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Malaria burden and control in Bangladesh and prospects for elimination: An epidemiological and economic assessment

Haque, Ubydul; Overgaard, Hans; Norris, Douglas; Islam, Nazrul; Karim, Jahirul; Roy, Shyamal; Haque, Waziul; Kabir, Moktadir; Smith, David L; Glass, Gregory E; Clements, Archie

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Background: Malaria is endemic in 13 of 64 districts in Bangladesh. About 14 million people are at risk. Some evidence suggests that the prevalence of malaria in Bangladesh has decreased since the the Global Fund to Fight AIDS, Tuberculosis and Malaria started to support the National Malaria Control Program (NMCP) in 2007. We did an epidemiological and economic assessment of malaria control in Bangladesh. Methods: We obtained annually reported, district-level aggregated malaria case data and...[Show more]

dc.contributor.authorHaque, Ubydul
dc.contributor.authorOvergaard, Hans
dc.contributor.authorNorris, Douglas
dc.contributor.authorIslam, Nazrul
dc.contributor.authorKarim, Jahirul
dc.contributor.authorRoy, Shyamal
dc.contributor.authorHaque, Waziul
dc.contributor.authorKabir, Moktadir
dc.contributor.authorSmith, David L
dc.contributor.authorGlass, Gregory E
dc.contributor.authorClements, Archie
dc.date.accessioned2015-12-13T22:26:59Z
dc.identifier.issn2214-109X
dc.identifier.urihttp://hdl.handle.net/1885/73742
dc.description.abstractBackground: Malaria is endemic in 13 of 64 districts in Bangladesh. About 14 million people are at risk. Some evidence suggests that the prevalence of malaria in Bangladesh has decreased since the the Global Fund to Fight AIDS, Tuberculosis and Malaria started to support the National Malaria Control Program (NMCP) in 2007. We did an epidemiological and economic assessment of malaria control in Bangladesh. Methods: We obtained annually reported, district-level aggregated malaria case data and information about disbursed funds from the NMCP. We used a Poisson regression model to examine the associations between total malaria, severe malaria, malaria-attributable mortality, and insecticide-treated net coverage. We identified and mapped malaria hotspots using the Getis-Ord Gi* statistic. We estimated the cost-effectiveness of the NMCP by estimating the cost per confirmed case, cost per treated case, and cost per person of insecticide-treated net coverage. Findings: During the study period (from Jan 1, 2008, to Dec 31, 2012) there were 285731 confirmed malaria cases. Malaria decreased from 6·2 cases per 1000 population in 2008, to 2·1 cases per 1000 population in 2012. Prevalence of all malaria decreased by 65% (95% CI 65-66), severe malaria decreased by 79% (78-80), and malaria-associated mortality decreased by 91% (83-95). By 2012, there was one insecticide-treated net for every 2·6 individuals (SD 0·20). Districts with more than 0·5 insecticide-treated nets per person had a decrease in prevalence of 21% (95% CI 19-23) for all malaria, 25% (17-32) for severe malaria, and 76% (35-91) for malaria-associated mortality among all age groups. Malaria hotspots remained in the highly endemic districts in the Chittagong Hill Tracts. The cost per diagnosed case was US$0·39 (SD 0·02) and per treated case was $0·51 (0·27); $0·05 (0·04) was invested per person per year for health education and $0·68 (0·30) was spent per person per year for insecticide-treated net coverage. Interpretation: Malaria elimination is an achievable prospect in Bangladesh and failure to push for elimination nearly ensures a resurgence of disease. Consistent financing is needed to avoid resurgence and maintain elimination goals. Funding: None.
dc.publisherElsevier
dc.rightsAuthor/s retain copyright
dc.sourceThe Lancet Global Health
dc.titleMalaria burden and control in Bangladesh and prospects for elimination: An epidemiological and economic assessment
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume2
dc.date.issued2014
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationU3488905xPUB3810
local.type.statusPublished Version
local.contributor.affiliationHaque, Ubydul, John Hopkins University
local.contributor.affiliationOvergaard, Hans, Norwegian University of Life Sciences
local.contributor.affiliationClements, Archie, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationNorris, Douglas, John Hopkins University
local.contributor.affiliationIslam, Nazrul, Malaria and Parasitic Disease Control
local.contributor.affiliationKarim, Jahirul, Malaria and Parasitic Disease Control
local.contributor.affiliationRoy, Shyamal, Malaria and Parasitic Disease Control
local.contributor.affiliationHaque, Waziul, Oslo and Akershus University College of Applied Sciences
local.contributor.affiliationKabir, Moktadir, BRAC Health
local.contributor.affiliationSmith, David L, John Hopkins University
local.contributor.affiliationGlass, Gregory E, John Hopkins Bloomberg School of Public Health
local.bibliographicCitation.issue2
local.bibliographicCitation.startpagee98
local.bibliographicCitation.lastpagee105
local.identifier.doi10.1016/S2214-109X(13)70176-1
local.identifier.absseo920499 - Public Health (excl. Specific Population Health) not elsewhere classified
dc.date.updated2015-12-11T08:26:40Z
local.identifier.scopusID2-s2.0-84892994994
dcterms.accessRightsOpen Access
CollectionsANU Research Publications

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