159
IRUS Total
Downloads

Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis

File Description SizeFormat 
PIIS1473309915701246.pdfPublished version4.41 MBAdobe PDFView/Open
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 Creative Commons