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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