Reactive Case Detection Strategy for Malaria Control and Elimination: A 12 Year Systematic Review and Meta-Analysis from 25 Malaria-Endemic Countries

Abstract

Reactive case detection (RACD) is the screening of household members and neighbors of index cases reported in passive surveillance. This strategy seeks asymptomatic infections and provides treatment to break transmission without testing or treating the entire population. This review discusses and highlights RACD as a recommended strategy for the detection and elimination of asymptomatic malaria as it pertains in different countries. Relevant studies published between January 2010 and September 2022 were identified mainly through PubMed and Google Scholar. Search terms included “malaria and reactive case detection”, “contact tracing”, “focal screening”, “case investigation”, “focal screen and treat”. MedCalc Software was used for data analysis, and the findings from the pooled studies were analyzed using a fixed-effect model. Summary outcomes were then presented using forest plots and tables. Fifty-four (54) studies were systematically reviewed. Of these studies, 7 met the eligibility criteria based on risk of malaria infection in individuals living with an index case < 5 years old, 13 met the eligibility criteria based on risk of malaria infection in an index case household member compared with a neighbor of an index case, and 29 met the eligibility criteria based on risk of malaria infection in individuals living with index cases, and were included in the meta-analysis. Individuals living in index case households with an average risk of 2.576 (2.540–2.612) were more at risk of malaria infection and showed pooled results of high variation heterogeneity chi-square = 235.600, (p < 0.0001) I2 = 98.88 [97.87–99.89]. The pooled results showed that neighbors of index cases were 0.352 [0.301–0.412] times more likely to have a malaria infection relative to index case household members, and this result was statistically significant (p < 0.001). The identification and treatment of infectious reservoirs is critical to successful malaria elimination. Evidence to support the clustering of infections in neighborhoods, which necessitates the inclusion of neighboring households as part of the RACD strategy, was presented in this review.

Understanding the impact of mobility on Plasmodium spp. carriage in an Amazon cross-border area with low transmission rate

“…In contexts with low or very low malaria transmission, reactive case detection and treatment and reactive indoor residual spraying have been shown to be pertinent and effective, as has targeted mass drug administration [ 39 , 53 – 55 ]. Looking at our results, these three strategies, if implemented in SGO, should consider both the area around the targeted population’s homes and the places these people have visited when the vector is present (e.g., slash-and-burn fields, medium to high vector density areas).…”

Malaria elimination in Ghana: recommendations for reactive case detection strategy implementation in a low endemic area of Asutsuare, Ghana

“…Studies reporting on RACD used a number of protocols to assess its effectiveness. Despite this, RACD was generally implemented in lower endemic settings [ 11 ]. According to the WHO, an annual parasite prevalence of 1–10% is considered low and ≥ 35% as high [ 12 ].…”

“…According to the WHO, an annual parasite prevalence of 1–10% is considered low and ≥ 35% as high [ 12 ]. Aidoo et al [ 11 ], in a systematic review of 55 published studies that reported on RACD from 25 countries, had no record of its implementation in Ghana. Malaria elimination is often first achieved in parts of the areas within a country and prevention of re-establishment started at the subnational level while countries are working on full interruption of transmission in all their regions [ 10 ].…”

Analysis of Malaria Transmission Dynamics at Borobudur Health Center, Magelang Regency (Case Study 2021-2022)

“…mosquitoes (3). The World Malaria Report 2022 states that there will be an estimated 247 million malaria cases in 84 malaria-endemic countries in 2021 (4). Data from the Ministry of Health of the Republic of Indonesia in 2021 indicated that there were 304,607 malaria cases in Indonesia (5).…”