Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;97(3_Suppl):89-98.
doi: 10.4269/ajtmh.16-0953.

Declines in Malaria Burden and All-Cause Child Mortality following Increases in Control Interventions in Senegal, 2005-2010

Julie Thwing  1 , Erin Eckert  2 , Demba Anta Dione  3 , Roger Tine  4 , Adama Faye  4 , Yazoume Yé  5 , Medoune Ndiop  6 , Moustapha Cisse  6 , Jacques Andre Ndione  7 , Mame Birame Diouf  8   2 , Mady Ba  6
Affiliations

Declines in Malaria Burden and All-Cause Child Mortality following Increases in Control Interventions in Senegal, 2005-2010

Julie Thwing et al. Am J Trop Med Hyg. 2017 Sep.

Abstract

Malaria is endemic in Senegal. The national malaria control strategy focuses on achieving universal coverage for major interventions, with a goal of reaching preelimination status by 2018. Senegal began distribution of insecticide-treated nets (ITNs) and introduced artemisinin-based combination therapy in 2006, then introduced rapid diagnostic tests in 2007. We evaluated the impact of these efforts using a plausibility design based on malaria's contribution to all-cause under-five mortality (ACCM) and considering other contextual factors which may influence ACCM. Between 2005 and 2010, household ownership of ITNs increased from 20% to 63%, and the proportion of people sleeping under an ITN the night prior to the survey increased from 6% to 29%. Malaria parasite prevalence declined from 6% to 3% from 2008 to 2010 among children under five. Some nonmalaria indicators of child health improved, for example, increase of complete vaccination coverage from 58% to 64%; however, nutritional indicators deteriorated, with an increase in stunting from 16% to 26%. Although economic indicators improved, environmental conditions favored an increase in malaria transmission. ACCM decreased 40% between 2005 and 2010, from 121 (95% confidence interval [CI] 113-129) to 72 (95% CI 66-77) per 1,000, and declines were greater among age groups, epidemiologic zones, and wealth quintiles most at risk for malaria. After considering coverage of malaria interventions, trends in malaria morbidity, effects of contextual factors, and trends in ACCM, it is plausible that malaria control interventions contributed to a reduction in malaria mortality and to the impressive gains in child survival in Senegal.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Epidemiologic stratification by parasite prevalence, Senegal 2009.
Figure 2.
Figure 2.
Financial contributions to malaria control in CFA, Senegal 2005–2010. (Source: Senegal National Strategic Framework for Malaria, 2014–2018).
Figure 3.
Figure 3.
(A) Use of insecticide-treated nets (ITNs) by children under-five by wealth quintile in Senegal, 2005–2010. (B) Use of ITNs by children under-five by epidemiological zone in Senegal, 2005–2010.
Figure 4.
Figure 4.
Proportional morbidity, proportional mortality, and case fatality rate at health facilities in Senegal, 2001–2009. Proportional morbidity: proportion of all-cause consultations associated with parasitologically confirmed malaria. Proportional mortality: proportion of all hospitalized deaths associated with parasitologically confirmed malaria. Case fatality rate: proportion of hospitalized cases of parasitologically confirmed malaria for whom death is the outcome.
Figure 5.
Figure 5.
Reported deaths due to confirmed malaria and to all causes in public health facilities in Senegal, 2005–2010. Source: NMCP, Senegal.
Figure 6.
Figure 6.
Weighted Anomaly Standardized Precipitation (WASP) Index for Senegal 1980–2010. Source: IRI, 2014.
See this image and copyright information in PMC

References

    1. Thiam S, et al. , 2011. Major reduction in anti-malarial drug consumption in Senegal after nation-wide introduction of malaria rapid diagnostic tests. PLoS One 6: e18419. - PMC - PubMed
    1. Roll Back Malaria, 2014. Guidance for Evaluating the Impact of National Malaria Control Programs in Highly Endemic Countries Available at: http://www.cpc.unc.edu/measure/resources/publications/ms-15-100. Accessed January 15, 2015.
    1. Rowe AK, et al., for the Roll Back Malaria Monitoring and Evaluation Reference Group, 2007. Evaluating the impact of malaria control efforts on mortality in sub-Saharan Africa. Trop Med Int Health 12: 1524–1539. - PubMed
    1. Yé Y, et al., 2017. Framework for evaluating the impact of malaria control interventions in sub-Saharan Africa. Am J Trop Med Hyg 97 (Suppl 3): 9–19. - PMC - PubMed
    1. Programme de Lutte Contre le Paludisme (PNLP), Senegal. Cadre Strategique National de Lutte Contre le Paludisme 2006–2010. Dakar, Senegal.