Malaria — SAIA

Despite efforts to control and eliminate malaria, the global burden of malaria remains high, especially among children under five. Accurate, timely diagnosis and treatment of malaria can reduce the incidence of severe disease and death.

Africa contributes to 95% of malaria cases and 96% of malaria death globally. The DRC contributes to 12% of the world's malaria cases and 13% of deaths, half of which are in children under five. The DRC has embraced the WHO's "test and treat" policy to facilitate prompt and effective diagnosis and treatment of malaria. However, substantial implementation challenges have prevented effective uptake. Implementation of the WHO policy is impaired by a weak health system infrastructure, the large size and diverse terrain of the country, and the ongoing conflict in certain regions. In this context, local solutions to improve pediatric malaria case management are urgently needed.

Cascade analysis is a strategy used to evaluate system performance and identify and prioritize system gaps and challenges by measuring the uptake/effectiveness of each step in the treatment cascade. Cascade analysis tools have been used extensively in HIV treatment, prevention of mother-to-child transmission of HIV (PMTCT), and integrated HIV-family planning services in Sub-Saharan Africa. These analysis tools have also been adapted to other diseases, including tuberculosis, hypertension, cervical cancer, and mental health. Such approaches have not yet been utilized to optimize malaria treatment. The goal of this research is to design and test a novel tablet-based cascade analysis tool that can contribute to improved pediatric malaria case management in Kinshasa. We will do this by adapting an existing HIV cascade analysis tool for pediatric malaria treatment in the DRC.

An optimized malaria cascade analysis tool (mCAT) will aid health workers, supervisors, and malaria program managers to identify and better understand gaps in service provision for children seeking treatment for malaria. It not only has the potential to improve malaria case management in DRC, but in other malaria-endemic areas of Sub-Saharan Africa, where malaria remains a leading cause of childhood mortality. The findings from this pilot research will directly inform the design of an intervention package, such as the systems analysis and improvement approach, to improve the management of malaria in children in the DRC.