| Autor: |
Hosseini Mehran, Korenromp Eline, Komatsu Ryuichi, Njau Ritha JA, Warsame Marian, Katikiti Samson, Molteni Fabrizio, Al-mafazy Abdul-wahiyd, Ali Abdullah S, Aregawi Maru W, Low-Beer Daniel, Bjorkman Anders, D'Alessandro Umberto, Coosemans Marc, Otten Mac |
| Jazyk: |
angličtina |
| Rok vydání: |
2011 |
| Předmět: |
|
| Zdroj: |
Malaria Journal, Vol 10, Iss 1, p 46 (2011) |
| Druh dokumentu: |
article |
| ISSN: |
1475-2875 |
| DOI: |
10.1186/1475-2875-10-46 |
| Popis: |
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. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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