title: A marked decline in the incidence of malaria in a remote region of Malaita, Solomon Islands, 2008 to 2013.
abstract: METHODS
  Atoifi Adventist Hospital (AAH), Solomon Islands, the only hospital in the East Kwaio region.
  
  
  OBJECTIVE
  To use routine surveillance data to assess the trends in malaria from 2008 to 2013.
  
  
  METHODS
  Descriptive study of records from (1) AAH laboratory malaria records; (2) admissions to AAH for malaria; and (3) malaria treatments from outpatient records.
  
  
  RESULTS
  AAH examined 35 608 blood films and diagnosed malaria in 4443 samples comprised of 2667 Plasmodium falciparum (Pf) and 1776 Plasmodium vivax (Pv). Between 2008 and 2013 the total number of malaria cases detected annually decreased by 86.5%, Pf by 96.7% and Pv by 65.3%. The ratio of Pf to Pv reversed in 2010 from 2.06 in 2008 to 0.19 in 2013. For 2013, Pf showed a seasonal pattern with no cases diagnosed in four months. From 2008 to 2013 admissions in AAH for malaria declined by 90.8%, and malaria mortality fell from 54 per 100 000 to zero. The annual parasite index (API) for 2008 and 2013 was 195 and 24, respectively. Village API has identified a group of villages with higher malaria incidence rates.
  
  
  CONCLUSIONS
  The decline in malaria cases in the AAH catchment area has been spectacular, particularly for Pf. This was supported by three sources of hospital surveillance data (laboratory, admissions and treatment records). The decline was associated with the use of artemisinin-based combined therapy and improved vertical social capital between the AAH and the local communities. Calculating village-specific API has highlighted which villages need to be targeted by the AAH malaria control team.
authors.affiliation: Atoifi Adventist Hospital, Atoifi, Malaita, Solomon Islands .
authors.forename: Hellen
authors.initials: H
authors.lastname: Oloifana-Polosovai
authors.affiliation: Atoifi Adventist Hospital, Atoifi, Malaita, Solomon Islands .
authors.forename: John
authors.initials: J
authors.lastname: Gwala
authors.affiliation: Atoifi Adventist Hospital, Atoifi, Malaita, Solomon Islands .
authors.forename: Humpress
authors.initials: H
authors.lastname: Harrington
authors.affiliation: Health Protection, Hunter New England Population Health, Tamworth, Australia .
authors.forename: Peter D
authors.initials: PD
authors.lastname: Massey
authors.affiliation: Atoifi Adventist Hospital, Atoifi, Malaita, Solomon Islands .
authors.forename: Elmer
authors.initials: E
authors.lastname: Ribeyro
authors.affiliation: Atoifi Adventist Hospital, Atoifi, Malaita, Solomon Islands .
authors.forename: Angelica
authors.initials: A
authors.lastname: Flores
authors.affiliation: Tropical Health Solutions Pty Ltd, Townsville, Australia .
authors.forename: Christopher
authors.initials: C
authors.lastname: Speare
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Australia .
authors.forename: Edwin
authors.initials: E
authors.lastname: McBride
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Australia .
authors.forename: David
authors.initials: D
authors.lastname: MacLaren
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia .
authors.forename: Rick
authors.initials: R
authors.lastname: Speare
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008542:Melanesia / Q000453:epidemiology; D008875:Middle Aged; D010963:Plasmodium falciparum; D010966:Plasmodium vivax; D011159:Population Surveillance / Q000379:methods; D012621:Seasons; D066270:Social Capital; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin