National Malaria Program, Federal Ministry of Health, Addis Ababa, Ethiopia.
Program in Public Health, University of California, Irvine, CA, 92697, USA.
Infect Dis Poverty. 2018 Nov 5;7(1):103. doi: 10.1186/s40249-018-0487-3.
BACKGROUND: Ethiopia is one of the African countries where Plasmodium falciparum and P. vivax co-exist. Monitoring and evaluation of current malaria transmission status is an important component of malaria control as it is a measure of the success of ongoing interventions and guides the planning of future control and elimination efforts. MAIN TEXT: We evaluated changes in malaria control policy in Ethiopia, and reviewed dynamics of country-wide confirmed and clinical malaria cases by Plasmodium species and reported deaths for all ages and less than five years from 2001 to 2016. Districts level annual parasite incidence was analysed to characterize the malaria transmission stratification as implemented by the Ministry of Health. We found that Ethiopia has experienced major changes from 2003 to 2005 and subsequent adjustment in malaria diagnosis, treatment and vector control policy. Malaria interventions have been intensified represented by the increased insecticide treated net (ITN) and indoor residual spraying (IRS) coverage, improved health services and improved malaria diagnosis. However, countrywide ITN and IRS coverages were low, with 64% ITN coverage in 2016 and IRS coverage of 92.5% in 2016 and only implemented in epidemic-prone areas of > 2500 m elevation. Clinical malaria incidence rate dropped from an average of 43.1 cases per 1000 population annually between 2001 and 2010 to 29.0 cases per 1000 population annually between 2011 and 2016. Malaria deaths decreased from 2.1 deaths per 100 000 people annually between 2001 and 2010 to 1.1 deaths per 100 000 people annually between 2011 to 2016. There was shrinkage in the malaria transmission map and high transmission is limited mainly to the western international border area. Proportion of P. falciparum malaria remained nearly unchanged from 2000 to 2016 indicating further efforts are needed to suppress transmission. CONCLUSIONS: Malaria morbidity and mortality have been significantly reduced in Ethiopia since 2001, however, malaria case incidence is still high, and there were major gaps between ITN ownership and compliance in malarious areas. Additional efforts are needed to target the high transmission area of western Ethiopia to sustain the achievements made to date.
背景:埃塞俄比亚是疟原虫恶性疟和间日疟共同流行的非洲国家之一。监测和评估当前疟疾传播状况是疟疾控制的重要组成部分,因为它是衡量正在进行的干预措施成功与否的标准,并为未来的控制和消除工作提供指导。
主要内容:我们评估了埃塞俄比亚疟疾控制政策的变化,并审查了 2001 年至 2016 年期间按疟原虫种类和报告的全年龄段和五岁以下疟疾确诊病例和临床病例以及死亡人数的动态。对各地区年度寄生虫发病率进行了分析,以确定卫生部门实施的疟疾传播分层情况。我们发现,埃塞俄比亚从 2003 年至 2005 年经历了重大变化,随后对疟疾诊断、治疗和病媒控制政策进行了调整。随着杀虫剂处理过的蚊帐(ITN)和室内滞留喷洒(IRS)覆盖率的提高,以及卫生服务的改善和疟疾诊断的改善,疟疾干预措施得到了加强。然而,全国 ITN 和 IRS 的覆盖率仍然很低,2016 年 ITN 覆盖率为 64%,IRS 覆盖率为 92.5%,仅在海拔>2500 米的流行地区实施。临床疟疾发病率从 2001 年至 2010 年期间的平均每年每 1000 人 43.1 例降至 2011 年至 2016 年期间的每年每 1000 人 29.0 例。疟疾死亡人数从 2001 年至 2010 年期间的每年每 10 万人 2.1 人降至 2011 年至 2016 年期间的每年每 10 万人 1.1 人。疟疾传播图有所缩小,高传播地区主要局限于西部国际边境地区。2000 年至 2016 年期间,恶性疟原虫疟疾的比例基本保持不变,这表明需要进一步努力抑制传播。
结论:自 2001 年以来,埃塞俄比亚的疟疾发病率和死亡率显著下降,但疟疾发病率仍然很高,在疟疾流行地区,ITN 的拥有率和使用率之间存在较大差距。需要进一步努力,以维持目前在埃塞俄比亚西部高传播地区所取得的成果。
Infect Dis Poverty. 2018-11-5
Infect Dis Model. 2025-7-25
Front Public Health. 2016-8-15