ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Active Case Finding for Malaria: A 3-Year National Evaluation of Optimal Approaches to Detect Infections and Hotspots Through Reactive Case Detection in the Low-transmission Setting of Eswatini.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 6 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Detection of Plasmodium in Anopheles spp (Diptera: Nematocera: Culicidae) using molecular biology techniques: a systematic review.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Pooled it
- Reactive Case Detection and Treatment and Reactive Drug Administration for Reducing Malaria Transmission: A Systematic Review and Meta-Analysis.The American journal of tropical medicine and hygiene · 2024Pooled it
- A Review of the Ring Trial Design for Evaluating Ring Interventions for Infectious Diseases.Epidemiologic reviews · 2022Pooled it
- A Systematic Review and Meta-Analysis of Malaria Test Positivity Outcomes and Programme Interventions in Low Transmission Settings in Southern Africa, 2000-2021.International journal of environmental research and public health · 2022Pooled it
- Effectiveness of spatially targeted interventions for control of HIV, tuberculosis, leprosy and malaria: a systematic review.BMJ open · 2021Pooled it
- Pooled it
- Trial
- Effectiveness and cost-effectiveness of reactive, targeted indoor residual spraying for malaria control in low-transmission settings: a cluster-randomised, non-inferiority trial in South Africa.Lancet (London, England) · 2021Trial
- Effectiveness of reactive focal mass drug administration and reactive focal vector control to reduce malaria transmission in the low malaria-endemic setting of Namibia: a cluster-randomised controlled, open-label, two-by-two factorial design trial.Lancet (London, England) · 2020Trial
- Community perspective on feasibility of malaria mass drug administration: a qualitative evidence from the Eastern Region of Ghana.Malaria journal · 2026Article
- Malaria antibody responses augment surveillance in low-transmission settings in the Upper River Region, the Gambia.Frontiers in epidemiology · 2026Article
- Adapting reactive case detection strategies for high-risk populations to increase malaria infection detection in Aceh Province, Indonesia.PLOS global public health · 2026Article
- Sensitive near point-of-care detection of asymptomatic and submicroscopic Plasmodium falciparum infections in African endemic countries.Nature communications · 2025Article
- Asymptomatic malaria infections and associated risk factors in malaria-eliminating settings of Nong District, Savannakhet Province, Lao People's Democratic Republic.Tropical medicine and health · 2025Article
- Integrating forest data and health facility surveys to optimise risk-based malaria surveillance in the Philippines.Frontiers in public health · 2025Article
- Implementation and fidelity of reactive surveillance and response strategies for malaria elimination: a systematic review and meta-analysis.BMJ public health · 2025Article
- The emergence of artemisinin partial resistance in Africa: how do we respond?The Lancet. Infectious diseases · 2024Review
- Reactive Case Detection Strategy for Malaria Control and Elimination: A 12 Year Systematic Review and Meta-Analysis from 25 Malaria-Endemic Countries.Tropical medicine and infectious disease · 2023Review
- Article
- The impact of reactive case detection on malaria transmission in Zanzibar in the presence of human mobility.Epidemics · 2022Article
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundReactive case detection (RACD) is a widely practiced malaria elimination intervention whereby close contacts of index cases receive malaria testing to inform treatment and other interventions. However, the optimal diagnostic and operational approaches for this resource-intensive strategy are not clear.
methodsWe conducted a 3-year prospective national evaluation of RACD in Eswatini, a malaria elimination setting. Loop-mediated isothermal amplification (LAMP) was compared to traditional rapid diagnostic testing (RDT) for the improved detection of infections and for hotspots (RACD events yielding ≥1 additional infection). The potential for index case-, RACD-, and individual-level factors to improve efficiencies was also evaluated.
resultsAmong 377 RACD events, 10 890 participants residing within 500 m of index cases were tested. Compared to RDT, LAMP provided a 3-fold and 2.3-fold higher yield to detect infections (1.7% vs 0.6%) and hotspots (29.7% vs 12.7%), respectively. Hotspot detection improved with ≥80% target population coverage and response times within 7 days. Proximity to the index case was associated with a dose-dependent increased infection risk (up to 4-fold). Individual-, index case-, and other RACD-level factors were considered but the simple approach of restricting RACD to a 200-m radius maximized yield and efficiency.
conclusionsWe present the first large-scale national evaluation of optimal RACD approaches from a malaria elimination setting. To inform delivery of antimalarial drugs or other interventions, RACD, when conducted, should utilize more sensitive diagnostics and clear context-specific operational parameters. Future studies of RACD's impact on transmission may still be needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.