Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa

Shr-Jie Wang¹ , Christian Lengeler¹ , Thomas A Smith¹ , Penelope Vounatsou¹ , Guéladio Cissé² , Diadie A Diallo³ , Martin Akogbeto⁴ , Deo Mtasiwa⁵ , Awash Teklehaimanot⁶ and Marcel Tanner¹

¹Swiss Tropical Institute (STI), P.O. Box, CH-4002 Basel, Switzerland

²Centre Suisse de Recherches Scientifiques (CSRS), 01 B.P. 1303 Abidjan, 01 Côte d'Ivoire

³Centre National de Recherche et de Formation sur le Paludisme, (CNRFP) 01 B.P. 2208, Ouagadougou 01, Burkina Faso

⁴Centre de Recherche Entomologique de Cotonou (CREC), Ministère de la Santé Publique, B. P. 06-2604, Cotonou, Benin

⁵Regional/City Medical Office of Health, P.O. Box 9084, Dar es Salaam, Tanzania

⁶The Earth Institute at Columbia University, 215 West 125th St Suite 301, New York NY, 10027, USA

author email corresponding author email

Malaria Journal 2005, 4:40doi:10.1186/1475-2875-4-40


Published:	9 September 2005

Abstract

Background

The rapid urban malaria appraisal (RUMA) methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology.

Methods

This work was done in Yopougon municipality (Abidjan), Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1) a literature review, 2) the collection of available health statistics, 3) a risk mapping, 4) school parasitaemia surveys, 5) health facility-based surveys and 6) a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness.

Results

A substantial amount of literature (including unpublished theses and statistics) was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period.

Conclusion

RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.