Monitoring changes in malaria epidemiology and effectiveness of interventions in Ethiopia and Uganda: Beyond Garki Project baseline survey

Malaria Journal

Research

Ashenafi Assefa¹  Takele Kefyalew²  Gezahegn Tesfaye²  Zelalem Kebede²  Esey Batisso²  Tessema Awano²  Agonafer Tekalegne²  Tedila Habte³  Anthony Nuwa⁴  Irene Kyomuhagi⁴  Stella Bakeera-Ssali⁴  Godfrey Magumba⁴  James Ssekitooleko⁴  Sarah C. Akiror⁴  Sylvia R. Meek⁵  Tarekegn A. Abeku⁵  Sarala Nicholas⁵  Matthew J. Kirby⁶  Michelle E. H. Helinski⁷  Laura Erdmanis⁸  Angela Nalwoga⁹  Stephen Cose^1,10  Vincent Katamba^1,11  Chris Bass^1,12 

[1] Ethiopian Public Health Institute, Addis Ababa, Ethiopia;Malaria Consortium, Addis Ababa, Ethiopia;Malaria Consortium, Addis Ababa, Ethiopia;South Nations, Nationalities and Peoples Regional Health Bureaux, Hawassa, Ethiopia;Malaria Consortium, Kampala, Uganda;Malaria Consortium, London, UK;Malaria Consortium, London, UK;London School of Hygiene & Tropical Medicine, London, UK;Malaria Consortium, London, UK;Malaria Consortium, Kampala, Uganda;Malaria Consortium, London, UK;Rothamsted Research, Harpenden, UK;Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda;Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda;London School of Hygiene & Tropical Medicine, London, UK;National Malaria Control Programme, Ministry of Health, Kampala, Uganda;Rothamsted Research, Harpenden, UK;

关键词: Malaria;    Plasmodium falciparum;    Plasmodium vivax;    Anopheles gambiae;    Anopheles arabiensis;    Anopheles funestus;    Vector control;    Epidemiology;    Undernutrition;   

DOI  :  10.1186/s12936-015-0852-7

 received in 2015-04-24, accepted in 2015-08-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundScale-up of malaria interventions seems to have contributed to a decline in the disease but other factors may also have had some role. Understanding changes in transmission and determinant factors will help to adapt control strategies accordingly.MethodsFour sites in Ethiopia and Uganda were set up to monitor epidemiological changes and effectiveness of interventions over time. Here, results of a survey during the peak transmission season of 2012 are reported, which will be used as baseline for subsequent surveys and may support adaptation of control strategies. Data on malariometric and entomological variables, socio-economic status (SES) and control coverage were collected.ResultsMalaria prevalence varied from 1.4 % in Guba (Ethiopia) to 9.9 % in Butemba (Uganda). The most dominant species was Plasmodium vivax in Ethiopia and Plasmodium falciparum in Uganda. The majority of human-vector contact occurred indoors in Uganda, ranging from 83 % (Anopheles funestus sensu lato) to 93 % (Anopheles gambiae s.l.), which is an important factor for the effectiveness of insecticide-treated nets (ITNs) or indoor residual spraying (IRS). High kdr-L1014S (resistance genotype) frequency was observed in A. gambiae sensu stricto in Uganda. Too few mosquitoes were collected in Ethiopia, so it was not possible to assess vector habits and insecticide resistance levels. ITN ownership did not vary by SES and 56–98 % and 68–78 % of households owned at least one ITN in Ethiopia and Uganda, respectively. In Uganda, 7 % of nets were purchased by households, but the nets were untreated. In three of the four sites, 69–76 % of people with access to ITNs used them. IRS coverage ranged from 84 to 96 % in the three sprayed sites. Half of febrile children in Uganda and three-quarters in Ethiopia for whom treatment was sought received diagnostic tests. High levels of child undernutrition were detected in both countries carrying important implications on child development. In Uganda, 7–8 % of pregnant women took the recommended minimum three doses of intermittent preventive treatment.ConclusionMalaria epidemiology seems to be changing compared to earlier published data, and it is essential to have more data to understand how much of the changes are attributable to interventions and other factors. Regular monitoring will help to better interpret changes, identify determinants, modify strategies and improve targeting to address transmission heterogeneity.

【 授权许可】

CC BY   
© Abeku et al. 2015