scholarly journals Malaria incidence and mortality in Zimbabwe during the COVID-19 pandemic: analysis of routine surveillance data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Samuel Gavi ◽  
Oscar Tapera ◽  
Joseph Mberikunashe ◽  
Mufaro Kanyangarara
Keyword(s):  
Health Services ◽  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
Population Data ◽  
District Level ◽  
Mitigation Measures ◽  
Spatial And Temporal Variation ◽  
Health Management Information System ◽  
Unique Challenge ◽  
Incidence And Mortality

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has posed a unique challenge to health care systems globally. To curb COVID-19 transmission, mitigation measures such as travel restrictions, border closures, curfews, lockdowns, and social distancing have been implemented. However, these measures may directly and indirectly affect the delivery and utilization of essential health services, including malaria services. The suspension of indoor residual spraying (IRS) and insecticide-treated net (ITN) distribution, shortages of malaria commodities, and reduced demand for health services have hindered the continued delivery of malaria services. The overall goal of this analysis was to describe the trends in malaria incidence and mortality in Zimbabwe prior to and during the pandemic to understand the consequences of COVID-19-related changes in the delivery and utilization of malaria services. Methods Monthly data on the number of malaria cases and deaths by district for the period January 2017 to June 2020 were obtained from the national health management information system (HMIS). District-level population data were obtained from the 2012 Census. Malaria incidence per 1000 population and malaria deaths per 100,000 population were calculated for 2017, 2018, 2019, and 2020 and mapped to describe the spatial and temporal variation of malaria at the district level. Results Compared to the same period in 2017, 2018 and 2019, there was an excess of over 30,000 malaria cases from January to June 2020. The number of malaria deaths recorded in January to June 2020 exceeded the annual totals for 2018 and 2019. District level maps indicated that areas outside high malaria burden provinces experienced higher than expected malaria incidence and mortality, suggesting potential outbreaks. Conclusions The observed surge in malaria cases and deaths in January to June 2020 coincided with the onset of COVID-19 in Zimbabwe. While further research is needed to explore possible explanations for the observed trends, prioritizing the continuity of essential malaria services amid the COVID-19 pandemic remains crucial.

scholarly journals Impact of insecticide resistance in Anopheles arabiensis on malaria incidence and prevalence in Sudan and the costs of mitigation

2017 ◽  
Vol 114 (52) ◽  
pp. E11267-E11275 ◽  
Author(s):  
Hmooda Toto Kafy ◽  
Bashir Adam Ismail ◽  
Abraham Peter Mnzava ◽  
Jonathan Lines ◽  
Mogahid Shiekh Eldin Abdin ◽  
...  
Keyword(s):  
Insecticide Resistance ◽  
Pyrethroid Resistance ◽  
Malaria Incidence ◽  
Disease Incidence ◽  
Indoor Residual Spraying ◽  
Sub Saharan Africa ◽  
Malaria Vectors ◽  
Incidence And Mortality ◽  
Additional Protection ◽  
The Impact

Insecticide-based interventions have contributed to ∼78% of the reduction in the malaria burden in sub-Saharan Africa since 2000. Insecticide resistance in malaria vectors could presage a catastrophic rebound in disease incidence and mortality. A major impediment to the implementation of insecticide resistance management strategies is that evidence of the impact of resistance on malaria disease burden is limited. A cluster randomized trial was conducted in Sudan with pyrethroid-resistant and carbamate-susceptible malaria vectors. Clusters were randomly allocated to receive either long-lasting insecticidal nets (LLINs) alone or LLINs in combination with indoor residual spraying (IRS) with a pyrethroid (deltamethrin) insecticide in the first year and a carbamate (bendiocarb) insecticide in the two subsequent years. Malaria incidence was monitored for 3 y through active case detection in cohorts of children aged 1 to <10 y. When deltamethrin was used for IRS, incidence rates in the LLIN + IRS arm and the LLIN-only arm were similar, with the IRS providing no additional protection [incidence rate ratio (IRR) = 1.0 (95% confidence interval [CI]: 0.36–3.0; P = 0.96)]. When bendiocarb was used for IRS, there was some evidence of additional protection [interaction IRR = 0.55 (95% CI: 0.40–0.76; P < 0.001)]. In conclusion, pyrethroid resistance may have had an impact on pyrethroid-based IRS. The study was not designed to assess whether resistance had an impact on LLINs. These data alone should not be used as the basis for any policy change in vector control interventions.

