Final published version
Licence: CC BY: Creative Commons Attribution 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Monitoring changes in malaria epidemiology and effectiveness of interventions in Ethiopia and Uganda
T2 - Beyond Garki Project baseline survey
AU - Abeku, Tarekegn A
AU - Helinski, Michelle E H
AU - Kirby, Matthew J
AU - Kefyalew, Takele
AU - Awano, Tessema
AU - Batisso, Esey
AU - Tesfaye, Gezahegn
AU - Ssekitooleko, James
AU - Nicholas, Sarala
AU - Erdmanis, Laura
AU - Nalwoga, Angela
AU - Bass, Chris
AU - Cose, Stephen
AU - Assefa, Ashenafi
AU - Kebede, Zelalem
AU - Habte, Tedila
AU - Katamba, Vincent
AU - Nuwa, Anthony
AU - Bakeera-Ssali, Stella
AU - Akiror, Sarah C
AU - Kyomuhangi, Irene
AU - Tekalegne, Agonafer
AU - Magumba, Godfrey
AU - Meek, Sylvia R
PY - 2015/9/4
Y1 - 2015/9/4
N2 - BACKGROUND: Scale-up of malaria interventions seems to have contributed to a decline in the disease but other factors may also have had some role. Understanding changes in transmission and determinant factors will help to adapt control strategies accordingly.METHODS: Four sites in Ethiopia and Uganda were set up to monitor epidemiological changes and effectiveness of interventions over time. Here, results of a survey during the peak transmission season of 2012 are reported, which will be used as baseline for subsequent surveys and may support adaptation of control strategies. Data on malariometric and entomological variables, socio-economic status (SES) and control coverage were collected.RESULTS: Malaria prevalence varied from 1.4 % in Guba (Ethiopia) to 9.9 % in Butemba (Uganda). The most dominant species was Plasmodium vivax in Ethiopia and Plasmodium falciparum in Uganda. The majority of human-vector contact occurred indoors in Uganda, ranging from 83 % (Anopheles funestus sensu lato) to 93 % (Anopheles gambiae s.l.), which is an important factor for the effectiveness of insecticide-treated nets (ITNs) or indoor residual spraying (IRS). High kdr-L1014S (resistance genotype) frequency was observed in A. gambiae sensu stricto in Uganda. Too few mosquitoes were collected in Ethiopia, so it was not possible to assess vector habits and insecticide resistance levels. ITN ownership did not vary by SES and 56-98 % and 68-78 % of households owned at least one ITN in Ethiopia and Uganda, respectively. In Uganda, 7 % of nets were purchased by households, but the nets were untreated. In three of the four sites, 69-76 % of people with access to ITNs used them. IRS coverage ranged from 84 to 96 % in the three sprayed sites. Half of febrile children in Uganda and three-quarters in Ethiopia for whom treatment was sought received diagnostic tests. High levels of child undernutrition were detected in both countries carrying important implications on child development. In Uganda, 7-8 % of pregnant women took the recommended minimum three doses of intermittent preventive treatment.CONCLUSION: Malaria epidemiology seems to be changing compared to earlier published data, and it is essential to have more data to understand how much of the changes are attributable to interventions and other factors. Regular monitoring will help to better interpret changes, identify determinants, modify strategies and improve targeting to address transmission heterogeneity.
AB - BACKGROUND: Scale-up of malaria interventions seems to have contributed to a decline in the disease but other factors may also have had some role. Understanding changes in transmission and determinant factors will help to adapt control strategies accordingly.METHODS: Four sites in Ethiopia and Uganda were set up to monitor epidemiological changes and effectiveness of interventions over time. Here, results of a survey during the peak transmission season of 2012 are reported, which will be used as baseline for subsequent surveys and may support adaptation of control strategies. Data on malariometric and entomological variables, socio-economic status (SES) and control coverage were collected.RESULTS: Malaria prevalence varied from 1.4 % in Guba (Ethiopia) to 9.9 % in Butemba (Uganda). The most dominant species was Plasmodium vivax in Ethiopia and Plasmodium falciparum in Uganda. The majority of human-vector contact occurred indoors in Uganda, ranging from 83 % (Anopheles funestus sensu lato) to 93 % (Anopheles gambiae s.l.), which is an important factor for the effectiveness of insecticide-treated nets (ITNs) or indoor residual spraying (IRS). High kdr-L1014S (resistance genotype) frequency was observed in A. gambiae sensu stricto in Uganda. Too few mosquitoes were collected in Ethiopia, so it was not possible to assess vector habits and insecticide resistance levels. ITN ownership did not vary by SES and 56-98 % and 68-78 % of households owned at least one ITN in Ethiopia and Uganda, respectively. In Uganda, 7 % of nets were purchased by households, but the nets were untreated. In three of the four sites, 69-76 % of people with access to ITNs used them. IRS coverage ranged from 84 to 96 % in the three sprayed sites. Half of febrile children in Uganda and three-quarters in Ethiopia for whom treatment was sought received diagnostic tests. High levels of child undernutrition were detected in both countries carrying important implications on child development. In Uganda, 7-8 % of pregnant women took the recommended minimum three doses of intermittent preventive treatment.CONCLUSION: Malaria epidemiology seems to be changing compared to earlier published data, and it is essential to have more data to understand how much of the changes are attributable to interventions and other factors. Regular monitoring will help to better interpret changes, identify determinants, modify strategies and improve targeting to address transmission heterogeneity.
KW - Adolescent
KW - Adult
KW - Anemia
KW - Animals
KW - Anopheles
KW - Child
KW - Child, Preschool
KW - Cross-Sectional Studies
KW - Ethiopia/epidemiology
KW - Female
KW - Fever
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Insect Vectors
KW - Insecticides
KW - Malaria/epidemiology
KW - Male
KW - Malnutrition
KW - Mosquito Control
KW - Plasmodium falciparum
KW - Plasmodium vivax
KW - Pregnancy
KW - Pregnancy Complications
KW - Prevalence
KW - Uganda/epidemiology
KW - Young Adult
U2 - 10.1186/s12936-015-0852-7
DO - 10.1186/s12936-015-0852-7
M3 - Journal article
C2 - 26337671
VL - 14
JO - Malaria Journal
JF - Malaria Journal
SN - 1475-2875
M1 - 337
ER -