Malaria

MICS3 Data Analysis and Report Writing

Background

• An estimated 350-500 million clinical malaria cases and more than one million malaria deaths occur each year, with 90% of these deaths in Sub-Saharan Africa.

• Repeated episodes of fever and anemia take a toll on a child’s mental and physical development - impairing their education and their growth into productive adults.

• Pregnant women and their unborn children are also particularly vulnerable to malaria, which is a major cause of low birth weight, anemia and infant death.

International Goals & Targets

Reduce by one half the burden of disease

associated with malaria and ensure that 60%

of all people at risk of malaria,

especially children and women, sleep under

insecticide-treated bednets

Have halted and begun to reverse the incidence of malaria and

other major diseases

List of Indicators

• Household availability of ITNs or any net • Children under five sleeping under an ITN

• Malaria treatment for children under five

• Intermittent preventive malaria treatment

Definition of Indicators

Percentage of households with at least one insecticide-treated net (or any net)

Numerator: Number of households with at least one mosquito net, either permanently treated or treated within the previous 12 months (or any net)

Denominator: Number of households surveyed

Household Availability of ITNs or Any Net

Tabulation PlanTable CH.10: Availability of ITNs

Definition of Indicators

Percentage of children under five sleeping under an insecticide-treated net

Numerator: Number of children aged 0-59 months that slept under and insecticide-treated net the previous night

Denominator: Number of children aged 0-59 months surveyed

Children Under-Five Sleeping Under ITNs

Definition of Indicators

Percentage of children under five with reported fever receiving antimalarials

Numerator: Number of children aged 0-59 months reported to havefever in the 2 weeks prior to the survey that were treated with an appropriate antimalarial within 24 hours of onset of symptoms

Denominator: Number of children aged 0-59 months surveyed that were reported to have fever in the 2 weeks prior to the survey

Malaria Treatment in Children Under-Five

Methodological Issues

• Insecticide-treated nets include a mosquito net, either permanently treated or treated within the previous 12 months

Tabulation PlanTable CH.11: Children sleeping under bednets

000011111111122222223344444556677788910

151618

36

0 20 40 60 80 100

SomaliaSwaziland

UgandaSudan

AzerbaijanBurundi

ColombiaGuatemalaCameroon

ChadCongo, Dem Rep

Eq. GuineaNigeria

Tajikistan Angola

Burkina FasoCAR

SenegalSierra Leone

TogoNamibia

SurinameEritrea

Côte d'IvoireGhana

GuineaMauritania

KenyaRwandaGuyana

NigerZambia

BeninGuinea-Bissau

Timor-LesteMali

ComorosTanzania

GambiaViet NamLao PDR

Malawi

ITN Use

% children aged 0-59 months

sleeping under an ITN

Methodological Issues

• Appropriate antimalarial treatment includes SP/Fansidar, Chloroquine, Amodiaquine, Quinine, Artemisinin-based combinations or other antimalarials (not paracetamol, aspirin or ibuprofen) given same day or next day

• Comparability issue since most surveys did not consider timing of anti-malarial treatment.

• Growing resistance to Chloroquine and SP/Fansidar treatment in some areas, which reduces the effectiveness of those drugs.

• Changes in drug policies for anti-malarial treatment.

Methodological Issues

Methodological Issues

• Percentages given various antimalarials will not add to 100 since children may have been given more than one type of drug

• Use of GPS (geocoding) to identify malarious parts of countries.

Methodological Issues

• Issue of timing of antimalarial treatment:any time v. same day/next day

Tabulation Plan (Antimalarials)

112334

79

12131415

192627

31323233343436

3845

4748495050

525556

5858

606061

636363

666969

0 20 40 60 80 100

AzerbaijanIndonesiaNicaragua

GuyanaEthiopia

EritreaViet NamLao PDR

HaitiRwandaNamibia

MozambiqueSomalia

SwazilandKenya

BurundiChad

MalawiMauritania

NigeriaMadagascar

SenegalMali

Congo, DemTimor-Leste

NigerEq. Guinea

SudanBurkina Faso

ZambiaGambiaGuinea

Guinea-BissauTanzania

TogoBenin

Sierra LeoneAngolaGhana

ComorosCameroonTajikistan

CAR

Antimalarial Use

% children aged 0-59 months

with fever receiving

antimalarials

Definition of Indicators

Percentage of pregnant women receiving intermittent preventive malaria treatment (IPT)

Numerator: Number of women receiving appropriate intermittent medication to prevent malaria (defined as at least 2 doses of SP/Fansidar) during the last pregnancy leading to a live birth within the 2 years prior to the survey

Denominator: Number of women who have had a live birth within the 2 years prior to the survey

Intermittent Preventive Malaria Treatment

Methodological Issues

• Note that if the percentage of pregnant women receiving SP/Fansidar an unknown number of times is less than 1% this column may be omitted from the table

Tabulation PlanCH.13: Intermittent preventive treatment for malaria