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Early results of integrated malaria control and implications for the management of fever in under-five children at a peripheral health facility: a case study of Chongwe rural health centre in Zambia.

Chanda P, Hamainza B, Mulenga S, Chalwe V, Msiska C, Chizema-Kawesha E - Malar. J. (2009)

Bottom Line: Amoxicillin was the most prescribed antibiotic followed by septrin.The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections.These findings have implications for the management of non-malaria fevers in children under the age of five years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Ministry of Health Headquarters, Lusaka, Zambia. pascychanda@yahoo.com

ABSTRACT

Background: Zambia has taken lead in implementing integrated malaria control so as to attain the National Health Strategic Plan goal of "reducing malaria incidence by 75% and under-five mortality due to malaria by 20% by the year 2010". The strategic interventions include the use of long-lasting insecticide-treated nets and indoor residual spraying, the use of artemisinin-based combination therapies (ACT) for the treatment of uncomplicated malaria, improving diagnostic capacity (both microscopy and rapid diagnostic tests), use of intermittent presumptive treatment for pregnant women, research, monitoring and evaluation, and behaviour change communication. Financial barriers to access have been removed by providing free malaria prevention and treatment services.

Methods: Data involving all under-five children reporting at the health facility in the first quarter of 2008 was evaluated prospectively. Malaria morbidity, causes of non-malaria fever, prescription patterns treatment patterns and referral cases were evaluated

Results: Malaria infection was found only in 0.7% (10/1378), 1.8% (251378) received anti-malarial treatment, no severe malaria cases and deaths occurred among the under-five children with fever during the three months of the study in the high malaria transmission season. 42.5% (586/1378) of the cases were acute respiratory infections (non-pneumonia), while 5.7% (79/1378) were pneumonia. Amoxicillin was the most prescribed antibiotic followed by septrin.

Conclusion: Malaria related OPD visits have reduced at Chongwe rural health facility. The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections. These findings have implications for the management of non-malaria fevers in children under the age of five years.

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Trends in parasite rates among fever patients at Chongwe health facility 2003–2008.
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Figure 1: Trends in parasite rates among fever patients at Chongwe health facility 2003–2008.

Mentions: The study has shown parasite rates lower than the national average. The health facility is situated in a district where an integrated package for malaria control has been implemented. The parasite prevalence at OPD was less than 1%, only 10 confirmed cases in three months during the rainy season. Earlier parasite survey results conducted at the same facility in January and February 2006 among under-five children, recorded a parasite prevalence of 28% at OPD, 7.9% among pregnant women and 7.0% among asymptomatic primary school children (aged 2–14 years) at Chongwe basic school [23]. Further, in 2005, out of the 3338 all OPD visits, malaria was confirmed in 35% of all patients with fever, while in 2006, malaria accounted for 24% of health facility visits at Chongwe rural health facility [24]. So it appears that the malaria disease burden at Chongwe rural health facility has been on a steady decline as shown in figure 1.


Early results of integrated malaria control and implications for the management of fever in under-five children at a peripheral health facility: a case study of Chongwe rural health centre in Zambia.

Chanda P, Hamainza B, Mulenga S, Chalwe V, Msiska C, Chizema-Kawesha E - Malar. J. (2009)

Trends in parasite rates among fever patients at Chongwe health facility 2003–2008.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2662870&req=5

Figure 1: Trends in parasite rates among fever patients at Chongwe health facility 2003–2008.
Mentions: The study has shown parasite rates lower than the national average. The health facility is situated in a district where an integrated package for malaria control has been implemented. The parasite prevalence at OPD was less than 1%, only 10 confirmed cases in three months during the rainy season. Earlier parasite survey results conducted at the same facility in January and February 2006 among under-five children, recorded a parasite prevalence of 28% at OPD, 7.9% among pregnant women and 7.0% among asymptomatic primary school children (aged 2–14 years) at Chongwe basic school [23]. Further, in 2005, out of the 3338 all OPD visits, malaria was confirmed in 35% of all patients with fever, while in 2006, malaria accounted for 24% of health facility visits at Chongwe rural health facility [24]. So it appears that the malaria disease burden at Chongwe rural health facility has been on a steady decline as shown in figure 1.

Bottom Line: Amoxicillin was the most prescribed antibiotic followed by septrin.The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections.These findings have implications for the management of non-malaria fevers in children under the age of five years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Ministry of Health Headquarters, Lusaka, Zambia. pascychanda@yahoo.com

ABSTRACT

Background: Zambia has taken lead in implementing integrated malaria control so as to attain the National Health Strategic Plan goal of "reducing malaria incidence by 75% and under-five mortality due to malaria by 20% by the year 2010". The strategic interventions include the use of long-lasting insecticide-treated nets and indoor residual spraying, the use of artemisinin-based combination therapies (ACT) for the treatment of uncomplicated malaria, improving diagnostic capacity (both microscopy and rapid diagnostic tests), use of intermittent presumptive treatment for pregnant women, research, monitoring and evaluation, and behaviour change communication. Financial barriers to access have been removed by providing free malaria prevention and treatment services.

Methods: Data involving all under-five children reporting at the health facility in the first quarter of 2008 was evaluated prospectively. Malaria morbidity, causes of non-malaria fever, prescription patterns treatment patterns and referral cases were evaluated

Results: Malaria infection was found only in 0.7% (10/1378), 1.8% (251378) received anti-malarial treatment, no severe malaria cases and deaths occurred among the under-five children with fever during the three months of the study in the high malaria transmission season. 42.5% (586/1378) of the cases were acute respiratory infections (non-pneumonia), while 5.7% (79/1378) were pneumonia. Amoxicillin was the most prescribed antibiotic followed by septrin.

Conclusion: Malaria related OPD visits have reduced at Chongwe rural health facility. The reduction in health facility malaria cases has led to an increase in diagnoses of respiratory infections. These findings have implications for the management of non-malaria fevers in children under the age of five years.

Show MeSH
Related in: MedlinePlus