National Malaria Control and Scaling Up for Impact: The Zambia Experience through 2006

Richard W. Steketee Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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Naawa Sipilanyambe Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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John Chimumbwa Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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James J. Banda Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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Abdirahman Mohamed Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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John Miller Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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Suprotik Basu Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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Simon K. Miti Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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Carlos C. Campbell Malaria Control and Evaluation Partnership in Africa, PATH, Seattle, Washington, Lusaka, Zambia, and Ferney, France; National Malaria Control Centre, Ministry of Health, Lusaka, Zambia; Roll Back Malaria Partnership, East Africa Regional Network, Secretariat, Nairobi, Kenya; Roll Back Malaria Partnership Secretariat, Geneva, Switzerland; Malaria Booster Program, The World Bank, Washington, District of Columbia; Ministry of Health, Lusaka, Zambia

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With its 2006–2011 National Malaria Strategic Plan, Zambia committed to control malaria at a national scale. This scale-up for impact approach was facilitated by sound business planning and financing in 2006 of approximately US$35 million. Compared with surveys in 2001 and 2004, a 2006 national survey of 14,681 persons in 2,999 households at the end of the transmission season showed substantial coverage increases for preventive interventions. Ownership and use rates of insecticide-treated mosquito nets (ITNs) among vulnerable groups doubled, with 44% of households owning ITNs and 23% of children less than five years of age and 24% of pregnant women using them. Roll Back Malaria Abuja targets for intermittent preventive treatment in pregnancy (IPTp) were exceeded, with 62% of pregnant women receiving at least two doses of IPTp. As of 2006, Zambia is demonstrating substantial progress toward the national targets (80% population coverage rates for the interventions) and aspires to show that malaria need not be its leading health problem, and that malaria control is a sound national investment.

Author Notes

  • 1

    Roll Back Malaria (RBM) Partnership Secretariat, 2005. Global Strategic Plan, 2005–2015. Geneva, RBM Partnership Secretariat. Available at: http://www.rollbackmalaria.org/forumV/docs/gsp_en.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 2

    World Health Organization, 2003. A Strategic Framework for Malaria Prevention and Control During Pregnancy in the African Region. Geneva: World Health Organization, 2003; AFR/MAL/04/01. Available at: http://www.cdc.gov/malaria/pdf/strategic_framework_mip_04.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 3

    RBM Technical Support Network for Insecticide-Treated Materials, 2005. Scaling Up Insecticide-Treated Netting Programmes in Africa: A Strategic Framework for Coordinated National Action. Geneva: World Health Organization, November 2005. Available at: http://www.rollbackmalaria.org/partnership/wg/wg_itn/docs/WINITN_StrategicFramework.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 4

    Roll Back Malaria (RBM) Partnership Secretariat, 2004. RBM Partnership Consensus Statement on Insecticide Treated Netting. Geneva: RBM Partnership Secretariat. Available at: http://rbm.who.int/partnership/wg/wg_itn/docs/RBMWINStatementVector.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 5

    Roll Back Malaria (RBM) Partnership Secretariat, 2005. Changing Malaria Treatment Policy to Artemisinin-Based Combinations: An Implementation Guide. Geneva: RBM Partnership Secretariat. Available at: http://www.rollbackmalaria.org/docs/mmss/act_implementationguide-e.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 6

    Roll Back Malaria (RBM) Partnership Secretariat, 2004. Increasing Access to Effective Malaria Case Management. Consensus Statement of the RBM Partnership. Geneva: RBM Partnership Secretariat.

    • PubMed
    • Export Citation
  • 7

    Lengler C, 2004. Insecticide-treated bednets and curtains for preventing malaria. Cochrane Database of Syst Rev: CD000363: Oxford, United Kingdom: The Cochrane Library.

