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The use of schools for malaria surveillance and programme evaluation in Africa
Simon Brooker, Jan H Kolaczinski, Carol W Gitonga, Abdisalan M Noor, Robert W Snow
Malaria Journal , 2009, DOI: 10.1186/1475-2875-8-231
Abstract: The burden of malaria in some areas of sub-Saharan Africa (SSA) has started to decline over recent years: analyses of hospital admission data provide evidence of declining morbidity and mortality in Kenya [1,2], The Gambia [3], South Africa [4], Zanzibar [5], and Eritrea [6]. Such reductions have been variously attributed to the expanded distribution of insecticide-treated nets (ITNs), changing first-line treatments to artemisinin combination therapy (ACT) and increasing access to it, and the renewed use of indoor residual spraying (IRS). There are, however, fewer reports on the impact of these interventions on malaria transmission [5,7]. This is partly due to the technical and ethical difficulties associated with quantifying transmission using vector-based indices, such as the entomological inoculation rate [8]. A more frequently used malariometric index is the Plasmodium falciparum parasite rate (PfPR): the proportion of surveyed persons harbouring parasites in their peripheral blood. The PfPR among children aged 2-10 years provides an indirect quantitative measure of transmission intensity across a range of malaria endemicities [9,10]. Historically, the measurement of PfPR had important roles during the first phase of the Global Malaria Elimination Programme (GMEP) and was subsequently used to monitor progress and verify interruption of transmission [11]. Moreover, contemporary maps of PfPR can provide important information for national malaria control programmes by targeting interventions according to endemicity, thus cost-effectively targeting resources for malaria control [12,13].Currently, the most robust sampling framework for national malaria surveys are household cluster surveys, including: Demographic and Health Surveys [14], the Multiple Indicator Cluster Surveys [15], and Malaria Indicator Surveys (MIS) [16]. All of these surveys collect household-level information on malaria intervention coverage, patterns of anti-malarial use, and in selected MIS, on
The Contribution of the Global Framework for Climate Services Adaptation Programme in Africa (GFCS APA) in National Adaptation Plan (NAP) Process for Tanzania  [PDF]
Agnes Kijazi, Ladislaus Chang’a, Philbert Luhunga, Hashim Ng’ongolo, Mecklina Merchades, Pamela Levira
Atmospheric and Climate Sciences (ACS) , 2019, DOI: 10.4236/acs.2019.94040
Abstract: This article assesses the contribution of the Global Framework for Climate Services Adaptation Programme in Africa (GFCS APA) in the National Adaptation Plan (NAP) process for Tanzania. Different research project outputs (field survey and workshop reports) produced during the implementation of GFCS APA are reviewed to assess the contribution of GFCS APA programme in the establishment and implementation of NAP process in Tanzania. It is found that the implementation of GFCS-APA programme in Tanzania has improved the availability, accessibility, and applicability of climate information to different stakeholders. This has in turn attributed to significant use of climate information in planning and decision making in target sectors: agriculture and food security, disaster risk reduction, energy, health and water resource management. This has increased the adaptation capacity of vulnerable communities from the impacts of climate variability and change. Furthermore, it is evident that the aims and objectives of establishments of NAP process in Tanzania have been addressed through implementation of GFCS APA Programme. Moreover, since the GFCS APA in Tanzania is implemented within its five pillars namely: observation and monitoring, research, modeling and prediction, climate information systems, user interface platform and capacity development. The achievement made in each pillar contributed in enhancement of resilience of vulnerable communities to climate variability and change hence addressing the aims and objectives of NAP process in Tanzania. Therefore, it is recommended that achievements of GFCS APA Programme in Tanzania to be used as a guide to the development and implementations of the NAP process in Tanzania.
