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Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System.

Publication ,  Journal Article
Khandekar, E; Kramer, R; Ali, AS; Al-Mafazy, A-W; Egger, JR; LeGrand, S; Mkali, HR; McKay, M; Ngondi, JM
Published in: The American journal of tropical medicine and hygiene
February 2019

As countries transition toward malaria elimination, malaria programs rely on surveillance-response systems, which are often supported by web- and mobile phone-based reporting tools. Such surveillance-response systems are interventions for elimination, making it important to determine if they are operating optimally. A metric to measure this by is timeliness. This study used a mixed-methods approach to investigate the response time of Zanzibar's malaria elimination surveillance-response system, Malaria Case Notification (MCN). MCN conducts both passive and reactive case detection, supported by a mobile phone-based reporting tool called Coconut Surveillance. Using data obtained from RTI International and the Zanzibar Malaria Elimination Program (ZAMEP), analysis of summary statistics was conducted to investigate the association of response time with geography, and time series techniques were used to investigate trends in response time and its association with the number of reported cases. Results indicated that response time varied by the district in Zanzibar (0.6-6.05 days) and that it was not associated with calendar time or the number of reported cases. Survey responses and focus groups with a cadre of health workers, district malaria surveillance officers, shed light on operational challenges faced during case investigation, such as incomplete health records and transportation issues, which stem from deficiencies in aspects of ZAMEP's program management. These findings illustrate that timely response for malaria elimination depends on effective program management, despite the automation of web-based or mobile phone-based tools. For surveillance-response systems to work optimally, malaria programs should ensure that optimal management practices are in place.

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Published In

The American journal of tropical medicine and hygiene

DOI

EISSN

1476-1645

ISSN

0002-9637

Publication Date

February 2019

Volume

100

Issue

2

Start / End Page

256 / 263

Related Subject Headings

  • Tropical Medicine
  • Time Factors
  • Telemedicine
  • Tanzania
  • Mosquito Nets
  • Malaria
  • Humans
  • Health Personnel
  • Epidemiological Monitoring
  • Disease Notification
 

Citation

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Chicago
ICMJE
MLA
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Khandekar, E., Kramer, R., Ali, A. S., Al-Mafazy, A.-W., Egger, J. R., LeGrand, S., … Ngondi, J. M. (2019). Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System. The American Journal of Tropical Medicine and Hygiene, 100(2), 256–263. https://doi.org/10.4269/ajtmh.17-0546
Khandekar, Eeshan, Randall Kramer, Abdullah S. Ali, Abdul-Wahid Al-Mafazy, Joseph R. Egger, Sara LeGrand, Humphrey R. Mkali, Michael McKay, and Jeremiah M. Ngondi. “Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System.The American Journal of Tropical Medicine and Hygiene 100, no. 2 (February 2019): 256–63. https://doi.org/10.4269/ajtmh.17-0546.
Khandekar E, Kramer R, Ali AS, Al-Mafazy A-W, Egger JR, LeGrand S, et al. Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System. The American journal of tropical medicine and hygiene. 2019 Feb;100(2):256–63.
Khandekar, Eeshan, et al. “Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System.The American Journal of Tropical Medicine and Hygiene, vol. 100, no. 2, Feb. 2019, pp. 256–63. Epmc, doi:10.4269/ajtmh.17-0546.
Khandekar E, Kramer R, Ali AS, Al-Mafazy A-W, Egger JR, LeGrand S, Mkali HR, McKay M, Ngondi JM. Evaluating Response Time in Zanzibar's Malaria Elimination Case-Based Surveillance-Response System. The American journal of tropical medicine and hygiene. 2019 Feb;100(2):256–263.

Published In

The American journal of tropical medicine and hygiene

DOI

EISSN

1476-1645

ISSN

0002-9637

Publication Date

February 2019

Volume

100

Issue

2

Start / End Page

256 / 263

Related Subject Headings

  • Tropical Medicine
  • Time Factors
  • Telemedicine
  • Tanzania
  • Mosquito Nets
  • Malaria
  • Humans
  • Health Personnel
  • Epidemiological Monitoring
  • Disease Notification