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Monitoring &Surveillance Bill Brieger | 20 Dec 2010 07:50 am

Lessons from 3 Rounds of Malaria Indicator Surveys in Zambia

mis-2010-report-cover-2.JPGTodd Jennings of MACEPA (Malaria Control and Evaluation Partnership in Africa, PATH)
and the National Malaria Control Centre, Lusaka, provides us with an update on the newly completed Malaria Indicator Survey from Zambia.

Earlier this month Zambia’s Ministry of Health released results from their 2010 National Malaria Indicator Survey (MIS).  The full report, summary and technical brief are available on the National Malaria Control Center website.

Zambia is the first African country to have conducted three of these surveys, continuing a trend in benchmarking progress and providing evidence for decision makers to guide malaria control needs.  First the good news:

  • The use of insecticide-treated mosquito nets increased for children under the age of five increased to 50%, and to over 60% in household that owned nets in 2010.
  • Over 70 percent of Zambian households are now covered by at least one treated mosquito net or recent indoor residual spraying.  This represents a 69 percent increase since the 2006 survey.
  • Pregnant women are more protected from malaria with 70% receiving at least two doses of preventive anti-malarial medicine during pregnancy.
  • Among children using anti-malarials for treating fever, more children are receiving Coartem®, the first line treatment for malaria, rising from 30% in 2008 to 76% this year.

progress-in-itn-use-in-zambian-children-under.jpgThese figures are among the best in Africa. Better diagnostics nationwide, especially with rapid tests to confirm malaria parasitemia, mean fewer patients with symptomatic fever are being given anti-malarial drugs and more receive better treatment counseling based on the rapid and accurate results.

But these encouraging figures are tempered with news that Luapula, Northern and Eastern Provinces reported higher levels of malaria and severe anaemia.  This can partly be attributed to heavy, late rains that possibly extended the length and intensity of the transmission season and partly because net ownership and use of nets in Luapula and Northern Provinces saw a marked decrease since 2008.

mis2010_parasitemia06-10d-2.jpgThe MIS is a powerful tool needed to maintain predictable funding streams to sustain levels of commodity coverage.  Gains are fragile; any interruption in supply, e.g. bednets, can quickly result in a malaria comeback.  Zambia and partners are already taking steps to address the country’s gap in bednet coverage. Other countries could benefit from more timely surveys and stronger partnership responses.

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