    • PubMed
    • Export Citation
  • 8

    Hawley WA, ter Kuile FO, Steketee RW, Nahlen BL, Terlouw DJ, Gimnig JE, Shi YP, Vulule JM, Alaii JA, Hightower AW, Kolczak MS, Kariuki SK, Phillips-Howard PA, 2003. Implications of the western Kenya permethrin-treated bed net study for policy, program implementation, and future research. Am J Trop Med Hyg 68 (Suppl 4):168–173.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, 2003. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):121–127.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Lengler C, Sharp B, 2003. Indoor residual spraying and insecticide-treated nets. Technical Report: Reducing Malaria’s Burden: Evidence of Effectiveness for Decision Makers. Washington, DC: Global Health Council. Available at: http://www.globalhealth.org/assets/publications/malaria.pdf. Accessed August 2, 2007.

    • PubMed
    • Export Citation
  • 11

    Zucker JR, Lackritz EM, Ruebush TK 2nd, Hightower AW, Adungosi JE, Were JB, Metchock B, Patrick E, Campbell CC, 1996. Childhood mortality during and after hospitalization in western Kenya: effect of malaria treatment regimens. Am J Trop Med Hyg 55 :655–660.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Kidane G, Morrow RH, 2000. Teaching mothers to provide home treatment of malaria in Tigray, Ethiopia: a randomized trial. Lancet 12 :550–555.

  • 13

    World Health Organization, Division of Control of Tropical Diseases, 1990. Severe and complicated malaria. Trans R Soc Trop Med Hyg 84 (Suppl 2):1–65.

  • 14

    World Health Organization, 2006. Guidelines for the Treatment of Malaria. WHO/HTM/MAL.2006;1108. Available at: http://www.who.int/malaria/docs/TreatmentGuidelines2006.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 15

    Goodman CA, Coleman PG, Mills A, 2000. Economic analysis of malaria control in sub-Saharan Africa. Geneva: Global Forum for Health Research. Available at: http://www.who.int/tdr/publications/tdrnews/news63/gfhrpublication.htm. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 16

    Hanson K, Goodman C, Lines J, Meek S, Bradley D, Mills A, 2004. The Economics of Malaria Control Interventions. Global Forum for Health Research. c/o World Health Organization, Geneva, Switzerland, 2004. Available at: http://whqlibdoc.who.int/publications/2004/2940286159.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 17

    Financing Mechanisms for Malaria, All-Party Parliamentary Group, 2007. Report of the All-Party Parliamentary Malaria Group (APPMG) using evidence presented to the APPMG in 2006. Available at: http://www.appmg-malaria.org.uk/uploads/5510C54D-D881-7E3C-8EF3F40279B51788/Financing_Mechanisms_for_Malaria_full_report.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 18

    Southern Africa Regional Poverty Network, 2005 Zambia Poverty and Vulnerability Assessment. Available at: http://www.sarpn.org.za/documents/d0001457/PVA_Zambia_June2005_Exec-summary.pdf.

    • PubMed
    • Export Citation
  • 19

    Central Statistical Office, Zambia Central Board of Health and ORC Macro., 2003. Zambia Demographic and Health Survey 2001–2002. Calverton, MD: Central Statistical Office, Central Board of Health, and ORC Macro.

    • PubMed
    • Export Citation
  • 20

    Sipilanyambe N, Simon JL, Chanda P, Olumese P, Snow RW, Hamer DH, 2008. From chloroquine to artemether-lumefantrine: the process of drug policy change in Zambia. Malar J 7 :25.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    President’s Malaria Initiative, 2008. Malaria Operational Plan, Zambia 2008. Available at: http://www.fightingmalaria.gov/countries/mops.html.

