Abstract
BackgroundIn Togo, the National Malaria Control Programme, in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria, has implemented a pilot study for malaria sentinel surveillance since 2017, which consists of collecting information in real time and analysing this information for decision-making. The first 20 months of malaria morbidity and mortality trends, and malaria case management in health facilities included in the surveillance were assessed.MethodsSince July 2017, 16 health facilities called sentinel sites, 4 hospitals and 12 peripheral care units located in 2 epidemiologically different health regions, have provided weekly data on malaria morbidity and mortality for the following 3 target groups: < 5-years-old children, ≥ 5-years-old children and adults, and pregnant women. Data from week 29 in 2017 to week 13 in 2019 were analysed.ResultsEach sentinel site provided complete data and the median time to data entry was 4 days. The number of confirmed malaria cases increased during the rainy seasons both in children under 5 years old and in children over 5 years old and adults. Malaria-related deaths occurred mainly in children under 5 years old and increased during the rainy seasons. The mean percentage of tested cases for malaria among suspected malaria cases was 99.0%. The mean percentage of uncomplicated malaria cases handled in accordance with national guidelines was 99.4%. The mean percentage of severe malaria cases detected in peripheral care units that were referred to a hospital was 100.0%. Rapid diagnostic tests and artemisinin-based combination therapies were out of stock several times, mainly at the beginning and end of the year. No hospital was out of stock of injectable artesunate or injectable artemether.ConclusionsThese indicators showed good management of malaria cases in the sentinel sites. Real-time availability of data requires a good follow-up of data entry on the online platform. The management of input stocks and the promptness of data need to be improved to meet the objectives of this malaria sentinel surveillance system.
Highlights
In Togo, the National Malaria Control Programme, in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria, has implemented a pilot study for malaria sentinel surveillance since 2017, which consists of collecting information in real time and analysing this information for decision-making
The mean percentage of uncomplicated malaria cases handled in accordance with national guidelines was 99.4% (SD: 2.0) from week 29 in 2017 to week 13 in 2019
On the one hand, following evolution of malaria cases in real time enables the National Malaria Control Programme of Togo to take active and appropriate measures based on the collected data and to improve decision-making for the malaria response
Summary
In Togo, the National Malaria Control Programme, in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria, has implemented a pilot study for malaria sentinel surveillance since 2017, which consists of collecting information in real time and analysing this information for decision-making. The first 20 months of malaria morbidity and mortality trends, and malaria case management in health facilities included in the surveillance were assessed. In 2017, the World Health Organization (WHO) African Region still had the highest number of malaria cases (92%) and malaria deaths (93%). In Togo, the estimated number of malaria cases was 2.9 million and the estimated number of malaria deaths was 5,341 in 2017 [1]. In 2016, uncomplicated malaria was the first cause of outpatient consultations (41.7%) and severe malaria was the first cause of hospitalizations (20.5%) and the ninth cause of hospital mortality (3.8%) in Togo [2]. Malaria deaths are probably underestimated as 60.3% of severe malaria cases that were referred did not go to hospital in 2017 [3].
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