title: How much malaria occurs in urban Luanda, Angola? A health facility-based assessment.
abstract: We conducted a health facility-based survey of patients with fever during malaria transmission season to determine the proportion with laboratory-confirmed malaria in Luanda, Angola. We enrolled 864 patients at 30 facilities; each underwent a blood film for malaria and a questionnaire. Only 3.6% had a positive blood film. When stratified by distance of the facility to city center (< 15 km and > or = 15 km), the proportions were 1.5% (9/615) and 8.8% (22/249), respectively (P < 0.0001). Of patients traveling outside Luanda in the preceding 3 months, 6.8% (6/88) had malaria, compared with 3.2% (26/776) not traveling (P = 0.13). Children < 5 years of age were less likely to have malaria (2.4%; 12/510) than children ages 5-14 (8.7%; 9/104) and adults (4.0%; 10/250) (P = 0.03). The prevalence of laboratory-confirmed malaria in febrile patients in Luanda is very low, but increases with distance from the urban center. Prevention and treatment should be focused in surrounding rural areas.
authors.affiliation: Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. jthwing@cdc.govc
authors.forename: Julie I
authors.initials: JI
authors.lastname: Thwing
authors.forename: Jules
authors.initials: J
authors.lastname: Mihigo
authors.forename: Alexandra Pataca
authors.initials: AP
authors.lastname: Fernandes
authors.forename: Francisco
authors.initials: F
authors.lastname: Saute
authors.forename: Carolina
authors.initials: C
authors.lastname: Ferreira
authors.forename: Filomeno
authors.initials: F
authors.lastname: Fortes
authors.forename: Alexandre Macedo
authors.initials: AM
authors.lastname: de Oliveira
authors.forename: Robert D
authors.initials: RD
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D000810:Angola / Q000453:epidemiology; D001512:Bedding and Linens; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006268:Health Facilities; D006801:Humans; D007306:Insecticides / Q000494:pharmacology; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D009032:Mosquito Control / Q000379:methods; D014505:Urban Population
chemical_list: D007306:Insecticides