Abstract
BackgroundFollowing enhanced malaria control measures, such as nationwide free distribution of insecticide-treated bed nets (ITN) by the government of Cameroon, its impact on malariometric and red cell indices in children ≤14 years in Muea, in the Mount Cameroon area was evaluated.MethodsTwo cross-sectional studies were conducted during the malaria transmission season (March-July) in 2006 (baseline) and 2013 (follow-up), respectively. The investigative methods included the use of a questionnaire to assess ITN use and coverage, clinical evaluation and laboratory investigations. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and density as well as full blood count determination using standard procedures and also an automated haematology analyzer.ResultsThe majority of children (81.5%) possessed an ITN in 2013. The proportion of effective users of ITN increased significantly from 20.9% (CI = 17.3-25%) in 2006 to 35.2% (CI = 31–39.7%) in 2013. The highest relative risk reduction in prevalence during the follow-up study was observed in malaria anaemia (79%, CI = 58.0-69.1% [69.1 to 14.5%]), followed by gametocytaemia (71.6%, CI = 58.9-80.3% [25.6 to 7.3%]), anaemia (64%, CI = 58.0-69.1% [80.1 to 28.9%]), and malaria parasitaemia (57.2%, CI = 51.4-62.3% [85.4 to 36.6%]). In the baseline survey, the prevalence of splenomegaly was significantly highest (χ2 = 18.3, P <0.001) in the youngest group of children while in the follow-up study, it was highest in the oldest (χ2 = 6.03, P = 0.049). The overall prevalence of mild, moderate and severe anaemia in the study population at baseline (59.6, 14.9, 6.3%) decreased significantly (P <0.001) to 24.4, 2.7 and 1.3%, respectively during the follow-up with the highest relative risk reduction in prevalence occurring in moderate anaemia (82.1%, CI = 67.3-90.2% [14.9 to 2.7%]). Microcytic anaemia also decreased significantly (P <0.001) from 56 to 7.7% during the follow-up survey.ConclusionFollowing interventions, anaemia (moderate to severe) was a more sensitive measure to changes in malaria exposure and children between 11–14 years of age experienced a significant increase in malaria-related morbidity.
Highlights
Following enhanced malaria control measures, such as nationwide free distribution of insecticide-treated bed nets (ITN) by the government of Cameroon, its impact on malariometric and red cell indices in children ≤14 years in Muea, in the Mount Cameroon area was evaluated
As high coverage rates are needed to realize the full potential of vector control, the World Health Organization (WHO) recommends that in areas targeted for malaria prevention, and for which ITNs are selected as the vector control method, they should be made available to all people at risk, i.e., universal access [8]
Characteristics of study populations In 2006, a total of 411 children (215, 52.3% males and 196, 47.7% females) ≤14 years with a mean age of 6.4 (7.4) years were examined for the presence of malaria parasites and some malaria-related indices
Summary
Following enhanced malaria control measures, such as nationwide free distribution of insecticide-treated bed nets (ITN) by the government of Cameroon, its impact on malariometric and red cell indices in children ≤14 years in Muea, in the Mount Cameroon area was evaluated. The use of ITNs may be easier to implement and sustain than available alternative vector control methods, such as environmental sanitation. This is because of the immediate perceptible benefits to the user in personally preventing them from the nuisance of mosquitoes, as well as their killing effect on head lice [6] and bed bugs [7]. As high coverage rates are needed to realize the full potential of vector control, the World Health Organization (WHO) recommends that in areas targeted for malaria prevention, and for which ITNs are selected as the vector control method, they should be made available to all people at risk, i.e., universal access [8]. In Cameroon, a high (>70%) percentage of the population potentially covered by ITNs distributed in 2011 was reported, yet no decrease in admissions and deaths were registered [9]
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