PLoS Med. 2011 Jan 25;8(1):e1000400. doi: 10.1371/journal.pmed.1000400.
Monitoring, evaluation, and surveillance measure how well public health programs operate over time and achieve their goals. As countries approach malaria elimination, these activities will need to shift from measuring reductions in morbidity and mortality, to detecting infections (with or without symptoms) and measuring transmission. Thus, the monitoring and evaluation and surveillance research and development agenda needs to develop the tools and strategies that will replace passive surveillance of morbidity with active and prompt detection of infection, including confirmation of interruption of transmission by detecting present and past infections, particularly in mobile populations. The capacity to assess trends and respond without delay will need to be developed, so that surveillance itself becomes an intervention. Research is also needed to develop sensitive field tests that can detect low levels of parasitaemia, together with strategies for their implementation. Other areas to explore include the rigorous evaluation of the utility of more detailed maps of disease and infection incidence and prevalence, the development of new maps to inform programmatic responses and the use of surveillance technologies based on cell phone or real-time internet Web-based reporting. Because any new strategies for monitoring and evaluation and surveillance for eradication have major implications for program implementation, research is also needed to test systems of delivery for acceptability, feasibility, efficiency, cost-effectiveness, and community engagement. Finally, there is a clear need to systematically review the information from past elimination efforts for malaria and other infectious diseases.
监测、评估和监测措施可衡量公共卫生计划随着时间的推移的运行情况以及实现其目标的程度。随着各国接近消除疟疾，这些活动将需要从衡量发病率和死亡率的降低，转变为检测感染（有症状和无症状）和衡量传播。因此，监测、评估和监测研究与开发议程需要开发工具和策略，用主动和及时地检测感染来替代对发病率的被动监测，包括通过检测当前和过去的感染来确认传播的中断，特别是在流动人口中。需要发展评估趋势和及时作出反应的能力，以便监测本身成为一种干预措施。还需要开展研究，开发能够检测到低水平寄生虫血症的敏感现场检测方法，并制定实施这些方法的战略。其他需要探索的领域包括严格评估更详细的疾病和感染发病率和流行地图的实用性，开发新地图以告知规划应对措施以及利用基于手机或实时互联网的基于网络的报告的监测技术。由于任何新的监测、评估和监测消灭疟疾和其他传染病的策略都对方案执行有重大影响，因此还需要开展研究，测试可接受性、可行性、效率、成本效益和社区参与度的交付系统。最后，显然需要系统地审查过去消灭疟疾和其他传染病的努力所产生的信息。
