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Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis
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Title: | Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis |
Authors: | Walker, PGT White, MT Griffin, JT Reynolds, A Ferguson, NM Ghani, AC |
Item Type: | Journal Article |
Abstract: | Background The ongoing Ebola epidemic in parts of west Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved over the past decade. We quantified this additional indirect burden of Ebola virus disease. Methods We estimated the number of cases and deaths from malaria in Guinea, Liberia, and Sierra Leone from Demographic and Health Surveys data for malaria prevalence and coverage of malaria interventions before the Ebola outbreak. We then removed the effect of treatment and hospital care to estimate additional cases and deaths from malaria caused by reduced health-care capacity and potential disruption of delivery of insecticide-treated bednets. We modelled the potential effect of emergency mass drug administration in affected areas on malaria cases and health-care demand. Findings If malaria care ceased as a result of the Ebola epidemic, untreated cases of malaria would have increased by 45% (95% credible interval 43–49) in Guinea, 88% (83–93) in Sierra Leone, and 140% (135–147) in Liberia in 2014. This increase is equivalent to 3·5 million (95% credible interval 2·6 million to 4·9 million) additional untreated cases, with 10 900 (5700–21 400) additional malaria-attributable deaths. Mass drug administration and distribution of insecticide-treated bednets timed to coincide with the 2015 malaria transmission season could largely mitigate the effect of Ebola virus disease on malaria. Interpretation These findings suggest that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems. |
Issue Date: | 1-Jul-2015 |
Date of Acceptance: | 17-Mar-2015 |
URI: | http://hdl.handle.net/10044/1/26239 |
DOI: | 10.1016/S1473-3099(15)70124-6 |
ISSN: | 1473-3099 |
Publisher: | Elsevier |
Start Page: | 825 |
End Page: | 832 |
Journal / Book Title: | Lancet Infectious Diseases |
Volume: | 15 |
Issue: | 7 |
Copyright Statement: | © Walker et al. Open Access article distributed under the terms of CC BY |
Sponsor/Funder: | Bill & Melinda Gates Foundation Bill & Melinda Gates Foundation Medical Research Council (MRC) National Institutes of Health Medical Research Council (MRC) Medical Research Council (MRC) National Institute for Health Research Medical Research Council (MRC) |
Funder's Grant Number: | OPP1092240 OPP1068440 G1002284 1U01GM110721-03 G0600719B MR/L012189/1 HPRU-2012-10080 MR/K010174/1B |
Keywords: | Science & Technology Life Sciences & Biomedicine Infectious Diseases PLASMODIUM-FALCIPARUM MALARIA AFRICA DISEASE Adolescent Child Child, Preschool Cost of Illness Developing Countries Epidemics Guinea Health Resources Health Services Accessibility Hemorrhagic Fever, Ebola Humans Insecticide-Treated Bednets Liberia Malaria Models, Theoretical Sierra Leone Humans Hemorrhagic Fever, Ebola Malaria Models, Theoretical Cost of Illness Developing Countries Adolescent Child Child, Preschool Health Resources Health Services Accessibility Guinea Liberia Sierra Leone Insecticide-Treated Bednets Epidemics Science & Technology Life Sciences & Biomedicine Infectious Diseases PLASMODIUM-FALCIPARUM MALARIA AFRICA DISEASE Microbiology 1103 Clinical Sciences 1108 Medical Microbiology 1117 Public Health and Health Services |
Publication Status: | Published |
Online Publication Date: | 2015-04-23 |
Appears in Collections: | Department of Infectious Diseases Faculty of Medicine School of Public Health |
This item is licensed under a Creative Commons License