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Sun Z, Zhou H, Chen F, Lu S, Liang H, Wan E, Tao Z, Zhao H, Zhou X, Yang F, Wang D, Zhang X. Understanding the China-Tanzania Malaria Control Project: lessons learned from a multi-stakeholder qualitative study. Front Public Health 2023; 11:1229675. [PMID: 37808986 PMCID: PMC10552642 DOI: 10.3389/fpubh.2023.1229675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background Tanzania is among the countries with the highest malaria cases and deaths worldwide, where vulnerable populations have been severely affected due to poverty and weakness in health system and infrastructure. The China-Tanzania Malaria Control Project (the Project) was a two-phase global health intervention project implemented between 2015 and 2021 that aimed to transfer project-designated intervention experience in malaria elimination to the Tanzanian health system. This study aims to identify the barriers and facilitators encountered during the Project and to improve our understanding of the emerging phenomenon of South-South global health collaboration. Methods We conducted thematic analysis of qualitative data collected from a purposive sample of 14 participants from multiple stakeholders including project management office, project implementation agency, funding partners and external evaluators of the Project. A conceptual framework was developed to construct the interviews guides. The interviews were transcribed verbatim, crossover checked, translated into English, and analyzed with NVivo 12.0. We conducted the open coding followed by the axial coding based on the Grounded Theory to generate themes and subthemes, and identified key influencing factors that aided or hindered the malaria control in Tanzania. Results The findings suggested that malaria control strategies should largely be tailored due to varied socioeconomic contexts. The perceived enablers in practice include project-designated intervention experiences and technologies, professional and self-learning capabilities of the implementation team, sustainable financial assistance, and support from the international partners. The barriers include the shortage of global health talents, existing gaps to meet international standards, defects in internal communication mechanisms, inadequacy of intergovernmental dialogue, and limitations in logistical arrangements. A checklist and policy implications for China's future engagement in malaria control in resource-limited settings have been proposed. Conclusions The initiative of Health Silk Road has generated strong global interest in promoting development assistance in health. In the hope of generalizing the evidence-based interventions to high malaria-endemic countries in Africa, the need for China to carefully face the challenges of funding gaps and the lack of support from recipient governments remains ongoing. It is recommended that China should form an institutionalized scheme and sustainable funding pool to ensure the steady progress of development assistance in health.
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Affiliation(s)
- Zhishan Sun
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Zhou
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Fumin Chen
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Shenning Lu
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Huan Liang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Erya Wan
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zecheng Tao
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Hanqing Zhao
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaonong Zhou
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Fan Yang
- Institute of Population Research, Peking University, Beijing, China
| | - Duoquan Wang
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Xiaoxi Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
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Mariki M, Mduma N, Mkoba E. Characterisation of Malaria Diagnosis Data in High and Low Endemic Areas of Tanzania. East Afr Health Res J 2022; 6:171-179. [PMID: 36751682 PMCID: PMC9887499 DOI: 10.24248/eahrj.v6i2.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/25/2022] [Indexed: 01/01/2023] Open
Abstract
Background Malaria remains a significant cause of morbidity and mortality, especially in the sub-Saharan African region. Malaria is considered preventable and treatable, but in recent years, it has increased outpatient visits, hospitalisation, and deaths worldwide, reaching a 9% prevalence in Tanzania. With the massive number of patient records in the health facilities, this study aims to understand the key characteristics and trends of malaria diagnostic symptoms, testing and treatment data in Tanzania's high and low endemic regions. Methods This study had retrospective and cross-sectional designs. The data were collected from four facilities in two regions in Tanzania, i.e., Morogoro Region (high endemicity) and Kilimanjaro Region (low endemicity). Firstly, malaria patient records were extracted from malaria patients' files from 2015 to 2018. Data collected include (i) the patient's demographic information, (ii) the symptoms presented by the patient when consulting a doctor, (iii) the tests taken and results, (iv) diagnosis based on the laboratory results and (v) the treatment provided. Apart from that, we surveyed patients who visited the health facility with malaria-related symptoms to collect extra information such as travel history and the use of malaria control initiatives such as insecticide-treated nets. A descriptive analysis was generated to identify the frequency of responses. Correlation analysis random effects logistic regression was performed to determine the association between malaria-related symptoms and positivity. Significant differences of p < 0.05 (i.e., a Confidence Interval of 95%) were accepted. Results Of the 2556 records collected, 1527(60%) were from the high endemic area, while 1029(40%) were from the low endemic area. The most observed symptoms were the following: for facilities in high endemic regions was fever followed by headache, vomiting and body pain; for facilities in the low endemic region was high fever, sweating, fatigue and headache. The results showed that males with malaria symptoms had a higher chance of being diagnosed with malaria than females. Most patients with fever had a high probability of being diagnosed with malaria. From the interview, 68% of patients with malaria-related symptoms treated themselves without proper diagnosis. Conclusions Our data indicate that proper malaria diagnosis is a significant concern. The majority still self-medicate with anti-malaria drugs once they experience any malaria-related symptoms. Therefore, future studies should explore this challenge and investigate the potentiality of using malaria diagnosis records to diagnose the disease.
