Abstract
IntroductionThe last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. However, there is only limited country-specific information on the health impact of expanded coverage of these interventions.MethodsPaediatric admission data were assembled from 4 hospitals in Malawi reflecting different malaria ecologies. Trends in monthly clinical malaria admissions between January 2000 and December 2010 were analysed using time-series models controlling for covariates related to climate and service use to establish whether changes in admissions can be related to expanded coverage of interventions aimed at reducing malaria infection.ResultsIn 3 of 4 sites there was an increase in clinical malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean clinical malaria admission rates at two hospitals (trend P<0.05). At these hospitals clinical malaria admissions had increased from 2000 by 41% to 100%. Comparison of changes in malaria risk and ITN coverage appear to correspond to a lack of disease declines over the period. Changes in intervention coverage within hospital catchments showed minimal increases in ITN coverage from <6% across all sites in 2000 to maximum of 33% at one hospital site by 2010. Additionally, malaria transmission intensity remained unchanged between 2000–2010 across all sites.DiscussionDespite modest increases in coverage of measures to reduce infection there has been minimal changes in paediatric clinical malaria cases in four hospitals in Malawi. Studies across Africa are increasingly showing a mixed set of impact results and it is important to assemble more data from more sites to understand the wider implications of malaria funding investment. We also caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may become evident within a period when coverage reaches optimal levels.
Highlights
The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance
We caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may become evident within a period when coverage reaches optimal levels
Increased overseas development assistance (ODA) for malaria has led to a rapid increase in coverage of interventions aimed at reducing the malaria burden across Africa over the last five years [2,3]
Summary
The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. Increased overseas development assistance (ODA) for malaria has led to a rapid increase in coverage of interventions aimed at reducing the malaria burden across Africa over the last five years [2,3]. The largest between country evidence comes from observations of hospital admissions [30] and while limited in their geographic coverage they continue to represent a valuable empirical evidenceplatform on changing patterns of disease since the launch of the Roll Back Malaria (RBM) Initiative in 2000. We explore the impact of changing coverage of malaria control in relation to paediatric admission rates across a wider geographical area at hospital settings in four areas of Malawi and site specific changes in malaria intervention coverage
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
