Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo

Lechthaler, Filippo; Matthys, Barbara; Lechthaler-Felber, Giulia; Likwela, Joris Losimba; Mavoko, Hypolite Muhindo; Rika, Junior Matangila; Mutombo, Meschac Mutombo; Ruckstuhl, Laura; Barczyk, Joanna; Shargie, Estifanos; Prytherch, Helen; Lengeler, Christian; Carvalho, Luzia Helena (2019). Trends in reported malaria cases and the effects of malaria control in the Democratic Republic of the Congo PLOS ONE, 14(7), e0219853. Public Library of Science 10.1371/journal.pone.0219853

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Background Considerable upscaling of malaria control efforts have taken place over the last 15 years in the Democratic Republic of Congo, the country with the second highest malaria case load after Nigeria. Malaria control interventions have been strengthened in line with the Millenium Development Goals. We analysed the effects of these interventions on malaria cases at health facility level, using a retrospective trend analysis of malaria cases between 2005 and 2014. Data were collected from outpatient and laboratory registers based on a sample of 175 health facilities that represents all eco-epidemiological malaria settings across the country. Methods We applied a time series analysis to assess trends of suspected and confirmed malaria cases, by health province and for different age groups. A linear panel regression model controlled for non-malaria outpatient cases, rain fall, nightlight intensity, health province and time fixed effects, was used to examine the relationship between the interventions and malaria case occurrences, as well as test positivity rates. Results Overall, recorded suspected and confirmed malaria cases in the DRC have increased. The sharp increase in confirmed cases from 2010 coincides with the introduction of the new treatment policy and the resulting scale-up of diagnostic testing. Controlling for confounding factors, the introduction of rapid diagnostic tests (RDTs) was significantly associated with the number of tested and confirmed cases. The test positivity rate fluctuated around 40% without showing any trend. Conclusion The sharp increase in confirmed malaria cases from 2010 is unlikely to be due to a resurgence of malaria, but is clearly associated with improved diagnostic availability, mainly the introduction of RDTs. Before that, a great part of malaria cases were treated based on clinical suspicion. This finding points to a better detection of cases that potentially contributed to improved case management. Furthermore, the expansion of diagnostic testing along with the increase in confirmed cases implies that before 2010, cases were underreported, and that the accuracy of routine data to describe malaria incidence has improved.

Item Type:

Journal Article (Original Article)

Division/Institute:

School of Agricultural, Forest and Food Sciences HAFL > Resource-efficient agricultural production systems
School of Agricultural, Forest and Food Sciences HAFL > HAFL Hugo P. Cecchini Institute

Name:

Lechthaler, Filippo;
Matthys, Barbara;
Lechthaler-Felber, Giulia;
Likwela, Joris Losimba;
Mavoko, Hypolite Muhindo;
Rika, Junior Matangila;
Mutombo, Meschac Mutombo;
Ruckstuhl, Laura;
Barczyk, Joanna;
Shargie, Estifanos;
Prytherch, Helen;
Lengeler, Christian and
Carvalho, Luzia Helena

Subjects:

R Medicine > R Medicine (General)
S Agriculture > S Agriculture (General)

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Nadine Werndli

Date Deposited:

08 Oct 2019 12:19

Last Modified:

22 Sep 2020 07:28

Publisher DOI:

10.1371/journal.pone.0219853

ARBOR DOI:

10.24451/arbor.8382

URI:

https://arbor.bfh.ch/id/eprint/8382

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