An Assessment Of Epidemiological Trends Of Malaria And Associated Control Interventions In Lusaka Province Of Zambia,2009-2013

Background: Malaria has outranked warfare as a source of human suffering globally yet it is a treatable and preventable infectious disease.Malaria is endemic in Zambia and has been the leading cause of morbidity in the country over the past decade.It presents severe social and economic burdens on communities living in endemic areas hence the realization by the Government,stakeholders and cooperating partners to fight the scourge by scaling up prevention,diagnosis and treatment.Objectives: This study aimed at assessing the epidemiological trends of malaria and associated control interventions in Lusaka Province and also to assess the testing uptake of malaria and IPT use from 2009 to 2013.Methodology: A retrospective,observational study was performed at each of the four original districts in Lusaka Province of Zambia.Annual reported,district-level,aggregated malaria surveillance data were collected from all the four original districts of Lusaka Province from 2009 to 2013 using the Zambian District Health Information System(DHIS)through structured questionnaires.Data on annual provincial population were collected from Central Statistics Office(CSO)of the Republic of Zambia.District level malaria surveillance data were analysed using a district level linear regression model to explore the association between malaria morbidity and coverage with ITNs and IRHS.Trends of malaria morbidity and mortality were analysed using Microsoft Excel.The study population included all patients who suffered from malaria in relation with the provincial population annually from January 2009 to December 2013.Results: Lusaka Province malaria morbidity was 80 per 1,000 population in 2009,90 per 1,000 in 2010 and 92 per 1,000 in 2011.The year 2012 reported 40 per 1,000 while the year 2013 reported 60 per 1,000 population.In 2009,malaria mortality rate was 0.13 per 1,000 population,0.15 per 1,000 in 2010,0.06 per 1,000 in 2011,0.02 per 1,000 in 2012 and 0.01 per 1,000 population in 2013.The association between malaria morbidity and IRHS coverage using multiple factor regression model showed the Pvalue = 0.851(p > 0.05)while malaria morbidity and ITN showed the P-value = 0.004(p < 0.05).There was insignificant or no association between malaria morbidity and IRHS in Lusaka Province from 2009–2013.However,there was a relatively strong association between malaria morbidity and ITN coverage.Conclusion: There was a significant reduction in the burden of malaria in Lusaka province from 2009 to 2013.However,malaria remains a major cause of morbidity and mortality in the Province with Luangwa District as the most affected and children younger than five years of age were the most affected.Increased ITN coverage led to the reduction in malaria morbidity in Lusaka Province.Malaria control interventions should be intensified in the province more especially in the rural districts where malaria badly hit the province.