The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011

Mulakwa Kamuliwo, Emmanuel Chanda, Ubydul Haque, Mercy Mwanza-Ingwe, Chadwick Sikaala, Cecilia Katebe-Sakala, Victor M. Mukonka, Douglas E. Norris, David L. Smith, Gregory E. Glass, William J. Moss

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Abstract

Background: Malaria control was strengthened in Zambia over the past decade. The two primary interventions for vector control are indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Using passive malaria surveillance data collected from 2006 to 2011 through the Zambian District Health Information System, the associations between increased coverage with LLINs and IRS and the burden of malaria in Zambia were evaluated. Methods. National passive malaria surveillance data from 2006 to 2011 were analysed. A district-level, random-effects model with Poisson regression was used to explore the association between malaria cases and coverage with LLINs and IRS. Malaria cases and LLINs and IRS coverage were mapped to visualize spatiotemporal variation in malaria for each year. Results: From 2006-2011, 24.6 million LLINs were distributed and 6.4 million houses were sprayed with insecticide. Coverage with LLINs was not uniformly distributed over the study period and IRS was targeted to central and southern districts where malaria transmission was low. LLIN coverage was associated with a reduction in malaria cases, although an increase in the number of malaria cases was reported in some districts over the study period. A high burden of malaria persisted in north-eastern Zambia, whereas a reduction in the number of reported malaria cases was observed in western and southern Zambia. Conclusion: Enhanced and targeted interventions in north-eastern Zambia where the burden of malaria remains high, as well as efforts to sustain low malaria transmission in the south-west, will be necessary for Zambia to achieve the national goal of being malaria free by 2030.

Original languageEnglish
Article number437
JournalMalaria Journal
Volume12
Issue number1
DOIs
StatePublished - 1 Dec 2013

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Zambia
Malaria
Insecticides
Health Information Systems

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Kamuliwo, Mulakwa ; Chanda, Emmanuel ; Haque, Ubydul ; Mwanza-Ingwe, Mercy ; Sikaala, Chadwick ; Katebe-Sakala, Cecilia ; Mukonka, Victor M. ; Norris, Douglas E. ; Smith, David L. ; Glass, Gregory E. ; Moss, William J. / The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011. In: Malaria Journal. 2013 ; Vol. 12, No. 1.
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title = "The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011",
abstract = "Background: Malaria control was strengthened in Zambia over the past decade. The two primary interventions for vector control are indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Using passive malaria surveillance data collected from 2006 to 2011 through the Zambian District Health Information System, the associations between increased coverage with LLINs and IRS and the burden of malaria in Zambia were evaluated. Methods. National passive malaria surveillance data from 2006 to 2011 were analysed. A district-level, random-effects model with Poisson regression was used to explore the association between malaria cases and coverage with LLINs and IRS. Malaria cases and LLINs and IRS coverage were mapped to visualize spatiotemporal variation in malaria for each year. Results: From 2006-2011, 24.6 million LLINs were distributed and 6.4 million houses were sprayed with insecticide. Coverage with LLINs was not uniformly distributed over the study period and IRS was targeted to central and southern districts where malaria transmission was low. LLIN coverage was associated with a reduction in malaria cases, although an increase in the number of malaria cases was reported in some districts over the study period. A high burden of malaria persisted in north-eastern Zambia, whereas a reduction in the number of reported malaria cases was observed in western and southern Zambia. Conclusion: Enhanced and targeted interventions in north-eastern Zambia where the burden of malaria remains high, as well as efforts to sustain low malaria transmission in the south-west, will be necessary for Zambia to achieve the national goal of being malaria free by 2030.",
author = "Mulakwa Kamuliwo and Emmanuel Chanda and Ubydul Haque and Mercy Mwanza-Ingwe and Chadwick Sikaala and Cecilia Katebe-Sakala and Mukonka, {Victor M.} and Norris, {Douglas E.} and Smith, {David L.} and Glass, {Gregory E.} and Moss, {William J.}",
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Kamuliwo, M, Chanda, E, Haque, U, Mwanza-Ingwe, M, Sikaala, C, Katebe-Sakala, C, Mukonka, VM, Norris, DE, Smith, DL, Glass, GE & Moss, WJ 2013, 'The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011', Malaria Journal, vol. 12, no. 1, 437. https://doi.org/10.1186/1475-2875-12-437

