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Malaria Morbidities Following Universal Coverage Campaign for Long-Lasting Insecticidal Nets: A Case Study in Ukerewe District, Northwestern Tanzania

Authors Kapesa A, Basinda N, Nyanza EC, Monge J, Ngallaba SE, Mwanga JR, Kweka EJ

Received 8 February 2020

Accepted for publication 3 July 2020

Published 29 July 2020 Volume 2020:11 Pages 53—60


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Mario Rodriguez-Perez

Anthony Kapesa,1 Namanya Basinda,1 Elias C Nyanza,2 Joshua Monge3,, Sospatro E Ngallaba,4 Joseph R Mwanga,4 Eliningaya J Kweka5,6

1Department of Community Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 2Department of Environmental and Occupational Health and GIS, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 3Department of Health, Ukerewe District Council, Mwanza, Tanzania; 4Department of Epidemiology, Biostatisticsand Behavioural Sciences, School of Public Health, Catholic University of Health Sciences and Allied Sciences, Mwanza, Tanzania; 5Department of Parasitology and Medical Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 6Division of Livestock and Human Disease Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania

†Deceased — died on June 16, 2019

Correspondence: Eliningaya J Kweka Email

Background: Surveillance of the clinical morbidity of malaria remains key for disease monitoring for subsequent development of appropriate interventions. This case study presents the current status of malaria morbidities following a second round of mass distribution of long-lasting insecticidal nets (LLINs) on Ukerewe Island, northwestern Tanzania.
Methods: A retrospective review of health-facility registers to determine causes of inpatient morbidities for every admitted child aged < 5 years was conducted to ascertain the contribution of malaria before and after distribution of LLINs. This review was conducted from August 2016 to July 2018 in three selected health facilities. To determine the trend of malaria admissions in the selected facilities, additional retrospective collection of all malaria and other causes of admission was conducted for both < 5- and > 5-year-old patients from July 2014 to June 2018. For comparison purposes, monthly admissions of malaria and other causes from all health facilities in the district were also collected. Moreover, an LLIN-coverage study was conducted among randomly selected households (n=684).
Results: Between August 2016 and July 2018, malaria was the leading cause of inpatient morbidity, accounting for 44.1% and 20.3% among patients < 5 and > 5 years old, respectively. Between October 2017 and January 2018, the mean number of admissions of patients aged < 5 years increased 2.7-fold at one health center and 1.02-fold for all admissions in the district. Additionally, approximately half the households in the study area had poor of LLIN coverage 1 year after mass distribution.
Conclusion: This trend analysis of inpatient morbidities among children aged < 5 years revealed an upsurge in malaria admissions in some health facilities in the district, despite LLIN intervention. This suggests the occurrence of an unnoticed outbreak of malaria admissions in all health facilities.

Keywords: malaria surveillance, inpatient morbidity, children < 5 years old, Tanzania

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