The main output of this module is to document and interpret the trends of mortality and morbidity taking into consideration all the factors. Controlling for confounders and effect modifiers will require documentation in trends of coverage of malaria preventive interventions such as ITNs, IRS coverage, and IPT. Other contextual determinants, including health system changes, which may act as confounders and/or effect modifiers will also be documented to the extent data is available. Depending on the intensity of transmission, widespread use of ACTs may reduce gametocyte rates and hence malaria transmission indices. Entomologic inoculation rates will be monitored in HDSS sites with entomology capacity. We will be able to determine the public health impact of treatment failure identified through data linkage and cohorts above, through several markers such as malaria associated morbidity as reported in health facilities and in our household surveys.