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Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia

Substantial efforts have seen the reduction in malaria prevalence from 33% in 2006 to 19.4% in 2015 in Zambia. Many studies have used effect measures, such as odds ratios, of malaria interventions without combining this information with coverage levels of the interventions to assess how malaria prev...

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Autores principales: Nawa, Mukumbuta, Halwindi, Hikabasa, Hangoma, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649733/
https://www.ncbi.nlm.nih.gov/pubmed/33209231
http://dx.doi.org/10.4081/jphia.2020.1096
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author Nawa, Mukumbuta
Halwindi, Hikabasa
Hangoma, Peter
author_facet Nawa, Mukumbuta
Halwindi, Hikabasa
Hangoma, Peter
author_sort Nawa, Mukumbuta
collection PubMed
description Substantial efforts have seen the reduction in malaria prevalence from 33% in 2006 to 19.4% in 2015 in Zambia. Many studies have used effect measures, such as odds ratios, of malaria interventions without combining this information with coverage levels of the interventions to assess how malaria prevalence would change if these interventions were scaled up. We contribute to filling this gap by combining intervention coverage information with marginal predictions to model the extent to which key interventions can bring down malaria in Zambia. We used logistic regression models and derived marginal effects using repeated cross-sectional survey data from the Malaria Indicator Survey (MIS) datasets for Zambia collected in 2010, 2012 and 2015. Average monthly temperature and rainfall data were obtained from climate explorer a satellite-generated database. We then conducted a counterfactual analysis using the estimated marginal effects and various hypothetical levels of intervention coverage to assess how different levels of coverage would affect malaria prevalence. Increasing IRS and ITNs from the 2015 levels of coverage of 28.9% and 58.9% respectively to at least 80% and rising standard housing to 20% from the 13.4% in 2015 may bring malaria prevalence down to below 15%. If the percentage of modern houses were increased further to 90%, malaria prevalence might decrease to 10%. Other than ITN and IRS, streamlining and increasing of the percentage of standard houses in malaria fight would augment and bring malaria down to the levels needed for focal malaria elimination. The effects of ITNs, IRS and Standard housing were pronounced in high than low epidemiological areas.
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spelling pubmed-76497332020-11-17 Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia Nawa, Mukumbuta Halwindi, Hikabasa Hangoma, Peter J Public Health Afr Article Substantial efforts have seen the reduction in malaria prevalence from 33% in 2006 to 19.4% in 2015 in Zambia. Many studies have used effect measures, such as odds ratios, of malaria interventions without combining this information with coverage levels of the interventions to assess how malaria prevalence would change if these interventions were scaled up. We contribute to filling this gap by combining intervention coverage information with marginal predictions to model the extent to which key interventions can bring down malaria in Zambia. We used logistic regression models and derived marginal effects using repeated cross-sectional survey data from the Malaria Indicator Survey (MIS) datasets for Zambia collected in 2010, 2012 and 2015. Average monthly temperature and rainfall data were obtained from climate explorer a satellite-generated database. We then conducted a counterfactual analysis using the estimated marginal effects and various hypothetical levels of intervention coverage to assess how different levels of coverage would affect malaria prevalence. Increasing IRS and ITNs from the 2015 levels of coverage of 28.9% and 58.9% respectively to at least 80% and rising standard housing to 20% from the 13.4% in 2015 may bring malaria prevalence down to below 15%. If the percentage of modern houses were increased further to 90%, malaria prevalence might decrease to 10%. Other than ITN and IRS, streamlining and increasing of the percentage of standard houses in malaria fight would augment and bring malaria down to the levels needed for focal malaria elimination. The effects of ITNs, IRS and Standard housing were pronounced in high than low epidemiological areas. PAGEPress Publications, Pavia, Italy 2020-04-29 /pmc/articles/PMC7649733/ /pubmed/33209231 http://dx.doi.org/10.4081/jphia.2020.1096 Text en ©Copyright: the Author(s) http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).
spellingShingle Article
Nawa, Mukumbuta
Halwindi, Hikabasa
Hangoma, Peter
Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title_full Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title_fullStr Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title_full_unstemmed Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title_short Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and program data in Zambia
title_sort modelling malaria reduction in a highly endemic country: evidence from household survey, climate, and program data in zambia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649733/
https://www.ncbi.nlm.nih.gov/pubmed/33209231
http://dx.doi.org/10.4081/jphia.2020.1096
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