scholarly journals Modeled Impact of Seasonal Malaria Chemoprevention on District-Level Suspected and Confirmed Malaria Cases in Chad Based on Routine Clinical Data (2013–2018)

2021 ◽  
Author(s):  
Sol Richardson ◽  
Azoukalne Moukenet ◽  
Mahamat Saleh Issakha Diar ◽  
Monica Anna de Cola ◽  
Christian Rassi ◽  
...  
Keyword(s):  
Health Management ◽  
Malaria Incidence ◽  
Routine Data ◽  
Health Facilities ◽  
Additive Models ◽  
District Level ◽  
Sensitivity Analyses ◽  
Health Management Information System ◽  
Seasonal Malaria Chemoprevention ◽  
The Impact

Sulfadoxine-pyrimethamine plus amodiaquine to children aged 3–59 months is delivered as seasonal malaria chemoprevention (SMC) in areas where transmission is highly seasonal such as Chad and other Sahelian countries. Although clinical trials show a 75% reduction in malaria cases, evidence of SMC’s impact at scale remains limited. Using data from the Chadian National Health Management Information System, we analyzed associations between SMC implementation during July–October and monthly district-level malaria incidence (suspected and confirmed outpatient cases) among children aged 0–59 months at health facilities in 23 health districts with SMC implementation during 2013–2018. Generalized additive models were fitted with separate cyclic cubic spline terms for each district to adjust for seasonality in cases. SMC implementation in Chad was associated, compared with no implementation, with lower monthly counts of both suspected (rate ratio [RR]: 0.82, 95% CI: 0.72–0.94. P = 0.006) and confirmed malaria cases (RR: 0.81, 95% CI: 0.71–0.93, P = 0.003), representing around 20% reduction in malaria incidence. Sensitivity analyses showed effect sizes of up to 28% after modifying model assumptions. Caution should be exercised in interpreting our findings, which may not be comparable with other studies, and may over- or underestimate impact of SMC; not all malaria cases present at health facilities, not all suspected cases are tested, and not all facilities report cases consistently. This study’s approach presents a solution for employing readily available routine data to evaluate the impact of health interventions at scale without extensive covariate data. Further efforts are needed to improve the quality of routine data in Chad and elsewhere.

scholarly journals Malaria epidemiology and stratification of incidence in the malaria elimination setting in Harari Region, Eastern Ethiopia

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Endashaw Esayas ◽  
Asefa Tufa ◽  
Fekadu Massebo ◽  
Abdulhamid Ahemed ◽  
Ibssa Ibrahim ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Incidence Rate ◽  
Malaria Elimination ◽  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
District Level ◽  
District Health ◽  
Eastern Ethiopia ◽  
Intervention Coverage ◽  
Malaria Epidemiology

Abstract Background Ethiopia has shown notable progress in reducing the burden of malaria over the past two decades. Because of this progress, the country has shifted efforts from control to elimination of malaria. This study was conducted to analyse the malaria epidemiology and stratification of incidence in the malaria elimination setting in eastern Ethiopia. Methods A retrospective study was conducted to analyse the epidemiology of malaria by reviewing the district health office data from 2013 to 2019 in Harari Region. In addition, three years of sub-district level malaria data were used to stratify the malaria transmission intensity. Malaria interventions (Long-lasting insecticidal nets [LLIN] and indoor residual spraying [IRS]) employed were reviewed to analyse the intervention coverage at the Regional level. Descriptive statistics were used to show the malaria transmission in terms of years, season and species of the malaria parasite. Incidence rate per 1000 population and death rate per 1 000 000 population at risk were computed using the total population of each year. Results In the Harari Region, malaria incidence showed a more pronounced declining trend from 2017 to 2019. Plasmodium falciparum, P. vivax and mixed infections accounted for 69.2%, 30.6% and 0.2% of the cases, respectively. There was an increment in malaria intervention coverage and improved malaria diagnosis. In the year 2019 the coverage of LLIN and IRS in the Region were 93.4% and 85.1% respectively. The annual malaria incidence rate dropped from 42.9 cases per 1000 population in 2013 to 6.7 cases per 1000 population in 2019. Malaria-related deaths decreased from 4.7 deaths per 1 000 000 people annually in 2013 to zero, and there have been no deaths reported since 2015. The malaria risk appears to be heterogeneous and varies between districts. A higher number of malaria cases were recorded in Erer and Jenella districts, which constitute 62% of the cases in the Region. According to the sub-district level malaria stratification, there was shrinkage in the malaria transmission map and about 70% of the sub-districts have achieved elimination targets. Conclusions In the Harari Region, malaria morbidity and mortality have been significantly declined. Thus, if this achievement is sustained and scaling-up of the existing malaria prevention and control strategies by focusing on those populations living in the higher malaria transmission districts and sub-districts, planning of malaria elimination from the study area might be feasible.

