Nchelenge District is in the northwest of Luapula Province in the marshlands of the Luapula River and bordering Lake Mweru, sharing an international border with the Democratic Republic of Congo (Figure 1 ). Nchelenge has a tropical climate with three seasons: a cool, dry winter (May-August), a hot, dry season (September-October), and a hot, rainy season (November-April) [10 ]. The population Census in 2010 recorded 147,927 people: 72,797 males and 75,130 females, living in 31,724 houses [11 ]. Fishing and agriculture are common means of livelihood. Some people engage in fishing, leading nomadic lifestyles and move to agricultural regions when fishing is not permitted.
DHIS data were collected at 11 health facilities in paper form and were sent to the DHO for electronic entry and validation. Information on cases of malaria, malaria deaths, use of malaria diagnostics, and malaria control interventions were obtained from the Nchelenge DHO and consisted of routine surveillance data. The DHO collate the number of malaria cases (malaria is considered to be cases with fever who require anti-malarial treatment [12 ]) diagnosed by direct microscopy, RDT or based on clinical symptoms [13 ] reported by health facilities. Yearly aggregated IRS coverage of targeted areas was captured using daily spray forms that were consolidated at the DHO. Data were also available on the number of LLINs distributed annually through all distribution channels, including antenatal and under-fives’ clinics and mass vaccination campaigns. Coverage rate of LLINs (defined as universal access and use of LLINs [14 ]) was calculated per 1,000 population assuming an average life span of three years [15 -17 (link)].
Trends in the prevalence of malaria, severe malaria (a set of clinical and laboratory parameters associated with an increased risk of death with the presence of Plasmodium falciparum parasitaemia) [18 (link)] and malaria-attributable deaths (malaria as the cause of death confirmed by laboratory diagnosis in the hospital) from 2006 to 2012 were assessed for Nchelenge District. Malaria cases were reported annually from 2006 to 2007 and monthly from 2008 to 2012.
Demographic data from the 2000 and 2010 censuses were obtained from the Zambian Bureau of Statistics [11 ,19 ] and annual demographic data were projected for 2006 to 2009 and for 2011 to 2012 using an exponential population growth model. The number of houses was projected assuming linear growth. These estimates served as denominators. Descriptive analyses were performed regarding trends in the number of malaria cases, methods of diagnosis, malaria positivity rate among pregnant women, and interventions coverage from 2006 to 2012.
Entomological data were obtained from the Tropical Diseases Research Centre (TDRC) and Luapula Health Office. Entomological data collections were conducted in 2011 and 2012 by the TDRC using pyrethrum spray-catches, mouth-aspirated hand catches and Centers for Disease Control and Prevention (CDC) light-trap methods to determine vector species and indoor densities. Malaria vectors were identified morphologically as Anopheles gambiae s.l. and Anopheles funestus s.l. using standard keys [20 ,21 ]. Insecticide resistance profiles of malaria vectors were determined for 4% DDT and 0.05% deltamethrin using the standard World Health Organization (WHO) tube assay protocol [22 ].
DHIS data were collected at 11 health facilities in paper form and were sent to the DHO for electronic entry and validation. Information on cases of malaria, malaria deaths, use of malaria diagnostics, and malaria control interventions were obtained from the Nchelenge DHO and consisted of routine surveillance data. The DHO collate the number of malaria cases (malaria is considered to be cases with fever who require anti-malarial treatment [12 ]) diagnosed by direct microscopy, RDT or based on clinical symptoms [13 ] reported by health facilities. Yearly aggregated IRS coverage of targeted areas was captured using daily spray forms that were consolidated at the DHO. Data were also available on the number of LLINs distributed annually through all distribution channels, including antenatal and under-fives’ clinics and mass vaccination campaigns. Coverage rate of LLINs (defined as universal access and use of LLINs [14 ]) was calculated per 1,000 population assuming an average life span of three years [15 -17 (link)].
Trends in the prevalence of malaria, severe malaria (a set of clinical and laboratory parameters associated with an increased risk of death with the presence of Plasmodium falciparum parasitaemia) [18 (link)] and malaria-attributable deaths (malaria as the cause of death confirmed by laboratory diagnosis in the hospital) from 2006 to 2012 were assessed for Nchelenge District. Malaria cases were reported annually from 2006 to 2007 and monthly from 2008 to 2012.
Demographic data from the 2000 and 2010 censuses were obtained from the Zambian Bureau of Statistics [11 ,19 ] and annual demographic data were projected for 2006 to 2009 and for 2011 to 2012 using an exponential population growth model. The number of houses was projected assuming linear growth. These estimates served as denominators. Descriptive analyses were performed regarding trends in the number of malaria cases, methods of diagnosis, malaria positivity rate among pregnant women, and interventions coverage from 2006 to 2012.
Entomological data were obtained from the Tropical Diseases Research Centre (TDRC) and Luapula Health Office. Entomological data collections were conducted in 2011 and 2012 by the TDRC using pyrethrum spray-catches, mouth-aspirated hand catches and Centers for Disease Control and Prevention (CDC) light-trap methods to determine vector species and indoor densities. Malaria vectors were identified morphologically as Anopheles gambiae s.l. and Anopheles funestus s.l. using standard keys [20 ,21 ]. Insecticide resistance profiles of malaria vectors were determined for 4% DDT and 0.05% deltamethrin using the standard World Health Organization (WHO) tube assay protocol [22 ].
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