A progressive declining in the burden of malaria in north-eastern Tanzania

Abstract

BackgroundThe planning and assessment of malaria interventions is complicated due to fluctuations in the burden of malaria over time. Recently, it has been reported that the burden of malaria in some parts of Africa has declined. However, community-based longitudinal data are sparse and the reasons for the apparent decline are not well understood.MethodsMalaria prevalence and morbidity have been monitored in two villages in north-eastern Tanzania; a lowland village and a highland village from 2003 to 2008. Trained village health workers treated presumptive malaria with the Tanzanian first-line anti-malarial drug and collected blood smears that were examined later. The prevalence of malaria parasitaemia across years was monitored through cross-sectional surveys.ResultsThe prevalence of malaria parasitaemia in the lowland village decreased from 78.4% in 2003 to 13.0% in 2008, whereas in the highland village, the prevalence of parasitaemia dropped from 24.7% to 3.1% in the same period. Similarly, the incidence of febrile malaria episodes in the two villages dropped by almost 85% during the same period and there was a marked reduction in the number of young children who suffered from anaemia in the lowland village.ConclusionThere has been a marked decline in malaria in the study villages during the past few years. This decline is likely to be due to a combination of factors that include improved access to malaria treatment provided by the trained village helpers, protection from mosquitoes by increased availability of insecticide-impregnated bed nets and a reduced vector density. If this decline in malaria morbidity is sustained, it will have a marked effect on the disease burden in this part of Tanzania.

Prevalence of Single Nucleotide Polymorphisms in the Plasmodium falciparum Multidrug Resistance Gene (Pfmdr-1) in Korogwe District in Tanzania Before and After Introduction of Artemisinin-Based Combination Therapy

“…During the SP era, AQ was used as a second-line antimalarial drug. As previously described, 17 the study area has experienced a dramatic reduction in the prevalence of malaria parasitemia, which in Mkokola, dropped from 78% in 2003 to 13% in 2008, whereas in Kwamasimba, the prevalence of parasitemia dropped from 25% to 3%. In 2009, point prevalence in children under 5 years of age was 0% in Kwamasimba, and for Mkokola, it was 4%; in 2010, it was 0% and 3%, respectively (unpublished data).…”

“…The study presented here was performed in an area where malaria burden has been reduced dramatically in the last decade, 17 and therefore, our sample sizes in the latter years were very small; conclusions should be interpreted cautiously. However, our results are in line with data found recently in Gabon, 14 where the N86 showed raised prevalence after introduction of AL.…”

“…The study area has previously been described. 17,18 Finger-prick blood samples were collected on Whatman filter paper number 3 from individuals aged 0-20 years. Collection was performed annually except in 2004, when collection was done two times; in this case, the samples were pooled after statistical analysis showed no difference in distribution between collections (data not shown).…”

IgG Antibodies to Endothelial Protein C Receptor-Binding Cysteine-Rich Interdomain Region Domains of Plasmodium falciparum Erythrocyte Membrane Protein 1 Are Acquired Early in Life in Individuals Exposed to Malaria

“…Both thick and thin blood slides were also prepared, stained with Giemsa and investigated for the presence of malaria parasites. During the study period, the area witnessed a dramatic decrease in malaria transmission (32). This was reflected in the prevalence of parasitemia among the study participants, which in Mkokola and Kwamasimba fell from 65.8 and 15.0% in 2004 to 6.0 and 0% in 2009, respectively.…”

<i>In vitro</i> evaluation of antiplasmodial activity of extracts of <i>Acanthospermum hispidum</i> dc (Asteraceae) and <i>Ficus thonningii</i> blume (moraceae), two plants used in traditional medicine in the republic of Congo

“…The development of new tools like artemisinin-based combination therapy (ACT) for the treatment of uncomplicated malaria, the long lasting insecticide treated nets, the intermittent preventive treatment for pregnant women and children have led to reduction of the burden of malaria in some endemic countries (Mmbando et al, 2010;WHO, 2008). Elimination and eradication of malaria have been set as new goals that may be achieved if new tools are elaborated and widely deployed, including efficacious malaria vaccines (Snow et al, 2005;Leading, 2010).…”