Web-based climate information resources for malaria control in Africa
Emily K Grover-Kopec, M Benno Blumenthal, Pietro Ceccato, Tufa Dinku, Judy A Omumbo, Stephen J Connor
Malaria Journal , 2006, DOI: 10.1186/1475-2875-5-38
Abstract: Malaria remains a major public health threat to the African continent and its control is critical to achieving the Millennium Development Goals in this region. The recently published Global Strategic Plan for Roll Back Malaria 2005–2015 has stated that "Six out of eight Millennium Development Goals can only be reached with effective malaria control in place" [1]. The greatest burden of malaria in Africa is born by populations in regions where the disease pathogen is perennially present in the community. In these regions, the environment is conducive to interactions between the Anopheles mosquito, malaria parasites and human hosts because they contain surface water in which mosquitoes can lay their eggs, humid conditions which facilitate adult mosquito life spans of adequate length, and relative warmth which allows both the mosquito and the malaria parasite to develop rapidly. In addition, housing quality is generally poor and offers little protection from human-mosquito interaction. Those most vulnerable to endemic malaria are young children (<5 years of age) who have yet to acquire disease immunity, pregnant women, whose immunity is reduced, and non-immune migrants or travelers.Epidemic malaria tends to occur along the geographical margins of the endemic regions, when the conditions supporting the equilibrium between the human, parasite and mosquito vector populations are disturbed. This leads to a sharp but temporary increase in disease incidence. More than 124 million Africans live in such areas and experience epidemics causing around 12 million malaria episodes and up to 310,000 deaths annually [2]. In these regions, an individual's exposure to malaria is infrequent and, therefore, little acquired immunity to this life threatening disease is developed. All age groups are, therefore, vulnerable to epidemic malaria [3]. The development of an online product that supports epidemic risk monitoring has been previously reported [4].While economic development has played
Difficulties in organizing first indoor spray programme against malaria in Angola under the President's Malaria Initiative
Somandjinga,Martinho; Lluberas,Manuel; Jobin,William R;
Bulletin of the World Health Organization , 2009, DOI: 10.1590/S0042-96862009001100017
Abstract: problem: successful attempts to control malaria require understanding of its complex transmission patterns. unfortunately malaria transmission in africa is often assessed using routine administrative reports from local health units, which are plagued by sporadic reporting failures. in addition, the lack of microscopic analyses of blood slides in these units introduces the effects of many confounding diseases. approach: the danger of using administrative reports was illustrated in angola, the first country in which malaria control was attempted under the president's malaria initiative, a development programme of the government of the united states of america. local setting: each local health unit submitted monthly reports indicating the number of suspected malaria cases to their municipality. the identification of the disease was based on clinical diagnoses, without microscopic examination of blood slides. the municipal and provincial reports were then passed on to the national headquarters, with sporadic reporting lapses at all levels. relevant changes: after the control effort was completed, the defective municipal reports were corrected by summarizing only the data from those health units which had submitted reports for every month during the evaluation period. lessons learned: the corrected data, supplemented by additional observations on rainfall and mosquito habitats, indicated that there had probably been no malaria transmission before starting the control operations. thus the expensive malaria control effort had been wasted. it is unfortunate that who is also trying to plan and evaluate its malaria control efforts based on these same kinds of inadequate administrative reports.
Improving epidemic malaria planning, preparedness and response in Southern Africa
Joaquim DaSilva, Brad Garanganga, Vonai Teveredzi, Sabine M Marx, Simon J Mason, Stephen J Connor
Malaria Journal , 2004, DOI: 10.1186/1475-2875-3-37
Abstract: The SADC countries have adopted the Abuja targets for Roll Back Malaria in Africa, which include improved epidemic detection and response, i.e., that 60% of epidemics will be detected within two weeks of onset, and 60% of epidemics will be responded to within two weeks of detection. The SADC countries recognize that to achieve these targets they need improved information on where and when to look for epidemics. The WHO integrated framework for improved early warning and early detection of malaria epidemics has been recognized as a potentially useful tool for epidemic preparedness and response planning. Following evidence of successful adoption and implementation of this approach in Botswana, the SADC countries, the WHO Southern Africa Inter-Country Programme on Malaria Control, and the SADC Drought Monitoring Centre decided to organize a regional meeting where countries could gather to assess their current control status and community vulnerability, consider changes in epidemic risk, and develop a detailed plan of action for the forthcoming 2004–2005 season. The following is a report on the 1st Southern African Regional Epidemic Outlook Forum, which was held in Harare, Zimbabwe, 26th–29th September, 2004.The Southern African region has a long and varied history of malaria control with periodic epidemics occurring [1,2]. These epidemics can be regional in scale, as in 1996 and 1997, or much more focal, affecting specific districts or sub-districts. The countries of the Southern African Development Community are committed to the Abuja Targets for Roll Back Malaria in Africa, and this includes improved detection and response to epidemics [1]. To meet these targets countries are expected to detect 60% of malaria epidemics within two weeks of onset, and respond to 60% of epidemics within two weeks of their detection. The countries recognize that to achieve these targets they need improved information on where epidemics are most likely to occur, and ideally some indicatio
Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa
Nicole Mamotte, Douglas Wassenaar, Jennifer Koen, Zaynab Essack
BMC Medical Ethics , 2010, DOI: 10.1186/1472-6939-11-3
Abstract: In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009.Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing.The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.Africa continues to bear a disproportionate share of the global burden of HIV, TB and malaria. There are 22 million people living with HIV in sub-Saharan Africa, 67% of the 33 million people living with HIV globally [1]. An estimated 9.27 million new cases of TB [2] and 1.7 million deaths from TB [3] occurred globally in 2007. Thirteen of the 15 countries with the highest estimated TB incidence rates are in Africa, a result of high rates of HIV co-infection [2]. In 2006, there were an estimated 247 million episodes of malaria and an estimated 881 000 malaria deaths [4]. Eighty-six percent (212 million) of these malaria episodes and 91% (801 000) of malaria deaths in 2006 occurred in Africa (Ibid.). Malaria and TB complicate the effective control of HIV, due to their shared risk factors, geographic overlap and co-infection, particularly in sub-Saharan Africa. TB is a leading cause of death among people living with HIV/AIDS in Africa [5]. Only 1% of people living with HIV/AIDS are reported to have been screened for TB, of which more than 25% have TB [6]. HIV also increases the risk of malaria infection and the development of clinical malaria, while malaria has been sho
An Overview of the Malaria Control Programme in Zambia  [PDF]
Emmanuel Chanda,Mulakwa Kamuliwo,Richard W. Steketee,Michael B. Macdonald,Olusegun Babaniyi,Victor M. Mukonka
ISRN Preventive Medicine , 2013, DOI: 10.5402/2013/495037
Abstract: The Zambian national malaria control programme has made great progress in the fight against Malaria. The country has solid, consistent, and coordinated policies, strategies, and guidelines for malaria control, with government prioritizing malaria in both the National Health Strategic Plan and the National Development Plan. This has translated into high coverage of proven and effective key preventive, curative, and supportive interventions with concomitant marked reduction in both malaria cases and deaths. The achievements attained can be attributed to increased advocacy, communication and behaviour changes, efficient partnership coordination including strong community engagement, increased financial resources, and evidence-based deployment of key technical interventions in accordance with the national malaria control programme policy and strategic direction. The three-ones strategy has been key for increased and successful public-private sector partner coordination, strengthening, and mobilization. However, maintaining the momentum and the gains is critical as the programme strives to achieve universal coverage of evidence-based and proven interventions. The malaria control programme’s focus is to maintain the accomplishments, by mobilizing more resources and partners, increasing the government funding towards malaria control, scaling up and directing interventions based on epidemiological evidence, and strengthen active malaria surveillance and response to reduce transmission and to begin considering elimination. 1. Introduction Malaria continues to be a disease of major public health significance in Zambia despite recent successes in scaling up interventions and documented reductions in malaria burden among children [1–4]. The report article entitled “Achievements in Malaria Control: The Zambian Story 2000–2010” was published in 2010 by the Directorate of Public Health and Research of the Ministry of Health (MoH) in Zambia [2]. The publication indicates that in the 10–20 years leading up to the year 2000, relatively limited malaria prevention existed in the country and much of the activities were focused on treatment of malaria. This led to steady increase in the disease burden, with hospital admissions increasing from 8.8% in 1976 to over 20% in the 1990s. Accordingly, case fatality rates in hospitalized patients increased from 10.6 deaths per 1000 malaria admissions in 1976 to 51 deaths per 1000 malaria admissions in 1994 [5]. In 1999, approximately 3.46 million malaria cases were recorded for a population of 10.8 million inhabitants. The malaria
The affordable medicines facility-malaria—A success in peril  [cached]
Talisuna Ambrose O,Adibaku Seraphine,Amojah Chioma N,Amofah George K
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-370
Abstract: The Affordable Medicines Facility-malaria (AMFm) has put into place a bold financing plan for artemisinin-combination therapy in a pilot phase in seven countries covering half the population at risk of malaria in Africa. A report of the AMFm independent evaluation, conducted by ICF International and the London School of Hygiene and Tropical Medicine, describes the success of the programme in the pilot sites: Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania (mainland and Zanzibar) and Uganda, comparing availability and affordability of high-quality artemisinin-combination therapies before and after AMFm launched. Proof of concept was achieved: AMFm increased availability and kept prices low, meeting its initial, ambitious benchmarks in most settings. Despite this overwhelming success, opposition to the programme and dwindling resources for malaria control conspire to cripple or kill AMFm.
