Group | Effectiveness and Impact Research

In the Effectiveness and Impact research group we focus on generating evidence to support the effective roll-out of health interventions with a current emphasis on malaria.

In the real world, health interventions work differently than in a controlled trial. Our research investigates the impact of interventions rolled out on a large scale (e.g. regional or national) and how the effectiveness of interventions may be improved to make best use of limited resources. We are particularly interested in the role of surveillance-response systems to target interventions in areas with declining disease burden.

Field epidemiological studies are at the core of our activities, combining classic epidemiological approaches with molecular epidemiology, population genetics, and modeling.

We work in close partnership with academic institutions, NGOs and national malaria control programmes.

Impact Evaluation and Operational Research

Evaluating the impact of interventions implemented by the malaria control programme is crucial for programme planning and allocation of resources. Yet, existing routine data sources are often insufficient for providing  the evidence required to understand which factors may result in a decay in effectiveness and why interventions may not achieve the intended outcome. In partnership with Papua New Guinea Institute of Medical Research, we provide long-term support to the evaluation of the national malaria control of Papua New Guinea and conduct operational research to inform evidence-based decision-making.

Supporting the National Malaria Control Program of Papua New Guinea

 

Surveillance-Response

Surveillance has been recognized by the World Health Organization as a core intervention in malaria control and elimination programmes. An effective surveillance-response system aims to detect and classify cases, prevent outbreaks, and provide data to target interventions. We work with malaria control programmes in Zanzibar and Papua New Guinea to assess the effectiveness of existing surveillance-response systems and validate new and innovative approaches.

Link to RADZEC Project

Residual Malaria Transmission

Despite high coverage of existing interventions such as long-lasting insecticidal nets and treatment with artemisinin-based combination therapy, residual malaria transmission continues in some low-transmission settings. In Papua New Guinea and Tanzania, we investigate, what the drivers are of ongoing residual malaria transmission and how effectiveness gaps in existing interventions may be addressed.

Link to Project in PNG

Severe Malaria

Despite the existence of efficacious medicines to treat malaria, malaria mortality (particularly in young children) remains high in some parts of sub-Saharan Africa. One of the key problems is that treatment for severe malaria episodes is only available in hospitals which are few and far between. In order to address the unacceptable death toll from malaria, we work with partners in DRC, Nigeria and Uganda to measure the impact of introducing rectal artesunate at community level for pre-referral treatment of severe malaria.

Link to CARAMAL Project

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Selected projects at this location:

Evaluation Task Force of Roll Back Malaria’s Monitoring and Evaluation Reference Group. Framework for evaluating national malaria programs in moderate and low transmission settings. Chapel Hill, NC, USA: MEASURE Evaluation, 2019

Fola A.A et al. Nationwide genetic surveillance of Plasmodium vivax in Papua New Guinea reveals heterogeneous transmission dynamics and routes of migration amongst subdivided populations. Infect Genet Evol. 2018;58:83-95. DOI: 10.1016/j.meegid.2017.11.028

Hetzel M.W, Genton B. Mass drug administration for malaria elimination: do we understand the settings well enough?. BMC Med. 2018;16(1):239. DOI: 10.1186/s12916-018-1230-4

Hetzel M.W et al. Papua New Guinea malaria indicator survey 2016-2017: malaria prevention, infection and treatment. Goroka: Papua New Guinea Institute of Medical Research, 2018

Koimbu G et al. Status of insecticide resistance in Papua New Guinea: an update from nation-wide monitoring of anopheles mosquitoes. Am J Trop Med Hyg. 2018;98(1):162-165. DOI: 10.4269/ajtmh.17-0454