Comparison of anaemia and parasitaemia as indicators of malaria control in household and EPI-health facility surveys in Malawi

Malaria Journal

Research

Grace J Malenga¹  Don P Mathanga²  Carl H Campbell³  Meghna Desai³  Jodi Vanden Eng³  Adam Wolkon³  Rachel N Bronzan³  Doreen Ali⁴ 

[1] Malaria Alert Centre, College of Medicine, University of Malawi, P/Bag 360, Blantyre 3, Malawi;Malaria Alert Centre, College of Medicine, University of Malawi, P/Bag 360, Blantyre 3, Malawi;Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi;Malaria Branch, Centers for Disease Control and Prevention, Atlanta, USA;Ministry of Health, National Malaria Control Programme, Malawi;

关键词: Malaria;    Global Position System;    Malaria Intervention;    Artemisinin Combination Therapy;    Severe Malarial Anaemia;   

DOI  :  10.1186/1475-2875-9-107

 received in 2009-12-10, accepted in 2010-04-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe World Health Organization has recommended that anaemia be used as an additional indicator to monitor malaria burden at the community level as malaria interventions are nationally scaled up. To date, there are no published evaluations of this recommendation.MethodsTo evaluate this recommendation, a comparison of anaemia and parasitaemia among 6-30 month old children was made during two repeated cross-sectional household (HH) and health facility (HF) surveys in six districts across Malawi at baseline (2005) and in a follow-up survey (2008) after a scale up of malaria control interventions.ResultsHH net ownership did not increase between the years (50.5% vs. 49.8%), but insecticide treated net (ITN) ownership increased modestly from 41.5% (95% CI: 37.2%-45.8%) in 2005 to 45.3% (95% CI: 42.6%-48.0%) in 2008. ITN use by children 6-30 months old, who were living in HH with at least one net, increased from 73.6% (95% CI:68.2%-79.1%) to 80.0% (95% CI:75.9%-84.1%) over the three-year period. This modest increase in ITN use was associated with a decrease in moderate to severe anaemia (Hb <8 g/dl) from 18.4% (95% CI:14.9%-21.8%) in 2005 to 15.4% (13.2%-17.7%) in 2008, while parasitaemia, measured as positive-slide microscopy, decreased from 18.9% (95% CI:14.7%-23.2%) to 16.9% (95% CI:13.8%-20.0%), a relative reduction of 16% and 11%, respectively. In HF surveys, anaemia prevalence decreased from 18.3% (95% CI: 14.9%-21.7%) to 15.4% (95% CI: 12.7%-18.2%), while parasitaemia decreased from 30.6% (95% CI: 25.7%-35.5%) to 13.2% (95% CI: 10.6%-15.8%), a relative reduction of 15% and 57%, respectively.ConclusionIncreasing access to effective malaria prevention was associated with a reduced burden of malaria in young Malawian children. Anaemia measured at the HF level at time of routine vaccination may be a good surrogate indicator for its measurement at the HH level in evaluating national malaria control programmes.

【 授权许可】

CC BY   
© Mathanga et al; licensee BioMed Central Ltd. 2010