The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011. / Kamuliwo, Mulakwa; Chanda, Emmanuel; Haque, Ubydul; Mwanza-Ingwe, Mercy; Sikaala, Chadwick; Katebe-Sakala, Cecilia; Mukonka, Victor M.; Norris, Douglas E.; Smith, David L.; Glass, Gregory E.; Moss, William J.

In: Malaria Journal, Vol. 12, No. 1, 437, 01.12.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The changing burden of malaria and association with vector control interventions in Zambia using district-level surveillance data, 2006-2011

AU - Kamuliwo, Mulakwa

AU - Chanda, Emmanuel

AU - Haque, Ubydul

AU - Mwanza-Ingwe, Mercy

AU - Sikaala, Chadwick

AU - Katebe-Sakala, Cecilia

AU - Mukonka, Victor M.

AU - Norris, Douglas E.

AU - Smith, David L.

AU - Glass, Gregory E.

AU - Moss, William J.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Background: Malaria control was strengthened in Zambia over the past decade. The two primary interventions for vector control are indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Using passive malaria surveillance data collected from 2006 to 2011 through the Zambian District Health Information System, the associations between increased coverage with LLINs and IRS and the burden of malaria in Zambia were evaluated. Methods. National passive malaria surveillance data from 2006 to 2011 were analysed. A district-level, random-effects model with Poisson regression was used to explore the association between malaria cases and coverage with LLINs and IRS. Malaria cases and LLINs and IRS coverage were mapped to visualize spatiotemporal variation in malaria for each year. Results: From 2006-2011, 24.6 million LLINs were distributed and 6.4 million houses were sprayed with insecticide. Coverage with LLINs was not uniformly distributed over the study period and IRS was targeted to central and southern districts where malaria transmission was low. LLIN coverage was associated with a reduction in malaria cases, although an increase in the number of malaria cases was reported in some districts over the study period. A high burden of malaria persisted in north-eastern Zambia, whereas a reduction in the number of reported malaria cases was observed in western and southern Zambia. Conclusion: Enhanced and targeted interventions in north-eastern Zambia where the burden of malaria remains high, as well as efforts to sustain low malaria transmission in the south-west, will be necessary for Zambia to achieve the national goal of being malaria free by 2030.

AB - Background: Malaria control was strengthened in Zambia over the past decade. The two primary interventions for vector control are indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Using passive malaria surveillance data collected from 2006 to 2011 through the Zambian District Health Information System, the associations between increased coverage with LLINs and IRS and the burden of malaria in Zambia were evaluated. Methods. National passive malaria surveillance data from 2006 to 2011 were analysed. A district-level, random-effects model with Poisson regression was used to explore the association between malaria cases and coverage with LLINs and IRS. Malaria cases and LLINs and IRS coverage were mapped to visualize spatiotemporal variation in malaria for each year. Results: From 2006-2011, 24.6 million LLINs were distributed and 6.4 million houses were sprayed with insecticide. Coverage with LLINs was not uniformly distributed over the study period and IRS was targeted to central and southern districts where malaria transmission was low. LLIN coverage was associated with a reduction in malaria cases, although an increase in the number of malaria cases was reported in some districts over the study period. A high burden of malaria persisted in north-eastern Zambia, whereas a reduction in the number of reported malaria cases was observed in western and southern Zambia. Conclusion: Enhanced and targeted interventions in north-eastern Zambia where the burden of malaria remains high, as well as efforts to sustain low malaria transmission in the south-west, will be necessary for Zambia to achieve the national goal of being malaria free by 2030.

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