Challenges and the Path Forward on Malaria Elimination Intervention: A Systematic Review

  • Khandan SHAHANDEH Deputy of Research and Technology, Tehran University of Medical Sciences, Tehran, Iran
  • Hamid Reza BASSERI Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Systematic review; Malaria elimination; Intervention; Challenges


Abstract Background: This systematic review was conducted to highlights key challenges, and outlines important next steps to maximize the potential to contribute to the broader malaria elimination interventions. Methods: This systematic review on malaria elimination intervention and challenges was undertaken searching six databases, between 1995 and 2018. Inclusion and exclusion criteria were set. The references were collated and categorized according to type of study, intervention, population, and health outcome. Articles selection based on title and abstract, retrieval of full text and additions of articles from reference lists and recommendations from experts. Disagreement in data extraction was solved by consultation of third reviewer. Results: Overall, 4039 records were examined related to malaria elimination that initially identified by our designated electronic databases search. Overall, 35 studies contained 14 experimental studies (40%) and 21 analytic observational studies (60%) met the inclusion criteria for this review. Studies used a wide variety of malaria elimination interventions. Types of interventions either elimination-focused interventions or general interventions on educational, prevention and treatment of malaria are included. This review pointed out the variety of challenges for eliminate malaria among low and high endemic countries. Conclusion: Malaria elimination is facilitated by strong health systems, determined leadership, appropriate incentivization, an effective surveillance system, and regional collaborations. We have identified areas for elimination-specific interventions deserve more attention in the conduct and reporting.  


