Step 3: Situation Analysis of Epidemiology and Context

A company malaria management programme will include aspects on protecting and informing travelling staff as well as location specific control programmes.

Location specific control programmes must first and foremost be grounded on a detailed and accurate understanding of the epidemiological context. Required activities include:

• Vector surveys: These will address the following questions:
  • What are the dominant malaria vector species?
  • What are their behaviours?
  • What is the insecticide resistance profile?
  Answering these questions will require specialist entomological surveys.
• Epidemiological profiling: This will address the following questions:
  • What is the transmission profile? Is malaria stable or unstable?
  • Who are the most affected groups (where caseloads or infection rates are highest)?
  • What phase of control effort is the country in? Control or moving towards elimination?
  • What malaria species are present?
  • What is the range of transmission relevant to the site of interest? i.e. is transmission localized in specific company assets of interest, or are nearby communities involved in the transmission?

Epidemiological profiling requires access to very high quality and localised data and it is likely that this type of data will only be available if dedicated malaria prevalence surveys are carried out. Such surveys involve a representative sample of the population group of interest providing blood samples for testing. These surveys must be designed by a malaria surveillance specialist with appropriate skills to ensure the results are robust and that ethical requirements are attended to.

• Malaria related knowledge, attitudes, practices and behaviours surveys should be conducted and targeted at the relevant group (either the workforce or the local communities) who may be included in a control programme. A researcher with expertise on malaria and qualitative research should be responsible for this survey.
• Health system surveys should include health facility surveys as well as a broader assessment of the capacity (resources, infrastructure, equipment, personnel and systems) of the health system in the area of interest. These will inform planners about opportunities for linking and supporting the local health system, with potential for more sustainable programme impacts. The health system survey should be conducted by an expert in health systems, and malaria.
• Geo-spatial mapping: overlaying malaria prevalence information with meteorological and land cover information can give a useful visual understanding of the areas targeted in the control programmes and the variation within them. Specialist software and skills are required.
• Workforce reviews to determine high risk groups: combining information from the epidemiology in specific locations and the practices of different employees, the company should identify who are the highest risk groups in the work force. This may include those who travel locally or internationally between malarious and non-malarious areas and security guards or other night shift workers who work in malarious sites.
• Stakeholder analyses should define which groups are relevant to potential malaria control activities, their level of interest, level of support and the potential roles they could play as supporters, funders or implementing partners.

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Examples of successful industry malaria control programmes
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