What is the value of reactive case detection in malaria control? A case-study in India and a systematic review

Anna Maria Van Eijk, Lalitha Ramanathapuram, Patrick L. Sutton, Deena Kanagaraj, G. Sri Lakshmi Priya, Sangamithra Ravishankaran, Aswin Asokan, Nikunj Tandel, Ankita Patel, Nisha Desai, Ranvir Singh, Steven A. Sullivan, Jane M. Carlton, H. C. Srivastava, Alex Eapen

Research output: Contribution to journalArticle

Abstract

Background: Reactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries. Methods: RCD programmes were piloted in two urban areas of India with a low prevalence of mainly Plasmodium vivax malaria in 2014. Cases were identified in a clinic by microscopy and contacts were screened within 2 weeks; PCR, in addition to microscopy, was used to detect Plasmodium parasites. A systematic review was conducted to identify RCD experiences in the literature. Results: In Chennai, 868 contacts were enrolled for 18 index cases of clinical malaria; in Nadiad, 131 contacts were enrolled for 20 index cases. No new malaria infections were detected in Nadiad among contacts, and four new infections were detected in Chennai (three P. vivax and one Plasmodium falciparum), of which two were among household members of index cases. An additional five studies describing results from an RCD strategy were identified in the literature: Four in Africa and one in Thailand. Including the results from India, the average number of contacts screened per index case in a total of seven studies ranged from four to 50, and 126 in a case study in Thailand with one index case. Malaria was detected in 0-45 % of the contacted persons. The average number of index cases needed to be traced to find one new case of malaria ranged from one to five, and could not be assessed in one study in India (no contacts positive for 20 cases). Sharing the household with an index case was associated with a five-fold increased risk of malaria compared to contacts from households without an index case (pooled risk ratio 5.29, 95 % CI 3.31-8.47, I2 0 %, four studies). Conclusions: RCD in areas of low malaria transmission is a labour-intensive strategy, and its benefit is not clear. Studies are needed to assess how RCD can be optimized or into alternatives where interventions are targeted to family members or hotspots.

Original languageEnglish (US)
Article number67
JournalMalaria Journal
Volume15
Issue number1
DOIs
StatePublished - Feb 6 2016

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Malaria
India
Thailand
Microscopy
Infection
Vivax Malaria
Plasmodium vivax
Plasmodium
Plasmodium falciparum
Parasites
Odds Ratio
Polymerase Chain Reaction

Keywords

  • Malaria
  • Plasmodium falciparum
  • Plasmodium vivax
  • Reactive case detection
  • Surveillance

ASJC Scopus subject areas

  • Infectious Diseases
  • Parasitology

Cite this

Van Eijk, A. M., Ramanathapuram, L., Sutton, P. L., Kanagaraj, D., Sri Lakshmi Priya, G., Ravishankaran, S., ... Eapen, A. (2016). What is the value of reactive case detection in malaria control? A case-study in India and a systematic review. Malaria Journal, 15(1), [67]. https://doi.org/10.1186/s12936-016-1120-1

What is the value of reactive case detection in malaria control? A case-study in India and a systematic review. / Van Eijk, Anna Maria; Ramanathapuram, Lalitha; Sutton, Patrick L.; Kanagaraj, Deena; Sri Lakshmi Priya, G.; Ravishankaran, Sangamithra; Asokan, Aswin; Tandel, Nikunj; Patel, Ankita; Desai, Nisha; Singh, Ranvir; Sullivan, Steven A.; Carlton, Jane M.; Srivastava, H. C.; Eapen, Alex.

In: Malaria Journal, Vol. 15, No. 1, 67, 06.02.2016.

Research output: Contribution to journalArticle

Van Eijk, AM, Ramanathapuram, L, Sutton, PL, Kanagaraj, D, Sri Lakshmi Priya, G, Ravishankaran, S, Asokan, A, Tandel, N, Patel, A, Desai, N, Singh, R, Sullivan, SA, Carlton, JM, Srivastava, HC & Eapen, A 2016, 'What is the value of reactive case detection in malaria control? A case-study in India and a systematic review', Malaria Journal, vol. 15, no. 1, 67. https://doi.org/10.1186/s12936-016-1120-1
Van Eijk AM, Ramanathapuram L, Sutton PL, Kanagaraj D, Sri Lakshmi Priya G, Ravishankaran S et al. What is the value of reactive case detection in malaria control? A case-study in India and a systematic review. Malaria Journal. 2016 Feb 6;15(1). 67. https://doi.org/10.1186/s12936-016-1120-1
Van Eijk, Anna Maria ; Ramanathapuram, Lalitha ; Sutton, Patrick L. ; Kanagaraj, Deena ; Sri Lakshmi Priya, G. ; Ravishankaran, Sangamithra ; Asokan, Aswin ; Tandel, Nikunj ; Patel, Ankita ; Desai, Nisha ; Singh, Ranvir ; Sullivan, Steven A. ; Carlton, Jane M. ; Srivastava, H. C. ; Eapen, Alex. / What is the value of reactive case detection in malaria control? A case-study in India and a systematic review. In: Malaria Journal. 2016 ; Vol. 15, No. 1.
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AU - Sri Lakshmi Priya, G.

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AU - Tandel, Nikunj

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AU - Desai, Nisha

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N2 - Background: Reactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries. Methods: RCD programmes were piloted in two urban areas of India with a low prevalence of mainly Plasmodium vivax malaria in 2014. Cases were identified in a clinic by microscopy and contacts were screened within 2 weeks; PCR, in addition to microscopy, was used to detect Plasmodium parasites. A systematic review was conducted to identify RCD experiences in the literature. Results: In Chennai, 868 contacts were enrolled for 18 index cases of clinical malaria; in Nadiad, 131 contacts were enrolled for 20 index cases. No new malaria infections were detected in Nadiad among contacts, and four new infections were detected in Chennai (three P. vivax and one Plasmodium falciparum), of which two were among household members of index cases. An additional five studies describing results from an RCD strategy were identified in the literature: Four in Africa and one in Thailand. Including the results from India, the average number of contacts screened per index case in a total of seven studies ranged from four to 50, and 126 in a case study in Thailand with one index case. Malaria was detected in 0-45 % of the contacted persons. The average number of index cases needed to be traced to find one new case of malaria ranged from one to five, and could not be assessed in one study in India (no contacts positive for 20 cases). Sharing the household with an index case was associated with a five-fold increased risk of malaria compared to contacts from households without an index case (pooled risk ratio 5.29, 95 % CI 3.31-8.47, I2 0 %, four studies). Conclusions: RCD in areas of low malaria transmission is a labour-intensive strategy, and its benefit is not clear. Studies are needed to assess how RCD can be optimized or into alternatives where interventions are targeted to family members or hotspots.

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