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Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

Peak CM, Thuan PD, Britton A, Nguyen TD, Wolbers M, Thanh NV, Buckee CO, Boni MF - Am. J. Trop. Med. Hyg. (2015)

Bottom Line: In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite.However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess.One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found.

View Article: PubMed Central - PubMed

Affiliation: Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Institute for Malariology, Parasitology, and Entomology, Ho Chi Minh City, Vietnam; Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom.

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Regression coefficients and respective 95% confidence intervals are shown from models predicting each of the four malaria incidence outcomes: Total Suspected Cases (T); Slide-Confirmed (C); Plasmodium falciparum (F); and Plasmodium vivax (V). Blue circles represent results from models including the proportion of drugs containing an artemisinin component, proportion of provincial population covered by insecticide-treated nets (ITN) or indoor residual spraying (IRS), and proportion of provincial population living in urban settings. Light green triangles represent results from models with the addition of the following health systems capacity covariates: discretionary provincial malaria budget per capita and number of staff trained per 100 people.
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Figure 3: Regression coefficients and respective 95% confidence intervals are shown from models predicting each of the four malaria incidence outcomes: Total Suspected Cases (T); Slide-Confirmed (C); Plasmodium falciparum (F); and Plasmodium vivax (V). Blue circles represent results from models including the proportion of drugs containing an artemisinin component, proportion of provincial population covered by insecticide-treated nets (ITN) or indoor residual spraying (IRS), and proportion of provincial population living in urban settings. Light green triangles represent results from models with the addition of the following health systems capacity covariates: discretionary provincial malaria budget per capita and number of staff trained per 100 people.

Mentions: Table 1 reports regression results from models including: 1) the proportion of drugs containing an artemisinin component, 2) the proportion of provincial population covered by ITN or IRS, and 3) the proportion of provincial population living in urban settings. The proportion of drug purchases containing artemisinin was negatively associated with each of the four malaria outcomes measured: 1) the number of clinically diagnosed suspected cases, 2) the number of slide-confirmed cases, 3) the number of slide-confirmed P. falciparum cases, and 4) the number of slide-confirmed P. vivax cases. Urbanization and coverage with ITNs or IRS were not significant predictors of any of the malaria outcomes after accounting for changes in the proportion of drug regimens that contain artemisinin (Figure 3).


Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

Peak CM, Thuan PD, Britton A, Nguyen TD, Wolbers M, Thanh NV, Buckee CO, Boni MF - Am. J. Trop. Med. Hyg. (2015)

Regression coefficients and respective 95% confidence intervals are shown from models predicting each of the four malaria incidence outcomes: Total Suspected Cases (T); Slide-Confirmed (C); Plasmodium falciparum (F); and Plasmodium vivax (V). Blue circles represent results from models including the proportion of drugs containing an artemisinin component, proportion of provincial population covered by insecticide-treated nets (ITN) or indoor residual spraying (IRS), and proportion of provincial population living in urban settings. Light green triangles represent results from models with the addition of the following health systems capacity covariates: discretionary provincial malaria budget per capita and number of staff trained per 100 people.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385779&req=5

Figure 3: Regression coefficients and respective 95% confidence intervals are shown from models predicting each of the four malaria incidence outcomes: Total Suspected Cases (T); Slide-Confirmed (C); Plasmodium falciparum (F); and Plasmodium vivax (V). Blue circles represent results from models including the proportion of drugs containing an artemisinin component, proportion of provincial population covered by insecticide-treated nets (ITN) or indoor residual spraying (IRS), and proportion of provincial population living in urban settings. Light green triangles represent results from models with the addition of the following health systems capacity covariates: discretionary provincial malaria budget per capita and number of staff trained per 100 people.
Mentions: Table 1 reports regression results from models including: 1) the proportion of drugs containing an artemisinin component, 2) the proportion of provincial population covered by ITN or IRS, and 3) the proportion of provincial population living in urban settings. The proportion of drug purchases containing artemisinin was negatively associated with each of the four malaria outcomes measured: 1) the number of clinically diagnosed suspected cases, 2) the number of slide-confirmed cases, 3) the number of slide-confirmed P. falciparum cases, and 4) the number of slide-confirmed P. vivax cases. Urbanization and coverage with ITNs or IRS were not significant predictors of any of the malaria outcomes after accounting for changes in the proportion of drug regimens that contain artemisinin (Figure 3).

Bottom Line: In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite.However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess.One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found.

View Article: PubMed Central - PubMed

Affiliation: Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Institute for Malariology, Parasitology, and Entomology, Ho Chi Minh City, Vietnam; Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom.

Show MeSH
Related in: MedlinePlus