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An Epidemiological Profile of Malaria in Mali

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An Epidemiological Profile of Malaria in Mali Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé, Bamako, Mali Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali The INFORM Project (www.inform-malaria.org) Kenya Medical Research Institute - Wellcome Trust Programme Nairobi, Kenya February 2015 Author details Diakalia Koné Programme National de Lutte contre le Paludisme Ministère de la Santé, B.P. 232, Bamako, Mali Email: [email protected] Drissa Coulibaly, Ogobara Doumbo Malaria Research and Training Centre University of Bamako, B.P. E.1805, Bamako, Mali Email: [email protected]; [email protected] Ibrahima-Socé Fall World Health Organization, AFRO B.P. 99, Bamako, Mali Email: [email protected] Eliud Kibuchi, Bernard Mitto, Gilbert Sang, David Kyalo, Robert W Snow and Abdisalan M Noor INFORM, Information for Malaria Project Department of Public Health Research KEMRI-Wellcome Trust Programme Nairobi, Kenya Email: [email protected] 2 Acknowledgments The authors would like to especially acknowledge Dr Seydou Fomba of the PNLP and Mahamadou A Thera of the MRTC who have supported this project throughout. We are indebted to Stella Kasura of the INFORM Project, KEMRI-Wellcome Trust programme for technical and administrative support; Catherine Linard for assistance in modelling human population settlement; Muriel Bastien, Marie Sarah Villemin Partow, Reynald Erard and Christian Pethas- Magilad of the WHO archives in Geneva; Christian Sany, Catherine Cecilio and Agnès Raymond- Denise of the Scientific Media Library and Archives at the Institut Pasteur, Paris and Dirk Schoonbaert Librarian – Institute of Tropical Medicine Antwerp. The following national scientists and their international collaborators have provided access to unpublished data or have helped geo-locate survey locations and health facilities for the purposes of this report: Modibo Bamadio, Sian Clarke, Amadou Baïlo Diallo, Diadier Diallo, Seybou Diarra, Alassane Dicko, Abdoulaye Djimde, Boubacar Maiga, Natalie Roschnik, Saba Rouhani, Massambou Sacko, Issaka Sagara, Mahamadou Sissoko, Sékou F Traoré, Guimogo Dolo, Ousmane Toure, Manijeh Vafa. Mahamadou A Thera, Abdoulaye K Koné, Karim Traoré, Amadou Niangaly, Modibo Daou and Abdoualye Dabo have provided help in translation into French. Finally the authors acknowledge the support and encouragement provided by Alistair Robb of the UK government's Department for International Development (DFID) and Thomas Teuscher of RBM, Geneva. This work was supported by funds provided by the RBM partnership through DFID- UK support and grants from The Wellcome Trust, UK to Professor Bob Snow (# 079080) and Dr Abdisalan Mohamed Noor (# 095127). Suggested citation: PNLP, MRTC and INFORM (2015). An epidemiological profile of malaria in Mali. A report prepared for the Ministry of Health, Mali, the Roll Back Malaria Partnership and the Department for International Development, UK. February, 2015. 3 Contents Author details ............................................................................................................................................... 2 Acknowledgments ......................................................................................................................................... 3 1. Introduction .............................................................................................................................................. 5 2. Country context ........................................................................................................................................ 6 2.1. Location and geographical features................................................................................................... 6 2.2. Climate............................................................................................................................................... 7 2.3. Economy, natural resources and poverty .......................................................................................... 9 2.4. Population distribution .................................................................................................................... 10 2.5. Conflict and refugee populations .................................................................................................... 12 2.6. Health indicators ............................................................................................................................. 12 2.7. Decentralized planning .................................................................................................................... 14 2.8. Health delivery structure and facility mapping ................................................................................ 15 3. 100 years of malaria control ................................................................................................................... 18 4. Mapping the epidemiology of malaria transmission ............................................................................... 25 4.1. The early years: 1900-1999 ............................................................................................................. 25 4.2. Malaria risk stratification 2000-2013 ............................................................................................... 26 4.3. Revised malaria risk maps ................................................................................................................ 32 4.3.1. Background ................................................................................................................................ 32 4.3.2. Assembling empirical data on malaria infection prevalence ..................................................... 32 4.4. Other malaria parasites ................................................................................................................... 37 5. Dominant vectors and bionomics ........................................................................................................... 38 5.1. Background ...................................................................................................................................... 38 5.2. Historical studies on malaria entomology in Mali ............................................................................ 38 5.3. Data assembly .................................................................................................................................. 39 5.4. The Anopheles distribution database .............................................................................................. 39 5.5. Insecticide resistance in Mali ........................................................................................................... 44 6. ITN and IRS coverage 2000-2013 ............................................................................................................ 47 6.1. Background to insecticide treated net (ITN) distribution 2000-2014 .............................................. 47 6.2. Changing coverage of ITNs nationally .............................................................................................. 48 6.4. Modelling spatial aggregates of ITN coverage using Small Area Estimation .................................... 49 6.5. Indoor Residual Spraying of houses ................................................................................................. 51 7. Seasonal Malaria Chemoprevention – target districts and populations from 2014-2015 ...................... 54 7.1. Background ...................................................................................................................................... 54 7.2. Methods and outputs ...................................................................................................................... 55 7.2.1. Overview of methods ................................................................................................................ 55 7.3. SMC implementation activities in Mali ............................................................................................ 58 7.3.1 Challenges in implementation of SMC activities in Mali ............................................................. 60 8. Conclusions and future recommendations ............................................................................................. 60 8.1 Defining the spatial extents of P. falciparum risk ............................................................................. 61 8.2 Mapping of vector control intervention coverage at health decision making units ......................... 61 8.3 Health service mapping needs .......................................................................................................... 62 8.4 Seasonal malaria chemoprevention ................................................................................................. 63 Annex A ....................................................................................................................................................... 64 A.1. Parasite prevalence data assembly .............................................................................................. 64 A.2. Model development ..................................................................................................................... 70 Annex B Small area Estimation using INLA .................................................................................................. 77 B.1. Methods .........................................................................................................................................
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