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Table 3 Tailoring malaria surveillance to phases along the spectrum of endemicity*§:

From: Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands

Surveillance tools Control phase
Intense stable endemic (hyper-holoendemic)
Intensified
Control phase
Moderate stable endemic
(mesoendemic)
Elimination phase
Unstable endemic
(hypoendemic/
outbreak risk)
Elimination phase Non-endemic, disease free
(outbreak risk)
Case finding
and treatment
PCD and standard treatment protocol PCD and standard treatment protocol PLUS Baseline
MBS with radical treatment (with
G6PD testing or
DOTs) and transmission risk mapping/coverage mapping
PCD and standard treatment protocol
PLUS 'Reactive'
case detection/case investigation with targeted/localised
MDA (particularly
in context of low parasitaemia/low prevalence)
PCD and standard treatment protocol PLUS 'Reactive'
case detection/case investigation with targeted/localised MDA PLUS Maintenance phase periodic survey of age stratified serology to confirm disease free status
Entomology Resistance
monitoring and evaluation of effectiveness of
vector control interventions
Resistance
monitoring and evaluation of effectiveness of
vector control interventions
Regular
entomological
surveys to
monitor
resistance
development,
effectiveness of
integrated vector
control interventions
and vector behaviour
Maintenance entomological
surveys
Border
surveillance
Not indicated Not indicated Targeted sub-
national border surveillance
based on
transmission
data (i.e. use only
if transmission is a
result of mobility
and repeated re-introduction rather
than from persistent indigenous foci)
National level
border surveillance
Community engagement Education and engagement of
influential
community-based structures to
encourage early treatment-seeking
for fever
Education and engagement of influential
community-based structures to
encourage early treatment-seeking
for fever PLUS participatory
vector surveillance activities
'Eyes and ears'
approach for early treatment-seeking/
case reporting
PLUS participatory
vector surveillance
PLUS Feedback of surveillance data to communities to
maintain motivation
(consider incentives
for community case identification in final
push to eliminate**)
Incentives for
case identification** PLUS participatory vector surveillance during elimination
and maintenance
PLUS Feedback of surveillance data to community (+/-
SMS technology)
  1. *Endemicity classifications adapted from Hay et al. 2008; §Surveillance tools recommended across the spectrum of endemicity adapted from recommendations by malERA Consultative Group on Monitoring, Evaluation, and Surveillance; MBS - Mass blood survey; DOT - Directly observed treatment; MDA - Mass drug administration; PCD - Passive case detection; ACD - Active case detection; RDT - Rapid Diagnostic Test; G6PD - Glucose- 6 -phosphate dehrogenase; SMS - Short Message Service; ** Incentives may be non monetory