Kate Battle

Risk stratification for intervention planning

Geospatial Modelling For Malaria Risk Stratification And Intervention Targeting

Under the leadership of Dr Katherine Battle and Dr Ewan Cameron, MAP is working with Clinton Health Access Initiative (CHAI) to produce rapidly updatable, high resolution malaria risk maps to help countries better target and stratify intervention measures. A range of modelling methodologies are employed to produce these maps to accommodate data on case incidence, intervention coverage and treatment-seeking behaviours that are available at varying levels of spatial and temporal aggregation. Final outputs are then shared with national malaria programmes with supporting information on how best to use and interpret this information to improve strategic planning for elimination in each country and at the regional level.

As malaria endemic countries move towards elimination, the control strategies shift from mass intervention campaigns to targeted measures that aim at more focal and heterogeneous transmission landscapes. Routine or responsive surveillance are deployed to describe these settings, but the strength of surveillance systems vary both among and within countries. Understanding the accuracy of the surveillance and malaria situation between sentinel sites can be challenging.

Newly developed spatial modelling techniques, along with remotely sensed high resolution environmental and socio-demographic variables, can be used to translate case data observed at varying surveillance resolutions to fine-scale malaria incidence maps. This includes down-scaling the most widely available surveillance data source, case counts reported at the administrative-level, to illustrate sub-unit heterogeneity. Case counts from health facilities are increasingly obtainable and can also inform pixel-level maps while also accounting for aspects that may contribute to underreporting such as accessibility to health facilities and care-seeking behaviours.

Finally, cases followed up from facilities and geopositioned to the household level increase the resolution of the predictions through point-process models. Bespoke modelling frameworks developed for countries based on the type of data available can produce pixel-level maps that support countries in developing informed and sustainable elimination strategies in a wide range of settings.

Clinton Health Access Initiative

The Clinton Health Access Initiative (CHAI) is a global health organization committed to strengthening integrated health systems in the developing world and expanding access to care and treatment for HIV/AIDS, malaria and tuberculosis. CHAI’s solution-oriented approach focuses on improving market dynamics for medicines and diagnostics; lowering prices for treatment; accelerating access to life-saving technologies; and helping governments build the capacity required for high-quality care and treatment programs.

CHAI is supporting a number of countries in Southern Africa, South-East Asia, Hispaniola and Mesoamerica to sustainably accelerate efforts to eliminate indigenous cases of malaria from 2015-2020 by providing direct technical and management support to governments on elimination planning, surveillance, and targeted attached and response activities.