title: Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa.
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  A substantial amount of literature (including unpublished theses and statistics) was found at each site, providing a good overview of the malaria situation.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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Swiss Tropical Institute, CH-4002 Basel, Switzerland. shrjie.wang@unibas.ch
authors.forename: Shr-Jie
authors.initials: SJ
authors.lastname: Wang
authors.forename: Christian
authors.initials: C
authors.lastname: Lengeler
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Smith
authors.forename: Penelope
authors.initials: P
authors.lastname: Vounatsou
authors.forename: Guéladio
authors.initials: G
authors.lastname: Cissé
authors.forename: Diadie A
authors.initials: DA
authors.lastname: Diallo
authors.forename: Martin
authors.initials: M
authors.lastname: Akogbeto
authors.forename: Deo
authors.initials: D
authors.lastname: Mtasiwa
authors.forename: Awash
authors.initials: A
authors.lastname: Teklehaimanot
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D001541:Benin / Q000453:epidemiology; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D007560:Cote d'Ivoire / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000191:economics / Q000453:epidemiology*; D009032:Mosquito Control / Q000379:methods; D011159:Population Surveillance / Q000379:methods; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health; D014505:Urban Population