Karen Barnes|David N Dürrheim|Francesca Little|Amanda Jackson|Ushma Mehta|Elizabeth Allen|Siphiwe N. Dlamini|Joyce Mahlako. Tsoka|B. L. F. Bredenkamp|D.J. Mthembu|Nicholas J. White|Brian Sharp
Effect of Artemether-Lumefantrine Policy and Improved Vector Control on Malaria Burden in KwaZulu–Natal, South Africa
University of Cape Town|Hunter New England Local Health District|University of Cape Town|South African Medical Research Council|University of Cape Town|University of Cape Town|South African Medical Research Council|South African Medical Research Council|South African Medical Research Council|Churchill Hospital|Mahidol Oxford Tropical Medicine Research Unit|Mahidol University|South African Medical Research Council
background 1995 2000 kwazulunatal province south africa experienced marked increase plasmodium falciparum malaria fuelled pyrethroid sulfadoxinepyrimethamine resistance response vector control strengthened artemetherlumefantrine al deployed first ministry health artemisininbased combination treatment policy africa south africa effective vector parasite control historically ensured lowintensity malaria transmission malaria diagnosed definitively treatment provided free charge reasonably accessible publicsector healthcare facilities methods findings reviewed four years malaria morbidity mortality data four sentinel healthcare facilities within kwazulunatals malariaendemic area year following improved vector control implementation al treatment malariarelated admissions deaths declined 89 outpatient visits decreased 85 sentinel facilities 2003 malariarelated outpatient cases admissions fallen 99 malariarelated deaths decreased 97 concomitant marked sustained decline notified malaria throughout province serious adverse events associated causally al treatment active sentinel pharmacovigilance survey prospective study 42 follow al cured 9798 99 prevented gametocyte developing patients consistent findings focus group discussions household survey found selfreported adherence sixdose al regimen 96 conclusion together concurrent strengthening vector control measures antimalarial treatment policy change al kwazulunatal contributed marked sustained decrease malaria cases admissions deaths greatly improving clinical parasitological cure rates reducing gametocyte carriage