Table 1.

Selected NMCP operational and implementation research priorities addressed in collaboration with the WA-ICEMR

Malaria Control Program component*	Operational challenges encountered in implementing malaria control program component	Operational research performed to mitigate operational challenges
Malaria case management and treatment	Lack of adequate and current management and treatment practices at local health facilities	Performance improvement techniques offered to health workers on a regular basis to improve adherence to current clinical treatment guidelines as well as training in malaria diagnosis
Malaria in pregnancy	Low health worker compliance with guidelines for administration of IPTp in health facilities Low coverage and uptake of IPTp with three doses of SP	New service delivery strategies and behavior change interventions to increase SP compliance
SMC	Limited knowledge on level of compliance, side effects and possible barriers to SMC treatment	Post-SMC surveys on compliance and possible SMC-caused side effects and drug metabolite measurement (ELISA) for compliance
	Lack of knowledge on the long-term impact of SMC on malaria epidemiology and transmission (rebound effect on immune response, burden of the disease, parasite genotypes and possible drug resistance development)	SMC impact studies on prevalence and incidence of Plasmodium falciparum infection and disease Cohort-based immunogenomics studies to measure the possible impact of SMC on immunological indices Molecular/genomic surveillance of antimalarial drug resistance markers studies and potential impact on malaria incidence
	Need for evaluation of alternative drugs for SMC	Test of DHA-PQ as an alternative drug for SMC
Antimalarial drug resistance	Lack of knowledge on current prevalence and the possible impact of molecular antimalarial drug resistance markers relevant for treatment (ACTs) and preventive treatment	Repeated molecular surveillance of antimalarial drug resistance markers and ex vivo testing
Malaria mosquito transmission	Need for updated knowledge on the impact of current vector control strategies on vector abundance, species composition, and biting behavior	Longitudinal monitoring of entomological parameters at WA-ICEMR study sites
	Lack of knowledge on vector habitat and survival strategies through the dry season	Studies of vector ecology and larval source identification applying drones, ground-truthing and GIS/RS
LLIN use	Lack of updated knowledge on coverage, usage, and residual effects of ITNs on adult mosquitoes	Coverage and usage patterns of ITNs regarding trends in malaria transmission
	Need for evidence on the effectiveness of the deployment of next-generation ITNs	Assessment of the residual effect of insecticides Testing for the effectiveness of next-generation ITNs
Insecticide resistance	Need for regular, routine information on insecticide resistance profiles of primary malaria vectors	Continuous monitoring of susceptibility patterns in vector populations, particularly in intervention areas (molecular resistance markers, genomic surveillance)
Monitoring and evaluation	Large amounts of data at both the individual and molecular levels, with limited capacity for data modeling and analysis	Assistance with analyses for routine data monitoring Application of monitoring data to improve program implementation Data sharing and continuous analyses of research data to assist NMCP

ACT = artemisinin-based combination therapy; DHA-PQ = dihydroartemisinin-piperaquine; ELISA = enzyme-linked immunosorbent assay; GIS = geographic information systems; ITN = insecticide-treated net; IPTp = intermittent preventive treatment of malaria during pregnancy; LLIN = long-lasting insecticide-treated bed net; NMCP = Mali National Malaria Control Program; RS = remote sensing; SMC = seasonal malaria chemoprevention; SP = sulfadoxine-pyrimethamine; WA-ICEMR = West Africa International Center of Excellence in Malaria Research.

^*Performed by the Mali NMPC.