Two decades of malaria control in Malawi: Geostatistical Analysis of the changing malaria prevalence from 2000-2022.

Autor:	Mategula D; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi.; Liverpool School of Tropical Medicine, Liverpool, L35QA, UK.; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Gichuki J; Strathmore University, Institute of Healthcare Management, Nairobi, Kenya., Chipeta MG; African Institute for Development Policy (AFIDEP), Lilongwe, Malawi., Chirombo J; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi., Kalonde PK; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi.; Liverpool School of Tropical Medicine, Liverpool, L35QA, UK., Gumbo A; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi., Kayange M; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi., Samuel V; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Kwizombe C; U.S. President's Malaria Initiative, United States Agency for International Development (USAID), Lilongwe, Malawi., Hamuza G; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi., Kalanga A; Mulanje District Council, Mulanje, Malawi., Kamowa D; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Mitambo C; Research Unit, Ministry of Health, Lilongwe, Malawi., Kawonga J; Country Health Information Systems and Data Use (CHISU) Program, Lilongwe, Malawi., Banda B; Country Health Information Systems and Data Use (CHISU) Program, Lilongwe, Malawi., Kafulafula J; Nkhotakota District Council, Nkhotakota, Malawi., Banda A; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi., Twabi H; Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi., Musa E; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Masambuka M; Kasungu District Council, Kasungu, Malawi., Ntwere T; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Ligomba C; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi., Munthali L; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Sakala M; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi., Bangoura A; PMI VectorLink Project, Abt Associates,, Lilongwe, Malawi., Kapito-Tembo A; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Masingi-Mbeye N; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Mathanga DP; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Southern, Malawi., Terlouw DJ; Malawi-Liverpool Wellcome Programme, Blantyre, Malawi.; Liverpool School of Tropical Medicine, Liverpool, L35QA, UK.
Jazyk:	angličtina
Zdroj:	Wellcome open research [Wellcome Open Res] 2024 Jan 08; Vol. 8, pp. 264. Date of Electronic Publication: 2024 Jan 08 (Print Publication: 2023).
DOI:	10.12688/wellcomeopenres.19390.2
Abstrakt:	Background: Malaria remains a public health problem in Malawi and has a serious socio-economic impact on the population. In the past two decades, available malaria control measures have been substantially scaled up, such as insecticide-treated bed nets, artemisinin-based combination therapies, and, more recently, the introduction of the malaria vaccine, the RTS,S/AS01. In this paper, we describe the epidemiology of malaria for the last two decades to understand the past transmission and set the scene for the elimination agenda. Methods: A collation of parasite prevalence surveys conducted between the years 2000 and 2022 was done. A spatio-temporal geostatistical model was fitted to predict the yearly malaria risk for children aged 2-10 years (PfPR 2-10) at 1×1 km spatial resolutions. Parameter estimation was done using the Monte Carlo maximum likelihood method. District-level prevalence estimates adjusted for population are calculated for the years 2000 to 2022. Results: A total of 2,595 sampled unique locations from 2000 to 2022 were identified through the data collation exercise. This represents 70,565 individuals that were sampled in the period. In general, the PfPR2_10 declined over the 22 years. The mean modelled national PfPR2_10 in 2000 was 43.93 % (95% CI:17.9 to 73.8%) and declined to 19.2% (95%CI 7.49 to 37.0%) in 2022. The smoothened estimates of PfPR2_10 indicate that malaria prevalence is very heterogeneous with hotspot areas concentrated on the southern shores of Lake Malawi and the country's central region. Conclusions: The last two decades are associated with a decline in malaria prevalence, highly likely associated with the scale-up of control interventions. The country should move towards targeted malaria control approaches informed by surveillance data. Competing Interests: No competing interests were disclosed. (Copyright: © 2024 Mategula D et al.)
Databáze:	MEDLINE
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