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Affiliation(s)
- Martina Mariki
- Department of Information Communication Science and Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Neema Mduma
- Department of Information Communication Science and Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Elizabeth Mkoba
- Department of Information Communication Science and Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
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Trends of Malaria Prevalence in Selected Districts of Kaffa Zone, Southwest Ethiopia. J Trop Med 2022; 2022:3556140. [PMID: 36274749 PMCID: PMC9586818 DOI: 10.1155/2022/3556140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Malaria remains one of the world's major public health issues, particularly in low- and middle-income countries. In Ethiopia, cases have declined over the last decade, and attempts to eradicate the illness are underway. The purpose of this study was to determine trends in malaria prevalence in selected areas of the Kaffa zone during the last five years (Decha and Gimbo districts). Methods All malaria cases registered from 2017 to 2021 were reviewed to assess the trends of malaria prevalence. A checklist was used to collect the secondary data from registers and entered it into an Excel spreadsheet, which was then exported to the Statistical Package for the Social Sciences (SPSS) version 25.0 for analysis. The malaria incidence rate was calculated with the total number of person-years as the denominator and the number of new cases as the numerator. Seasons, years, gender, age, and malaria parasite species were all used to show trends in malaria transmission in the areas. Tables and figures were used to present the data. Results Out of 20,045 individuals screened for malaria, 13.6% (2,732/20,045) of them were recorded to have Plasmodium species tested using microscopy and rapid diagnostic test (RDT). Plasmodium falciparum, Plasmodium vivax, and mixed infections (Plasmodium falciparum + Plasmodium vivax) accounted for 1200 (5.9%), 1114 (5.56%), and 418 (2.09%) of the confirmed malaria cases, respectively. Overall, malaria incidence decreased with an interannual variation, from 4.08 cases per 1000 person-years in 2017 to 3.62 cases per 1000 person-years in 2018, then increased to 4.94 cases per 1000 person-years in 2021. Conclusion The malaria trend over the last five years has revealed a nonconsistent pattern of cases in different years. The number of malaria cases has shown an increase over the period of 2017 to 2021. Interannual and intra-annual variations have been observed in the transmission of the disease.
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Maniga JN, Samuel M, Rael M, Odda J, Martin O, Ntulume I, Bwogo P, Mfitundinda W, Akinola SA. Trend of Malaria Burden Among Residents of Kisii County, Kenya After More Than a Decade Usage of Artemisinin Combined Therapies, 11-Year Laboratory Based Retrospective Study. Infect Drug Resist 2022; 15:5221-5232. [PMID: 36097528 PMCID: PMC9464030 DOI: 10.2147/idr.s370218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Malaria remains a major vector borne disease globally, with the majority of the casualties reported in Africa. Despite this fact, there is drastic reduction in malaria infection using Artemisinin combined therapies (ACTs). Malaria is characterized by significant inconsistency in different geographical locations due to different confounding factors. There is need to identify zone-specific malaria trends and interventions to completely eliminate the disease. Thus the study was aimed at assessing the 11-year trend of microscopically confirmed malaria cases in Kisii County, Kenya, so as to devise area-specific evidence-based interventions, informed decisions, and to track the effectiveness of malaria control programs. Methods This was a retrospective study carried out to determine 11-year malaria trend rates centered on the admission and laboratory records from health facilities located at four Sub-Counties in Kisii County, Kenya. Parasitological positivity rates of malaria were determined by comparing with the register records in health facilities which recorded confirmed malaria cases with the total number of monthly admissions over the entire year. Data was analyzed by using descriptive tools and chi-square test. Results There were 36,946 suspect cases, with 8449 (22.8%) confirmed malaria cases reported in this study. The overall malaria slide positivity rate over the last 11 years in the study area was 22.6%. The months of April and August showed the largest number of malaria cases (63%). The age group of ≥18 years contained the most positive confirmed cases, having a prevalence rate of 2953 (35.45%). Out of the confirmed malaria cases, 2379 (28.1%) were males and 6070 (71.9%) were females The highest malaria prevalence rate was recorded in 2014, with Marani Sub-County recording the highest positivity rate of 37.94%. Conclusion From the observed trends, malaria prevalence and transmission still remains stable in the study area. Thus more interventions need to be scaled up.
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Affiliation(s)
- Josephat Nyabayo Maniga
- Department of Biological Sciences, Kisii University, Kisii, Kenya.,Department of Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda.,College of Medicine, Health and Life Sciences, School of Medicine, King Ceasor University, Kampala, Uganda
| | | | - Masai Rael
- Department of Biological Sciences, Kisii University, Kisii, Kenya
| | - John Odda
- School of Pharmacy, Kampala International University Western Campus, Bushenyi, Uganda.,Department of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda
| | - Odoki Martin
- Department of Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda.,College of Medicine, Health and Life Sciences, School of Medicine, King Ceasor University, Kampala, Uganda
| | - Ibrahim Ntulume
- Department of Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda.,School of Biosecurity, Biotechnical and Laboratory Science, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Pacifica Bwogo
- Department of Biological Sciences, Kisii University, Kisii, Kenya
| | - Wilberforce Mfitundinda
- College of Medicine, Health and Life Sciences, School of Medicine, King Ceasor University, Kampala, Uganda
| | - Saheed Adekunle Akinola
- Department of Microbiology and Immunology, Kampala International University Western Campus, Bushenyi, Uganda.,Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
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