National Malaria Control and Scaling Up for Impact: The Zambia Experience through 2006

Steketee, Richard W.; Sipilanyambe, Naawa; Chimumbwa, John; Banda, James J.; Mohamed, Abdirahman; Miller, John M.; Basu, Suprotik; Miti, Simon K.; Campbell, Carlos C.

doi:10.4269/ajtmh.2008.79.45

Cited by 61 publications

(60 citation statements)

References 19 publications

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“…The decrease in malaria prevalence is consistent with findings from other countries that high coverage of malaria control interventions [25] probably contributed importantly to the decrease in population infection rates and, consequently, the threat of potential malaria epidemics. However, attributing the decrease in parasitaemia to the scale-up of key malaria interventions (mainly ITNs and ACTs) should be done with caution.…”

Section: Discussionsupporting

confidence: 89%

Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions

Jima

Getachew²,

Bilak³

et al. 2010

Malar J

128

138

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BackgroundIn 2005, a nationwide survey estimated that 6.5% of households in Ethiopia owned an insecticide-treated net (ITN), 17% of households had been sprayed with insecticide, and 4% of children under five years of age with a fever were taking an anti-malarial drug. Similar to other sub-Saharan African countries scaling-up malaria interventions, the Government of Ethiopia set an ambitious national goal in 2005 to (i) provide 100% ITN coverage in malarious areas, with a mean of two ITNs per household; (ii) to scale-up indoor residual spraying of households with insecticide (IRS) to cover 30% of households targeted for IRS; and (iii) scale-up the provision of case management with rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT), particularly at the peripheral level.MethodsA nationally representative malaria indicator survey (MIS) was conducted in Ethiopia between September and December 2007 to determine parasite and anaemia prevalence in the population at risk and to assess coverage, use and access to scaled-up malaria prevention and control interventions. The survey used a two-stage random cluster sample of 7,621 households in 319 census enumeration areas. A total of 32,380 people participated in the survey. Data was collected using standardized Roll Back Malaria Monitoring and Evaluation Reference Group MIS household and women's questionnaires, which were adapted to the local context.ResultsData presented is for households in malarious areas, which according to the Ethiopian Federal Ministry of Health are defined as being located <2,000 m altitude. Of 5,083 surveyed households, 3,282 (65.6%) owned at least one ITN. In ITN-owning households, 53.2% of all persons had slept under an ITN the prior night, including 1,564/2,496 (60.1%) children <5 years of age, 1,891/3,009 (60.9%) of women 15 - 49 years of age, and 166/266 (65.7%) of pregnant women. Overall, 906 (20.0%) households reported to have had IRS in the past 12 months. Of 747 children with reported fever in the two weeks preceding the survey, 131 (16.3%) sought medical attention within 24 hours. Of those with fever, 86 (11.9%) took an anti-malarial drug and 41 (4.7%) took it within 24 hours of fever onset. Among 7,167 surveyed individuals of all ages, parasitaemia as estimated by microscopy was 1.0% (95% CI 0.5 - 1.5), with 0.7% and 0.3% due to Plasmodium falciparum and Plasmodium vivax, respectively. Moderate-severe anaemia (haemoglobin <8 g/dl) was observed in 239/3,366 (6.6%, 95% CI 4.9-8.3) children <5 years of age.ConclusionsSince mid-2005, the Ethiopian National Malaria Control Programme has considerably scaled-up its malaria prevention and control interventions, demonstrating the impact of strong political will and a committed partnership. The MIS showed, however, that besides sustaining and expanding malaria intervention coverage, efforts will have to be made to increase intervention access and use. With ongoing efforts to sustain and expand malaria intervention coverage, to increase intervention access and use, and with ...

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Section: Discussionsupporting

confidence: 89%

Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions

Jima

Getachew²,

Bilak³

et al. 2010

Malar J

128

138

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“…The prevalence of malaria declined in this area over the past decade from 13.7% in 2006 to 5.7% in 2010. 20 Artemesinin combination therapies (ACTs) were introduced as first-line antimalarial therapy in Zambia in 2002 21 and into the study area in 2004. In Zambia, LLINs are distributed through antenatal care (ANC) clinics and additional mass distribution campaigns.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia

Pinchoff

Hamapumbu

Tamaki

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Understanding factors influencing sustained use of long-lasting insecticide-treated nets (LLIN) in areas of declining malaria transmission is critical to sustaining control and may facilitate elimination. From 2008 to 2013, 655 households in Choma District, Zambia, were randomly selected and residents were administered a questionnaire and malaria rapid diagnostic test. Mosquitoes were collected concurrently by light trap. In a multilevel model, children and adolescents of 5-17 years of age were 55% less likely to sleep under LLIN than adults (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.35, 0.58). LLIN use was 80% higher during the rainy season (OR = 1.8; CI = 1.5, 2.2) and residents of households with three or more nets were over twice as likely to use a LLIN (OR = 2.1; CI = 1.4, 3.1). For every increase in 0.5 km from the nearest health center, the odds of LLIN use decreased 9% (OR = 0.9; CI = 0.88, 0.98). In a second multilevel model, the odds of LLIN use were more than twice high if more than five mosquitoes (anopheline and culicine) were captured in the house compared with households with no mosquitoes captured (OR = 2.1; CI = 1.1, 3.9). LLIN use can be sustained in low-transmission settings with continued education and distributions, and may be partially driven by the presence of nuisance mosquitoes.

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“…Over the past 10 years, Zambia has implemented malaria control at various times with different effects depending on the available resources [4,5] . Also, during the 20 years before 1999, much of the emphasis on malaria control in Zambia was focused on treatment, with little efforts placed on prevention.…”

Section: Introductionmentioning

confidence: 99%

Review of the malaria epidemiology and trends in Zambia

Masaninga

Chanda

Chanda‐Kapata

et al. 2013

Asian Pacific Journal of Tropical Biomedicine

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National Malaria Control and Scaling Up for Impact: The Zambia Experience through 2006

Cited by 61 publications

References 19 publications

Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions

Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions

Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia

Review of the malaria epidemiology and trends in Zambia

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