Major decline in malaria morbidity and mortality in the Union of Comoros between 2010 and 2014: The effect of a combination of prevention and control measures

What is it about?

Background. Malaria remains a public health challenge in sub-Saharan Africa. In response to this, many countries are working towards achieving the World Health Assembly and Roll Back Malaria Partnership target of a 75% decline in malaria incidence. Objective. To assess the trend in malaria morbidity and mortality in the three islands of the Comoros archipelago from 2010 to 2014. Methods. This was a retrospective study in which all confirmed malaria cases and deaths recorded between 2010 and 2014 were accessed using the national malaria control database. Trends and comparisons in malaria incidence and case fatality rates for all age groups, including under-five children and pregnant women, were analyzed using Microsoft Excel and SPSS version 16. Results. A substantial decline in malaria incidence was observed for each island between 2010 and 2014; from 75.98 cases per 1000 population in 2010 to 0.14 cases per 1000 population in 2014 in Moheli, 60.60 to 0.02 cases per 1000 population in Anjouan and 235.36 to 5.47 cases per 1000 population in Grand Comoro. Additionally, a general reduction in malaria case fatality was observed. In Moheli, there were no case fatality rate from 2010 - 2014 while there was a decline in Anjouan (1.20 to 0) and Grand Comoros (0.51 to 0). There was also a significant difference (p<0.05) in malaria incidence and case fatality between the three islands. A similar trend was observed for pregnant women and under-five children. Conclusion. Our study indicates a significant decline in malaria morbidity and mortality in the islands of Moheli, Anjouan and Grand Comoro from 2010 to 2014. This considerable reduction is attributed to the combination of malaria prevention and control interventions implemented during the study period

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