Table 1.
Details of data collected in the MESA-ICEMR study sites
| Study | Data collected | MESA sites | Clinical impact and translational value | |||
|---|---|---|---|---|---|---|
| Themes | – | AVBRH | GMC | KGVK | RMRC-NE | |
| Source of data | a) Routine health information system | • | • | • | • | – |
| b) Household-based surveys | – | – | – | • | – | |
| 1. Malaria knowledge | 1.1 Proportion of population at risk who know the main symptom of malaria | – | – | – | • | 1.a Community engagement |
| 1.2 Proportion of population at risk who know the treatment of malaria | – | – | – | • | 1.b Community awareness | |
| 1.3 Proportion of population at risk who know preventive measures for malaria | – | – | – | • | 1.c Receptiveness to malaria control measures | |
| 2. Vector control | 2.1 Number of surveyed subjects sleeping under an ITN or living in house sprayed by IRS in the previous 12 months | – | – | – | • | 2.a Reduction in number of infective bites |
| 2.2 Number of surveyed subjects who slept under an ITN the previous night | – | – | – | • | 2.b Reduction in vector habitats | |
| 3. Diagnostic testing | 3.1 Total number of febrile cases who received a parasitological test for malaria (Annual Blood Examination Rate) | – | • | – | – | 3.a Screening capacity in health facilities |
| 3.2 Improved light microscopy tool for counting low parasitemia P. vivax infections | – | • | – | – | 3.b Treatment seeking pattern of infected individuals | |
| – | – | – | – | – | 3.c Sensitivity of diagnosis and surveillance | |
| 4. Surveillance | 4.1 Confirmed malaria cases species wise per 1,000 population at risk | • | • | • | • | 4.a Transmission reservoir, intensity, species distribution |
| 4.2 Number of severe cases species wise | • | • | • | • | 4.b Burden of severe cases and species responsible for it | |
| 4.3 Demography—age, gender, and occupation | • | • | • | • | 4.c Age, gender occupation as risk factor for infection | |
| 4.4 Travel history | • | • | • | • | 4.d Proportion of imported cases | |
| 4.5 Distribution of cases during different seasons | • | • | • | • | 4.e Seasonality of cases | |
| 4.6 Spatial and temporal heterogeneity of transmission | – | • | – | – | 4.f Stratifying malaria cases | |
| 4.7 Proportion of low density and asymptomatic infections | – | – | – | • | 4.g Role of submicroscopic and asymptomatic infections in transmission | |
| 4.8 Genotype of parasites from different study sites | – | • | – | • | 4.h Genetic diversity of parasite populations in different regions | |
| 5. Treatment | 5.1 Proportion of patients with confirmed malaria who received first-line antimalarial treatment according to national policy | • | • | • | • |
|
| 5.2 Proportion of patients with P. vivax malaria who received radical cure treatment with primaquine | • | • | • | • | 5.c Percentage of referred cases from primary healthcare to tertiary health care facility because of severity | |
| 5.3 Proportion of confirmed P. falciparum cases who received single, low-dose primaquine | • | • | • | • | 5.d Artemisinin resistance status | |
| 5.4 Proportion of severe malaria cases that were referred | – | • | – | – | – | |
| 5.5 Proportion of referred patients with severe malaria that received prereferral treatment | – | • | – | – | ||
| 5.6 Proportion of ACT resistant infections (in vitro) | – | • | – | • | – | |
| 6. Vector studies | 6.1 Geographic and seasonal distribution of Anopheles species specific to a site | – | • | – | • | 6.a Tailor made control measures depending on vector |
| 6.2 Time (early/late), place (indoor/ outdoor), and host choice (humans/animals) for biting | – | • | – | • | 6.b species 6.c distribution (geographic and seasonal) | |
| 6.3 Insecticide resistance status | – | • | – | • | 6.d biting preferences | |
| 6.4 Morphotaxonomic classification of vectors and sibling species analysis | – | • | – | • | 6.e vector sensitivity to insecticides used for spraying | |
| 6.5 Sporozoite positivity rate | – | • | – | • | 6.f entomological transmission metric | |
| 7. Pathogenesis | 7.1 Role of invasion ligand/host-receptor interaction | – | • | – | – | 7.a Variation in usage of invasion ligands and their association with disease severity |
| 7.2 Role of var gene expression in P. falciparum pathogenesis | – | • | – | – | 7.b Potential marker of shift from non lethal to lethal form | |
| 7.3 Host cell preference for P.vivax infection | – | • | – | – | ||
| 7.4 Short-term P. vivax culture system | – | • | – | – | 7.c Drug and invasion assays for P. vivax | |
| 7.5 Multiplicity of infection | – | • | – | – | 7.d Diversity of infection | |
| 8. Host Response | 8.1 Seroreactivity and antibody response against parasite proteins | – | • | – | – | 8.a Biomarkers of population wide-NAI |
| 8.2 Differential seroreactivity to P. falciparum antigens in severe and nonsevere cohorts | – | • | – | – | 8.b Variation in immunity | |
| 9. Drug resistance | 9.1 Monitoring polymorphisms related to drug resistance in the study sites | – | • | – | • | 9.a Surveillance of region-specific drug resistance markers |
| 9.2 Monitoring antimalarial drug sensitivity in vitro | – | • | • | 9.b Surveillance of region-specific antimalarial sensitivity | ||
| 9.3 Mechanisms of acquiring resistance by parasites against currently used antimalarials and drugs in development | – | • | • | 9.c Strategies to avoid drug resistance | ||
| 10. Impact of control measures | ||||||
| 10A. Prevalence | 10A.1 Parasite prevalence: proportion of population with evidence of infection with malaria parasites | • | • | • | • | 10.a Changes in transmission reservoir and intensity |
| 10B. Incidence | 10B.1 Number and rate of confirmed malaria cases per 1,000 people per year | • | • | • | • | 10.b Effectiveness of malaria control regimen in the study sites to curb morbidity and mortality |
| 10B.2 Number of malaria inpatients | • | • | • | • | ||
| 10B.3 Malaria test positivity rate | • | • | • | • | – | |
| 10C. Mortality | 10C.1 Number and rate of malaria deaths per 100,000 people per year | • | • | • | • | – |
| 10C.2 Proportion of inpatient deaths due to malaria | • | • | • | • | – | |
The clinical and translational value of this data is outlined in the context of malaria control and elimination in India. AVBRH = Acharya Vinoba Bhave Rural Hospital, Wardha; GMC = Goa Medical College, Goa; KGVK = Krishi Gram Vikas Kendra, Ranchi; NAI = Naturally Acquired Immunity; RMRC-NE = Regional Medical Research Center-Northeast, Dibrugarh.