The Impact of Artemisinin Combination Therapy and Long-Lasting Insecticidal Nets on Forest Malaria Incidence in Tribal Villages of India, 2006–2011Reportar como inadecuado




The Impact of Artemisinin Combination Therapy and Long-Lasting Insecticidal Nets on Forest Malaria Incidence in Tribal Villages of India, 2006–2011 - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Introduction

New tools for malaria control, artemisinin combination therapy ACT and long-lasting insecticidal nets LLINs were recently introduced across India. We estimated the impact of universal coverage of ACT and ACT plus LLINs in a setting of hyperendemic, forest malaria transmission.

Methods

We reviewed data collected through active and passive case detection in a vaccine trial cohort of 2,204 tribal people residing in Sundargarh district, Odisha between 2006 and 2011. We compared measures of transmission at the village and individual level in 2006–2009 versus 2010–2011 after ACT in all villages and LLINs in three villages were implemented.

Results

During 2006–2009 malaria incidence per village ranged from 156–512 per 1000 persons per year and slide prevalence ranged from 28–53%. Routine indoor residual spray did not prevent seasonal peaks of malaria. Post-intervention impact in 2010–2011 was dramatic with ranges of 14–71 per 1000 persons per year and 6–16% respectively. When adjusted for village, ACT alone decreased the incidence of malaria by 83% IRR 0.17, 95%CI: 0.10, 0.27 and areas using ACT and LLINs decreased the incidence of malaria by 86% IRR 0.14, 95%CI: 0.05, 0.38. After intervention, the age of malaria cases, their parasite density, and proportion with fever at the time of screening increased.

Conclusions

ACT, and LLINs along with ACT, effectively reduced malaria incidence in a closely monitored population living in a forest ecotype. It is unclear whether LLINs were impactful when prompt and quality antimalarial treatment was available. In spite of universal coverage, substantial malaria burden remained.



Autor: Naman K. Shah, Prajesh Tyagi, Surya K. Sharma

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados