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Zambia: Malaria Indicator Survey (MIS) 2006 results at a glance
1. ITN coverage and use
There has been an approximate doubling of coverage with ITNs nationally since 2002 with a 3-4-fold increase in the proportion of children under the age of 5 sleeping under an ITN. There is still much coverage and use to be achieved given the Abuja target of 60% coverage (red line) and the Zambia-specific coverage target of 80% of HHs with an average of 3 nets per household (HH).
IRS is carried out in 15 districts, and is mainly targeted to urban areas. Where carried out, IRS coverage varied greatly, reaching up to 77% in the Central province. The data presented is based on all households within these target districts; additional analysis is required to assess specific coverage per IRS-eligible HH. There is not data from past surveys for comparison.
a. Febrile children
There has been little if any change in the pattern of prompt treatment of fever illness in young children. Most drugs are obtained from government (public) health facilities or health workers (85%). Despite the national policy to use ACTs* (Coartem) as first line drug, SP** was used 3 times more often than Coartem (data not shown) and PECM coverage with Coartem is currently low (12.6% nationwide estimate). Red line represents the Abuja target.
*ACT: artemisinin-based combination therapy
b. Intermittent preventive treatment in pregnant women
Coverage of the two malaria prevention interventions in pregnancy has doubled since 2002. Zambia has exceeded the original Abuja targets (red line) for IPTp (>60%) full coverage with 2 or more doses (no data available for the DHS 2002 study). ITN coverage and use reflects that found in the general population (see data for children above). Variability in coverage rates by Province remains large (e.g., 2+ doses of IPTp during pregnancy varies from 47% to 83% between Provinces) (data not shown).
Children under 6 years of age living in a house with two or more mosquito nets had 51% less malaria infection compared to those in houses without a mosquito net or IRS.
Overall, 16% of children under 6 years of age suffer from severe anemia. Children living in a house with two or more mosquito nets had 30% less severe anemia compared to those in houses without a mosquito net or IRS. In the most vulnerable group <36 months old, mosquito nets were associated with a 56% reduction in severe anemia. Consistent with many other studies, malaria-associated anemia was much less common after age 3 and minimally affected by the interventions.
Malaria Interventions coverage by wealth index