TY - JOUR
T1 - What is the value of reactive case detection in malaria control? A case-study in India and a systematic review
AU - Van Eijk, Anna Maria
AU - Ramanathapuram, Lalitha
AU - Sutton, Patrick L.
AU - Kanagaraj, Deena
AU - Sri Lakshmi Priya, G.
AU - Ravishankaran, Sangamithra
AU - Asokan, Aswin
AU - Tandel, Nikunj
AU - Patel, Ankita
AU - Desai, Nisha
AU - Singh, Ranvir
AU - Sullivan, Steven A.
AU - Carlton, Jane M.
AU - Srivastava, H. C.
AU - Eapen, Alex
N1 - Funding Information:
We would like to thank the staff of the malaria clinics in Besant Nagar clinic, Chennai, and Civil Hospital, Nadiad, for their help. We thank the NIMR staff at the Chennai, Nadiad and Delhi sites for their support, specifically N Bhaskar and B Reeta for screening blood smears, G Balaji, V Sangeetha, V Vaishanavi Pavithra, Paresh Rana, and Jay Joshi for data entry. The Director of NIMR Neena Valecha is thanked for her management and support of the Center for the Study of Complex Malaria in India. Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number U19AI089676 as part of the International Centers for Excellence in Malaria Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This manuscript bears the NIMR (Indian Council of Medical Research) publication screening committee approval number 1\2016.
Publisher Copyright:
© 2016 van Eijk et al.
PY - 2016/2/6
Y1 - 2016/2/6
N2 - Background: Reactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries. Methods: RCD programmes were piloted in two urban areas of India with a low prevalence of mainly Plasmodium vivax malaria in 2014. Cases were identified in a clinic by microscopy and contacts were screened within 2 weeks; PCR, in addition to microscopy, was used to detect Plasmodium parasites. A systematic review was conducted to identify RCD experiences in the literature. Results: In Chennai, 868 contacts were enrolled for 18 index cases of clinical malaria; in Nadiad, 131 contacts were enrolled for 20 index cases. No new malaria infections were detected in Nadiad among contacts, and four new infections were detected in Chennai (three P. vivax and one Plasmodium falciparum), of which two were among household members of index cases. An additional five studies describing results from an RCD strategy were identified in the literature: Four in Africa and one in Thailand. Including the results from India, the average number of contacts screened per index case in a total of seven studies ranged from four to 50, and 126 in a case study in Thailand with one index case. Malaria was detected in 0-45 % of the contacted persons. The average number of index cases needed to be traced to find one new case of malaria ranged from one to five, and could not be assessed in one study in India (no contacts positive for 20 cases). Sharing the household with an index case was associated with a five-fold increased risk of malaria compared to contacts from households without an index case (pooled risk ratio 5.29, 95 % CI 3.31-8.47, I2 0 %, four studies). Conclusions: RCD in areas of low malaria transmission is a labour-intensive strategy, and its benefit is not clear. Studies are needed to assess how RCD can be optimized or into alternatives where interventions are targeted to family members or hotspots.
AB - Background: Reactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries. Methods: RCD programmes were piloted in two urban areas of India with a low prevalence of mainly Plasmodium vivax malaria in 2014. Cases were identified in a clinic by microscopy and contacts were screened within 2 weeks; PCR, in addition to microscopy, was used to detect Plasmodium parasites. A systematic review was conducted to identify RCD experiences in the literature. Results: In Chennai, 868 contacts were enrolled for 18 index cases of clinical malaria; in Nadiad, 131 contacts were enrolled for 20 index cases. No new malaria infections were detected in Nadiad among contacts, and four new infections were detected in Chennai (three P. vivax and one Plasmodium falciparum), of which two were among household members of index cases. An additional five studies describing results from an RCD strategy were identified in the literature: Four in Africa and one in Thailand. Including the results from India, the average number of contacts screened per index case in a total of seven studies ranged from four to 50, and 126 in a case study in Thailand with one index case. Malaria was detected in 0-45 % of the contacted persons. The average number of index cases needed to be traced to find one new case of malaria ranged from one to five, and could not be assessed in one study in India (no contacts positive for 20 cases). Sharing the household with an index case was associated with a five-fold increased risk of malaria compared to contacts from households without an index case (pooled risk ratio 5.29, 95 % CI 3.31-8.47, I2 0 %, four studies). Conclusions: RCD in areas of low malaria transmission is a labour-intensive strategy, and its benefit is not clear. Studies are needed to assess how RCD can be optimized or into alternatives where interventions are targeted to family members or hotspots.
KW - Malaria
KW - Plasmodium falciparum
KW - Plasmodium vivax
KW - Reactive case detection
KW - Surveillance
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U2 - 10.1186/s12936-016-1120-1
DO - 10.1186/s12936-016-1120-1
M3 - Review article
C2 - 26852118
AN - SCOPUS:84957604983
SN - 1475-2875
VL - 15
JO - Malaria Journal
JF - Malaria Journal
IS - 1
M1 - 67
ER -