How Much Malaria Occurs in Urban Luanda, Angola? A Health Facility-Based Assessment

Thwing, Julie; Mihigo, Jules; Fernandes, Alexandra Pataca; Saúte, Francisco; Ferreira, Carolina Miguel; Fortes, Filomeno; Oliveira, Alexandre Macedo de; Newman, Robert D.

doi:10.4269/ajtmh.2009.80.487

Cited by 21 publications

(19 citation statements)

References 11 publications

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“…• data from presumptive diagnoses or self-diagnoses, while widely available and frequently cited [15-18], do not reliably reflect the incidence of malaria, particularly in large cities [7,35]. …”

Section: Discussionmentioning

confidence: 99%

Malaria indicator surveys demonstrate a markedly lower prevalence of malaria in large cities of sub-Saharan Africa

Pond¹

2013

Malar J

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BackgroundOne in eight sub-Saharan Africans now lives in a city with a population greater than 750,000. Decision makers require additional evidence regarding the burden of malaria in these large cities. This paper presents results from analysis of existing data from nationwide household surveys measuring malaria parasitaemia by microscopy among children six to 59 months of age in 15 countries of sub-Saharan Africa.MethodsGeo-coordinates for each survey cluster were used to determine the distance from the cluster to the centre of each of 16 large cities with populations greater than 750,000. Geo-coordinates of each site within 25 km of the centre were entered into Google Earth to obtain a satellite image of the location and determine whether it was within the boundaries of the metropolis. In the case of two countries for which survey geo-coordinates were not available, clusters located in an additional four large cities were identified based upon their designated district. Data from all sites within city boundaries were pooled together and compared to data from all rural sites within 150 km of the city centre or in the same zone of malaria endemicity.ResultsOf the 20 large cities, only in Ouagadougou were more than 10% of children found to have a malaria infection. The prevalence was less than 5% for 16 of these cities. Apart from Antananarivo where both the large city and the comparison rural communities were parasite-free, the prevalence in each of the large cities was 0 to 40% of that found among children living in rural communities within 150 km of these cities or within the same zone of malaria endemicity. In 14 of the 20 large cities, all of the children living in 75% or more of the clusters were malaria parasite-free.ConclusionsExisting data from malaria indicator surveys can be used to document the substantially lower prevalence of malaria in specific large cities. These findings will help policy makers, public health programmers and clinical workers in each country to develop and promote malaria control strategies that are suited to large cities as well as to those living in smaller communities.

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Section: Discussionmentioning

confidence: 99%

Malaria indicator surveys demonstrate a markedly lower prevalence of malaria in large cities of sub-Saharan Africa

Pond¹

2013

Malar J

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“…A recent study in Luanda, capital of Angola, showed that 3.6% of febrile patients presenting to HFs had laboratory-confirmed malaria. 6 However, the prevalence of malaria was above 20% among febrile patients visiting HFs in Ouagadougou. 7 These differences in malaria prevalence have major programmatic implications for the implementation of malaria prevention and control measures.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Malaria among Patients Attending Public Health Facilities in Maputo City, Mozambique

Oliveira

Mutemba²,

Morgan³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted a health facility-based survey to estimate the prevalence of malaria among febrile patients at health facilities (HFs) in Maputo City. Patients answered a questionnaire on malaria risk factors and underwent malaria testing. A malaria case was defined as a positive result for malaria by microscopy in a patient with fever or history of fever in the previous 24 hours. Among 706 patients with complete information, 111 (15.7%) cases were identified: 105 were positive for Plasmodium falciparum only, two for Plasmodium ovale only, and four for both P. falciparum and P. ovale . Fever documented at study enrollment, age ≥ 5 years, rural HF, and travel outside Maputo City were statistically significantly associated with malaria by multivariate analysis. We found a high prevalence of laboratory-confirmed malaria among febrile patients in Maputo City. Further studies are needed to relate these findings with mosquito density to better support malaria prevention and control.

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“…More recently, health facility-based surveys of malaria infection prevalence in febrile patients have been used as part of the rapid analysis of malaria risks in urban settings in Angola, [12] Mozambique [13], Burkina Faso, Benin, Tanzania and Côte d’Ivoire [14]. They have also been used as part of national surveys of malaria epidemiology in Niger [15] and The Gambia [16], and as a means to operationally measure intervention effectiveness through sentinel based case-control studies in Benin [17] and Madagascar [18].…”

Section: Introductionmentioning

confidence: 99%

A national health facility survey of malaria infection among febrile patients in Kenya, 2014

Githinji

Noor

Malinga

et al. 2016

Malar J

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BackgroundThe use of malaria infection prevalence among febrile patients at clinics has a potential to be a valuable epidemiological surveillance tool. However, routine data are incomplete and not all fevers are tested. This study was designed to screen all fevers for malaria infection in Kenya to explore the epidemiology of fever test positivity rates.MethodsRandom sampling was used within five malaria epidemiological zones of Kenya (i.e., high lake endemic, moderate coast endemic, highland epidemic, seasonal low transmission and low risk zones). The selected sample was representative of the number of hospitals, health centres and dispensaries within each zone. Fifty patients with fever presenting to each sampled health facility during the short rainy season were screened for malaria infection using a rapid diagnostic test (RDT). Details of age, pregnancy status and basic demographics were recorded for each patient screened.Results10,557 febrile patients presenting to out-patient clinics at 234 health facilities were screened for malaria infection. 1633 (15.5%) of the patients surveyed were RDT positive for malaria at 124 (53.0%) facilities. Infection prevalence among non-pregnant patients varied between malaria risk zones, ranging from 0.6% in the low risk zone to 41.6% in the high lake endemic zone. Test positivity rates (TPR) by age group reflected the differences in the intensity of transmission between epidemiological zones. In the lake endemic zone, 6% of all infections were among children aged less than 1 year, compared to 3% in the coast endemic, 1% in the highland epidemic zone, less than 1% in the seasonal low transmission zone and 0% in the low risk zone. Test positivity rate was 31% among febrile pregnant women in the high lake endemic zone compared to 9% in the coast endemic and highland epidemic zones, 3.2% in the seasonal low transmission zone and zero in the low risk zone.ConclusionMalaria infection rates among febrile patients, with supporting data on age and pregnancy status presenting to clinics in Kenya can provide invaluable epidemiological data on spatial heterogeneity of malaria and serve as replacements to more expensive community-based infection rates to plan and monitor malaria control.

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How Much Malaria Occurs in Urban Luanda, Angola? A Health Facility-Based Assessment

Cited by 21 publications

References 11 publications

Malaria indicator surveys demonstrate a markedly lower prevalence of malaria in large cities of sub-Saharan Africa

Malaria indicator surveys demonstrate a markedly lower prevalence of malaria in large cities of sub-Saharan Africa

Prevalence of Malaria among Patients Attending Public Health Facilities in Maputo City, Mozambique

A national health facility survey of malaria infection among febrile patients in Kenya, 2014

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