In the most ideal setting it would be aptly measured using indicators like sporozoite rate/ parasite prevalence before and after the vector control or other interventions, thereby determining the actual decline in malaria transmission due to the intervention applied and the remaining being residual transmission. If surveillance data is reliable, then rates of transmission measured in new infections per 1000 people can also be measured longitudinally to ascertain the amount of transmission that can't be eliminated due to existing vector control interventions and/or diagnosis and treatment. In a study presently being conducted there were reported around 300 cases in 6000 people of the target area in a cross-sectional survey with an API of over 100 in the year before, before implementing a large scale LLIN installation and massive diagnosis and treatment. In subsequent years, with continued monitoring of use of bednets and annual cover-up campaigns, the API reduced to 30 in the first year and below 10 in the second. As some vector control interventions take time to have its full effect, it might not be possible to ascertain well the residual transmission based just on incidence data, thus the need for sporozoite rates which are much harder to ascertain but more likely to be representative. This also would avoid the problem of differentiating relapses from new infections in case P. vivax was the study objective.
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