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Open Access From diagnosis to case investigation for malaria elimination in Swaziland: is reporting and response timely?

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Background: Swaziland is one of the southern African countries that aim to eliminate malaria by 2020. In 2010, the country introduced an Immediate Disease Notification System (IDNS) for immediate reporting of notifiable diseases, including malaria. Health facilities are to report malaria cases within 24 h through a toll-free telephone number (977), triggering an alert for case investigation at the patient's household within 48 h. We assessed the completeness of reporting in the IDNS, the subsequent case investigation, and whether it was done within the stipulated timelines.

Methods: A cross-sectional study using routine country-wide data.

Results: Of 1991 malaria cases notified between July 2011 and June 2015, 76% were reported in the IDNS, of which 68% were investigated—a shortfall of 24% in reporting and 32% in case investigations. Of the 76% of cases reported through the IDNS, 62% were reported within 24 h and 20% were investigated within 48 h. These shortcomings were most pronounced in hospitals and private facilities. Investigated cases (n = 1346) were classified as follows: 60% imported, 35% local and 5% undetermined.

Conclusion: The utilisation of the IDNS for case reporting to trigger investigation is crucial for active surveillance. There is a need to address the reporting and investigation gaps identified to ensure that malaria cases receive appropriate interventions.
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Keywords: immediate reporting; malaria surveillance; response

Document Type: Research Article

Affiliations: 1: National Malaria Control Programme, Ministry of Health (MoH), Mbabane, Swaziland 2: Global AIDS Interfaith Alliance, San Rafael, California, USA 3: Clinton Health Access Initiative, Mbabane, Swaziland 4: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya 5: National Tuberculosis Control Programme, MoH, Mbabane, Swaziland 6: World Health Organization Country Office for Swaziland, Mbabane, Swaziland 7: Médecins Sans Frontières, Luxembourg, Luxembourg

Publication date: April 25, 2018

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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