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Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI)
BACKGROUND: The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. This stud...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987525/ https://www.ncbi.nlm.nih.gov/pubmed/29866113 http://dx.doi.org/10.1186/s12936-018-2368-4 |
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author | Khadka, Aayush Perales, Nicole A. Wei, Dorothy J. Gage, Anna D. Haber, Noah Verguet, Stéphane Patenaude, Bryan Fink, Günther |
author_facet | Khadka, Aayush Perales, Nicole A. Wei, Dorothy J. Gage, Anna D. Haber, Noah Verguet, Stéphane Patenaude, Bryan Fink, Günther |
author_sort | Khadka, Aayush |
collection | PubMed |
description | BACKGROUND: The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. This study assesses the potential impact of such a programme at the Angolan–Namibian border. METHODS: Community-based malaria prevention programmes involving bed net distribution and behaviour change home visits were rolled-out using a controlled, staggered (stepped wedge) design between May 2014 and July 2016 in a 100 × 40 km corridor along the Angolan–Namibian border. Three rounds of survey data were collected. The primary outcome studied was fever among children under five in the 2 weeks prior to the survey. Multivariable linear and logistic regression models were used to assess overall programme impact and the relative impact of unilateral versus coordinated bilateral intervention programmes. RESULTS: A total of 3844 child records were analysed. On average, programme rollout reduced the odds of child fever by 54% (aOR: 0.46, 95% CI 0.29 to 0.73) over the intervention period. In Namibia, the programme reduced the odds of fever by 30% in areas without simultaneous Angolan efforts (aOR: 0.70, 95% CI 0.34 to 1.44), and by an additional 62% in areas with simultaneous Angolan programmes. In Angola, the programme was highly effective in areas within 5 km of Namibian programmes (OR: 0.37, 95% CI 0.22 to 0.62), but mostly ineffective in areas closer to inland Angolan areas without concurrent anti-malarial efforts. CONCLUSIONS: The impact of malaria programmes depends on programme efforts in surrounding areas with differential control efforts. Coordinated malaria programming within and across countries will be critical for achieving the vision of a malaria free world. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-018-2368-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5987525 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59875252018-07-10 Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) Khadka, Aayush Perales, Nicole A. Wei, Dorothy J. Gage, Anna D. Haber, Noah Verguet, Stéphane Patenaude, Bryan Fink, Günther Malar J Research BACKGROUND: The transmission of malaria through population inflows from highly endemic areas with limited control efforts poses major challenges for national malaria control programmes. Several multilateral programmes have been launched in recent years to address cross-border transmission. This study assesses the potential impact of such a programme at the Angolan–Namibian border. METHODS: Community-based malaria prevention programmes involving bed net distribution and behaviour change home visits were rolled-out using a controlled, staggered (stepped wedge) design between May 2014 and July 2016 in a 100 × 40 km corridor along the Angolan–Namibian border. Three rounds of survey data were collected. The primary outcome studied was fever among children under five in the 2 weeks prior to the survey. Multivariable linear and logistic regression models were used to assess overall programme impact and the relative impact of unilateral versus coordinated bilateral intervention programmes. RESULTS: A total of 3844 child records were analysed. On average, programme rollout reduced the odds of child fever by 54% (aOR: 0.46, 95% CI 0.29 to 0.73) over the intervention period. In Namibia, the programme reduced the odds of fever by 30% in areas without simultaneous Angolan efforts (aOR: 0.70, 95% CI 0.34 to 1.44), and by an additional 62% in areas with simultaneous Angolan programmes. In Angola, the programme was highly effective in areas within 5 km of Namibian programmes (OR: 0.37, 95% CI 0.22 to 0.62), but mostly ineffective in areas closer to inland Angolan areas without concurrent anti-malarial efforts. CONCLUSIONS: The impact of malaria programmes depends on programme efforts in surrounding areas with differential control efforts. Coordinated malaria programming within and across countries will be critical for achieving the vision of a malaria free world. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-018-2368-4) contains supplementary material, which is available to authorized users. BioMed Central 2018-06-04 /pmc/articles/PMC5987525/ /pubmed/29866113 http://dx.doi.org/10.1186/s12936-018-2368-4 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Khadka, Aayush Perales, Nicole A. Wei, Dorothy J. Gage, Anna D. Haber, Noah Verguet, Stéphane Patenaude, Bryan Fink, Günther Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title | Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_full | Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_fullStr | Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_full_unstemmed | Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_short | Malaria control across borders: quasi-experimental evidence from the Trans-Kunene malaria initiative (TKMI) |
title_sort | malaria control across borders: quasi-experimental evidence from the trans-kunene malaria initiative (tkmi) |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987525/ https://www.ncbi.nlm.nih.gov/pubmed/29866113 http://dx.doi.org/10.1186/s12936-018-2368-4 |
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