Masaninga Freddie, Chanda Emmanuel, Chanda-Kapata Pascalina, Hamainza Busiku, Masendu Hieronymo T, Kamuliwo Mulakwa, Kapelwa Wambinji, Chimumbwa John, Govere John, Otten Mac, Fall Ibrahima Soce, Babaniyi Olusegun
World Health Organization (WHO), Country Office, Zambia.
Asian Pac J Trop Biomed. 2013 Feb;3(2):89-94. doi: 10.1016/S2221-1691(13)60030-1.
A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control. This review considered data from the National Health Information Management System, Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages. Data showed three distinct epidemiological strata after a notable malaria reduction (66%) in in-patient cases and deaths, particularly between 2000-2008. These changes occurred following the (re-)introduction and expansion of indoor residual spraying up to 90% coverage, scale-up of coverage of long-lasting insecticide-treated nets in household from 50% to 70%, and artemisin-based combination therapy nationwide. However, malaria cases and deaths re-surged, increasing in 2009-2010 in the northern-eastern parts of Zambia. Delays in the disbursement of funds affected the implementation of interventions, which resulted in resurgence of cases and deaths. In spite of a decline in malaria disease burden over the past decade in Zambia, a reversal in impact is notable in the year 2009-2010, signifying that control gains are fragile and must be sustained to eliminate malaria.
2000年至2010年期间，赞比亚对疟疾趋势进行了全面的案头审查，以研究疟疾流行病学和趋势，为有效的疟疾控制策略和方法提供指导。该审查考虑了来自国家卫生信息管理系统、疟疾调查和项目审查报告的数据，并分析了所有年龄段的疟疾住院病例和死亡情况与干预覆盖率的关系。数据显示，在住院病例和死亡人数显著减少（66%）之后，尤其是在2000年至2008年期间，出现了三个不同的流行病学层次。这些变化发生在室内滞留喷洒（覆盖率达到90%）重新引入并扩大、家庭长效驱虫蚊帐覆盖率从50%扩大到70%以及全国范围内采用青蒿素联合疗法之后。然而，疟疾病例和死亡人数再次激增，2009年至2010年在赞比亚东北部地区有所增加。资金发放延迟影响了干预措施的实施，导致病例和死亡人数再次出现。尽管赞比亚过去十年疟疾疾病负担有所下降，但2009年至2010年的影响出现逆转，这表明控制成果很脆弱，必须持续努力以消除疟疾。
