Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania
Abstract: Malaria morbidity and mortality data from clinical records provide essential
information towards defining disease burden in the area and for planning control strategies, but
should be augmented with data on transmission intensity and serological data as measures for
exposure to malaria. The objective of this study was to estimate the malaria burden based on
serological data and prevalence of malaria, and compare it with existing self-treatment practices
in Magugu in Babati District of northern Tanzania. Prospectively, 470 individuals were selected
for the study. Both microscopy and Rapid Diagnostic Test (RDT) were used for malaria diagnosis.
Seroprevalence of antibodies to merozoite surface proteins (MSP-119) and apical membrane
antigen (AMA-1) was performed and the entomological inoculation rate (EIR) was estimated. To
complement this information, retrospective data on treatment history, prescriptions by
physicians and use of bed nets were collected. Malaria prevalence in the area was 6.8% (32/470).
Of 130 individuals treated with artemisinin combination therapy (ACT), 22.3 % (29/130) were
slide confirmed while 75.3% (98/130) of them were blood smear negative. Three of the slides
confirmed individuals were not treated with ACT. Fever was reported in 38.2% of individuals, of
whom 48.8 % (88/180) were given ACT. Forty-two (32.3%) of those who received ACT had no
history of fever. About half (51.1%) of those treated with ACT were children <10 years old.
Immunoglobulin against MSP-119 was positive in 16.9% (74/437) while against AMA-1 was was
positive in 29.8 % (130/436). Transmission intensity estimated at <0.2 infectious bites per person
per year. The RDT was highly specific (96.3%) but with low sensitivity (15.6%). The low
sensitivity of RDT reflects the low number of immune individuals as well as the low parasite
density. CONCLUDE IN RELATION TO YOUR OBJECTIVE