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...striving to overcome malaria
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Locations:
Malaria Prevalence
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The southern province of Zambia, including the area round Macha Hospital, has endemic P. falciparum malaria with cases existing year round, although there is a peak incidence during the rainy season, which runs from November through June. P. vivax and P. malaria are also present in the country but are relatively rare, being found in less than 5% of positive blood smears. The hospital out patient department sees over 5,000 cases of malaria each year, the majority of them confirmed by a positive malaria smear. The pediatric ward admits approximately 700 children annually with slide-confirmed malaria, with 50 to 60 children with cerebral and 160 to 195 children with severe malaria anemia. Malaria is the foremost discharge diagnosis and accounts for 35% of pediatric discharges.
Chloroquine resistance is now present clinically
in about 60% of treated malaria cases, with sulfadoxine/pyrimethamine
resistance present in 25-30% of cases. The Zambian government
policy continues to be that chloroquine is first-line therapy for malaria,
although this policy is currently under review.
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Community-based
studies have documented parasite prevalence rates ranging from 30% in
the "dry" season (June to October) to 85% during the "rainy"
season (November through May). Prospective studies have shown that children
are particularly susceptible, averaging 3 to 4 episodes of P falciparum
clinical malaria during the six month period of high transmission. Entomological
Inoculation Rates are not currently available, although data from a
recent entomological study, once analyzed, should give this rate.
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