Failure of malaria control in Nchelenge District, Zambia

Abstract

Background: The burden ofmalaria has decreased dramatically in many parts of Southern Africa including Zambia. However, in Zambia the decline in the burden of malaria has not been uniform despite scaling up of various interventions. In order to better understand the underlying epidemiology factors, vector biology and parasite genomics to guide control strategies the Southern Africa International Centers of Excellence for Malaria Research (ICEMR) has conducted a series of studies including the prevalence of malaria in Nchelenge district. We report on the prevalence of malaria in Nchelenge District between April 2012 and May 2013. Methods & Materials: Data on the prevalence of malaria was collected through passive surveillance of parasitaemia using SMS text messages from rural health centres and active case detection through cross-sectional and longitudinal community surveys. Results: Eleven health care facilities reported 49,831 cases of confirmed malaria between April 2012 and May 2013. The prevalence of malaria by RDT was 40% among 638 residents of 169 households in the cross-sectional surveys and 66% among 165 residents of 29 households followed longitudinally every othermonth. The prevalence of malaria was higher in children 5 to 16 years of age (64%) compared with children younger than five years of age (38%) and adults older than 16 years of age (22%). The prevalence of malaria was 21% by microscopy in the cross-sectional surveys. Conclusion:NchelengeDistrict continues to have a high burden ofmalaria despitemalaria control interventions. This is higher than thenational average. Efforts arebeingmade tounderstand themain determinant of malaria prevalence in Nchelenge