Malaria programme reviews: - World Health Organization

A manual for reviewing the performance of malaria control and elimination programmes 21
• Imported malaria is considered to have occurred when an investigation reveals that the infection
was acquired outside the area in which it was diagnosed.
• The annual parasite incidence is the proportion of all blood smears containing malaria parasite
per year per 1000 population. This indicator depends on the adequacy of case finding.
This indicator is mostly used in low-incidence countries.
• The annual blood examination rate is the proportion of the total number of blood slides examined
per year per 1000 population, which reflects the adequacy of case detection. The
minimum annual blood examination rate should be 1% per month and 10% per year.
• The malaria test (slide or rapid diagnostic test) positivity rate is the proportion of the total
number of blood slides or RDT results found positive for malaria parasites in the total number
of blood samples examined. This gives the parasite load in the community and does not depend
on the completeness of case detection.
• The P. falciparum percentage is the proportion of the total number of blood smears or rapid
tests results found positive for P. falciparum out of the total number of blood smears or RDTs
performed with species differentiation. This gives an indication of the trends in P. falciparum
infections.
6.2.2.2 Mortality
Trends of inpatient malaria deaths provide a measure of progress in preventing severe malaria
and malaria-related death.
Malaria-specific proportionate mortality can also be estimated using verbal autopsies during
population surveys, however, sensitivity and specificity issues can complicate interpretation.
Trends in all-cause child mortality can be examined, although these trends are not malaria
specific.
6.2.2.3 Malaria parasite prevalence rate
The prevalence rate is the number of all cases of a disease in a defined population at a specific
time.
The malaria parasite rate in children 2-9 years is the proportion of all children aged 2–9 years
found to have malaria parasites out of the total number of children examined in blood surveys.
These measurements are used to assess the levels and types of malaria transmission and to
monitor the progress and impact of malaria programmes.
6.2.3 majoR PRogRamme activities, achievements and best PRactice
The team should summarize the main malaria programme activities in the strategic plan and
use reports to determine the level of achievement, ascertain the representativeness and accuracy
of the information and make meaningful inferences for the malaria situation in the
country. They should also note the major activities, achievements, best practices, problems or
challenges and lessons learnt.