National Malaria Control Programme, Public Health Division, Ghana Health Service, Accra, Ghana.
Department of Public Health, Cape Coast Teaching Hospital, Cape Coast, Ghana.
PLoS One. 2024 Feb 6;19(2):e0286212. doi: 10.1371/journal.pone.0286212. eCollection 2024.
BACKGROUND: Global efforts over the years have resulted in a 27% reduction in malaria incidence and an estimated 51% reduction in malaria mortality since 2000. Meanwhile, COVID-19 pandemic disrupted provision and utilization of malaria services, leading to a surge in malaria incidence and mortality. Globally, 627000 malaria deaths were recorded in 2020, representing about 69000 more deaths compared to 2019. Also, 14 million more cases of malaria were recorded in 2020 compared to 2019. This study sought to determine whether excess malaria deaths were recorded in Ghana during the COVID-19 pandemic era. METHODS: This was a descriptive study on routine malaria mortality data in Ghana for the period 2016 to 2021. Data was retrieved from the District Health Information Management System using a data extraction guide. Excess mortality was defined as occurrence of malaria deaths more than expected value for the period 2020 and 2021. The expected number of mortalities for 2020 and 2021 were determined using 2016 to 2019 average. Excess mortality (P-score) was estimated using the formula: [(reported mortalities-expected mortalities)/expected mortalities X 100%]. Data were summarized and processed in Microsoft excel version 16.0. Malaria mortality in Ghana and its regions was described using tables and line graphs. RESULTS: An average of 535 malaria deaths per year were recorded nationwide from 2016 to 2020. About 50% (1603/3207) of deaths occurred in children aged less than five years. The p-scores for the country were -53% and -58% for 2020 and 2021 respectively. No region recorded excess all-age malaria mortality in 2020, rather significant reduction. Stratified by age, Greater Accra region reported 90% higher than expected deaths among persons aged five years and above in 2020 (p-score = 90%, 95% CI: 21-159). All regions reported reduction in under-five mortality in 2020. No significant excess malaria mortalities were reported among the regions in 2021. CONCLUSION: Although negative p-scores suggested a decline in malaria mortalities nationwide, some regions recorded excess deaths during the COVID-19 pandemic era. There is a need to integrate COVID-19 control activities with malaria control and prevention efforts to mitigate the impact of COVID-19 on malaria case management and mortality.
背景：多年来，全球努力使疟疾发病率降低了 27%，死亡率降低了约 51%，自 2000 年以来。与此同时，COVID-19 大流行扰乱了疟疾服务的提供和利用，导致疟疾发病率和死亡率上升。全球 2020 年记录了 62.7 万例疟疾死亡，比 2019 年增加了约 6.9 万例。此外，2020 年记录的疟疾病例比 2019 年增加了 1400 万例。本研究旨在确定 COVID-19 大流行期间加纳是否记录了过多的疟疾死亡。 方法：这是一项关于加纳 2016 年至 2021 年期间常规疟疾死亡率的描述性研究。使用数据提取指南从地区卫生信息管理系统中检索数据。超额死亡定义为 2020 年和 2021 年期间发生的疟疾死亡人数超过预期值。2020 年和 2021 年的预期死亡人数是使用 2016 年至 2019 年的平均水平确定的。使用公式 [(报告的死亡人数-预期死亡人数)/预期死亡人数×100%] 估计超额死亡率 (P 分数)。数据在 Microsoft excel 版本 16.0 中进行汇总和处理。使用表格和折线图描述加纳及其地区的疟疾死亡率。 结果：2016 年至 2020 年，全国平均每年记录 535 例疟疾死亡。约 50%（1603/3207）的死亡发生在五岁以下儿童中。该国的 P 分数分别为-53%和-58%，分别为 2020 年和 2021 年。2020 年，没有任何地区记录全年龄段疟疾死亡人数过多，反而有所减少。按年龄分层，大阿克拉地区 2020 年五岁及以上人群的死亡人数比预期高出 90%（P 分数=90%，95%CI：21-159）。所有地区的五岁以下儿童死亡率均有所下降。2021 年，各地区均未报告疟疾死亡人数过多。 结论：尽管负 P 分数表明全国疟疾死亡率下降，但 COVID-19 大流行期间一些地区的死亡人数仍有所增加。需要将 COVID-19 控制活动与疟疾控制和预防工作相结合，以减轻 COVID-19 对疟疾病例管理和死亡率的影响。
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