Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea
Abstract Background Long-lasting insecticidal nets (LLIN), improved diagnosis and artemisinin-based combination therapy (ACT) have reduced malaria prevalence in Papua New Guinea since 2008. Yet, national incidence trends are inconclusive due to confounding effects of the scale-up of rapid diagnostic...
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doaj-763c8819a6d54989b97fec889f7161002020-11-25T04:08:30ZengBMCMalaria Journal1475-28752019-11-0118111310.1186/s12936-019-2993-6Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New GuineaDaniela Rodriguez-Rodriguez0Seri Maraga1Lina Lorry2Leanne J. Robinson3Peter M. Siba4Ivo Mueller5Justin Pulford6Amanda Ross7Manuel W. Hetzel8Swiss Tropical and Public Health InstitutePapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchWalter and Eliza Hall Institute of Medical ResearchLiverpool School of Tropical MedicineSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteAbstract Background Long-lasting insecticidal nets (LLIN), improved diagnosis and artemisinin-based combination therapy (ACT) have reduced malaria prevalence in Papua New Guinea since 2008. Yet, national incidence trends are inconclusive due to confounding effects of the scale-up of rapid diagnostic tests, and inconsistencies in routine reporting. Methods Malaria trends and their association with LLIN and ACT roll-out between 2010 and 2014 in seven sentinel health facilities were analysed. The analysis included 35,329 fever patients. Intervention effects were estimated using regression models. Results Malaria incidence initially ranged from 20 to 115/1000 population; subsequent trends varied by site. Overall, LLIN distributions had a cumulative effect, reducing the number of malaria cases with each round (incidence rate ratio ranging from 0.12 to 0.53 in five sites). No significant reduction was associated with ACT introduction. Plasmodium falciparum remained the dominant parasite in all sentinel health facilities. Resurgence occurred in one site in which a shift to early and outdoor biting of anophelines had previously been documented. Conclusions LLINs, but not ACT, were associated with reductions of malaria cases in a range of settings, but sustainability of the gains appear to depend on local factors. Malaria programmes covering diverse transmission settings such as Papua New Guinea must consider local heterogeneity when choosing interventions and ensure continuous monitoring of trends.http://link.springer.com/article/10.1186/s12936-019-2993-6MalariaIncidenceVector controlArtemisinin-based combination therapyPlasmodium falciparumPlasmodium vivax |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Daniela Rodriguez-Rodriguez Seri Maraga Lina Lorry Leanne J. Robinson Peter M. Siba Ivo Mueller Justin Pulford Amanda Ross Manuel W. Hetzel |
spellingShingle |
Daniela Rodriguez-Rodriguez Seri Maraga Lina Lorry Leanne J. Robinson Peter M. Siba Ivo Mueller Justin Pulford Amanda Ross Manuel W. Hetzel Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea Malaria Journal Malaria Incidence Vector control Artemisinin-based combination therapy Plasmodium falciparum Plasmodium vivax |
author_facet |
Daniela Rodriguez-Rodriguez Seri Maraga Lina Lorry Leanne J. Robinson Peter M. Siba Ivo Mueller Justin Pulford Amanda Ross Manuel W. Hetzel |
author_sort |
Daniela Rodriguez-Rodriguez |
title |
Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea |
title_short |
Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea |
title_full |
Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea |
title_fullStr |
Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea |
title_full_unstemmed |
Repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in Papua New Guinea |
title_sort |
repeated mosquito net distributions, improved treatment, and trends in malaria cases in sentinel health facilities in papua new guinea |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2019-11-01 |
description |
Abstract Background Long-lasting insecticidal nets (LLIN), improved diagnosis and artemisinin-based combination therapy (ACT) have reduced malaria prevalence in Papua New Guinea since 2008. Yet, national incidence trends are inconclusive due to confounding effects of the scale-up of rapid diagnostic tests, and inconsistencies in routine reporting. Methods Malaria trends and their association with LLIN and ACT roll-out between 2010 and 2014 in seven sentinel health facilities were analysed. The analysis included 35,329 fever patients. Intervention effects were estimated using regression models. Results Malaria incidence initially ranged from 20 to 115/1000 population; subsequent trends varied by site. Overall, LLIN distributions had a cumulative effect, reducing the number of malaria cases with each round (incidence rate ratio ranging from 0.12 to 0.53 in five sites). No significant reduction was associated with ACT introduction. Plasmodium falciparum remained the dominant parasite in all sentinel health facilities. Resurgence occurred in one site in which a shift to early and outdoor biting of anophelines had previously been documented. Conclusions LLINs, but not ACT, were associated with reductions of malaria cases in a range of settings, but sustainability of the gains appear to depend on local factors. Malaria programmes covering diverse transmission settings such as Papua New Guinea must consider local heterogeneity when choosing interventions and ensure continuous monitoring of trends. |
topic |
Malaria Incidence Vector control Artemisinin-based combination therapy Plasmodium falciparum Plasmodium vivax |
url |
http://link.springer.com/article/10.1186/s12936-019-2993-6 |
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