Increase in cases of malaria in Mozambique, 2014: epidemic or new endemic pattern?

Arroz, Jorge

doi:10.1590/s1518-8787.2016050006105

Cited by 18 publications

(18 citation statements)

References 8 publications

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“…Mozambique is one of the 10 countries with the highest malaria burden in the world, with parasite prevalence ranging from 3% in the south to >50% in the north of the country [1]. While the last decade witnessed significant reductions in the burden of malaria throughout the country, the gains have since stalled, and an increase in disease incidence [2,3] has been observed since 2014 [4]. Mozambique's National Malaria Control Program (NMCP) has focused on increasing the coverage of long-lasting insecticidal nets (LLINs), improved case management, and surveillance systems throughout the country while aiming for elimination in the low endemic areas of the south through yearly rounds of universal indoor residual spraying (IRS) [5].…”

Section: Introductionmentioning

confidence: 99%

A multiphase program for malaria elimination in southern Mozambique (the Magude project): A before-after study

et al. 2020

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Background Malaria eradication remains the long-term vision of the World Health Organization (WHO). However, whether malaria elimination is feasible in areas of stable transmission in sub-Saharan Africa with currently available tools remains a subject of debate. This study aimed to evaluate a multiphased malaria elimination project to interrupt Plasmodium falciparum malaria transmission in a rural district of southern Mozambique. Methods and findings A before-after study was conducted between 2015 and 2018 in the district of Magude, with 48,448 residents living in 10,965 households. Building on an enhanced surveillance system, two rounds of mass drug administrations (MDAs) per year over two years (phase I, August 2015-2017), followed by one year of reactive focal mass drug administrations (rfMDAs) (phase II, September 2017-June 2018) were deployed with annual indoor residual spraying (IRS), programmatically distributed long-lasting insecticidal nets (LLINs), and standard case management. The four MDA rounds covered 58%-72% of the population, and annual IRS reported coverage was >70%. Yearly parasite surveys and routine surveillance data were used to monitor the primary outcomes of the study-malaria prevalence and incidence-at baseline and annually since the onset of the project. Parasite prevalence by rapid diagnostic test (RDT) declined from 9.1% (95% confidence interval [CI] 7.0-11.8) in May 2015 to 2.6% (95% CI 2.0-3.4), representing a 71.3% (95% CI 71.1-71.4, p < 0.001) reduction after

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Section: Introductionmentioning

confidence: 99%

A multiphase program for malaria elimination in southern Mozambique (the Magude project): A before-after study

et al. 2020

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“…While the last decade had witnessed significant reductions in the burden of malaria throughout the country, the gains have since stalled, and an increase in disease incidence consistent with modelled estimates [21, 22] has been reported since 2014 throughout the country [23]. In this context, it was clear that business as usual was no longer an option for Mozambique, and the country had no option but to intensify its control efforts to meet the targeted decrease in malaria incidence and mortality in the national strategic plan [11].…”

Section: The Rationale For Malaria Elimination In Southern Mozambiquementioning

confidence: 79%

Setting the scene and generating evidence for malaria elimination in Southern Mozambique

Aíde

Candrinho

Galatas

et al. 2019

Malar J

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Mozambique has historically been one of the countries with the highest malaria burden in the world. Starting in the 1960s, malaria control efforts were intensified in the southern region of the country, especially in Maputo city and Maputo province, to aid regional initiatives aimed to eliminate malaria in South Africa and eSwatini. Despite significant reductions in malaria prevalence, elimination was never achieved. Following the World Health Organization’s renewed vision of a malaria-free-world, and considering the achievements from the past, the Mozambican National Malaria Control Programme (NMCP) embarked on the development and implementation of a strategic plan to accelerate from malaria control to malaria elimination in southern Mozambique. An initial partnership, supported by the Bill and Melinda Gates Foundation and the La Caixa Foundation, led to the creation of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) and the Malaria Technical and Advisory Committee (MTAC) to promote national ownership and partner coordination to work towards the goal of malaria elimination in local and cross-border initiatives. Surveillance systems to generate epidemiological and entomological intelligence to inform the malaria control strategies were strengthened, and an impact and feasibility assessment of various interventions aimed to interrupt malaria transmission were conducted in Magude district (Maputo Province) through the “ Magude Project ”. The primary aim of this project was to generate evidence to inform malaria elimination strategies for southern Mozambique. The goal of malaria elimination in areas of low transmission intensity is now included in the national malaria strategic plan for 2017–22 and the NMCP and its partners have started to work towards this goal while evidence continues to be generated to move the national elimination agenda forward.

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“…However, this access is lower in rural areas [ 16 ]. The major malaria burden in Mozambique is in the central and northern provinces of Zambezia and Nampula [ 2 , 17 ]. Nampula province has an estimated 1,016,455 households with an average 4.8 members per household [ 16 ] resulting in an estimated 4,878,984 inhabitants.…”

Section: Methodsmentioning

confidence: 99%

Implementation strategies to increase access and demand of long-lasting insecticidal nets: a before-and-after study and scale-up process in Mozambique

Arroz

Mendis

Pinto

et al. 2017

Malar J

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BackgroundThe universal coverage bed nets campaign is a proven health intervention promoting increased access, ownership, and use of bed nets to reduce malaria burden. This article describes the intervention and implementation strategies that Mozambique carried out recently in order to improve access and increase demand for long-lasting insecticidal nets (LLINs).MethodsA before-and-after study with a control group was used during Stage I of the implementation process. The following strategies were tested in Stage I: (1) use of coupons during household registration; (2) use of stickers to identify the registered households; (3) new LLIN ascription formula (one LLIN for every two people). In Stage II, the following additional strategies were implemented: (4) mapping and micro-planning; (5) training; and (6) supervision. Odds ratio (OR) and 95% confidence interval (CI) were used to compare and establish differences between intervened and control districts in Stage I. Main outcomes were: percentage of LLINs distributed, percentage of target households benefited.ResultsIn Stage I, 87.8% (302,648) of planned LLINs were distributed in the intervention districts compared to 77.1% (219,613) in the control districts [OR: 2.14 (95% CI 2.11–2.16)]. Stage I results also showed that 80.6% (110,453) of households received at least one LLIN in the intervention districts compared to 72.8% (87,636) in the control districts [OR: 1.56 (95% CI 1.53–1.59)]. In Stage II, 98.4% (3,536,839) of the allocated LLINs were delivered, covering 98.6% (1,353,827) of the registered households.ConclusionsStage I results achieved better LLINs and household coverage in districts with the newly implemented strategies. The results of stage II were also encouraging. Additional strategies adaptation is required for a wide-country LLIN campaign.Electronic supplementary materialThe online version of this article (10.1186/s12936-017-2086-3) contains supplementary material, which is available to authorized users.

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Increase in cases of malaria in Mozambique, 2014: epidemic or new endemic pattern?

Cited by 18 publications

References 8 publications

A multiphase program for malaria elimination in southern Mozambique (the Magude project): A before-after study

A multiphase program for malaria elimination in southern Mozambique (the Magude project): A before-after study

Setting the scene and generating evidence for malaria elimination in Southern Mozambique

Implementation strategies to increase access and demand of long-lasting insecticidal nets: a before-and-after study and scale-up process in Mozambique

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