No evidence of decline in malaria burden from 2006 to 2013 in a rural Province of Gabon: implications for public health policy

BMC Public Health

Thierry Fandeur²  Dieudonné Nkoghe¹  Gildas Ella Ndoh¹  Vanessa Assele² 

[1] Unité de Recherche et d’Analyses Médicales, Centre International de Recherches Médicales de Franceville, Franceville, Gabon;Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville, Franceville BP 769, Gabon

关键词: Health Information System;    Ogooué-Ivindo province;    Slide positive rate;    Morbidity;    Rural Gabon;    Malaria trends;   

Others  :  1122794
DOI  :  10.1186/s12889-015-1456-4

 received in 2014-07-17, accepted in 2015-01-23,  发布年份 2015

【 摘 要 】

Background

The morbidity of malaria has steady declined in the urban regions of Gabon between 2000 and 2008, but caution should be exercised before generalizing this trend to the whole country because this finding has not been systematically confirmed in remote rural provinces.

Methods

We conducted a retrospective survey using data on malaria cases recorded in North Eastern Gabon between 2006 and 2013 at health facilities in Makokou. Malaria data were analyzed, and associations with annual variations and patient age were assessed.

Results

A global increase in clinical and confirmed malaria cases was observed over the study period. The rate of infection was significantly higher in children aged between 0 to 4 years than in children of 5 years and above, and in adults. Contrary to prior observations in urban and semi-urban areas of Gabon, malaria burden remained mostly unchanged or even increased in Makokou in the Ogooué-Ivindo province during these last 8 years.

Conclusions

The persistence of Plasmodium falciparum pockets of sustained malaria transmission in rural Gabon may be related to an inadequate coverage of key interventions, to poor treatment seeking behavior and/or to a decline efficacy of treatments. Our results highlight the need to better adapt malaria control strategies to local epidemiological contexts and to environmental constraints. Equitable delivery of health service to hard-to-reach populations constitutes a challenging issue for the health authorities of Gabon.

【 授权许可】

   
2015 Assele et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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