Assessing the effects of malaria interventions on the geographical distribution of parasitaemia risk in Burkina Faso.
BACKGROUND
Burkina Faso conducted its first nationally representative household malaria survey in 2010/2011. The survey collected among others, information on malaria interventions, treatment choices and malaria parasite prevalence in children aged 6-59 months.


METHODS
In this study, Bayesian geostatistical models were employed to assess the effects of health interventions related to insecticide-treated bed nets (ITN), indoor residual spray (IRS), artemisinin-based combination therapy (ACT) coverage associated with childhood malaria parasite risk at national and sub-national level, after taking into account geographical disparities of climatic/environmental and socio-economic factors. Several ITN coverage measures were calculated and Bayesian variable selection was used to identify the most important ones. Parasitaemia risk depicting spatial patterns of infections were estimated.


RESULTS
The results show that the predicted population-adjusted parasitaemia risk ranges from 4.04 % in Kadiogo province to 82 % in Kompienga province. The effect of ITN coverage was not important at national level; however ITNs have an important protective effect in Ouagadougou as well as in three districts in the western part of the country with high parasitaemia prevalence and low to moderate coverage. There is a large variation in ACT coverage between the districts. Although at national level the ACT effects on parasitaemia risk was not important, at sub-national level 18 districts around Ouagadougou deliver effective treatment.


CONCLUSIONS
The produced maps show great variations in parasitaemia risk across the country and identify the districts where interventions are being effective. These outputs are valuable tools that can help improve malaria control in Burkina Faso.
Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland.|University of Basel, Basel, Switzerland.|Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
Eric
E
Diboulo
Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland.
Ali
A
Sié
Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland. penelope.vounatsou@unibas.ch.|University of Basel, Basel, Switzerland. penelope.vounatsou@unibas.ch.
Penelope
P
Vounatsou
D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage; D037621:Artemisinins / Q000008:administration & dosage; D001499:Bayes Theorem; D002050:Burkina Faso / Q000453:epidemiology; D002675:Child, Preschool; D002980:Climate; D009033:Culicidae; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data; D007306:Insecticides; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D018512:Parasitemia / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment
D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D007306:Insecticides; C031327:artemisinin
Bayesian geostatistical models; Burkina Faso; Geographical distribution; Malaria intervention effects; Parasitaemia risk