ArticleBMC infectious diseases2022
A framework for evaluating health system surveillance sensitivity to support public health decision-making for malaria elimination: a case study from Indonesia.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- High resolution physically based modelling reveals malaria incidence reduction by vector control measures.Scientific reports · 2026Article
- Evidence-based decision making for malaria elimination applying the Freedom From Infection statistical framework in five malaria eliminating countries: an observational study.The Lancet. Global health · 2025Observational
- Malaria and determinants of health: a scoping review of malaria vulnerabilities in Southeast Asia.Tropical medicine and health · 2025Review
- Applying novel Plasmodium Vivax serological exposure markers to quantify residual malaria transmission in the Philippines through repeated health facility surveys: the SMaRT study protocol.BMC infectious diseases · 2025Article
- Incorporating Community Case Management in Risk-Based Surveillance for Malaria Elimination in the Dominican Republic.The American journal of tropical medicine and hygiene · 2025Article
- Freedom from infection: enhancing decision-making for malaria elimination.BMJ global health · 2024Article
- Utility of surveillance data for planning for dengue elimination in Yogyakarta, Indonesia: a scenario-tree modelling approach.BMJ global health · 2023Article
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10 authors.
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Abstract
backgroundThe effectiveness of a surveillance system to detect infections in the population is paramount when confirming elimination. Estimating the sensitivity of a surveillance system requires identifying key steps in the care-seeking cascade, from initial infection to confirmed diagnosis, and quantifying the probability of appropriate action at each stage. Using malaria as an example, a framework was developed to estimate the sensitivity of key components of the malaria surveillance cascade.
methodsParameters to quantify the sensitivity of the surveillance system were derived from monthly malaria case data over a period of 36 months and semi-quantitative surveys in 46 health facilities on Java Island, Indonesia. Parameters were informed by the collected empirical data and estimated by modelling the flow of an infected individual through the system using a Bayesian framework. A model-driven health system survey was designed to collect empirical data to inform parameter estimates in the surveillance cascade.
resultsHeterogeneity across health facilities was observed in the estimated probability of care-seeking (range = 0.01-0.21, mean ± sd = 0.09 ± 0.05) and testing for malaria (range = 0.00-1.00, mean ± sd = 0.16 ± 0.29). Care-seeking was higher at facilities regularly providing antimalarial drugs (Odds Ratio [OR] = 2.98, 95% Credible Intervals [CI]: 1.54-3.16). Predictably, the availability of functioning microscopy equipment was associated with increased odds of being tested for malaria (OR = 7.33, 95% CI = 20.61).
conclusionsThe methods for estimating facility-level malaria surveillance sensitivity presented here can help provide a benchmark for what constitutes a strong system. The proposed approach also enables programs to identify components of the health system that can be improved to strengthen surveillance and support public-health decision-making.
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