The short-term impact of a malaria elimination initiative in Southern Mozambique: Application of the synthetic control method to routine surveillance data

R. Thomas, L. Cirera, J. Brew, F. Saúte, E. Sicuri

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2021 John Wiley & Sons Ltd.In public health epidemiology, quasi-experimental methods are widely used to estimate the causal impacts of interventions. In this paper, we demonstrate the contribution the synthetic control method (SCM) can make in evaluating public health interventions, when routine surveillance data are available and the validity of other quasi-experimental approaches may be in question. In our application, we evaluate the short-term effects of a large-scale Mass Drug Administration (MDA) based malaria elimination initiative in Southern Mozambique. We apply the SCM to district level weekly malaria incidence data and compare the observed reduction in age group specific malaria incidence. Between August 2015 and April 2017, a total of 13,322 (78%) cases of malaria were averted relative to the synthetic control. During the peak malaria seasons, the elimination initiative resulted in an 87% reduction in Year 1 (December 2015–April 2016), and 79% reduction in Year 2 (December 2016–April 2017). Comparison with an interrupted time series approach shows the SCM accounts for pre-intervention trends in the data and post-intervention weather events influencing malaria cases. We conclude MDA brought about a drastic reduction in malaria burden and can be a useful addition to existing (or new) vector control strategies and tools in accelerating towards elimination.
Original languageEnglish
Pages (from-to)2168-2184
JournalHealth Economics (United Kingdom)
Volume30
Issue number9
DOIs
Publication statusPublished - 1 Sept 2021

Funding

We thank the community of Magude, the district authorities and the team for allowing this project to take place. We also thank the Ministry of Health (MOH) and National Malaria Control Program (NMCP) in Mozambique for providing us access to the BES data. A special thanks to Beatriz Galatas and to Helena Martí, for their comments and suggestions. We extend our gratitude to the participants of the Health Economics Seminar at Imperial College London, Paris Sorbonne Sustainable Development Seminar, LSE Health Policy Seminar and seminar at the Academic Unit of Health Economics, University of Leeds for their comments on this paper. Joe Brew was funded by the Erasmus Mundus Joint Doctorate Fellowship, Grant Agreement 2016‐1346. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya ( http://cerca.cat/en/suma/ ). CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID). (NCT02914145) was funded by the Bill and Melinda Gates Foundation and Obra Social “la Caixa” Partnership for the Elimination of Malaria in Southern Mozambique (OPP1115265). Magude Project The Magude Project We thank the community of Magude, the district authorities and the Magude Project team for allowing this project to take place. We also thank the Ministry of Health (MOH) and National Malaria Control Program (NMCP) in Mozambique for providing us access to the BES data. A special thanks to Beatriz Galatas and to Helena Mart?, for their comments and suggestions. We extend our gratitude to the participants of the Health Economics Seminar at Imperial College London, Paris Sorbonne Sustainable Development Seminar, LSE Health Policy Seminar and seminar at the Academic Unit of Health Economics, University of Leeds for their comments on this paper. Joe Brew was funded by the Erasmus Mundus Joint Doctorate Fellowship, Grant Agreement 2016-1346. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya (http://cerca.cat/en/suma/). CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID). The Magude Project (NCT02914145) was funded by the Bill and Melinda Gates Foundation and Obra Social ?la Caixa? Partnership for the Elimination of Malaria in Southern Mozambique (OPP1115265).

FundersFunder number
Elimination of Malaria in Southern MozambiqueOPP1115265
Government of Mozambique
National Malaria Control Program2016‐1346
Obra Social “la Caixa
Spanish Agency for International Development
Bill and Melinda Gates Foundation
Ministerio de Sanidad, Consumo y Bienestar Social
Generalitat de Catalunya
Agencia Española de Cooperación Internacional para el DesarrolloNCT02914145

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