Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008
Abstract Background In Zanzibar, the Ministry of Health and partners accelerated malaria control from September 2003 onwards. The impact of the scale-up of insecticide-treated nets (ITN), indoor-residual spraying (IRS) and artemisinin-combination therapy (ACT) combined on malaria burden was assessed...
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ftdoajarticles:oai:doaj.org/article:130e5157491a47bb871c06b5b9f0e7e7 2023-05-15T15:12:24+02:00 Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 Hosseini Mehran Korenromp Eline Komatsu Ryuichi Njau Ritha JA Warsame Marian Katikiti Samson Molteni Fabrizio Al-mafazy Abdul-wahiyd Ali Abdullah S Aregawi Maru W Low-Beer Daniel Bjorkman Anders D'Alessandro Umberto Coosemans Marc Otten Mac 2011-02-01T00:00:00Z https://doi.org/10.1186/1475-2875-10-46 https://doaj.org/article/130e5157491a47bb871c06b5b9f0e7e7 EN eng BMC http://www.malariajournal.com/content/10/1/46 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-46 1475-2875 https://doaj.org/article/130e5157491a47bb871c06b5b9f0e7e7 Malaria Journal, Vol 10, Iss 1, p 46 (2011) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2011 ftdoajarticles https://doi.org/10.1186/1475-2875-10-46 2022-12-31T00:41:19Z Abstract Background In Zanzibar, the Ministry of Health and partners accelerated malaria control from September 2003 onwards. The impact of the scale-up of insecticide-treated nets (ITN), indoor-residual spraying (IRS) and artemisinin-combination therapy (ACT) combined on malaria burden was assessed at six out of seven in-patient health facilities. Methods Numbers of outpatient and inpatient cases and deaths were compared between 2008 and the pre-intervention period 1999-2003. Reductions were estimated by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period. Results In 2008, for all age groups combined, malaria deaths had fallen by an estimated 90% (95% confidence interval 55-98%)(p < 0.025), malaria in-patient cases by 78% (48-90%), and parasitologically-confirmed malaria out-patient cases by 99.5% (92-99.9%). Anaemia in-patient cases decreased by 87% (57-96%); anaemia deaths and out-patient cases declined without reaching statistical significance due to small numbers. Reductions were similar for children under-five and older ages. Among under-fives, the proportion of all-cause deaths due to malaria fell from 46% in 1999-2003 to 12% in 2008 (p < 0.01) and that for anaemia from 26% to 4% (p < 0.01). Cases and deaths due to other causes fluctuated or increased over 1999-2008, without consistent difference in the trend before and after 2003. Conclusions Scaling-up effective malaria interventions reduced malaria-related burden at health facilities by over 75% within 5 years. In high-malaria settings, intensified malaria control can substantially contribute to reaching the Millennium Development Goal 4 target of reducing under-five mortality by two-thirds between 1990 and 2015. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 10 1 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Hosseini Mehran Korenromp Eline Komatsu Ryuichi Njau Ritha JA Warsame Marian Katikiti Samson Molteni Fabrizio Al-mafazy Abdul-wahiyd Ali Abdullah S Aregawi Maru W Low-Beer Daniel Bjorkman Anders D'Alessandro Umberto Coosemans Marc Otten Mac Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background In Zanzibar, the Ministry of Health and partners accelerated malaria control from September 2003 onwards. The impact of the scale-up of insecticide-treated nets (ITN), indoor-residual spraying (IRS) and artemisinin-combination therapy (ACT) combined on malaria burden was assessed at six out of seven in-patient health facilities. Methods Numbers of outpatient and inpatient cases and deaths were compared between 2008 and the pre-intervention period 1999-2003. Reductions were estimated by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period. Results In 2008, for all age groups combined, malaria deaths had fallen by an estimated 90% (95% confidence interval 55-98%)(p < 0.025), malaria in-patient cases by 78% (48-90%), and parasitologically-confirmed malaria out-patient cases by 99.5% (92-99.9%). Anaemia in-patient cases decreased by 87% (57-96%); anaemia deaths and out-patient cases declined without reaching statistical significance due to small numbers. Reductions were similar for children under-five and older ages. Among under-fives, the proportion of all-cause deaths due to malaria fell from 46% in 1999-2003 to 12% in 2008 (p < 0.01) and that for anaemia from 26% to 4% (p < 0.01). Cases and deaths due to other causes fluctuated or increased over 1999-2008, without consistent difference in the trend before and after 2003. Conclusions Scaling-up effective malaria interventions reduced malaria-related burden at health facilities by over 75% within 5 years. In high-malaria settings, intensified malaria control can substantially contribute to reaching the Millennium Development Goal 4 target of reducing under-five mortality by two-thirds between 1990 and 2015. |
format |
Article in Journal/Newspaper |
author |
Hosseini Mehran Korenromp Eline Komatsu Ryuichi Njau Ritha JA Warsame Marian Katikiti Samson Molteni Fabrizio Al-mafazy Abdul-wahiyd Ali Abdullah S Aregawi Maru W Low-Beer Daniel Bjorkman Anders D'Alessandro Umberto Coosemans Marc Otten Mac |
author_facet |
Hosseini Mehran Korenromp Eline Komatsu Ryuichi Njau Ritha JA Warsame Marian Katikiti Samson Molteni Fabrizio Al-mafazy Abdul-wahiyd Ali Abdullah S Aregawi Maru W Low-Beer Daniel Bjorkman Anders D'Alessandro Umberto Coosemans Marc Otten Mac |
author_sort |
Hosseini Mehran |
title |
Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
title_short |
Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
title_full |
Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
title_fullStr |
Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
title_full_unstemmed |
Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 |
title_sort |
reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in zanzibar, 1999-2008 |
publisher |
BMC |
publishDate |
2011 |
url |
https://doi.org/10.1186/1475-2875-10-46 https://doaj.org/article/130e5157491a47bb871c06b5b9f0e7e7 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 10, Iss 1, p 46 (2011) |
op_relation |
http://www.malariajournal.com/content/10/1/46 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-10-46 1475-2875 https://doaj.org/article/130e5157491a47bb871c06b5b9f0e7e7 |
op_doi |
https://doi.org/10.1186/1475-2875-10-46 |
container_title |
Malaria Journal |
container_volume |
10 |
container_issue |
1 |
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1766343080525430784 |