Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010

In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this...

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Main Authors:	Peak, Corey M., Thuan, Phung Duc, Britton, Amadea, Nguyen, Tran Dang, Wolbers, Marcel, Thanh, Ngo Viet, Buckee, Caroline O., Boni, Maciej F.
Format:	Online
Language:	English
Published:	The American Society of Tropical Medicine and Hygiene 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385779/

id	pubmed-4385779
recordtype	oai_dc
spelling	pubmed-43857792015-04-16 Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010 Peak, Corey M. Thuan, Phung Duc Britton, Amadea Nguyen, Tran Dang Wolbers, Marcel Thanh, Ngo Viet Buckee, Caroline O. Boni, Maciej F. Articles In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8–41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. The American Society of Tropical Medicine and Hygiene 2015-04-01 /pmc/articles/PMC4385779/ /pubmed/25667053 http://dx.doi.org/10.4269/ajtmh.14-0461 Text en ©The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Peak, Corey M. Thuan, Phung Duc Britton, Amadea Nguyen, Tran Dang Wolbers, Marcel Thanh, Ngo Viet Buckee, Caroline O. Boni, Maciej F.
spellingShingle	Peak, Corey M. Thuan, Phung Duc Britton, Amadea Nguyen, Tran Dang Wolbers, Marcel Thanh, Ngo Viet Buckee, Caroline O. Boni, Maciej F. Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
author_facet	Peak, Corey M. Thuan, Phung Duc Britton, Amadea Nguyen, Tran Dang Wolbers, Marcel Thanh, Ngo Viet Buckee, Caroline O. Boni, Maciej F.
author_sort	Peak, Corey M.
title	Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
title_short	Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
title_full	Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
title_fullStr	Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
title_full_unstemmed	Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010
title_sort	measuring the association between artemisinin-based case management and malaria incidence in southern vietnam, 1991–2010
description	In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8–41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not.
publisher	The American Society of Tropical Medicine and Hygiene
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385779/
_version_	1613207784185135104

Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010

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