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An Epidemiological Profile of Malaria and Its Control in Ghana

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An Epidemiological Profile of Malaria and its Control in Ghana Report prepared by National Malaria Control Programme, Accra, Ghana & University of Health & Allied Sciences, Ho, Ghana & AngloGold Ashanti Malaria Control Program, Obuasi, Ghana & World Health Organization, Country Programme, Accra, Ghana & The INFORM Project Department of Public Health Research Kenya Medical Research Institute - Wellcome Trust Progamme Nairobi, Kenya Version 1.0 November 2013 Acknowledgments The authors are indebted to the following individuals from the MPHD, KEMRI-Oxford programme: Ngiang-Bakwin Kandala, Caroline Kabaria, Viola Otieno, Damaris Kinyoki, Jonesmus Mutua and Stella Kasura; we are also grateful to the help provided by Philomena Efua Nyarko, Abena Asamoabea, Osei-Akoto and Anthony Amuzu of the Ghana Statistical Service for help providing parasitological data on the MICS4 survey; Catherine Linard for assistance on modelling human population settlement; and Muriel Bastien, Marie Sarah Villemin Partow, Reynald Erard and Christian Pethas-Magilad of the WHO archives in Geneva. We acknowledge in particular all those who have generously provided unpublished data, helped locate information or the geo-coordinates of data necessary to complete the analysis of malaria risk across Ghana: Collins Ahorlu, Benjamin Abuaku, Felicia Amo-Sakyi, Frank Amoyaw, Irene Ayi, Fred Binka, David van Bodegom, Michael Cappello, Daniel Chandramohan, Amanua Chinbua, Benjamin Crookston, Ina Danquah, Stephan Ehrhardt, Johnny Gyapong, Maragret Gyapong, Franca Hartgers, Debbie Humphries, Juergen May, Seth Owusu-Agyei, Kwadwo Koram, Margaret Kweku, Frank Mockenhaupt, Philip Ricks, Sylvester Segbaya, Harry Tagbor and Mitchell Weiss. The authors also acknowledge the support and encouragement provided by the RBM Partnership, Shamwill Issah and Alistair Robb of the UK government's Department for International Development (DFID), Claude Emile Rwagacondo of the West African RBM sub- regional network and Thomas Teuscher of RBM, Geneva. This work was supported by grants from The Wellcome Trust, UK to Professor Bob Snow (# 079080) and Dr Abdisalan Mohamed Noor (# 095127) and a contract between the University of Oxford and RBM with funds provided by DFID-UK. Suggested citation: National Malaria Control Programme, University of Health & Allied Sciences, AGA Malaria Control Programme, World Health Organization and the INFORM Project (2013). An epidemiological profile of malaria and its control in Ghana. A report prepared for the Ministry of Health, Ghana, the Roll Back Malaria Partnership and the Department for International Development, UK. November, 2013 i Author details Keziah L Malm, Wahjib Mohammed, James Frimpong, Vivian NA Aubyn, Godson Osae, Aba Baffoe-Willmot, & Constance Bart-Plange National Malaria Control Programme, Ghana Health Service, Ministry of Health, P.O.Box KB 493, Korle-Bu, Accra, Ghana Emails: [email protected] Fred Binka & Frank Baiden University of Health and Allied Sciences PMB 31, Ho, Ghana Email: [email protected] Sylvester Segbaya & Frank P Amoyaw AngloGold Ashanti Malaria Control Program, Obuasi PO Box 10, Obuasi, Ghana Email: [email protected] Felicia Owusu-Antwi World Health Organization, Country Office PO Box MB 142, Accra, Ghana Email: [email protected] Abdisalan M Noor, Clara W Mundia, Bernard Mitto, Punam Amratia & Robert W Snow The INFORM Project Department of Public Health Research, KEMRI-Wellcome Trust Programme P.O.Box 43640 00100 Nairobi, Kenya Email: [email protected] ii Table of Contents Executive Summary ................................................................................................................................ 1 Chapter 1: Introduction .......................................................................................................................... 2 Chapter 2: Country context, administration, population & health services .......................................... 6 2.1 Location ......................................................................................................................................... 7 2.2 Social and political evolution ........................................................................................................ 7 2.3 Economy ........................................................................................................................................ 8 2.4 Decentralization & administrative boundaries ............................................................................. 9 2.5 Poverty ........................................................................................................................................ 11 2.6 Child survival ............................................................................................................................... 12 2.7 Population growth and distribution ............................................................................................ 14 2.8 Urbanization ................................................................................................................................ 16 2.9 Health services ............................................................................................................................ 18 2.9.1 Evolution of the current health services in Ghana ........................................................ 18 2.9.2 Development of health facility database and mapping................................................. 19 2.10 References................................................................................................................................. 22 Chapter 3: The first 100 years of malaria control ................................................................................ 26 3.1 Background ................................................................................................................................. 27 3.2 Malaria control pre-World War II ............................................................................................... 27 3.3 Malaria control during World War II ........................................................................................... 31 3.4 Malaria control in the 1950s ....................................................................................................... 33 3.4.1 Chemoprohylaxis trials ...................................................................................................... 33 3.4.2 Ghana-1 project ................................................................................................................. 35 3.5 Malaria control 1970-1999 ......................................................................................................... 36 3.6 The Roll Back Malaria era 2000-2015 ......................................................................................... 39 3.7 References................................................................................................................................... 41 Chapter 4: Mapping malaria transmission intensity............................................................................. 45 4.1 Previous malaria map use in Ghana ............................................................................................ 46 4.2 Malaria parasite prevalence data assembly, modeling and risk mapping .................................. 50 4.2.1 Parasite prevalence data search strategy ....................................................................... 50 4.2.2 Data abstraction .............................................................................................................. 52 4.2.3 Data geo-coding .............................................................................................................. 52 4.2.4 Database fidelity checks, exclusions and pre-processing ............................................... 54 4.2.5 Age standardization ........................................................................................................ 55 4.2.6 Parasite prevalence data summaries .............................................................................. 55 4.3 Model Based Geostatistical modeling of age-corrected parasite prevalence ........................... 56 4.3.1 Model form ..................................................................................................................... 56 4.3.2 Selection of covariates .................................................................................................... 57 4.4 Model predictions and populations at risk ................................................................................ 60 4.5 Model uncertainty and validation statistics ............................................................................... 64 4.6 Other parasite species ............................................................................................................... 65 4.7 Malaria seasonality .................................................................................................................... 66 4.8 Special control areas: combined mapped images for control ................................................... 68 iii 4.9 References.................................................................................................................................. 71 Chapter 5: Dominant malaria vectors in Ghana .................................................................................. 79 5.1 Background ................................................................................................................................
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