Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008.
In: Malaria Journal, Jg. 10 (2011), Heft 1, S. 46-54
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Zugriff:
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 artemisinincombination 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 preintervention 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 outpatient cases by 99.5% (92-99.9%). Anaemia in-patient cases decreased by 87% (57-96%); anaemia deaths and outpatient 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. [ABSTRACT FROM AUTHOR]
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Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008.
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Autor/in / Beteiligte Person: | Aregawi, Maru W. ; Ali, Abdullah S. ; Al-mafazy, Abdul-wahiyd ; Molteni, Fabrizio ; Katikiti, Samson ; Warsame, Marian ; Njau, Ritha J. A. ; Komatsu, Ryuichi ; Korenromp, Eline ; Hosseini, Mehran ; Low-Beer, Daniel ; Bjorkman, Anders ; D'Alessandro, Umberto ; Coosemans, Marc ; Otten, Mac |
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Zeitschrift: | Malaria Journal, Jg. 10 (2011), Heft 1, S. 46-54 |
Veröffentlichung: | 2011 |
Medientyp: | academicJournal |
ISSN: | 1475-2875 (print) |
DOI: | 10.1186/1475-2875-10-46 |
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