The focus of this project will be to monitor changes in malaria epidemiology based on existing interventions in Ethiopia, Nigeria, Uganda and Cambodia, and assessment of the conditions necessary to reduce transmission below the critical level.
The Beyond Garki project addressed a gap that exists in understanding of the current dynamics of the epidemiology and control of malaria. The project aimed to:
- Monitor changes in the epidemiology of malaria within the context of the implemented interventions
- Assess conditions for reducing transmission below its critical level
- Make recommendations to adapt prevention and control measures to observed changes
A scale-up of malaria interventions through a concerted international effort to increase the coverage and use of key tools and vector control measures as well as an increase in diagnosis and effective treatment.
In order to support effective strategies, it is essential to understand more about how control measures are contributing to this decline but also the changing patterns of malaria, as the disease becomes more unevenly distributed.
In addition to interventions, changes in demographic, socioeconomic, political, technological and environmental factors, as well as changes in vector and parasite populations may contribute to the changing landscape of malaria.Changes in the vector, the parasite, the host and the environment, and the interactions between these changes, should be understood in order to modify prevention and control strategies accordingly.
Some of the findings of the project may mean that a radical re-thinking of intervention strategies is required in order to produce the desired impact on the disease.
Five sites, ranging from high transmission to pre-elimination settings, are being monitored in Uganda, Ethiopia and Cambodia, and more will be added from Nigeria, including areas monitored in related studies.
The first surveys were conducted between September 2012 and February 2013. Household, malariometric and serological surveys were implemented in all sites to gather data on scores of important variables that will be monitored biannually or annually. Anaemia, stunting, morbidity and mortality data were collected together with coverage and use of interventions.
Entomological surveys and drug efficacy studies were carried out in Ethiopia and Uganda, and data was collected on the situation of malaria in hard-to-reach migrant populations in Cambodia using response-driven sampling. Meteorological stations were set up to monitor climatic changes.