Moving towards universal coverage with malaria control interventions: achievements and challenges in rural Burkina Faso

Abstract

This paper reports on a study, which assessed coverage with malaria control interventions in rural Burkina Faso, namely insecticide-treated mosquito nets (ITN) ownership, intermittent preventive treatment (IPTp) for pregnant women and artemisinin-based combination therapy (ACT) for under-five children. The study also addressed the distributional impact of such interventions, with specific reference to equity. The study used data from a representative household survey conducted on 1106 households in the Nouna Health District in 2010. Findings indicated that 59% of all households owned at least one ITN, 66% of all pregnant women received IPT at least once and 34% of under-five children reporting a malaria case were treated with ACT. Multivariate logistic regression revealed that higher socio-economic status, ownership of at least one radio and living in a village within a Health and Demographic Surveillance System were significantly positively associated with ITN, IPTp and ACT coverage. ITN coverage was higher among households in villages, which had previously hosted an ITN trial and/or the most favourable arm of a trial. Comparing current findings with previous estimates suggests that the country has made substantial progress towards scaling up malaria control interventions but that current coverage rates are still far from achieving the universal coverage targets set by the Roll Back Malaria Partnership. In addition, current coverage patterns reveal the existence of multiple inequities across groups, suggesting that current policies are inadequate to achieve equitable scaling up. Future planning of malaria control interventions ought to take into consideration current inadequacies and lead to programmes better designed to overcome them.

Decreasing Disparities in Infant Survival Using Surveillance Data from Burkina Faso

“…25 Coverage with insecticide-treated bed nets (ITNs) and artemisinin-based combination therapies (ACT) has much increased over the study period. 12,13 As malaria is the main cause of mortality in the second half of infancy and as roughly half of all childhood mortality is attributed to malaria in the study area, 26,27 increasing access to and use of malaria interventions will likely have played a major role with regard to the observed mortality effects.…”

“…[9][10][11][12][13] It is of interest to know whether these interventions have improved infant survival in the study area.…”

The Need for More Research and Public Health Interventions on Dengue Fever in Burkina Faso

“…The health system, which is already finding it very difficult to cope with malaria [20], is not prepared to contend with dengue fever. Health workers, mainly nurses and nurse assistants in both the public and private sectors, are not sufficiently trained for syndromic case management of dengue.…”

“…Finally, the effort to control the vector, abandoned many years ago in Burkina Faso, must absolutely be revived, because it is one of the most effective means of dealing with the problem while waiting for a vaccine or another effective dengue control strategy [18]. The State and its technical and financial partners need to mobilize now so that the health system and its public health interventions can begin working on the most effective management of dengue fever [20].…”

Treatment of Asymptomatic Carriers of Plasmodium falciparum with Artemether–Lumefantrine: Impact on the Prevalence of Anemia

“…This suggests a possible study effect owing to the availability of AL for all confirmed cases of symptomatic malaria and the provision of an LLIN to every participant in the study. A recent study, which examined the coverage of malaria control interventions in Burkina Faso, reported that 59% of households in the study population owned an insecticide-treated bednet (ITN) and only 34% of children under 5 years of age with a reported malaria case were treated with an artemisinin-based combination therapy (ACT) [23]. It is, therefore, possible that receipt of an LLIN by every study participant increased the use of ITNs in both study arms.…”