Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants
Abstract Background A marked decline in malaria morbidity and mortality has been reported after the introduction of artemisinin-based combination therapy (ACT) in high malaria prevalence countries in Africa. Data on the impact of ACT and on the prevalence of malaria has so far been scarce for Southw...
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ftdoajarticles:oai:doaj.org/article:2faba49ee1fe447e97a63fd4a01f5510 2023-05-15T15:14:14+02:00 Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants Guenter Froeschl Elmar Saathoff Inge Kroidl Nicole Berens-Riha Petra Clowes Leonard Maboko Weston Assisya Wolfram Mwalongo Martina Gerhardt Elias Nyanda Ntinginya Michael Hoelscher 2018-06-01T00:00:00Z https://doi.org/10.1186/s12936-018-2389-z https://doaj.org/article/2faba49ee1fe447e97a63fd4a01f5510 EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2389-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2389-z 1475-2875 https://doaj.org/article/2faba49ee1fe447e97a63fd4a01f5510 Malaria Journal, Vol 17, Iss 1, Pp 1-11 (2018) Artemisinin-based combination therapy Cohort study Normalized Difference Vegetation Index Bed net Malaria Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2389-z 2022-12-31T02:15:31Z Abstract Background A marked decline in malaria morbidity and mortality has been reported after the introduction of artemisinin-based combination therapy (ACT) in high malaria prevalence countries in Africa. Data on the impact of ACT and on the prevalence of malaria has so far been scarce for Southwest Tanzania. Methods Between 2005 and 2011, a large general population cohort in the Mbeya Region in the south-west of Tanzania has been surveyed within the EMINI-study (Evaluation and Monitoring of the Impact of New Interventions). Participants were examined once per year, including rapid diagnostic testing for malaria. ACT was introduced in the region according to national guidelines in the time period 2006/2007, replacing sulfadoxine/pyrimethamine as first-line therapy. In four study sites, 6773 individuals who participated in the first two of three consecutive survey visits in the period from 2006 to 2009 were included in this analysis. The prevalence of Plasmodium infection prior to and after the introduction of ACT was compared by logistic regression, with consideration of climatic variability, age, sex, socio-economic status and bed net use as potential confounders. Results A significant reduction over time in the prevalence of Plasmodium falciparum infection from 2.5 to 0.3% was shown across the four study sites. The decline was not explained by other factors included in the analysis, therefore, the decline over time most likely reflects the impact of introduction of ACT in the study area. Conclusions The longitudinal study showed a significant and relevant decline in the prevalence of P. falciparum infection after introduction of ACT, which could not be explained by potential confounders. The data suggests that artemisinin-based combinations are not only an effective instrument for reduction of immediate morbidity and mortality, but also for reduction of transmission rates. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Artemisinin-based combination therapy Cohort study Normalized Difference Vegetation Index Bed net Malaria Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Artemisinin-based combination therapy Cohort study Normalized Difference Vegetation Index Bed net Malaria Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Guenter Froeschl Elmar Saathoff Inge Kroidl Nicole Berens-Riha Petra Clowes Leonard Maboko Weston Assisya Wolfram Mwalongo Martina Gerhardt Elias Nyanda Ntinginya Michael Hoelscher Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
topic_facet |
Artemisinin-based combination therapy Cohort study Normalized Difference Vegetation Index Bed net Malaria Plasmodium falciparum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background A marked decline in malaria morbidity and mortality has been reported after the introduction of artemisinin-based combination therapy (ACT) in high malaria prevalence countries in Africa. Data on the impact of ACT and on the prevalence of malaria has so far been scarce for Southwest Tanzania. Methods Between 2005 and 2011, a large general population cohort in the Mbeya Region in the south-west of Tanzania has been surveyed within the EMINI-study (Evaluation and Monitoring of the Impact of New Interventions). Participants were examined once per year, including rapid diagnostic testing for malaria. ACT was introduced in the region according to national guidelines in the time period 2006/2007, replacing sulfadoxine/pyrimethamine as first-line therapy. In four study sites, 6773 individuals who participated in the first two of three consecutive survey visits in the period from 2006 to 2009 were included in this analysis. The prevalence of Plasmodium infection prior to and after the introduction of ACT was compared by logistic regression, with consideration of climatic variability, age, sex, socio-economic status and bed net use as potential confounders. Results A significant reduction over time in the prevalence of Plasmodium falciparum infection from 2.5 to 0.3% was shown across the four study sites. The decline was not explained by other factors included in the analysis, therefore, the decline over time most likely reflects the impact of introduction of ACT in the study area. Conclusions The longitudinal study showed a significant and relevant decline in the prevalence of P. falciparum infection after introduction of ACT, which could not be explained by potential confounders. The data suggests that artemisinin-based combinations are not only an effective instrument for reduction of immediate morbidity and mortality, but also for reduction of transmission rates. |
format |
Article in Journal/Newspaper |
author |
Guenter Froeschl Elmar Saathoff Inge Kroidl Nicole Berens-Riha Petra Clowes Leonard Maboko Weston Assisya Wolfram Mwalongo Martina Gerhardt Elias Nyanda Ntinginya Michael Hoelscher |
author_facet |
Guenter Froeschl Elmar Saathoff Inge Kroidl Nicole Berens-Riha Petra Clowes Leonard Maboko Weston Assisya Wolfram Mwalongo Martina Gerhardt Elias Nyanda Ntinginya Michael Hoelscher |
author_sort |
Guenter Froeschl |
title |
Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
title_short |
Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
title_full |
Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
title_fullStr |
Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
title_full_unstemmed |
Reduction of malaria prevalence after introduction of artemisinin-combination-therapy in Mbeya Region, Tanzania: results from a cohort study with 6773 participants |
title_sort |
reduction of malaria prevalence after introduction of artemisinin-combination-therapy in mbeya region, tanzania: results from a cohort study with 6773 participants |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2389-z https://doaj.org/article/2faba49ee1fe447e97a63fd4a01f5510 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-11 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2389-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2389-z 1475-2875 https://doaj.org/article/2faba49ee1fe447e97a63fd4a01f5510 |
op_doi |
https://doi.org/10.1186/s12936-018-2389-z |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
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1766344709621415936 |