Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

Jerry O Jacobson, Carmen Cueto, Jennifer L Smith, Jimee Hwang, Roly Gosling, Adam Bennett, Jerry O Jacobson, Carmen Cueto, Jennifer L Smith, Jimee Hwang, Roly Gosling, Adam Bennett

Abstract

To eliminate malaria, malaria programmes need to develop new strategies for surveillance and response appropriate for the changing epidemiology that accompanies transmission decline, in which transmission is increasingly driven by population subgroups whose behaviours place them at increased exposure. Conventional tools of malaria surveillance and response are likely not sufficient in many elimination settings for accessing high-risk population subgroups, such as mobile and migrant populations (MMPs), given their greater likelihood of asymptomatic infections, illegal risk behaviours, limited access to public health facilities, and high mobility including extended periods travelling away from home. More adaptive, targeted strategies are needed to monitor transmission and intervention coverage effectively in these groups. Much can be learned from HIV programmes' experience with "second generation surveillance", including how to rapidly adapt surveillance and response strategies to changing transmission patterns, biological and behavioural surveys that utilize targeted sampling methods for specific behavioural subgroups, and methods for population size estimation. This paper reviews the strategies employed effectively for HIV programmes and offers considerations and recommendations for adapting them to the malaria elimination context.

Keywords: HIV; High risk populations; Malaria; Surveillance.

Figures

Fig. 1
Fig. 1
Principles of Second Generation Surveillance for HIV. Adapted from [48]
Fig. 2
Fig. 2
HIV and malaria surveillance activities for high-risk populations. Adapted from [49]; gen. pop., general population; STI, sexually transmitted infections
Fig. 3
Fig. 3
Surveillance cycle for targeting risk populations for malaria
Fig. 4
Fig. 4
Aims for field assessment for planning targeted studies
Fig. 5
Fig. 5
Flow diagram for selecting sampling methods for surveys in high-risk populations
Fig. 6
Fig. 6
Potential sources of social fragmentation among MMPs. Adapted from [77]
Fig. 7
Fig. 7
Lessons learned for peer-driven interventions

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Source: PubMed

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