The decline of malaria in Vietnam, 1991–2014
Abstract Background Despite the well-documented clinical efficacy of artemisinin-based combination therapy (ACT) against malaria, the population-level effects of ACT have not been studied thoroughly until recently. An ideal case study for these population-level effects can be found in Vietnam’s grad...
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doaj-46064dd051504bcbb558a12a14850c0d2020-11-25T01:11:57ZengBMCMalaria Journal1475-28752018-06-0117111210.1186/s12936-018-2372-8The decline of malaria in Vietnam, 1991–2014Sandra M. Goldlust0Phung Duc Thuan1Dang Duy Hoang Giang2Ngo Duc Thang3Guy E. Thwaites4Jeremy Farrar5Ngo Viet Thanh6Tran Dang Nguyen7Bryan T. Grenfell8Maciej F. Boni9Tran Tinh Hien10Oxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeNational Institutes for Malariology, Parasitology, and EntomologyOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeDepartment of Ecology and Evolutionary Biology, Princeton UniversityOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeOxford University Clinical Research Unit, Wellcome Trust Major Overseas ProgrammeAbstract Background Despite the well-documented clinical efficacy of artemisinin-based combination therapy (ACT) against malaria, the population-level effects of ACT have not been studied thoroughly until recently. An ideal case study for these population-level effects can be found in Vietnam’s gradual adoption of artemisinin in the 1990s. Methods and results Analysis of Vietnam’s national annual malaria reports (1991–2014) revealed that a 10% increase in artemisinin procurement corresponded to a 32.8% (95% CI 27.7–37.5%) decline in estimated malaria cases. There was no consistent national or regional effect of vector control on malaria. The association between urbanization and malaria was generally negative and sometimes statistically significant. Conclusions The decline of malaria in Vietnam can largely be attributed to the adoption of artemisinin-based case management. Recent analyses from Africa showed that insecticide-treated nets had the greatest effect on lowering malaria prevalence, suggesting that the success of interventions is region-specific. Continuing malaria elimination efforts should focus on both vector control and increased access to ACT.http://link.springer.com/article/10.1186/s12936-018-2372-8MalariaArtemisininVietnamVector controlUrbanization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sandra M. Goldlust Phung Duc Thuan Dang Duy Hoang Giang Ngo Duc Thang Guy E. Thwaites Jeremy Farrar Ngo Viet Thanh Tran Dang Nguyen Bryan T. Grenfell Maciej F. Boni Tran Tinh Hien |
spellingShingle |
Sandra M. Goldlust Phung Duc Thuan Dang Duy Hoang Giang Ngo Duc Thang Guy E. Thwaites Jeremy Farrar Ngo Viet Thanh Tran Dang Nguyen Bryan T. Grenfell Maciej F. Boni Tran Tinh Hien The decline of malaria in Vietnam, 1991–2014 Malaria Journal Malaria Artemisinin Vietnam Vector control Urbanization |
author_facet |
Sandra M. Goldlust Phung Duc Thuan Dang Duy Hoang Giang Ngo Duc Thang Guy E. Thwaites Jeremy Farrar Ngo Viet Thanh Tran Dang Nguyen Bryan T. Grenfell Maciej F. Boni Tran Tinh Hien |
author_sort |
Sandra M. Goldlust |
title |
The decline of malaria in Vietnam, 1991–2014 |
title_short |
The decline of malaria in Vietnam, 1991–2014 |
title_full |
The decline of malaria in Vietnam, 1991–2014 |
title_fullStr |
The decline of malaria in Vietnam, 1991–2014 |
title_full_unstemmed |
The decline of malaria in Vietnam, 1991–2014 |
title_sort |
decline of malaria in vietnam, 1991–2014 |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2018-06-01 |
description |
Abstract Background Despite the well-documented clinical efficacy of artemisinin-based combination therapy (ACT) against malaria, the population-level effects of ACT have not been studied thoroughly until recently. An ideal case study for these population-level effects can be found in Vietnam’s gradual adoption of artemisinin in the 1990s. Methods and results Analysis of Vietnam’s national annual malaria reports (1991–2014) revealed that a 10% increase in artemisinin procurement corresponded to a 32.8% (95% CI 27.7–37.5%) decline in estimated malaria cases. There was no consistent national or regional effect of vector control on malaria. The association between urbanization and malaria was generally negative and sometimes statistically significant. Conclusions The decline of malaria in Vietnam can largely be attributed to the adoption of artemisinin-based case management. Recent analyses from Africa showed that insecticide-treated nets had the greatest effect on lowering malaria prevalence, suggesting that the success of interventions is region-specific. Continuing malaria elimination efforts should focus on both vector control and increased access to ACT. |
topic |
Malaria Artemisinin Vietnam Vector control Urbanization |
url |
http://link.springer.com/article/10.1186/s12936-018-2372-8 |
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