Fire Risk Analysis Using Geospatial Approach and Mitigation Measures for South-West Delhi

2018 ◽  
Vol 6 (8) ◽  
pp. 131
Author(s):  
S. K. Tomar ◽  
A. Kaur ◽  
H. K. Dangi ◽  
T. Ghawana ◽  
K. Sarma
Keyword(s):  
Risk Analysis ◽  
Fire Risk ◽  
Population Data ◽  
Fire Service ◽  
Capital City ◽  
Mitigation Measures ◽  
Fire Risk Analysis ◽  
South West ◽  
Geospatial Tools ◽  
Fire Stations

One of the major challenge from unplanned growth in the cities is the fire incidents posing a serious threat to life and property. Delhi, the capital city of India, has seen unplanned growth of colonies resulting in a serious concern for the relevant agencies. This paper investigates the relation between potential causes of fire incidents during 2013-2016 in South-West Delhi Division of Delhi Fire Services as part of risk analysis using the data about fire stations & their jurisdictions, incidents of fire, water reservoirs available, landuse and population data along with the divisional & sub-divisional boundaries of South-West Delhi division under Delhi Fire Service. Statistical and Geospatial tools have been used together to perform the risk analysis. The analysis reveals that difference in actual occupancy and defined landuse as a part of unplanned growth of settlements is found to be the main reason behind the major fire incidents. The suggested mitigation measures focus on legal, policy, physical & technological aspects and highlight the need to bring the systemic changes with changing scenario of demographics and infrastructure to accommodate more aspects of ground reality.

scholarly journals Persistent Parasitemia Despite Dramatic Reduction in Malaria Incidence After 3 Rounds of Indoor Residual Spraying in Tororo, Uganda

2018 ◽  
Vol 219 (7) ◽  
pp. 1104-1111 ◽  
Author(s):  
Joaniter I Nankabirwa ◽  
Jessica Briggs ◽  
John Rek ◽  
Emmanuel Arinaitwe ◽  
Patience Nayebare ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
Dramatic Reduction

Dihydroartemisinin-piperaquine chemoprevention and malaria incidence after severe flooding: evaluation of a pragmatic intervention in rural Uganda

2021 ◽  
Author(s):  
Ross M Boyce ◽  
Brandon D Hollingsworth ◽  
Emma Baguma ◽  
Erin Xu ◽  
Varun Goel ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Mitigation Measures ◽  
Older Children ◽  
Post Intervention ◽  
Rapid Diagnostic Test Result ◽  
Western Uganda ◽  
And Control ◽  
The Impact ◽  
To Receive ◽  
Severe Flooding

Abstract Background Malaria epidemics are a well-described phenomenon after extreme precipitation and flooding, which account for nearly half of global disasters over the past two decades. Yet few studies have examined mitigation measures to prevent post-flood malaria epidemics. Methods We conducted an evaluation of a malaria chemoprevention program implemented in response to severe flooding in western Uganda. Children ≤12 years of age from one village were eligible to receive 3 monthly rounds of dihydroartemisinin-piperaquine (DP). Two neighboring villages served as controls. Malaria cases were defined as individuals with a positive rapid diagnostic test result as recorded in health center registers. We performed a difference-in-differences analysis to estimate changes in the incidence and test positivity of malaria between intervention and control villages. Results A total of 554 children received at least one round of chemoprevention with 75% participating in at least two rounds. Compared to control villages, we estimated a 53.4% reduction (aRR 0.47, 95% CI 0.34 – 0.62, p&lt;.01) in malaria incidence and a 30% decrease in the test positivity rate (aRR=0.70, CI 0.50 - 0.97, p=0.03) in the intervention village in the six months post-intervention. The impact was greatest among children receiving the intervention, but decreased incidence was also observed in older children and adults (aRR=0.57, CI 0.38-0.84, p&lt;.01). Conclusions Three rounds of chemoprevention with DP delivered under pragmatic conditions reduced the incidence of malaria after severe flooding in western Uganda. These findings provide a proof-of-concept for the use of malaria chemoprevention to reduce excess disease burden associated with severe flooding.

