How useful are malaria risk maps at the country level? Perceptions of decision-makers in Kenya, Malawi and the Democratic Republic of Congo

Malaria Journal

Jayne Webster¹  Jo Lines¹  Ludovica Ghilardi¹  Jenna Hoyt¹  Linda Nyondo-Mipando²  Chawanangwa Mahebere Chirambo²  Caroline A. Lynch³  George Okello⁴  Robert W. Snow⁵  Fathy Malongo⁶  Justin Parkhurst⁷  Yovitha Sedekia⁸  Jieun Lee⁹ 

[1] Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK;Department of Health Systems and Policy, College of Medicine, University of Malawi, Blantyre, Malawi;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Kenya Medical Research Institute-Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya;Kenya Medical Research Institute-Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, OX3 7LJ, Oxford, UK;Kinshasa School of Public Health, University of Kinshasa, Mont Amba/Lemba, BP 11850 Kin I, Kinshasa, Democratic Republic of Congo;London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK;Mwanza Intervention Trials Unit (MITU)/ National Institute for Medical Research (NIMR)- Mwanza Research Centre, P.O BOX 11936, Isamilo road, Mwanza, Tanzania;World Vision UK, 1rb, 11 Belgrave Rd, Pimlico, SW1V 1RB, London, UK;

关键词: Risk maps;    Pf;    Targeting;    National Malaria Control Programme;    Kenya;    Malawi;    Democratic Republic of Congo;   

DOI  :  10.1186/s12936-020-03425-z

来源: Springer

【 摘 要 】

BackgroundDeclining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated.MethodsA document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps.ResultsThree different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC).ConclusionsMaps were generally used to identify areas with high prevalence in order to implement specific interventions. Despite the availability of national level modelled PfPR maps in all three countries, they were only used in one country. Perceived utility of malaria risk maps was associated with the epidemiological structure of the country and use was driven by perceived need, understanding (quality and relevance), ownership and trust in the data used to develop the maps.

【 授权许可】

CC BY