Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Malar J. 2021 Mar 8;20(1):139. doi: 10.1186/s12936-021-03656-8.
Malaria control system (MCS), an Information technology (IT)-driven surveillance and monitoring intervention is being adopted for elimination of malaria in Mangaluru city, Karnataka, India since October 2015. This has facilitated 'smart surveillance' followed by required field response within a timeline. The system facilitated data collection of individual case, data driven mapping and strategies for malaria elimination programme. This paper aims to present the analysis of post-digitization data of 5 years, discuss the current operational functionalities of MCS and its impact on the malaria incidence.
IT system developed for robust malaria surveillance and field response is being continued in the sixth year. Protocol for surveillance control was followed as per the national programme guidelines mentioned in an earlier publication. Secondary data from the malaria control system was collated and analysed. Incidence of malaria, active surveillance, malariogenic conditions and its management, malariometric indices, shrinking malaria maps were also analysed.
Smart surveillance and subsequent response for control was sustained and performance improved in five years with participation of all stakeholders. Overall malaria incidence significantly reduced by 83% at the end of 5 years when compared with year of digitization (DY) (p < 0.001). Early reporting of new cases (within 48 h) was near total followed by complete treatment and vector control. Slide positivity rate (SPR) decreased from 10.36 (DY) to 6.5 (PDY 5). Annual parasite incidence (API) decreased from 16.17 (DY) to 2.64 (PDY 5). There was a negative correlation between contact smears and incidence of malaria. Five-year data analyses indicated declining trends in overall malaria incidence and correlation between closures by 14 days. The best impact on reduction in incidence of malaria was recorded in the pre-monsoon months (~ 85%) compared to lower impact in July-August months (~ 40%).
MCS helped to micromanage control activities, such as robust reporting, incidence-centric active surveillance, early and complete treatment, documentation of full treatment of each malaria patient, targeted mosquito control measures in houses surrounding reported cases. The learnings and analytical output from the data helped to modify strategies for control of both disease and the vector, heralding the city into the elimination stage.
自 2015 年 10 月以来，印度卡纳塔克邦芒格洛尔市一直在采用疟疾控制系统（MCS）作为消除疟疾的信息技术（IT）驱动的监测和监控干预措施。这促进了“智能监测”，并在规定时间内进行了必要的现场响应。该系统有助于收集个别病例的数据、数据驱动的绘图以及消除疟疾规划的策略。本文旨在介绍 5 年数字化后数据的分析，讨论 MCS 的当前运行功能及其对疟疾发病率的影响。
用于稳健疟疾监测和现场响应的 IT 系统在第六年继续使用。按照之前发表的国家规划指南中的规定，遵循了监测控制方案。从疟疾控制系统中收集和分析了次要数据。还分析了疟疾发病率、主动监测、疟原虫条件及其管理、疟原虫指数、缩小的疟疾地图。
通过所有利益相关者的参与，智能监测和随后的控制反应得以维持，并在五年内得到改善。与数字化当年（DY）相比，五年后疟疾总发病率显著降低（p<0.001）。新病例的早期报告（48 小时内）几乎全部完成，随后完成了治疗和病媒控制。幻灯片阳性率（SPR）从 10.36（DY）下降到 6.5（PDY5）。年寄生虫发病率（API）从 16.17（DY）下降到 2.64（PDY5）。接触涂片与疟疾发病率之间存在负相关。五年数据分析表明，疟疾总发病率呈下降趋势，且在 14 天内关闭的相关性。前季风月份对降低疟疾发病率的影响最大（85%），而 7 月至 8 月的影响较小（40%）。
MCS 有助于微观管理控制活动，如强大的报告、以发病率为中心的主动监测、早期和完整的治疗、记录每个疟疾患者的完整治疗、在报告病例周围的房屋中实施有针对性的蚊虫控制措施。从数据中获得的经验和分析结果有助于修改疾病和病媒控制策略，预示着该市进入消除阶段。
