Major decline in malaria morbidity and mortality in the Union of Comoros between 2010 and 2014: The effect of a combination of prevention and control measures.

Abstract

Malaria remains a public health challenge in sub-Saharan Africa. In response to this, many countries are working towardsachieving the World Health Assembly and Roll Back Malaria Partnership target of a 75% decline in malaria incidence. To assess trends in malaria morbidity and mortality in the three islands of the Comoros Archipelago from 2010 to 2014. This was a retrospective study in which all confirmed malaria cases and deaths recorded between 2010 and 2014 were accessedfrom the national malaria control database. Trends and comparisons in malaria incidence and case fatality rates for all age groups, includingunder-5 children and pregnant women, were analysed using Microsoft Excel and SPSS version 16. A substantial decline in malaria incidence was observed for each island between 2010 and 2014; from 75.98 cases per 1 000 populationin 2010 to 0.14 in 2014 in Moheli, 60.60 to 0.02 in Anjouan and 235.36 to 5.47 in Grand Comoro. Additionally, a general reduction in malariacase fatalities was observed. In Moheli, there were no case fatalities between 2010 and 2014, while there was a decline in the case fatality rate inAnjouan (from 1.20 fatalities per 1 000 cases to 0) and Grand Comoros (0.51 to 0). There were also significant differences (p<0.05) in malariaincidence and case fatalities between the three islands. A similar trend was observed for pregnant women and under-5 children. Our study indicates a significant decline in malaria morbidity and mortality in the islands of Moheli, Anjouan and GrandComoro from 2010 to 2014. This considerable reduction is attributed to a combination of malaria prevention and control interventionsimplemented during the study period.