ArticleMalaria journal2024
Evaluation of malaria outbreak detection methods, Uganda, 2022.
Article in Malaria journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 10 citations in OpenAlex.
- Effect of cumulative exposure to media channels for malaria messages on knowledge of malaria prevention among women (15-49 years) in Uganda.Malaria journal · 2026Article
- Quantifying the Role of Importation on Sustained Malaria Transmission in a Low-to-Moderate Burden Region of Southwest Uganda.The Journal of infectious diseases · 2026Article
- Individual and population level uncertainty interact to determine the performance of outbreak surveillance systems.PLoS computational biology · 2026Article
- Household and community-based approaches to malaria and cholera prevention: A narrative review with case studies from Uganda and Mozambique.PLoS neglected tropical diseases · 2026Review
- Comparison of ARIMA and FB-Prophet time series models for the prediction of national and regional malaria incidence in Uganda.Malaria journal · 2025Article
- Malaria epidemics and its drivers in Uganda in 2022.Malaria journal · 2025Article
- Unleashing the power of intelligence: revolutionizing malaria outbreak preparedness with an advanced warning system in Benin, West Africa.Archives of public health = Archives belges de sante publique · 2025Article
- Implementation of an infection prevention and control response strategy to combat the Sudan Virus Disease outbreak in an urban setting, the Kampala Metropolitan area, Uganda, 2022.BMC infectious diseases · 2025Article
- Article
- Experience of healthcare personnel on Co-payment mechanism and the implications on its use in private drug outlets in Uganda.PloS one · 2024Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMalaria outbreaks are detected by applying the World Health Organization (WHO)-recommended thresholds (the less sensitive 75th percentile or mean + 2 standard deviations [2SD] for medium-to high-transmission areas, and the more sensitive cumulative sum [C-SUM] method for low and very low-transmission areas). During 2022, > 50% of districts in Uganda were in an epidemic mode according to the 75th percentile method used, resulting in a need to restrict national response to districts with the highest rates of complicated malaria. The three threshold approaches were evaluated to compare their outbreak-signaling outputs and help identify prioritization approaches and method appropriateness across Uganda.
methodsThe three methods were applied as well as adjusted approaches (85th percentile and C-SUM + 2SD) for all weeks in 2022 for 16 districts with good reporting rates ( ≥ 80%). Districts were selected from regions originally categorized as very low, low, medium, and high transmission; district thresholds were calculated based on 2017-2021 data and re-categorized them for this analysis.
resultsUsing district-level data to categorize transmission levels resulted in re-categorization of 8/16 districts from their original transmission level categories. In all districts, more outbreak weeks were detected by the 75th percentile than the mean + 2SD method (p < 0.001). For all 9 very low or low-transmission districts, the number of outbreak weeks detected by C-SUM were similar to those detected by the 75th percentile. On adjustment of the 75th percentile method to the 85th percentile, there was no significant difference in the number of outbreak weeks detected for medium and low transmission districts. The number of outbreak weeks detected by C-SUM + 2SD was similar to those detected by the mean + 2SD method for all districts across all transmission intensities.
conclusionDistrict data may be more appropriate than regional data to categorize malaria transmission and choose epidemic threshold approaches. The 75th percentile method, meant for medium- to high-transmission areas, was as sensitive as C-SUM for low- and very low-transmission areas. For medium and high-transmission areas, more outbreak weeks were detected with the 75th percentile than the mean + 2SD method. Using the 75th percentile method for outbreak detection in all areas and the mean + 2SD for prioritization of medium- and high-transmission areas in response may be helpful.
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