Towards malaria elimination - a new thematic series
Marcel Tanner, Marcel Hommel
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-24
Abstract: The paradigm shift from malaria control to malaria eradication following declarations at the Gates Malaria Forum in October 2007 [1,2] and subsequent support voiced by World Health Organization (WHO) [2], the Board of the Roll Back Malaria (RBM) Partnership and many other institutions has renewed inspiration for innovation and public health action. New initiatives such as attempts to eliminate malaria in the Southern African region [3] and Pacific Island states [4] and the new global agenda and field manual for malaria elimination from WHO's Global Malaria Programme [5,6] foreshadowed this movement and are preparing the ground for another global attempt at eradication. Very swiftly a coherent global action plan for malaria eradication was established and approved by RBM in late 2008 [7]. A group of scientists, public health decision makers, control programme managers and funders, the Malaria Elimination Group, compiled - based on all currently available scientific evidence and case studies - a guide to policy makers for malaria elimination for areas that embark or have embarked on elimination strategies [8]. All these recent efforts illuminate a pathway from control through to elimination and, eventually to eradication, as the only ethical long-term strategy.Alongside and interrelated with these important developments over the past decade, a remarkable decline of malaria incidence in several countries in sub-Saharan Africa, and world-wide, has been observed in recent years. This fall seems to have started before the widespread introduction of insecticide-treated nets and is a reflection of the renewed efforts in malaria control [9-15]. In the world today, 108 countries are malaria-free and the remaining one hundred countries still experience malaria transmission; 39 of these countries have already embarked on elimination while the remaining 61 countries implement control strategies [8].It is against this background that the malaria community has to prepare for an "e
Using a Geographical-Information-System-Based Decision Support to Enhance Malaria Vector Control in Zambia  [PDF]
Emmanuel Chanda,Victor Munyongwe Mukonka,David Mthembu,Mulakwa Kamuliwo,Sarel Coetzer,Cecilia Jill Shinondo
Journal of Tropical Medicine , 2012, DOI: 10.1155/2012/363520
Abstract: Geographic information systems (GISs) with emerging technologies are being harnessed for studying spatial patterns in vector-borne diseases to reduce transmission. To implement effective vector control, increased knowledge on interactions of epidemiological and entomological malaria transmission determinants in the assessment of impact of interventions is critical. This requires availability of relevant spatial and attribute data to support malaria surveillance, monitoring, and evaluation. Monitoring the impact of vector control through a GIS-based decision support (DSS) has revealed spatial relative change in prevalence of infection and vector susceptibility to insecticides and has enabled measurement of spatial heterogeneity of trend or impact. The revealed trends and interrelationships have allowed the identification of areas with reduced parasitaemia and increased insecticide resistance thus demonstrating the impact of resistance on vector control. The GIS-based DSS provides opportunity for rational policy formulation and cost-effective utilization of limited resources for enhanced malaria vector control. 1. Introduction In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality [1]. Its transmission is driven by a complex interaction of the vector, host, parasite, and the environment, and is governed by different ecological and social determinants [2, 3]. The survival and bionomics of malaria vectors are affected by climate variability, that is, rainfall, temperature, and relative humidity [4]. In this light, even minute spatial variations and temporal heterogeneities in the mosquito population can result in significant malaria-risk [5, 6] and its endemicity [7–9]. Since malaria distribution is not homogeneous, much effort needs to be expended towards defining local spatial distribution of the disease [2] precedent to deployment of interventions [10]. In resource constrained environments, monitoring, and evaluation is often incomprehensive and irregular and tend to lack the actual spatial and temporal distribution patterns. If transmission determining parameters are to be harnessed effectively for decision-making and objectively plan, implement, monitor, and evaluate viable options for malaria vector control [11], they must be well organized, analyzed, and managed in the context of a geographical-information-system- (GIS-) based decision support system (DSS) [3, 12]. While vector control interventions are being deployed according to the World Health Organization-led Integrated Vector Management Straandtegy [10, 13, 14], prompt
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