Document Detail

Effectiveness of malaria control during changing climate conditions in Eritrea, 1998-2003.
MedLine Citation:
PMID:  18304268     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the effectiveness of impregnated mosquito nets, indoor residual spraying and larval control relative to the impacts of climate variability in the decline of malaria cases in Eritrea. METHODS: Monthly data on clinical malaria cases by subzoba (district) in three zobas (zones) of Eritrea for 1998-2003 were used in Poisson regression models to determine whether there is statistical evidence for reduction in cases by DDT, malathion, impregnated nets and larval control used over the period, while analysing the effects of satellite-derived climate variables in the same geographic areas. RESULTS: Both indoor residual spraying (with DDT or malathion) and impregnated nets were independently and significantly negatively associated with reduction in malaria cases, as was larval control in one zoba. Malaria cases were significantly positively related to differences in current and previous months' vegetation (NDVI) anomalies. The relationship to rainfall differences 2 and 3 months previously was also significant, but the direction of the effect varied by zoba. Standardized regression coefficients indicated a greater effect of climate in the zoba with less intense malaria transmission. CONCLUSION: The results support the view that both indoor residual spraying and impregnated nets have been independently effective against malaria, and that larval control was also effective in one area. Thus climate, while significant, is not the only explanation for the recent decline in malaria cases in Eritrea. If appropriate statistical approaches are used, routine surveillance data from cases attending health facilities can be useful for assessing control programme success and providing estimates of the effectiveness of individual control measures. Effectiveness estimates suitable for use in cost-effectiveness analysis have been obtained.
Patricia M Graves; Daniel E Osgood; Madeleine C Thomson; Kiros Sereke; Afwerki Araia; Mehari Zerom; Pietro Ceccato; Michael Bell; John Del Corral; Shashu Ghebreselassie; Eugene P Brantly; Tewolde Ghebremeskel
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Tropical medicine & international health : TM & IH     Volume:  13     ISSN:  1365-3156     ISO Abbreviation:  Trop. Med. Int. Health     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-28     Completed Date:  2008-03-17     Revised Date:  2008-10-21    
Medline Journal Info:
Nlm Unique ID:  9610576     Medline TA:  Trop Med Int Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  218-28     Citation Subset:  IM    
EpiVec Consulting, Atlanta, GA, USA.
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MeSH Terms
Bedding and Linens*
Child, Preschool
DDT / administration & dosage
Eritrea / epidemiology
Infant, Newborn
Insecticides* / administration & dosage
Malaria / epidemiology*
Malathion / administration & dosage
Mosquito Control / methods*
National Health Programs
Outcome Assessment (Health Care)*
Poisson Distribution
Reg. No./Substance:
0/Insecticides; 121-75-5/Malathion; 50-29-3/DDT
Erratum In:
Trop Med Int Health. 2008 Oct;13(10):1326

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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