The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006–2011

Malaria Journal

Research

David L Smith¹  Victor M Mukonka²  Cecilia Katebe-Sakala³  Emmanuel Chanda³  Chadwick Sikaala³  Mulakwa Kamuliwo³  Mercy Mwanza-Ingwe³  Ubydul Haque⁴  Gregory E Glass⁴  Douglas E Norris⁴  William J Moss⁵ 

[1] Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;Department of Public Health, Copperbelt University, School of Medicine, Ndola, Zambia;Ministry of Health, National Malaria Control Centre, Lusaka, Zambia;W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;

关键词: Malaria;    Malaria Transmission;    Malaria Control;    Malaria Case;    Severe Malaria;   

DOI  :  10.1186/1475-2875-12-437

 received in 2013-07-03, accepted in 2013-11-25,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMalaria control was strengthened in Zambia over the past decade. The two primary interventions for vector control are indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Using passive malaria surveillance data collected from 2006 to 2011 through the Zambian District Health Information System, the associations between increased coverage with LLINs and IRS and the burden of malaria in Zambia were evaluated.MethodsNational passive malaria surveillance data from 2006 to 2011 were analysed. A district-level, random-effects model with Poisson regression was used to explore the association between malaria cases and coverage with LLINs and IRS. Malaria cases and LLINs and IRS coverage were mapped to visualize spatiotemporal variation in malaria for each year.ResultsFrom 2006–2011, 24.6 million LLINs were distributed and 6.4 million houses were sprayed with insecticide. Coverage with LLINs was not uniformly distributed over the study period and IRS was targeted to central and southern districts where malaria transmission was low. LLIN coverage was associated with a reduction in malaria cases, although an increase in the number of malaria cases was reported in some districts over the study period. A high burden of malaria persisted in north-eastern Zambia, whereas a reduction in the number of reported malaria cases was observed in western and southern Zambia.ConclusionEnhanced and targeted interventions in north-eastern Zambia where the burden of malaria remains high, as well as efforts to sustain low malaria transmission in the south-west, will be necessary for Zambia to achieve the national goal of being malaria free by 2030.

【 授权许可】

Unknown   
© Kamuliwo et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.