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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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dc.contributor.author Aregawi, M. W.
dc.contributor.author Ali, A. S.
dc.contributor.author Al-Mafazy, A. W.
dc.contributor.author Molteni, F.
dc.contributor.author Katikiti, S.
dc.contributor.author Warsame, M.
dc.contributor.author Njau, R. J.
dc.contributor.author Komatsu, R.
dc.contributor.author Korenromp, E.
dc.contributor.author Hosseini, M.
dc.contributor.author Low-Beer, D.
dc.contributor.author Bjorkman, A.
dc.contributor.author D'Alessandro, U.
dc.contributor.author Coosemans, M.
dc.contributor.author Otten, M.
dc.date.accessioned 2011-03-22T15:55:11Z
dc.date.available 2011-03-22T15:55:11Z
dc.date.issued 2011
dc.identifier.issn 1475-2875
dc.identifier.doi http://dx.doi.org/10.1186/1475-2875-10-46
dc.identifier.other ITG-P13A
dc.identifier.other ITG-P14A
dc.identifier.other PARAS
dc.identifier.other U-MALAR
dc.identifier.other U-ENTOM
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other Abstract
dc.identifier.other UPD32
dc.identifier.uri http://hdl.handle.net/10390/6522
dc.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. en
dc.language English en
dc.subject Protozoal diseases en
dc.subject Malaria en
dc.subject Plasmodium falciparum en
dc.subject National programs en
dc.subject Control programs en
dc.subject Impregnated bednets en
dc.subject Insecticides en
dc.subject Residual spraying en
dc.subject Artemisinin combination therapies (ACT) en
dc.subject ACT en
dc.subject Hospitalization en
dc.subject Outpatients en
dc.subject Mortality rates en
dc.subject Mortality reduction en
dc.subject Survival en
dc.subject Anemia en
dc.subject Children en
dc.subject Health impact en
dc.subject Efficiency en
dc.subject Zanzibar en
dc.subject Tanzania en
dc.subject Africa, East en
dc.title Reductions in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999-2008 en
dc.type Article-E en
dc.citation.issue 46 en
dc.citation.jtitle Malaria Journal en
dc.citation.volume 10 en
dc.citation.pages 1-9 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/21332989
dc.citation.jabbreviation Malar J en


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