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Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo

BACKGROUND: Considerable upscaling of malaria control efforts have taken place over the last 15 years in the Democratic Republic of Congo, the country with the second highest malaria case load after Nigeria. Malaria control interventions have been strengthened in line with the Millenium Development...

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Autores principales: Lechthaler, Filippo, Matthys, Barbara, Lechthaler-Felber, Giulia, Likwela, Joris Losimba, Mavoko, Hypolite Muhindo, Rika, Junior Matangila, Mutombo, Meschac Mutombo, Ruckstuhl, Laura, Barczyk, Joanna, Shargie, Estifanos, Prytherch, Helen, Lengeler, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658057/
https://www.ncbi.nlm.nih.gov/pubmed/31344062
http://dx.doi.org/10.1371/journal.pone.0219853
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author Lechthaler, Filippo
Matthys, Barbara
Lechthaler-Felber, Giulia
Likwela, Joris Losimba
Mavoko, Hypolite Muhindo
Rika, Junior Matangila
Mutombo, Meschac Mutombo
Ruckstuhl, Laura
Barczyk, Joanna
Shargie, Estifanos
Prytherch, Helen
Lengeler, Christian
author_facet Lechthaler, Filippo
Matthys, Barbara
Lechthaler-Felber, Giulia
Likwela, Joris Losimba
Mavoko, Hypolite Muhindo
Rika, Junior Matangila
Mutombo, Meschac Mutombo
Ruckstuhl, Laura
Barczyk, Joanna
Shargie, Estifanos
Prytherch, Helen
Lengeler, Christian
author_sort Lechthaler, Filippo
collection PubMed
description BACKGROUND: Considerable upscaling of malaria control efforts have taken place over the last 15 years in the Democratic Republic of Congo, the country with the second highest malaria case load after Nigeria. Malaria control interventions have been strengthened in line with the Millenium Development Goals. We analysed the effects of these interventions on malaria cases at health facility level, using a retrospective trend analysis of malaria cases between 2005 and 2014. Data were collected from outpatient and laboratory registers based on a sample of 175 health facilities that represents all eco-epidemiological malaria settings across the country. METHODS: We applied a time series analysis to assess trends of suspected and confirmed malaria cases, by health province and for different age groups. A linear panel regression model controlled for non-malaria outpatient cases, rain fall, nightlight intensity, health province and time fixed effects, was used to examine the relationship between the interventions and malaria case occurrences, as well as test positivity rates. RESULTS: Overall, recorded suspected and confirmed malaria cases in the DRC have increased. The sharp increase in confirmed cases from 2010 coincides with the introduction of the new treatment policy and the resulting scale-up of diagnostic testing. Controlling for confounding factors, the introduction of rapid diagnostic tests (RDTs) was significantly associated with the number of tested and confirmed cases. The test positivity rate fluctuated around 40% without showing any trend. CONCLUSION: The sharp increase in confirmed malaria cases from 2010 is unlikely to be due to a resurgence of malaria, but is clearly associated with improved diagnostic availability, mainly the introduction of RDTs. Before that, a great part of malaria cases were treated based on clinical suspicion. This finding points to a better detection of cases that potentially contributed to improved case management. Furthermore, the expansion of diagnostic testing along with the increase in confirmed cases implies that before 2010, cases were underreported, and that the accuracy of routine data to describe malaria incidence has improved.
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spelling pubmed-66580572019-08-07 Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo Lechthaler, Filippo Matthys, Barbara Lechthaler-Felber, Giulia Likwela, Joris Losimba Mavoko, Hypolite Muhindo Rika, Junior Matangila Mutombo, Meschac Mutombo Ruckstuhl, Laura Barczyk, Joanna Shargie, Estifanos Prytherch, Helen Lengeler, Christian PLoS One Research Article BACKGROUND: Considerable upscaling of malaria control efforts have taken place over the last 15 years in the Democratic Republic of Congo, the country with the second highest malaria case load after Nigeria. Malaria control interventions have been strengthened in line with the Millenium Development Goals. We analysed the effects of these interventions on malaria cases at health facility level, using a retrospective trend analysis of malaria cases between 2005 and 2014. Data were collected from outpatient and laboratory registers based on a sample of 175 health facilities that represents all eco-epidemiological malaria settings across the country. METHODS: We applied a time series analysis to assess trends of suspected and confirmed malaria cases, by health province and for different age groups. A linear panel regression model controlled for non-malaria outpatient cases, rain fall, nightlight intensity, health province and time fixed effects, was used to examine the relationship between the interventions and malaria case occurrences, as well as test positivity rates. RESULTS: Overall, recorded suspected and confirmed malaria cases in the DRC have increased. The sharp increase in confirmed cases from 2010 coincides with the introduction of the new treatment policy and the resulting scale-up of diagnostic testing. Controlling for confounding factors, the introduction of rapid diagnostic tests (RDTs) was significantly associated with the number of tested and confirmed cases. The test positivity rate fluctuated around 40% without showing any trend. CONCLUSION: The sharp increase in confirmed malaria cases from 2010 is unlikely to be due to a resurgence of malaria, but is clearly associated with improved diagnostic availability, mainly the introduction of RDTs. Before that, a great part of malaria cases were treated based on clinical suspicion. This finding points to a better detection of cases that potentially contributed to improved case management. Furthermore, the expansion of diagnostic testing along with the increase in confirmed cases implies that before 2010, cases were underreported, and that the accuracy of routine data to describe malaria incidence has improved. Public Library of Science 2019-07-25 /pmc/articles/PMC6658057/ /pubmed/31344062 http://dx.doi.org/10.1371/journal.pone.0219853 Text en © 2019 Lechthaler et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lechthaler, Filippo
Matthys, Barbara
Lechthaler-Felber, Giulia
Likwela, Joris Losimba
Mavoko, Hypolite Muhindo
Rika, Junior Matangila
Mutombo, Meschac Mutombo
Ruckstuhl, Laura
Barczyk, Joanna
Shargie, Estifanos
Prytherch, Helen
Lengeler, Christian
Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title_full Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title_fullStr Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title_full_unstemmed Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title_short Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo
title_sort trends in reported malaria cases and the effects of malaria control in the democratic republic of the congo
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658057/
https://www.ncbi.nlm.nih.gov/pubmed/31344062
http://dx.doi.org/10.1371/journal.pone.0219853
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