Looking at the bigger picture: effect of performance-based contracting of district health services on equity of access to maternal health services in Zambia

2019 ◽  
Author(s):  
Collins Chansa ◽  
Mulenga Mary Mukanu ◽  
Chitalu Miriam Chama-Chiliba ◽  
Mpuma Kamanga ◽  
Nicholas Chikwenya ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Health Expenditure ◽  
Maternal Health Services ◽  
Health Facilities ◽  
District Level ◽  
Health Service Provision ◽  
Equity Of Access ◽  
The Impact

Abstract Zambia has been using output-based approaches for over two decades to finance whole or part of the public health system. Between 1996 and 2006, performance-based contracting (PBC) was implemented countrywide with the Central Board of Health (CBoH) as the provider of health services. This study reviews the association between PBC and equity of access to maternal health services in Zambia between 1996 and 2006. A comprehensive document review was undertaken to evaluate the implementation process, followed by a trend analysis of health expenditure at district level, and a segmented regression analysis of data on antenatal care (ANC) and deliveries at health facilities that was obtained from five demographic and health survey datasets (1992, 1996, 2002, 2007 and 2014). The results show that PBC was anchored by high-level political support, an overarching policy and legal framework, and collective planning and implementation with all key stakeholders. Decentralization of health service provision was also an enabling factor. ANC coverage increased in both the lower and upper wealth quintiles during the PBC era, followed by a declining trend after the PBC era in both quintiles. Further, the percentage of women delivering at health facilities increased during the PBC era, particularly in rural areas and among the poor. The positive trend continued after the PBC era with similar patterns in both lower and upper wealth quintiles. Despite these gains, per capita health expenditure at district level declined during the PBC era, with the situation worsening after the PBC era. The study concludes that a nationwide PBC approach can contribute to improved equity of access to maternal health services and that PBC is a cost-efficient and sustainable policy reform. The study calls for policymakers to comprehensively evaluate the impact of health system reforms before terminating them.

scholarly journals Effects of Socio-Environmental Factors on Malaria Infection in Pakistan: A Bayesian Spatial Analysis

2019 ◽  
Vol 16 (8) ◽  
pp. 1365 ◽  
Author(s):  
Muhammad Farooq Umer ◽  
Shumaila Zofeen ◽  
Abdul Majeed ◽  
Wenbiao Hu ◽  
Xin Qi ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Malaria Incidence ◽  
Meteorological Data ◽  
Random Effect ◽  
Control Program ◽  
Population Data ◽  
Mean Value ◽  
Malaria Control Program ◽  
Study Population ◽  
Bayesian Spatial Analysis

The role of socio-environmental factors in shaping malaria dynamics is complex and inconsistent. Effects of socio-environmental factors on malaria in Pakistan at district level were examined. Annual malaria cases data were obtained from Directorate of Malaria Control Program, Pakistan. Meteorological data were supplied by Pakistan Meteorological Department. A major limitation was the use of yearly, rather than monthly/weekly malaria data in this study. Population data, socio-economic data and education score data were downloaded from internet. Bayesian conditional autoregressive model was used to find the statistical association of socio-environmental factors with malaria in Pakistan. From 136/146 districts in Pakistan, >750,000 confirmed malaria cases were included, over a three years’ period (2013–2015). Socioeconomic status ((posterior mean value −3.965, (2.5% quintile, −6.297%), (97.5% quintile, −1.754%)) and human population density (−7.41 × 10−4, −0.001406%, −1.05 × 10−4 %) were inversely related, while minimum temperature (0.1398, 0.05275%, 0.2145%) was directly proportional to malaria in Pakistan during the study period. Spatial random effect maps presented that moderate relative risk (RR, 0.75 to 1.24) and high RR (1.25 to 1.99) clusters were scattered throughout the country, outnumbering the ones’ with low RR (0.23 to 0.74). Socio-environmental variables influence annual malaria incidence in Pakistan and needs further evaluation.

