Group | Intervention Effectiveness and Impact
In the Intervention Effectiveness and Impact research group we focus on generating evidence to support the effective roll-out of health interventions and make best use of limited resources. Our current focus is on vector borne diseases, particularly malaria.
In the real world, health interventions work differently than in a controlled setting, such as a clinical trial. Our research therefore investigates the impact of interventions rolled out on a large scale (e.g. regional or national) while we try to understand the underlying factors that influence their effectiveness. We are particularly interested in the role of surveillance-response systems to target interventions in areas with declining disease burden.
Large-scale epidemiological studies and operational research across a variety of settings are our core competences. We combine classic epidemiological approaches (surveys, sentinel surveillance, longitudinal studies) with molecular epidemiology, population genetics, and modeling.
We work in close partnership with academic institutions across the world, NGOs, international organizations and national malaria control programmes.
Malaria control and elimination in the South Pacific
Island nations in Melanesia exhibit a diverse malaria epidemiology ranging from high transmission comparable to sub-Saharan Africa in parts of Papua New Guinea to near-elimination situations in Vanuatu or the Solomon Islands. To accelerate progress towards elimination in the region, national malaria control programmes require evidence on appropriate intervention strategies and suitable data systems for targeting interventions. We provide technical and scientific support to the national malaria control programme of Papua New Guinea and conduct operational research and desk-based analyses to inform evidence-based decision-making across the region. Read more about our malaria research in Papua New Guinea
Surveillance has been recognized by the World Health Organization as a core intervention of 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.
Watch here how visualizing malaria case numbers may be useful to target malaria control in Papua New Guinea and read more about the RADZEC Project in Zanzibar.
Residual Malaria Transmission
Despite high coverage of existing interventions such as long-lasting insecticidal mosquito nets and treatment with artemisinin-based combination therapy, malaria transmission continues in many places because interventions fail to completely prevent human-mosquito contact. In Papua New Guinea and Tanzania we investigate the drivers of residual malaria transmission with a particular focus on the behavior of the human host and of the mosquito vector. This way, we aim to identify how traditional and new interventions may be improved to close the existing effectiveness gaps. Read more about our residual transmission project in Papua New Guinea
Despite the existence of efficacious medicines to treat malaria, close to half a million deaths from malaria still occur every year, particularly in young children in sub-Saharan Africa. One of the key challenges is that proper severe malaria treatment is only available in hospitals that are often far away and difficult to reach. In order to address the unacceptable death toll from malaria, we work with partners in DR Congo, Nigeria and Uganda to measure the impact of introducing rectal artesunate at community level for pre-referral treatment of severe malaria in children. The evidence generated should help malaria endemic countries to bring essential life-saving treatment closer to people’s homes. Read more about the CARAMAL project
Lambiris M.J et al. Health system readiness and the implementation of rectal artesunate for severe malaria in sub-Saharan Africa: an analysis of real-world costs and constraints. Lancet Glob Health. 2023;11(2):e256-e264. DOI: 10.1016/S2214-109X(22)00507-1
Signorell A et al. Health worker compliance with severe malaria treatment guidelines in the context of implementing pre-referral rectal artesunate in the Democratic Republic of the Congo, Nigeria, and Uganda: an operational study. PLoS Med. 2023;20(2):e1004189. DOI: 10.1371/journal.pmed.1004189
Awor P et al. Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda. Malar J. 2022;21:322. DOI: 10.1186/s12936-022-04348-7
Awor P et al. Care seeking and treatment of febrile children with and without danger signs of severe disease in northern Uganda: results from three household surveys (2018-2020). Am J Trop Med Hyg. 2022;107(4):934–938. DOI: 10.4269/ajtmh.21-1132
Brunner N.C et al. Prereferral rectal artesunate and referral completion among children with suspected severe malaria in the Democratic Republic of the Congo, Nigeria and Uganda. BMJ Glob Health. 2022;7(5):e008346. DOI: 10.1136/bmjgh-2021-008346