Optimizing strategies for malaria surveillance and measuring the impact of contro

疟疾流行国家的监测系统需要收集有关疟疾传播、感染和疾病的干预覆盖面和变化的信息。重要的是，监测数据必须有效地传达给政策制定者，以便为未来的干预战略提供信息。然而，目前在非洲大部分地区开展高质量疟疾监测的能力不足，现有的卫生信息系统不足以监测疟疾控制方面的进展。有关病媒行为和传播强度的数据并不是粗略收集的。在卫生机构收集的发病率和死亡率数据可能是有偏见的，往往是不完整、不准确的，并且在没有实验室确认的情况下在很大程度上依赖于临床诊断。社区调查是目前最强有力的疟疾监测战略，但费用昂贵，在后勤方面具有挑战性，很少进行，地理覆盖面有限，而且不够全面，不足以完全捕捉传播、感染和疾病的动态。为了提高我们对疟疾流行病学的了解，并为最大限度地发挥控制干预措施的影响提供证据基础，确定收集可靠数据进行疟疾常规监测的最佳方法至关重要。在这个项目中，将在3个流行病学差异很大的地点进行全面的疟疾监测研究，以收集关于传播强度、感染和疾病的测量数据，并确定监测的最佳方法。随后将精简监测活动，并扩大到6个哨所，以衡量关键疟疾控制干预措施对疟疾传播、感染和疾病的影响。我们的具体目标将是：1)通过比较不同传播强度的多个地点的不同方法，确定乌干达疟疾监测的最佳战略；2)利用乌干达多个地点的监测数据，估计关键的疟疾控制干预措施对传播强度、感染和疾病测量的影响；3)对疟疾控制干预措施进行经济评估，以确定最佳的覆盖水平和组合。 在乌干达的多个地点进行干预。

Surveillance systems in malaria endemic-countries are needed to capture information on intervention coverage and changes in malaria transmission, infection, and disease. Importanfiy, surveillance data must be effectively communicated to policy-makers to inform future intervention strategies. However, the capacity to conduct high-quality malaria surveillance is currenfiy inadequate in much of Africa and the existing health information system is insufficient for monitoring progress in malaria control. Data on vector behavior and transmission intensity are not roufinely collected. Morbidity and mortality data collected at health facilities may be biased and are often incomplete, inaccurate, and largely rely on clinical diagnosis in the absence of laboratory confirmation. Community surveys are currenfiy the most robust strategy for malaria surveillance, but are expensive and logistically challenging, conducted infrequently with limited geographic coverage, and not comprehensive enough to fully capture the dynamics of transmission, infecfion, and disease. Identifying the opfimal methods of gathering reliable data for roufine malaria surveillance is essenfial for improving our understanding of malaria epidemiology and providing an evidence base for maximizing the impact of control intervenfions. For this project comprehensive malaria surveillance studies will be conducted at 3 senfinel sites with widely varied epidemiology to collect data on measures of transmission intensity, infection and disease and identify opfimal methods for surveillance. Surveillance activities will then be streamlined and expand to 6 sentinel sites to measure the impact of key malaria control intervenfions on malaria transmission, infection, and disease. Our specific aims will be: 1) to identify opfimal strategies for malaria surveillance in Uganda by comparing different methodologies at mulfiple sites with varied transmission intensity, 2) to estimate the impact of key malaria control interventions on measures of transmission intensity, infecfion, and disease using surveillance data at mulfiple sites in Uganda, and 3) to conduct an economic evaluation of malaria control interventions to identify the optimal coverage levels and mix of interventions at mulfiple sites in Uganda.