scholarly journals (A182) Model to Assess Geo-Temporal Spread of Disease by Air Travel from Major World Cities to the United States

2011 ◽  
Vol 26 (S1) ◽  
pp. s51-s51
Author(s):  
G.M. Hwang ◽  
T. Wilson
Keyword(s):  
Assessment Tool ◽  
Metropolitan Areas ◽  
Infected Individual ◽  
Population Data ◽  
The United States ◽  
Air Travel ◽  
Disease Spread ◽  
Mitigation Measures ◽  
The Us ◽  
Control And Prevention

With increasing numbers of international flights and air travelers arriving in the US annually, the rapid spread of communicable diseases has grown. Epidemics of novel infectious diseases have emerged and rapidly spread globally in association with air travel, including the severe acute respiratory syndrome (SARS) outbreak in 2003 and H1N1 in 2009. In order to anticipate and mitigate the consequences of future rapid disease spread, the MITRE Corporation, in collaboration with the (US) Centers for Disease Control and Prevention, developed a risk assessment tool using a Susceptible-Exposed-Infectious-Recovered model and detailed flight and population data. The emergence and spread of prototypic pandemic influenza was simulated based on a theoretical geographical point of origin and its communicability. More than 50 international metropolitan areas were analyzed as potential points of origin to simulate the rapidity of spread to the US. The basic reproduction number (Ro), defined as the average number of persons to whom one infected individual transmits disease in an immune naive population, was varied from 1.4 to 1.9. The starting numbers of infectious persons at each origin also were varied (100 or 500 persons, 5% infectious may travel). Waves were computed as aggregate across metropolitan areas modeled in the US. The visualization of the first pandemic wave was most apparent in simulations of Ro = 1.9, resulting from 500 infectious persons at each origin. More than 50% of origins indicated that aggregate waves peaked around Day 125, while 30% of origins peaked around Day 90. Additionally, the time, in days, from its origin in six continents into the US was compared, and a two-week delay was found from South America compared with other continents. This simulation tool better equips policy makers and public health officials to quickly assess risk and leverage resources efficiently via targeted and scalable border mitigation measures during a rapid global outbreak.

scholarly journals Covid-19 Incidence and Mortality by Age Strata and Comorbidities in Mexico City: A Focus in the Pediatric Population

2021 ◽  
Vol 9 ◽  
Author(s):  
Nadia González-García ◽  
María F. Castilla-Peón ◽  
Fortino Solórzano Santos ◽  
Rodolfo Norberto Jiménez-Juárez ◽  
Maria Elena Martínez Bustamante ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Age Groups ◽  
Population Data ◽  
Older Age ◽  
Age Group ◽  
Education Policies ◽  
Infected People ◽  
Risk Of Death ◽  
Incidence And Mortality ◽  
Pediatric Populations

Background: SARS-COV2 appears less frequently and less severely in the pediatric population than in the older age groups. There is a need to precisely estimate the specific risks for each age group to design health and education policies suitable for each population.Objective: This study aimed to describe the risk of death in SARS-COV2 infected subjects by age group and according to the presence of comorbidities.Methods: We analyzed data of confirmed SARS-COV2 infection cases where symptoms began between February 22th, 2020, and April 18th, 2021, as published by the General Epidemiology Direction (DGE) of the Mexican Ministry of Health. We calculated COVID-19 incidence and mortality by age group using population data from the Statistics and Population National Institute (INEGI), and estimated the association between risk of death and the presence of comorbidities.Results: Mortality in SARS-COV2 infected people varied considerably, between 7 and 155 deaths per million per year in the under-20 age groups compared to 441 to 15,929 in the older age groups. Mortality in pediatric populations is strongly associated with comorbidities (OR: 4.6-47.9) compared to the milder association for older age groups (OR: 3.16–1.23).Conclusion: The risk of death from SARS-COV2 infection in children is low and is strongly associated with comorbidities.

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