Digitized smart surveillance and micromanagement using information technology for malaria elimination in Mangaluru, India: an analysis of five-year post-digitization data

Abstract

Background 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. Methods 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. Results 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%). Conclusion 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.

Impact of the malaria comprehensive case management programme in Odisha, India

“…This is consistent with the WHO Technical Strategy to transform malaria surveillance into a key intervention [30]. Consequently, the introduction of timely and accurate data collection and analysis will be essential in achieving India's malaria elimination goals [7,31]. The CCMP also employed MSAT successfully in difficult-to-reach areas.…”

“…Initially, EDCT is targeted at reducing morbidity and mortality, but ultimately aims to eliminate malaria by interrupting transmission through early identification of all cases and ensuring complete treatment of infected individuals. Programs and operational studies aimed at improving EDCT for malaria case reduction and elimination have been conducted in varies locations in India and other malaria endemic countries [2,[4][5][6][7][8][9][10][11]. However, although there are commonalities in community-based organisation and the available tools, the political, cultural, geographical and economic challenges are often unique to the region and require the design and testing of specific interventions.…”

Development and On-Field Deployment of a Mobile-Based Application ‘MoSQuIT’ for Malaria Surveillance in International Border Districts of Northeast India—Challenges and Opportunities

“…The use of digital platforms in the surveillance of vector-borne diseases like malaria is not new [ 6 ]. In India, the malaria control system (MCS) used in Mangaluru city, Karnataka, was able to document a significant reduction in malaria incidence in terms of slide positivity rate (SPR) and annual parasite incidence (API) over five years, during which, the system was employed [ 7 ]. Similarly, the Solution for Community Health Workers (SOCH) mobile application deployed in the Mandla district of Madhya Pradesh documented a 91% reduction of indigenous malaria cases in the district [ 8 ].…”

“…Since 2015, the Malaria Control System (MCS) has been used in Mangaluru, Karnataka, for malaria data collection, mapping and monitoring activities, and has demonstrated sustained reduction in malaria incidence over five years. This system collects surveillance data through an Android tablet with in-built geographical information system (GIS) tagging and transmits the data, which can be accessed through a web-based system [ 7 ]. Similarly, a mobile application tool known as SOCH (Solution for Community Health Workers) was implemented in 2017 for real-time malaria surveillance and reporting in the Mandla district of Madhya Pradesh [ 8 ].…”

The Effect of Socioeconomic Factors and Indoor Residual Spraying on Malaria in Mangaluru, India: A Case-Control Study

“…In 2015-2017, Mangaluru contributed half of all malaria cases in the state of Karnataka, which itself accounted for 1% of the overall malaria burden in India [15]. In 2015, 10,920 malaria cases were recorded in Mangaluru [16]. In that year, we conducted a case-control study among malaria patients attending Mangaluru's largest and governmental Wenlock District Hospital, many of whom were migrant workers [17] and community controls.…”