Malaria

The global effort of malaria control is in line with the one world one health concept, but then a globally defined ‘‘one-size-fits-all’’ malaria control strategy would be inefficient in endemic areas. Plasmodium falciparum is the type of malaria parasite that most often causes severe and life-threatening malaria. People get malaria by being bitten by an infective female Anopheles mosquito. Regional malaria elimination campaigns in 1940s followed by the Global Malaria Eradication Program in 1955 did not succeed in eliminating malaria from subSaharan Africa, which accounts for 80% of today’s burden of malaria. The basic reproductive number, Ro, has played a central role in epidemiological theory for malaria and other infectious diseases because it provides an index of transmission intensity and establishes threshold criteria.

Objective

To examine the likely impact of malaria parasite intervention points for a steady state regional control program in endemic areas

Existing EVD surveillance strategies in Sierra Leone use a centralized live alert system to refer suspect cases from the community to Ebola treatment centers. As EVD case burden declined in Port Loko District, so did the number of reported alerts. As EVD presents similarly to malaria, the number of alerts reported are expected to remain consistent with malaria prevalence in malaria-endemic areas, irrespective of a reduction in true EVD cases. Declines in reported suspect cases from the community alluded to the possibility that individuals were returning to healthcare centers to seek treatment for malaria, and that PHUs were not adequately reporting suspect EVD cases. District surveillance officers (DSOs) were used to investigate the usage of PHUs by community members, as well as the mechanisms that health center staff used in recording patient visits. Surveillance methods specific to PHUs were introduced to increase the number of reported EVD alerts, as well as establish the foundation for future integrated disease surveillance response strategies.

Objective

A community-based EVD surveillance system with improved symptom recording and follow-up of malaria positive patients at PHUs was implemented during low EVD transmission. The rationale and methodology in implementing a PHU-focused approach to strengthen surveillance system sensitivity is described.

Port Loko District has had over 1400 confirmed EVD cases during this outbreak. However, transmission declined rapidly in early 2015; by mid-April, a few weeks had passed with no known cases. Simultaneously, reporting of sick persons had plummeted across the district and the number of deaths reported in some areas was fewer than expected. These circumstances signaled the need for the EVD surveillance system to broaden its focus from using district surveillance officers (DSOs) to respond to reports of ill and deceased persons (hereafter, “sick and death alerts”) to a more proactive and comprehensive system that relied strongly on community engagement and surveillance through existing structures such as Peripheral Health Units (PHUs), schools and local authorities. While the involvement of local authorities and the community had been central to reporting suspected EVD cases earlier in the outbreak, the decrease in alerts suggested that engagement was diminishing. The reopening of schools and reemergence of the primary healthcare system provided opportunities to decentralize surveillance and strengthen the involvement of these structures. The primary objective was improving EVD surveillance, but the effort was also used to bolster routine surveillance, in preparation for implementating Integrated Disease Surveillance and Reporting.

Objective

Describe the evolution of Ebola Virus Disease (EVD) surveillance from a largely reactive system structured primarily around responding to reports of illness and death, to one that was more methodical, proactive and comprehensive

Using influenza like illness (ILI) data from the repository held by AFHSC, and publically available malaria data we characterized similarities and differences between military and civilian outbreaks. Pete Riley et al. utilized a similar ILI dataset to investigate civilian and military outbreaks similarity during the 2009 flu epidemic. They found, overall, high similarity between civilian and military outbreaks, with military peaking roughly one week after civilian. Our analysis is meant to extend their analysis temporally, geographically, and to see if such trends hold true for other diseases.

Objective

Compare and contrast military and civilian outbreaks for malaria and influenza like illness to identify indicators for early warning and detection

The estimated incidence of imported malaria in France is about 4,000 cases per year (1). The epidemiological surveillance of malaria in France is mainly based on a hospital laboratory surveillance network, which captures around 50% of cases. There is no comprehensive population surveillance. The SNIIRAM provides data about hospital stays and outpatient drug reimbursements, procedures, examinations and sickness leaves for almost the whole French population(2). We aimed to evaluate the usefulness of the SNIIRAM for implementing epidemiological surveillance of malaria.

Objective

Estimate the accuracy of the French ational ealth nsurance nformation ystem (SNIIRAM) as a support for a nationwide malaria surveillance