malaria

Malaria accounts for the largest portion of healthcare demand in Angola. Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. The results reveal important diferences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in Huambo compared to Uíge. A majority of true malaria cases seeking care in health facilities in Huambo were not appropriately treated with anti-malarials, highlighting the importance of continued training and supervision of healthcare workers in malaria case management, particularly in areas with decreased malaria transmission.

The neglected tropical diseases (NTDs) are the most common infections of humans in sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these "big three" diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts of NTDs on the big three.

The diagnosis of malaria in clinical laboratories mainly depends on blood smear microscopy, and this technique remains the most widely used in Ethiopia. Despite the importance of blood smear microscopy for patients’ diagnosis and treatment, little effort has been made to precisely determine and identify sources of error in malaria smear microscopic diagnosis and quantification of parasitaemia. The main objective of the present study was to assess the laboratory practices of health care laboratories carrying out blood films microscopy. A cross-sectional study was conducted in northwestern Ethiopia involving 29 health care institutes. A structured and pretested questionnaire was used to collect relevant information on the physical conditions, laboratory logistics, and laboratory practices carrying out blood smear microscopy. In most of the health care laboratories studied, availability of laboratory logistics and technical practices for malaria microscopy were found to be below the standard set by World Health Organization. Improving logistics access for malaria microscopy at all level of health care is important to increase accuracy of diagnosis and quantification of malaria parasites. Moreover, continued training and regular supervision of the staff and implementation of quality control program in the area are also crucial.

The Integrated Infectious Diseases Capacity Building Evaluation designed two interventions for mid-level practitioners from 36 primary care facilities in Uganda: the Integrated Management of Infectious Disease (IMID) training program and On-Site Support (OSS). We evaluated their effects on 23 facility performance indicators, including malaria case management.The combination of IMID and OSS was associated with statistically significant improvements in malaria case management.

Recent studies in Guyana and Suriname revealed diminished efficacy of artemisinin derivatives based on day-3 parasitaemia. Data on malaria medicine quality and pharmaceutical management, generated in the context of the Amazon Malaria Initiative, were reviewed and discussed. Numerous substandard artemisinin-containing malaria medicines were identified in both countries, particularly in Guyana. The quality of malaria medicines and the availability and use of non-recommended treatments could have played a role in the diminished efficacy of artemisinin derivatives described in Guyana and Suriname.

This paper examines the possible relationship between Hb concentration and severity of anemia with individual and household characteristics of children aged 6-59 months in Nigeria; and explores possible geographical variations of these outcome variables. Spatial analyses reveal a distinct north-south divide in Hb concentration of the children analyzed. States in Northern Nigeria possess a higher risk of anemia. Other important risk factors include the household wealth index, sex of the child, whether or not the child had fever or malaria in the 2 weeks preceding the survey, and age under 24 months of age. There is a need for state-level implementation of programs that target vulnerable children.

We examined the spatial pattern and risk factors of co-morbidity of malaria and non-malarial febrile illness among children aged 6-59 months in Nigeria. Using data from the 2010 Nigeria Malaria Indicator Survey, we considered the co-morbidity of malaria and non-malarial febrile illness among the children as multicategorical and selected a mixed multinomial logit model capable of incorporating covariates of different types. Inference was Bayesian, based on multicategorical linear mixed-model representation. We found that the risk of co-morbidity of malaria and non-malarial febrile illness increases as a child advances in age while the risk of non-malarial fever reduces after about 32 months of age. Area of residence (urban or rural), wealth index and type of roofing material used in the dwelling are other important risk factors for the co-morbidity found in this study. Further, children from four of Nigeria's 37 states are at high risk of malaria. Disease preventive measures need to be intensified, with more focus on rural areas and the poor. Campaigns for use of insecticide-treated bed nets need be more aggressive in all Nigerian states.

Monitoring implementation of the ‘‘test and treat’’ case-management policy for malaria is an important component of all malaria control programmes in Africa. Unfortunately, routine information systems are commonly deficient to provide necessary information. Using health facility surveys we monitored health systems readiness and malaria case management practices prior to and following implementation of the 2010 ‘‘test and treat’’ policy in Kenya. Between 2010 and 2013 six national, cross-sectional, health facility surveys were undertaken. Major improvements in the implementation of the ‘‘test and treat’’ policy were observed. Some gaps towards universal targets still remained. Other countries facing similar needs and challenges may consider health facility surveys to monitor malaria case-management.

Malaria during pregnancy is a major public health problem in Nigeria especially in malaria-endemic areas. It increases the risk of low birth weight and child/maternal morbidity/mortality. This paper addresses the impact of radio campaigns on the use of insecticide-treated bed nets among pregnant women in Nigeria. Pregnant women who listened to mass media campaigns were more likely to adopt strategies to protect themselves from malaria.

Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study “SMS for Life” was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data.

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