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High burden of malaria following scale-up of control interventions in Nchelenge District, Luapula Province, Zambia.

Mukonka VM, Chanda E, Haque U, Kamuliwo M, Mushinge G, Chileshe J, Chibwe KA, Norris DE, Mulenga M, Chaponda M, Muleba M, Glass GE, Moss WJ - Malar. J. (2014)

Bottom Line: Clinical diagnosis without accompanying confirmation declined from 95% in 2006 to 35% in 2012.The high parasite prevalence could accurately reflect the true burden, perhaps in part as a consequence of population movement, or improved access to care and case reporting.Quality information at fine spatial scales will be critical for targeting effective interventions and measurement of progress.

View Article: PubMed Central - HTML - PubMed

Affiliation: W Harry Feinstone Department of Molecular Microbiology & Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. ubydul.kth@gmail.com.

ABSTRACT

Background: Malaria control interventions have been scaled-up in Zambia in conjunction with a malaria surveillance system. Although substantial progress has been achieved in reducing morbidity and mortality, national and local information demonstrated marked heterogeneity in the impact of malaria control across the country. This study reports the high burden of malaria in Nchelenge District, Luapula Province, Zambia from 2006 to 2012 after seven years of control measures.

Methods: Yearly aggregated information on cases of malaria, malaria deaths, use of malaria diagnostics, and malaria control interventions from 2006 to 2012 were obtained from the Nchelenge District Health Office. Trends in the number of malaria cases, methods of diagnosis, malaria positivity rate among pregnant women, and intervention coverage were analysed using descriptive statistics.

Results: Malaria prevalence remained high, increasing from 38% in 2006 to 53% in 2012. Increasing numbers of cases of severe malaria were reported until 2010. Intense seasonal malaria transmission was observed with seasonal declines in the number of cases between April and August, although malaria transmission continued throughout the year. Clinical diagnosis without accompanying confirmation declined from 95% in 2006 to 35% in 2012. Intervention coverage with long-lasting insecticide-treated nets and indoor residual spraying increased from 2006 to 2012.

Conclusions: Despite high coverage with vector control interventions, the burden of malaria in Nchelenge District, Zambia remained high. The high parasite prevalence could accurately reflect the true burden, perhaps in part as a consequence of population movement, or improved access to care and case reporting. Quality information at fine spatial scales will be critical for targeting effective interventions and measurement of progress.

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Related in: MedlinePlus

Seasonal distribution of malaria cases in Nchelenge District (Deep blue, red, green, violet and light green line indicate total cases in 2008, 2009, 2010, 2011 and 2012 respectively).
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Figure 2: Seasonal distribution of malaria cases in Nchelenge District (Deep blue, red, green, violet and light green line indicate total cases in 2008, 2009, 2010, 2011 and 2012 respectively).

Mentions: Reported malaria prevalence increased from 38% in 2006 to 53% in 2012 (Table 1). The number of reported malaria cases per year was similar from 2006 to 2010 but increased in 2011 and 2012. Increasing numbers of cases of severe malaria were reported until 2010, with the highest number of deaths (n = 210) reported in 2008 and 2012. Intense seasonal malaria transmission was observed with seasonal declines in the number of cases between April and August, although malaria transmission continued throughout the year (Figure 2).


High burden of malaria following scale-up of control interventions in Nchelenge District, Luapula Province, Zambia.

Mukonka VM, Chanda E, Haque U, Kamuliwo M, Mushinge G, Chileshe J, Chibwe KA, Norris DE, Mulenga M, Chaponda M, Muleba M, Glass GE, Moss WJ - Malar. J. (2014)

Seasonal distribution of malaria cases in Nchelenge District (Deep blue, red, green, violet and light green line indicate total cases in 2008, 2009, 2010, 2011 and 2012 respectively).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4016669&req=5

Figure 2: Seasonal distribution of malaria cases in Nchelenge District (Deep blue, red, green, violet and light green line indicate total cases in 2008, 2009, 2010, 2011 and 2012 respectively).
Mentions: Reported malaria prevalence increased from 38% in 2006 to 53% in 2012 (Table 1). The number of reported malaria cases per year was similar from 2006 to 2010 but increased in 2011 and 2012. Increasing numbers of cases of severe malaria were reported until 2010, with the highest number of deaths (n = 210) reported in 2008 and 2012. Intense seasonal malaria transmission was observed with seasonal declines in the number of cases between April and August, although malaria transmission continued throughout the year (Figure 2).

Bottom Line: Clinical diagnosis without accompanying confirmation declined from 95% in 2006 to 35% in 2012.The high parasite prevalence could accurately reflect the true burden, perhaps in part as a consequence of population movement, or improved access to care and case reporting.Quality information at fine spatial scales will be critical for targeting effective interventions and measurement of progress.

View Article: PubMed Central - HTML - PubMed

Affiliation: W Harry Feinstone Department of Molecular Microbiology & Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. ubydul.kth@gmail.com.

ABSTRACT

Background: Malaria control interventions have been scaled-up in Zambia in conjunction with a malaria surveillance system. Although substantial progress has been achieved in reducing morbidity and mortality, national and local information demonstrated marked heterogeneity in the impact of malaria control across the country. This study reports the high burden of malaria in Nchelenge District, Luapula Province, Zambia from 2006 to 2012 after seven years of control measures.

Methods: Yearly aggregated information on cases of malaria, malaria deaths, use of malaria diagnostics, and malaria control interventions from 2006 to 2012 were obtained from the Nchelenge District Health Office. Trends in the number of malaria cases, methods of diagnosis, malaria positivity rate among pregnant women, and intervention coverage were analysed using descriptive statistics.

Results: Malaria prevalence remained high, increasing from 38% in 2006 to 53% in 2012. Increasing numbers of cases of severe malaria were reported until 2010. Intense seasonal malaria transmission was observed with seasonal declines in the number of cases between April and August, although malaria transmission continued throughout the year. Clinical diagnosis without accompanying confirmation declined from 95% in 2006 to 35% in 2012. Intervention coverage with long-lasting insecticide-treated nets and indoor residual spraying increased from 2006 to 2012.

Conclusions: Despite high coverage with vector control interventions, the burden of malaria in Nchelenge District, Zambia remained high. The high parasite prevalence could accurately reflect the true burden, perhaps in part as a consequence of population movement, or improved access to care and case reporting. Quality information at fine spatial scales will be critical for targeting effective interventions and measurement of progress.

Show MeSH
Related in: MedlinePlus