Surveillance is a core malaria intervention. Data standards, tools and curricula materials have been developed to support countries to strengthen and monitor national routine surveillance systems and to support use of data for decision-making in all transmission settings. These standards have been developed into malaria modules in DHIS2 for countries using this platform. These tools comprise:

• modules for burden reduction and elimination settings
• aggregate module
• case-based module
• modules for entomological surveillance and vector control interventions

The DHIS2 modules provide a set of data elements and indicators as well as validation rules and standard charts and tables presented in a set of dashboards.

The modules are accompanied by a guidance document and a curriculum to help programmes and participants understand and implement the content. The modules can used either separately or in conjunction with one another depending on the type of public health responses being implemented.

The modules comprise a standard set of data elements and indicators, validation rules and dashboards for visualization of core epidemiological and data quality indicators, as charts, tables and maps. Routine reports and data exports can be easily generated for rapid dissemination of information to decision-makers. The modules, which are configurable and can be used either separately or in conjunction with one another, are accompanied by a guidance document and a curriculum for facility-level data analysis, to help programmes to understand the content and how the data can be used in practice.

Aggregated malaria module

In settings in which transmission remains relatively high and where the aim of national programmes is to reduce the burdens of morbidity and mortality, data are aggregated to provide an overall picture of where and when malaria occurs and who is most affected. Surveillance data in high transmission settings permits monitoring of trends over time in terms of the number of cases and deaths, the distribution of cases and deaths geographically, the characteristics of people infected or dying from malaria, and the seasonality of transmission.

In high transmission settings, surveillance data can be used to stratify geographic units by their malaria prevalence or annual parasite incidence to permit better targeting of interventions. Surveillance data can be used to plan for the number of test kits, antimalarial drugs and supplies needed for different health facilities.

The malaria module is based on the guidance provided in the  Malaria surveillance, monitoring & evaluation: a reference manual and the  Framework for malaria elimination.

As of October 2019, 23 countries have installed the WHO aggregate malaria module and another 6 installations are planned over the next year. Five countries have already developed and integrated their own malaria module into DHIS2.

Case-based malaria module

When malaria is being eliminated, early identification of infections is crucial to prevent onward transmission. Case investigations become critical to classify the case and locate where the person was infected. This information allows to trigger focus investigations, which aim to identify the drivers of transmission in the area and to develop an appropriate response plan.

This module, due to be released soon, will support case investigations in elimination settings by allowing for line listing of suspected cases (optional), diagnosis and treatment, treatment follow-up (optional), case investigation, foci investigation foci response and follow-up. Data will be aggregated and feed into the elimination dashboards for analysis and reporting.

Vector insecticide resistance module

Malaria prevention relies heavily on insecticide-based tools that target malaria mosquitoes: long-lasting insecticidal nets and indoor residual insecticide sprays. This module supports monitoring of insecticide resistance by allowing for the collection and visualization of data generated.

This module is currently available upon request -- please contact: vectorsurveillance@who.int

IRS residual efficacy module

IRS protects populations for a certain number of months after the insecticide is sprayed. In the absence of other interventions, when the insecticidal effects fades away population are left unprotected. Knowing the duration of the residual efficacy of different insecticide formulations can help national malaria control programmes design better vector control strategies to provide better protection.

This module supports tracking the residual efficacy of IRS’s insecticide formulations after spraying through the collection and visualization of data from WHO standard cone bioassays.

This module is currently available upon request -- please contact: vectorsurveillance@who.int

IRS and LLIN campaign coverage modules

In order to ensure adequate coverage with effective vector control using a core intervention (ITNs or IRS), programme managers need to know the coverage levels achieved through ITNs mass distribution and IRS campaigns.

These modules, due to be released soon, will allow them to capture key information from IRS and ITNs campaign, including coverage by sprayed area. 

Other entomological surveillance tools under development

WHO aims at providing countries with a comprehensive package to collect and interpret key entomological indicators. Ongoing efforts focus on identifying key country needs and defining core standards for news modules. Current work focuses on tools to capture vector densities and biting and resting behaviour.

Country implementation

WHO is supporting Member states to implement these modules at national level. The modules give Member States the possibility to bring key malaria-related data into a single place, facilitating interpretation and the dynamic use of data for decision-making.

WHO has been working in coordination with national health management information systems (HMIS) departments of ministries of health, in particular the "High burden to high impact" (HBHI) countries, to establish structured dynamic databases that support NMPs subnationally to implement targeted malaria activities informed by clear stratification, to monitor disease trends, to effectively respond to epidemics, to evaluate programme performance and to develop national strategic plans.