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Multiple Indicator Cluster Surveys Survey Design Workshop. Questionnaire for Children Under Five: Malaria. Global goals and targets. MDG 6: Combat HIV/AIDS, malaria and other diseases Target 6.C By 2015 have halted and begun to reverse the incidence of malaria and other major diseases
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Multiple Indicator Cluster SurveysSurvey Design Workshop Questionnaire for Children Under Five: Malaria MICS4 Survey Design Workshop
Global goals and targets • MDG 6: Combat HIV/AIDS, malaria and other diseases • Target 6.C By 2015 have halted and begun to reverse the incidence of malaria and other major diseases • Indicator 6.6 Incidence and death rates associated with malaria • Indicator 6.7 % of children under five sleeping under ITNs (MICS) • Indicator 6.8 % of children under five treated with anti-malarials(MICS) • RBM Global Malaria Action Plan (2008) • Achieve universal coverage…with interventions for prevention and case management by 2010 (MICS) • Halve the malaria burden between 2000 and 2010 • Eliminate malaria in 8-10 countries by 2015…and in the long-term eradicate malaria worldwide… MICS4 Survey Design Workshop
Background • WHO estimates 190-330 million malaria episodes in 2006, resulting in nearly 1 million deaths • About 90 per cent of all malaria deaths occur in sub-Saharan Africa, most among children under five • Significant funding toward malaria control, and significant progress in scaling up ITNs in recent years • Major focus by RBM partners on achieving universal coverage targets by end-2010 MICS4 Survey Design Workshop
MICS Indicators • # 3.18:Anti-malarial treatment of children under age 5 - % under fives with fever receiving any anti-malarial medicine • # 3.17: Anti-malarial treatment of children under 5 the same or next day - % under fives with fever who were treated with any anti-malarial drug within the same or next day of onset of symptoms (NEW) • # 3.16: Malaria diagnostics usage - % under fives with fever receiving a finger or heel stick for malaria testing (NEW) MICS4 Survey Design Workshop
Survey questions • Questions ML.1 – ML.10 in U5 questionnaire • ML.1: Fever prevalence (Same as MICS3) • ML.2: Malaria diagnostics use (New) • At the time of the illness, did (NAME) have blood taken from his/her finger or heel for testing? • ML.3 – ML.10: Anti-malarial treatment (by timing, place of treatment and drug type) (Same as MICS3) MICS4 Survey Design Workshop
Methodological issues Survey preparation • Different anti-malarial medicines used in different countries • Develop list of local anti-malarial drugs and brand names (with photos or samples, if possible) • Obtain list of first-line anti-malarial treatment (available on WHO website). Note that most African countries recommend ACT for first-line treatment of uncomplicated malaria MICS4 Survey Design Workshop
Methodological issues • MICS often carried out in the dry season for logistical reasons; not during times of peak malaria transmission. • MICS does not measure coverage among sub-national populations at risk for malaria transmission • Responses limited by caregivers’ knowledge of drugs given to treat fever, and recall of treatment timing after fever onset • Does not measure proper dosage or treatment administration MICS4 Survey Design Workshop
Methodological issues • Fever may not be the result of malaria infection • Issue even more problematic with roll out of diagnostics, coupled with major declines in malaria cases – interpreting trends may become more complicated in future • Comparing historical data based on presumptive fever treatment with coverage based on diagnosed cases will inevitably show declining coverage over time – but in fact reflects more rational use of anti-malarial medicines • New question on diagnostics use will help to interpret trends MICS4 Survey Design Workshop