1. Impact of Malaria Control activities on Anemia on Bioko Island, Equatorial Guinea Luis Benavente1/ Immo Kleinschmidt2 1 Director, Improving Malaria Diagnostics Project, Medical Care Development International 2 London School of Hygiene and Tropical Medicine
2. Pre-intervention period March 1999 to Feb 2004 Intervention period starting March 2004 Malaria Indicator, Under 5 mortality and serology survey Annual malaria indicator surveys Baseline Malaria Indicator & under 5 mortality survey 2004 2005 2006 2007 2008 2009 2010 Year March 1999 Timelines of intervention and monitoring activities, 2004 to 2010 Malaria indicator surveys
21. Dietary counseling: Fe-rich foods If the diet is low in Fe-rich foods, iron supplements are more important than ever
22. Anemia classification and management at community level 200 mg iron sulphate / day + folic acid Double dose of iron sulphate x 3 months Continue 200 mg FeSO4/day No symptoms: as above Symptoms: refer as below Refer to level capable to do safe transfusions
23. Credits and acknowledgements Project funded by a consortium led by Marathon Oil Corp: Noble Energy, Atlantic Methanol, Sonagas, GEP, SK of Korea, and the Government of Equatorial Guinea. PDA survey program written by D. Jituboh, C. Schwabe and A. Wolkon (CDC). Survey data collected by enumerators and supervisors, too many to name. Survey data analyzed by LB, IK, C. Schwabe, L. Segura, G. Baltazar, and M. Worges.
Editor's Notes
The BIMCP received TA from CDC and financial support from USAID/PMI for the development of EG’s HIS
IRS started in early 2004 and ITN distribution in late2007
Surveys include parasitemia (RDT, validades confirmed by PCR in selected locations) and HB (Hemocue)
Proportion with anemia –by severity- and age
Excluding Moka- an island withinand island
Variables: age, parasitemia and hemoglobin (as a continuous variable)
Variables: year, age group, parasitemia and anemia
ANC coverage fluctuated widely during BIMCP-I, possibly reflecting availability of SP and other supplies. ANC seems to protect against marked-severe anemia but not against mild-moderate anemia
Before the BIMCP distributed bednets in late 07 consistent use by pregnant women was infrequent.% of pregnant women sleeping under an ITN the night prior to the survey was 53% in 2008 and 27% in 2009. Since 2009 ANC distribute ITNs to all pregnant women.
Consistent net use had a weak association with parasitemia, none with anemia
During routine ANC visits fever was a poor predictive of malarial infection, only headache, similar studies in Nigeria and Madagascar have show low specificity of fever to predict malarial parasitemia
Fe supplements seem to protect against marked-severe anemia but not against mild-moderate anemia
Parasitemia strongly associated to anemia, particularly marked-severe. National ANC guidelines, consistent with WHO’s , request testing for uncommon conditions but not testing of asymptomatic pregnant women for malaria parasites
Variables: year, maternal marked-severe anemia and Pf parasitemia
