Management of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreak

Hdl Handle:
http://hdl.handle.net/10144/619126
Title:
Management of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreak
Authors:
Moses, FL; Tamang, D; Denisiuk, O; Dumbuya, U; Hann, K; Zachariah, R
Journal:
Public Health Action
Abstract:
Setting: Sixty-eight primary health facilities, Koinadugu District, rural Sierra Leone. Objectives: Sierra Leone, a country with one of the highest burdens of malaria, was severely affected by the 2014-2015 Ebola virus disease outbreak. In under-five children, we compared trends in the completeness of malaria reports sent to the district office during the pre-Ebola, Ebola and post-Ebola periods, including the number of children with reported fever, malaria diagnostic testing performed and treatment for malaria initiated with artemisinin-based combination therapy (ACT). Design: A cross-sectional study. Results: Of 1904 expected malaria reports, 1289 (68%) were received. Completeness of reporting was 61% pre-Ebola, increased to 88% during the outbreak and dropped to 44% post-Ebola (P = 0.003). Total malaria testing (n = 105 558) exceeded the number of fever cases (n = 105 320). Pre-Ebola, 75% (n = 43 245) of all reported fever cases received malaria treatment, dropping to 34% (n = 50 453) during the Ebola outbreak. Of 36 804 confirmed malaria cases during Ebola, 17 438 (47%) were treated, significantly fewer than in the pre-Ebola period (96%, P < 0.001). Of the fever cases, 95% in both the pre- and post-Ebola periods received ACT, a rate that increased to 99% during the Ebola outbreak. Conclusion: Pre-existing gaps in malaria reporting worsened after the Ebola outbreak. Reassuringly, malaria testing matched fever cases, although only half of all confirmed cases received treatment during the outbreak, possibly explained by outbreak-related operational difficulties. These findings could be useful to guide health systems strengthening and recovery.
Publisher:
International Union Against Tuberculosis and Lung Disease
Issue Date:
21-Jun-2017
URI:
http://hdl.handle.net/10144/619126
DOI:
10.5588/pha.16.0085
PubMed ID:
28744435
Submitted date:
2018-05-16
Language:
en
ISSN:
2220-8372
Appears in Collections:
Operational Research Courses

Full metadata record

DC FieldValue Language
dc.contributor.authorMoses, FLen
dc.contributor.authorTamang, Den
dc.contributor.authorDenisiuk, Oen
dc.contributor.authorDumbuya, Uen
dc.contributor.authorHann, Ken
dc.contributor.authorZachariah, Ren
dc.date.accessioned2018-05-17T14:02:30Z-
dc.date.available2018-05-17T14:02:30Z-
dc.date.issued2017-06-21-
dc.date.submitted2018-05-16-
dc.identifier.citationManagement of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreak. 2017, 7 (Suppl 1):S22-S26 Public Health Actionen
dc.identifier.issn2220-8372-
dc.identifier.pmid28744435-
dc.identifier.doi10.5588/pha.16.0085-
dc.identifier.urihttp://hdl.handle.net/10144/619126-
dc.description.abstractSetting: Sixty-eight primary health facilities, Koinadugu District, rural Sierra Leone. Objectives: Sierra Leone, a country with one of the highest burdens of malaria, was severely affected by the 2014-2015 Ebola virus disease outbreak. In under-five children, we compared trends in the completeness of malaria reports sent to the district office during the pre-Ebola, Ebola and post-Ebola periods, including the number of children with reported fever, malaria diagnostic testing performed and treatment for malaria initiated with artemisinin-based combination therapy (ACT). Design: A cross-sectional study. Results: Of 1904 expected malaria reports, 1289 (68%) were received. Completeness of reporting was 61% pre-Ebola, increased to 88% during the outbreak and dropped to 44% post-Ebola (P = 0.003). Total malaria testing (n = 105 558) exceeded the number of fever cases (n = 105 320). Pre-Ebola, 75% (n = 43 245) of all reported fever cases received malaria treatment, dropping to 34% (n = 50 453) during the Ebola outbreak. Of 36 804 confirmed malaria cases during Ebola, 17 438 (47%) were treated, significantly fewer than in the pre-Ebola period (96%, P < 0.001). Of the fever cases, 95% in both the pre- and post-Ebola periods received ACT, a rate that increased to 99% during the Ebola outbreak. Conclusion: Pre-existing gaps in malaria reporting worsened after the Ebola outbreak. Reassuringly, malaria testing matched fever cases, although only half of all confirmed cases received treatment during the outbreak, possibly explained by outbreak-related operational difficulties. These findings could be useful to guide health systems strengthening and recovery.en
dc.language.isoenen
dc.publisherInternational Union Against Tuberculosis and Lung Diseaseen
dc.rightsArchived with thanks to Public Health Actionen
dc.titleManagement of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreaken
dc.identifier.journalPublic Health Actionen

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