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Rapid shifts in the age-specific burden of malaria following successful control interventions in four regions of Uganda.
- Source :
-
Malaria journal [Malar J] 2020 Mar 30; Vol. 19 (1), pp. 128. Date of Electronic Publication: 2020 Mar 30. - Publication Year :
- 2020
-
Abstract
- Background: Malaria control using long-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) has been associated with reduced transmission throughout Africa. However, the impact of transmission reduction on the age distribution of malaria cases remains unclear.<br />Methods: Over a 10-year period (January 2009 to July 2018), outpatient surveillance data from four health facilities in Uganda were used to estimate the impact of control interventions on temporal changes in the age distribution of malaria cases using multinomial regression. Interventions included mass distribution of LLINs at all sites and IRS at two sites.<br />Results: Overall, 896,550 patient visits were included in the study; 211,632 aged < 5 years, 171,166 aged 5-15 years and 513,752 > 15 years. Over time, the age distribution of patients not suspected of malaria and those malaria negative either declined or remained the same across all sites. In contrast, the age distribution of suspected and confirmed malaria cases increased across all four sites. In the two LLINs-only sites, the proportion of malaria cases in < 5 years decreased from 31 to 16% and 35 to 25%, respectively. In the two sites receiving LLINs plus IRS, these proportions decreased from 58 to 30% and 64 to 47%, respectively. Similarly, in the LLINs-only sites, the proportion of malaria cases > 15 years increased from 40 to 61% and 29 to 39%, respectively. In the sites receiving LLINs plus IRS, these proportions increased from 19 to 44% and 18 to 31%, respectively.<br />Conclusions: These findings demonstrate a shift in the burden of malaria from younger to older individuals following implementation of successful control interventions, which has important implications for malaria prevention, surveillance, case management and control strategies.
- Subjects :
- Adolescent
Adult
Age Distribution
Age Factors
Aged
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Uganda
Young Adult
Cost of Illness
Insecticide-Treated Bednets statistics & numerical data
Insecticides therapeutic use
Malaria prevention & control
Mosquito Control statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2875
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Malaria journal
- Publication Type :
- Academic Journal
- Accession number :
- 32228584
- Full Text :
- https://doi.org/10.1186/s12936-020-03196-7