Guidelines for the control of malaria in Zambia with emphasis on curative and prophylactic aspects

ABSTRACT

Malaria is endemic in all of Zambia and is a leading cause of morbidity and mortality. It is the most common cause of hospital admissions for all age groups. During the period 1976-1986; there has been a four-fold increase in the number of hospital deaths due to malaria and more than doubling of new cases. The incidence (new cases per year per 1000 population) has steadly increased from 137.8 in 1978 to 287.9 in 1988. The hospital case fatality rate has sharply increased; more than doubling from 13.9 per 1000 in 1978 to 74.8 per 1000 1988. The figures are an underestimate of the true epidemiological picture of malaria in the country as they represent only reported cases from public health institutions excluding information from the private practitioners and people who self treat their malaria when they fall ill. Factors influencing these trends include increasing disease virulence; increase in chloroquine resistant strains; loss herd immunity and changes in community prophylaxis