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Two decades of malaria control in Malawi: Geostatistical Analysis of the changing malaria prevalence from 2000-2022. | LitMetric

AI Article Synopsis

  • Malaria continues to be a significant public health issue in Malawi, impacting both health and socio-economics, despite the implementation of various control measures over the past two decades, including bed nets and vaccines.
  • A comprehensive review of malaria prevalence from 2000 to 2022 utilized a geostatistical model to assess malaria risk specifically among children aged 2-10 years across 2,595 unique sampling locations.
  • The findings indicate a notable decline in malaria prevalence, from 43.93% in 2000 to 19.2% in 2022, suggesting that increased control efforts are effective, and future strategies should focus on data-driven targeted interventions.

Article Abstract

Background: Malaria remains a public health problem in Malawi and has a serious socio-economic impact on the population. In the past two decades, available malaria control measures have been substantially scaled up, such as insecticide-treated bed nets, artemisinin-based combination therapies, and, more recently, the introduction of the malaria vaccine, the RTS,S/AS01. In this paper, we describe the epidemiology of malaria for the last two decades to understand the past transmission and set the scene for the elimination agenda.

Methods: A collation of parasite prevalence surveys conducted between the years 2000 and 2022 was done. A spatio-temporal geostatistical model was fitted to predict the yearly malaria risk for children aged 2-10 years (PfPR 2-10) at 1×1 km spatial resolutions. Parameter estimation was done using the Monte Carlo maximum likelihood method. District-level prevalence estimates adjusted for population are calculated for the years 2000 to 2022.

Results: A total of 2,595 sampled unique locations from 2000 to 2022 were identified through the data collation exercise. This represents 70,565 individuals that were sampled in the period. In general, the PfPR2_10 declined over the 22 years. The mean modelled national PfPR2_10 in 2000 was 43.93 % (95% CI:17.9 to 73.8%) and declined to 19.2% (95%CI 7.49 to 37.0%) in 2022. The smoothened estimates of PfPR2_10 indicate that malaria prevalence is very heterogeneous with hotspot areas concentrated on the southern shores of Lake Malawi and the country's central region.

Conclusions: The last two decades are associated with a decline in malaria prevalence, highly likely associated with the scale-up of control interventions. The country should move towards targeted malaria control approaches informed by surveillance data.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097645PMC
http://dx.doi.org/10.12688/wellcomeopenres.19390.2DOI Listing

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