the suspected case definition. Results A sample of 5873 suspected malaria cases was obtained from 239 health facilities. Except for Nicaragua and Colombia, malaria tests were requested in less than 10% of all cases. More cases were tested in areas with active transmission than areas without cases. Travel history was not systematically recorded in any country. Conclusions A statistically comparable, replicable, and standardized metric was proposed to measure ...