Background\ud
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Malaria continues to be a major public health problem in Africa. In Tanzania alone, thereare an estimated 17 to 20 million malaria cases per year resulting in approximately100,000 deaths. The main strategies to control malaria are vector control through insecticide treated nets (ITNs) and idoor residual spraying (IRS), intermittent preventive treatment during pregnancy (IPTp) and early diagnosis and prompt and effective treatment of cases. In 2001, the first Malaria Mid-Term Strategic Plan (MMTSP) was launched in Tanzania followed by the second MMTSP implemented in 2008. In order to evaluate the MMTSP, the NMCP conducted 4 cross-sectional community-based surveys in the years 2001, 2003, 2005 and 2008, as well as one survey collecting only malaria biomarkers in 2006. The findings of the latest survey are presented and analyzed in the present work.\ud
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Methods\ud
The NMCP 2008 malaria indicator survey was carried out in 21 malaria sentinel districts, one per region, in Mainland Tanzania. Demographic data of all household members and information on mosquito net availability and use was collected, as well as data on use of IPTp and prompt and effective treatment of fever in children. Further, malaria prevalence and haemoglobin levels were tested in children under the age of five years and in currently pregnant women. In the analysis, logistic regressions with the outcome variables net use, prevalence of malaria and anaemia, and linear regressions with the outcome haemoglobin level were conducted, using location, altitude, distance to health facility, sex and age group as explanatories.\ud
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Data found in this work was compared with both, the Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS) and the Tanzania National Insecticide Treated Nets Programme (NATNETS) survey (both conducted in 2008). Principle findings 8377 households were interviewed with a total population of 40,135. 65% of the households owned at least one mosquito net and 40% owned at least one ITN. Household net ownership was associated with location, altitude and distance to health facility. 42% of the population slept under a net the night before the survey and 27% under an ITN.\ud
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Location, distance to health facility, sex and age group were significant determinants for net use. Among children under the age of five years, net use was found to be 49% for any net and 33% for ITN, while among pregnant women it was 47% for any net and 31% for ITN. Overall, household net ownership and personal net use increased over the survey years.\ud
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Malaria and anaemia prevalence among children was 16.1% and 5.6%, respectively. Malaria prevalence was associated with location, altitude, age group and use of ITN, while anaemia prevalence was associated with altitude and age group. Both, prevalence of anaemia and malaria among children under five decreased between 2006 and 2008. 26% of the children reported to have had a fever during the past two weeks. 15% of these children received the first line antimalarial drug within 24 hours from onset. 76% of the women who had delivered during the two years prior to the survey used IPTp and 44% took at least two doses of SP as IPTp.\ud
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Discussion\ud
It was shown that increasing coverage of malaria prevention and control interventions is negatively correlated with malaria and anaemia prevalences, hence lower prevalences for both conditions. The results of the NMCP survey were similar to those of the THMIS and the NATNETS survey and were as well externally confirmed by other studies.\ud
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