1. Cohen JM, Moonen B, Snow RW, Smith DL (2010). How absolute is zero? An evaluation of historical and current definitions of malaria elimination. Malar J, 9:213.
2. WHO (2013) World Malaria Report 2013. World Health Organization, Geneva, pp. 290.
3. WHO (2012) Global Malaria Programme World malaria Report 2012. (eds) WC, 765, World Health organization, Switzerland, pp. 288.
4. WHO Malaria Policy Advisory Committee and Secretariat (2013). Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of September 2013 meeting. Malar J, 12:456.
5. Andersen F, Douglas NM, Bustos D et al (2011). Trends in malaria research in 11 Asian Pacific countries: an analysis of peer-reviewed publications over two decades. Malar J, 10:131.
6. Cohen JM, Smith DL, Cotter C et al (2012). Malaria resurgence: a systematic review and assessment of its causes. Malar J, 11:122.
7. Whittaker MA, Dean AJ, Chancellor A (2014). Advocating for malaria elimination - learning from the successes of other infectious disease elimination programmes. Malar J, 13:221.
8. Akoria OA, Arhuidese IJ (2014). Progress toward elimination of malaria in Nigeria: uptake of artemisinin-based combination therapies for the treatment of malaria in households in Benin City. Ann Afr Med, 13:104-13.
9. Silal SP, Little F, Barnes KI, White LJ (2014). Towards malaria elimination in Mpumalanga, South Africa: a population-level mathematical modelling approach. Malar J, 13:297.
10. Obaldia N, 3rd, Baro NK, Calzada JE et al (2015). Clonal outbreak of Plasmodium falciparum infection in Eastern Panama. J Infect Dis, 211(7):1087-96.
11. Parham PE, Hughes DA (2015). Climate influences on the cost-effectiveness of vector-based interventions against malaria in elimination scenarios. Philos Trans R Soc Lond B Biol Sci, 370(1665): 20130557.
12. Zhang Q, Sun J, Zhang Z et al (2016). Risk assessment of malaria in land border regions of China in the context of malaria elimination. Malar J, 15:546.
13. Zhou G, Yewhalaw D, Lo E et al (2016). Analysis of asymptomatic and clinical malaria in urban and suburban settings of southwestern Ethiopia in the context of sustaining malaria control and approaching elimination. Malar J, 15:250.
14. Zhu L, Muller GC, Marshall JM et al (2017). Is outdoor vector control needed for malaria elimination? An individual-based modelling study. Malar J, 16:266.
15. Yalew WG, Pal S, Bansil P et al (2017). Current and cumulative malaria infections in a setting embarking on elimination: Amhara, Ethiopia. Malar J, 16:242.
16. Wotodjo AN, Doucoure S, Gaudart J et al (2017). Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets? PLoS One, 12:e 0179528.
17. Zhang S, Guo S, Feng X et al (2017). Anopheles Vectors in Mainland China While Approaching Malaria Elimination. Trends Parasitol, 33:889-900.
18. von Seidlein L, Walraven G, Milligan PJ et al (2003). The effect of mass administration of sulfadoxine-pyrimethamine combined with artesunate on malaria incidence: a double-blind, community-randomized, placebo-controlled trial in The Gambia. Trans R Soc Trop Med Hyg, 97(2):217-25.
19. Kobylinski KC, Sylla M, Chapman PL et al (2011). Ivermectin mass drug administration to humans disrupts malaria parasite transmission in Senegalese villages. Am J Trop Med Hyg, 85(1):3-5.
20. Dial NJ, Ceesay SJ, Gosling RD et al (2014). A qualitative study to assess community barriers to malaria mass drug administration trials in The Gambia. Malar J, 13:47.
21. Larsen DA, Bennett A, Silumbe K et al (2015). Population-Wide Malaria Testing and Treatment with Rapid Diagnostic Tests and Artemether-Lumefantrine in Southern Zambia: A Community Randomized Step-Wedge Control Trial Design. Am J Trop Med Hyg, 92(5):913–921.
22. Sahan K, Pell C, Smithuis F, Phyo AK et al (2017). Community engagement and the social context of targeted malaria treatment: a qualitative study in Kayin (Karen) State, Myanmar. Malar J, 16:75.
23. Nguyen TN, Thu PN, Hung NT et al (2017). Community perceptions of targeted anti-malarial mass drug administrations in two provinces in Vietnam: a quantitative survey. Malar J, 16:17.
24. Cook J, Xu W, Msellem M et al (2015). Mass screening and treatment on the basis of results of a Plasmodium falciparum-specific rapid diagnostic test did not reduce malaria incidence in Zanzibar. J Infect Dis, 211(9):1476-83.
25. Canier L, Khim N, Kim S et al (2013). An innovative tool for moving malaria PCR detection of parasite reservoir into the field. Malar J, 12:405.
26. Basseri HR, Raeisi A, Holakouie K, Shanadeh K (2010). Malaria prevention among Afghani refugees in a malarious area, southeastern Iran. Bull Soc Pathol Exot, 103:340-5.
27. Yangzom T, Gueye CS, Namgay R et al (2012). Malaria control in Bhutan: case study of a country embarking on elimination. Malar J, 11:9.
28. Pindolia DK, Garcia AJ, Huang Z et al (2014). Quantifying cross-border movements and migrations for guiding the strategic planning of malaria control and elimination. Malar J, 13:169.
29. He CH, Hu XM, Wang GZ et al (2014). Eliminating Plasmodium falciparum in Hainan, China: a study on the use of behavioural change communication intervention to promote malaria prevention in mountain worker populations. Malar J, 13:273.
30. Shahandeh K, Basseri HR, Majdzadeh R et al (2015). Community Eagerness and Participation for Supporting Eliminate Malaria. Iran J Public Health, 44(5):659-64.
31. Win AYN, Maung TM, Wai KT et al (2017). Understanding malaria treatment-seeking preferences within the public sector amongst mobile/migrant workers in a malaria elimination scenario: a mixed-methods study. Malar J, 16:462.
32. Hlongwana KW, Sartorius B, Tsoka-Gwegweni J (2018). Malaria programme personnel's experiences, perceived barriers and facilitators to implementing malaria elimination strategy in South Africa. Malar J, 17:21.
33. Wirth DF, Casamitjana N, Tanner M, Reich MR (2018). Global action for training in malaria elimination. Malar J, 17:51.
34. Rojas W, Botero S, Garcia HI (2001). An integrated malaria control program with community participation on the Pacific Coast of Colombia. Cad Saude Publica, 17 Suppl:103-13.
35. Atkinson JA, Bobogare A, Vallely A et al (2009). A cluster randomized controlled cross-over bed net acceptability and preference trial in Solomon Islands: community participation in shaping policy for malaria elimination. Malar J, 8:298.
36. Shahandeh K, Basseri H, Pakari A, Riazi A (2010). Mosquito vector biting and community protection in a malarious area, siahoo district, hormozgan, iran. Iran J Arthropod Borne Dis, 4(2):35-41.
37. Basseri HR, Abai MR, Raeisi A, Shahandeh K (2012). Community sleeping pattern and anopheline biting in southeastern Iran: a country earmarked for malaria elimination. Am J Trop Med Hyg, 87(3):499-503.
38. Sanders KC, Rundi C, Jelip J et al (2014). Eliminating malaria in Malaysia: the role of partnerships between the public and commercial sectors in Sabah. Malar J, 13:24.
39. Shahandeh K, Basseri HR, Sharifzadeh Y (2014). An application of cultural model to assess and compare malaria prevention among Afghani migrant and Baluchi resident in the endemic area, southeastern Iran. J Immigr Minor Health, 16(1):102-10.
40. Tobgay T, Pem D, Dophu U et al (2013). Community-directed educational intervention for malaria elimination in Bhutan: quasi-experimental study in malaria endemic areas of Sarpang district. Malar J, 12:132.
41. Shahandeh K, Basseri HR, Majdzadeh R et al (2015). Health Workers Adjustment for Elimination of Malaria in a Low Endemic Area. Int J Prev Med, 6:105.
42. da Silva-Nunes M, Moreno M, Conn JE et al (2012). Amazonian malaria: asymptomatic human reservoirs, diagnostic challenges, environmentally driven changes in mosquito vector populations, and the mandate for sustainable control strategies. Acta Trop, 121(3):281-91.
43. Zhou G, Afrane YA, Malla S et al (2015). Active case surveillance, passive case surveillance and asymptomatic malaria parasite screening illustrate different age distribution, spatial clustering and seasonality in western Kenya. Malar J, 14:41.
44. Mharakurwa S, Daniels R, Scott A et al (2014). Pre-amplification methods for tracking low-grade Plasmodium falciparum populations during scaled-up interventions in Southern Zambia. Malar J, 13:89.
45. Simon C, Moakofhi K, Mosweunyane T et al (2013). Malaria control in Botswana, 2008-2012: the path towards elimination. Malar J, 12:458.
46. Monteiro WM, Franca GP, Melo GC et al (2014). Clinical complications of G6PD deficiency in Latin American and Caribbean populations: systematic review and implications for malaria elimination programmes. Malar J, 13:70.
47. Banek K, Lalani M, Staedke SG, Chandramohan D (2014). Adherence to artemisinin-based combination therapy for the treatment of malaria: a systematic review of the evidence. Malar J, 13:7.
How to Cite
SHAHANDEH K, BASSERI HR. Challenges and the Path Forward on Malaria Elimination Intervention: A Systematic Review. Iran J Public Health. 48(6):1004-1013.
Review Article(s)