Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI)
Abstract Background The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. T...
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ftdoajarticles:oai:doaj.org/article:dc939dcc6e5741fbab6e7ddc7ad41ee2 2023-05-15T15:15:11+02:00 Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) Aayush Khadka Nicole A. Perales Dorothy J. Wei Anna D. Gage Noah Haber Stéphane Verguet Bryan Patenaude Günther Fink 2018-06-01T00:00:00Z https://doi.org/10.1186/s12936-018-2368-4 https://doaj.org/article/dc939dcc6e5741fbab6e7ddc7ad41ee2 EN eng BMC http://link.springer.com/article/10.1186/s12936-018-2368-4 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2368-4 1475-2875 https://doaj.org/article/dc939dcc6e5741fbab6e7ddc7ad41ee2 Malaria Journal, Vol 17, Iss 1, Pp 1-13 (2018) Malaria Angola Namibia Trans-Kunene malaria initiative Cross-border Spillover Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2018 ftdoajarticles https://doi.org/10.1186/s12936-018-2368-4 2022-12-31T12:16:00Z Abstract Background The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. This study assesses the potential impact of such a programme at the Angolan–Namibian border. Methods Community-based malaria prevention programmes involving bed net distribution and behaviour change home visits were rolled-out using a controlled, staggered (stepped wedge) design between May 2014 and July 2016 in a 100 × 40 km corridor along the Angolan–Namibian border. Three rounds of survey data were collected. The primary outcome studied was fever among children under five in the 2 weeks prior to the survey. Multivariable linear and logistic regression models were used to assess overall programme impact and the relative impact of unilateral versus coordinated bilateral intervention programmes. Results A total of 3844 child records were analysed. On average, programme rollout reduced the odds of child fever by 54% (aOR: 0.46, 95% CI 0.29 to 0.73) over the intervention period. In Namibia, the programme reduced the odds of fever by 30% in areas without simultaneous Angolan efforts (aOR: 0.70, 95% CI 0.34 to 1.44), and by an additional 62% in areas with simultaneous Angolan programmes. In Angola, the programme was highly effective in areas within 5 km of Namibian programmes (OR: 0.37, 95% CI 0.22 to 0.62), but mostly ineffective in areas closer to inland Angolan areas without concurrent anti-malarial efforts. Conclusions The impact of malaria programmes depends on programme efforts in surrounding areas with differential control efforts. Coordinated malaria programming within and across countries will be critical for achieving the vision of a malaria free world. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 17 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Malaria Angola Namibia Trans-Kunene malaria initiative Cross-border Spillover Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Malaria Angola Namibia Trans-Kunene malaria initiative Cross-border Spillover Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Aayush Khadka Nicole A. Perales Dorothy J. Wei Anna D. Gage Noah Haber Stéphane Verguet Bryan Patenaude Günther Fink Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
topic_facet |
Malaria Angola Namibia Trans-Kunene malaria initiative Cross-border Spillover Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. This study assesses the potential impact of such a programme at the Angolan–Namibian border. Methods Community-based malaria prevention programmes involving bed net distribution and behaviour change home visits were rolled-out using a controlled, staggered (stepped wedge) design between May 2014 and July 2016 in a 100 × 40 km corridor along the Angolan–Namibian border. Three rounds of survey data were collected. The primary outcome studied was fever among children under five in the 2 weeks prior to the survey. Multivariable linear and logistic regression models were used to assess overall programme impact and the relative impact of unilateral versus coordinated bilateral intervention programmes. Results A total of 3844 child records were analysed. On average, programme rollout reduced the odds of child fever by 54% (aOR: 0.46, 95% CI 0.29 to 0.73) over the intervention period. In Namibia, the programme reduced the odds of fever by 30% in areas without simultaneous Angolan efforts (aOR: 0.70, 95% CI 0.34 to 1.44), and by an additional 62% in areas with simultaneous Angolan programmes. In Angola, the programme was highly effective in areas within 5 km of Namibian programmes (OR: 0.37, 95% CI 0.22 to 0.62), but mostly ineffective in areas closer to inland Angolan areas without concurrent anti-malarial efforts. Conclusions The impact of malaria programmes depends on programme efforts in surrounding areas with differential control efforts. Coordinated malaria programming within and across countries will be critical for achieving the vision of a malaria free world. |
format |
Article in Journal/Newspaper |
author |
Aayush Khadka Nicole A. Perales Dorothy J. Wei Anna D. Gage Noah Haber Stéphane Verguet Bryan Patenaude Günther Fink |
author_facet |
Aayush Khadka Nicole A. Perales Dorothy J. Wei Anna D. Gage Noah Haber Stéphane Verguet Bryan Patenaude Günther Fink |
author_sort |
Aayush Khadka |
title |
Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_short |
Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_full |
Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_fullStr |
Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_full_unstemmed |
Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_sort |
malaria control across borders: quasi-experimental evidence from the trans-kunene malaria initiative (tkmi) |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s12936-018-2368-4 https://doaj.org/article/dc939dcc6e5741fbab6e7ddc7ad41ee2 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 17, Iss 1, Pp 1-13 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s12936-018-2368-4 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-018-2368-4 1475-2875 https://doaj.org/article/dc939dcc6e5741fbab6e7ddc7ad41ee2 |
op_doi |
https://doi.org/10.1186/s12936-018-2368-4 |
container_title |
Malaria Journal |
container_volume |
17 |
container_issue |
1 |
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1766345555203588096 |