    • PubMed
    • Export Citation
  • 22

    World Health Organization, 2000. The African Summit on Roll Back Malaria, Abuja, Nigeria, 25 April. WHO/CDS/RBM/2000.17. Geneva: World Health Organization. Available at: http://www.rollbackmalaria.org/docs/abuja_declaration.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 23

    Bijl HM, Kager J, Koetsier DW, van der Werf TS, 2000. Chloroquine and sulfadoxine-pyrimethamine-resistant falciparum malaria in vivo: a pilot study in rural Zambia. Trop Med Int Health 5 :692–695.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Depoortere E, Guthmann JP, Presse J, Sipilanyambe N, Nkandu E, Balkan S, de Pecoulas PE, Legros D, 2005. Efficacy and effectiveness of the combination of sulfadoxine/pyrimethamine and a 3-day course of artesunate for the treatment of uncomplicated falciparum malaria in a refugee settlement in Zambia. Trop Med Int Health 10 :139–145.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Chanda P, Hawela M, Kango M, Sipilanyambe N, 2006. Assessment of the therapeutic efficacy of a Paediatric formulation of artemether-lumefantrine (Coartesiane) for the treatment of uncomplicated Plasmodium falciparum in children in Zambia. Malar J 28 :5–75.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Roll Back Malaria Monitoring and Evaluation Reference Group, World Health Organization, United Nations Children’s Fund, 2005. MEASURE DHS, MEASURE Evaluation, and U.S. Centers for Disease Control and Prevention, (CDC). Malaria Indicator Survey: Basic documentation for survey design and implementation. Calverton, MD: MEASURE Evaluation. Availabe at: http://www.rollbackmalaria.org/partnership/wg/wg_monitoring/docs/mis2005/misintro.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 27

    Zambia Ministry of Health, Zambia Central Statistical Office, PATH, MACEPA, CDC, WHO, 2006. Zambia National Malaria Indicator Survey 2006. Lusaka, Zambia: Ministry of Health. Available at: http://nmcc.org.zm.whsites.net/files/2006_Zambia_Malaria_Indicator_Survey.pdf. Accessed September 2, 2007.

    • PubMed
    • Export Citation
  • 28

    Miller JM, Robinson AL, Seiber E, Chanda P, Chizema E, Mukuka C, Mohamed A, Steketee RW, 2008. Household coverage of insectide-treated mosquito nets associated with a reduction in febrile episodes, malaria, and anemia in Zambian children: results of a national malaria indicator survey. Am J Trop Med Hyg 79 : (in press).

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Nevill CG, Some ES, Mung’ala VO, Mutemi W, New L, Marsh K, Lengeler C, Snow RW, 1996. Insecticide-treated bednets reduce mortality and severe morbidity from malaria among children on the Kenyan coast. Trop Med Int Health 1 :139–146.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, 2003. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):23–29.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kolczak MS, Kariuki SK, Shi YP, Kwena AM, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: cross-sectional survey. Am J Trop Med Hyg 68 (Suppl 4):100–107.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68 (Suppl 4):68–77.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Binka FN, Kubaje A, Adjuik M, Williams LA, Lengeler C, Maude GH, Armah GE, Kajihara B, Adiamah JH, Smith PG, 1996. Impact of permethrin impregnated bednets on child mortality in Kassena-Nankana district, Ghana: a randomized controlled trial. Trop Med Int Health 1 :147–154.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Habluetzel A, Diallo DA, Esposito F, Lamizana L, Pagnoni F, Lengeler C, Traore C, Cousens SN, 1997. Do insecticide-treated curtains reduce all-cause child mortality in Burkina Faso? Trop Med Int Health 2 :855–862.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Habluetzel A, Cuzin N, Diallo DA, Nebie I, Belem S, Cousens SN, Esposito F, 1999. Insecticide-treated curtains reduce the prevalence and intensity of malaria infection in Burkina Faso. Trop Med Int Health 4 :557–564.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Muller O, Traore C, Kouyate B, Ye Y, Frey C, Coulibaly B, Becher H, 2006. Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial. Bull World Health Organ 84 :120–126.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    UNICEF, Roll Back Malaria Partnership, 2007. Malaria and Children: Progress in Intervention Coverage. New York: United Nations.

    • PubMed
    • Export Citation
  • 38

    Roberts L, Enserink M, 2007. Malaria. Did they really say . eradication? Science 318 :1544–1545.

  • 39

    Anonymous, 2007. Is malaria eradication possible? Lancet 370 :1459.

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