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Aggressive active case detection: a malaria control strategy based on the Brazilian model

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  • Macauley, Cameron

Abstract

Since 1996, the Brazilian Ministry of Health has adopted a malaria control strategy known as aggressive active case detection (AACD) in which most or all members of every community are tested and treated for malaria on a monthly basis. The strategy attempts to identify and treat cases of asymptomatic malaria, which, if untreated, continue to transmit the infection. Malaria remains uncontrolled because almost all health care systems in the world rely on passive case detection: the treatment of only symptomatic cases of malaria. Research has shown conclusively that asymptomatic cases exist in any population where malaria transmission is stable and incidence is high: therefore passive case detection simply will not succeed in breaking the cycle of transmission. Numerous case studies show that malaria has been successfully controlled on a regional or national level by mass blood surveys. AACD is an effective malaria control strategy if used in conjunction with other methods, especially when (1) an effective treatment exists, (2) influx of potential carriers of the infection can be monitored, and (3) people are inclined to cooperate with monthly blood testing. AACD requires access to rapid diagnostic tests (RDTs), microscopy supplies, extensive human resources, and prompt, affordable, and effective treatment. AACD is compared to PCD in terms of clinical efficacy and cost effectiveness in a case study of malaria in the Brazilian Yanomami Indians. Where it is feasible, AACD could drastically reduce the incidence of malaria and should be an integral part of the World Health Organization's Roll Back Malaria strategy.

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  • Macauley, Cameron, 2005. "Aggressive active case detection: a malaria control strategy based on the Brazilian model," Social Science & Medicine, Elsevier, vol. 60(3), pages 563-573, February.
    • Handle: RePEc:eee:socmed:v:60:y:2005:i:3:p:563-573
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    3. Akhavan, Dariush & Musgrove, Philip & Abrantes, Alexandre & Gusmão, Renato d'A., 1999. "Cost-effective malaria control in Brazil: Cost-effectiveness of a Malaria Control Program in the Amazon Basin of Brazil, 1988-1996," Social Science & Medicine, Elsevier, vol. 49(10), pages 1385-1399, November.
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    1. Ana Paula Dal’Asta & Raquel Martins Lana & Silvana Amaral & Cláudia Torres Codeço & Antônio Miguel Vieira Monteiro, 2018. "The Urban Gradient in Malaria-Endemic Municipalities in Acre: Revisiting the Role of Locality," IJERPH, MDPI, vol. 15(6), pages 1-17, June.
    2. Diamantina Moreno-Gutierrez & Alejandro Llanos-Cuentas & José Luis Barboza & Juan Contreras-Mancilla & Dionicia Gamboa & Hugo Rodriguez & Gabriel Carrasco-Escobar & Raphaël Boreux & Marie-Pierre Hayet, 2018. "Effectiveness of a Malaria Surveillance Strategy Based on Active Case Detection during High Transmission Season in the Peruvian Amazon," IJERPH, MDPI, vol. 15(12), pages 1-20, November.
    3. Camila Bôtto-Menezes & Azucena Bardají & Giselane dos Santos Campos & Silke Fernandes & Kara Hanson & Flor Ernestina Martínez-Espinosa & Clara Menéndez & Elisa Sicuri, 2016. "Costs Associated with Malaria in Pregnancy in the Brazilian Amazon, a Low Endemic Area Where Plasmodium vivax Predominates," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(3), pages 1-19, March.
    4. Kelly M Searle & Timothy Shields & Harry Hamapumbu & Tamaki Kobayashi & Sungano Mharakurwa & Philip E Thuma & David L Smith & Gregory Glass & William J Moss, 2013. "Efficiency of Household Reactive Case Detection for Malaria in Rural Southern Zambia: Simulations Based on Cross-Sectional Surveys from Two Epidemiological Settings," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-10, August.

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