Lack of decline in childhood malaria, Malawi, 2001-2010

Abstract

In some areas of Africa, health facility data have indicated declines in malaria that might have resulted from increasingly effective control programs. Most such reports have been from countries where malaria transmission is highly seasonal or of modest intensity. In Malawi, perennial malaria transmission is intense, and malaria control measures have been scaled up during the past decade. We examined health facility data for children seen as outpatients and parasitemia-positive children hospitalized with cerebral malaria in a large national hospital. The proportion of Plasmodium falciparum-positive slides among febrile children at the hospital declined early in the decade, but no further reductions were observed after 2005. The number of admissions for cerebral malaria did not differ significantly by year. Continued surveillance for malaria is needed to evaluate the effects of the increased malaria control efforts.

Figure 1

Temporal trends of total monthly outpatient visits, malaria slides taken, and parasitemia-positive slides recorded in the Pediatric Accident and Emergency Unit at Queen Elizabeth Central Hospital, Blantyre, Malawi, 2001–2010.

Figure 2

Proportion of parasite density levels (A) and anemia categories (B) over time in the Pediatric Accident and Emergency Unit at Queen Elizabeth Central Hospital, Blantyre, Malawi, 2001–2010.

Figure 3

Mean age (95% CI) of children with cerebral malaria admitted to the research ward at Queen Elizabeth Central Hospital, Blantyre, Malawi, during January–June, 2001–2010. Data were not available for 2005. *Denotes a significant difference (p<0.001) in the mean age compared with that in the reference year (2001).