article · African Journal of Health and Medical Sciences (AFJHMS)
An analysis of Tanzania's malaria case-based surveillance system evaluated data from August 2021 to May 2022 across Kilimanjaro, Arusha, and Manyara regions to identify factors linked to malaria among contacts of index cases. During this period, 949 malaria cases were recorded, predominantly among individuals over 16 years old, with the majority being locally introduced cases. The Arusha region accounted for over half of these reports. Testing conducted on 642 contacts identified a 3.7 percent positivity rate. The findings demonstrate that living in households with fewer members, having recent fever, exposure to individuals treated for malaria in the prior 28 days, and travel to endemic areas within the past 28 days significantly increased malaria risk among contacts. These insights offer operational intelligence to guide targeted surveillance and elimination programmes in regions approaching low transmission.
As regions move toward malaria elimination, identifying remaining transmission drivers becomes critical. This study demonstrates that specific behavioural and exposure factors, such as travel history and recent contact with treated individuals, drive infection in low-prevalence zones. Understanding these specific risks helps public health officials direct proactive testing and treatment resources to the individuals most likely to sustain transmission chains.
The findings can inform public health agencies and non-governmental organisations designing digital surveillance tools, contact-tracing software, and risk-scoring algorithms for disease elimination programmes. The study represents applied operational health research, tested using existing real-world surveillance system data. However, the abstract does not indicate a commercialisation pathway or direct product development pipeline.
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Introduction: A malaria case-based surveillance system (mCBS) was established in Kilimanjaro, Arusha, and Manyara regions in Tanzania following reports of very low parasite prevalence. The system aims to eliminate malaria by 2030, but had not been analyzed since its start. Our study used data from August 2021 to May 2022 to identify factors associated with malaria among contacts of local cases Methods: This was a cross-sectional study that analyzed mCBS data collected between August 2021 and May 2022. The dataset included index cases and contacts information obtained through proactive and reactive case detection methods (pro-ACD and re-ACD respectively). Multivariate logistic regression was used to identify factors associated with malaria among contact cases. Statistical significance was tested at a 95% confidence interval and p-value ≤ 0.05 Results: From August 2021 to May 2022, 949 malaria cases were reported, with 63.8% being over 16 years old, median age 20 years. Most cases were local-introduced (96.5%), males accounting for 54.8%. Arusha region reported most cases (53%). Among 642 tested contacts, 51% were female, and only 3.7% tested positive. Factors associated with lower malaria positivity included, household size ≥ six members (aOR = 0.11, 95% CI = 0.02 – 0.62), being afebrile past three days (aOR = 0.03, 95% CI = 0.01 – 0.14), having no history of contact with individuals on malaria treatment within past 28 days (aOR = 0.01, 95% CI= 0.004 – 0.04), as well as having no history of travel to malaria-endemic areas within past 28 days (aOR= 0.24, 95% CI = 0.06 – 0.92) Conclusion: A history of contact with a household member treated for malaria or had travelled to an endemic area in past 28 days as well as a family size with fewer than three members are risk factors for malaria in regions implementing case-based surveillance in Tanzania.
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DOI: 10.59067/afjhms.v10i1.69
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