Effect of a Malaria Control Program on the Prevalence of Malaria, Fever and Anaemia in Children under Five Years in the Hohoe Municipality of Ghana: A Comparative Analysis of Cross-Sectional Surveys


Background: Malaria and anaemia continue to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission. In 2006, malaria control programme activities which provided In-secticide Treated Bed-Nets (ITNs) to resident children under five years and Artemisinin Combination Therapies (ACTs) for the management of malaria were introduced into the Hohoe Municipality. Before the introduction of the control programme, baseline surveys were carried out in communities in the Hohoe municipality to determine the prevalence of malaria, fever, anaemia, malaria parasite density, gametocytaemia and ITN ownership and use in June and November 2006 ahead of the intervention programme. Similar surveys were conducted in 2010 after the intervention to assess changes in the earlier indicators in the same communities. This report presents an evaluation of the intervention by comparing findings before and after the malaria control interventions. Methods: In 2010, two community-based surveys were carried out in thirty communities among children aged five years and below. The first one was at the beginning of the rainy and high malaria transmission season in June and the other was in November at the end of the rainy season. The surveys were to determine the prevalence of malaria, fever, anaemia and ITN ownership, use and effectiveness among children less than 5 years. Data were collected in the form of interviews using questionnaire and collection of biological samples. Findings were compared to those similar surveys conducted in the same communities and age groups in 2006. Pr-testi was used to analyze two sample tests for proportions and t-test was used for means. Findings: Malaria prevalence decreased by 20% [9.0% vs. 7.2%; p = 0.0.40], fever decreased by 47.8% [2.3% vs. 1.2%; p = 0.008] and anaemia decreased by 32.9% [7.8% vs. 5.3%; p = 0.002]. ITN ownership increased by 67.9% [20.8% vs. 64.8%; p < 0.001], ITN use increased by 64.2% [15.1% vs. 42.2%; p < 0.001] and ITN effectiveness increased by 41.7% [20.0% vs. 34.3%; p < 0.001]. The proportion of children with high density parasitaemia reduced by 17.9% [2.8% vs. 2.3%; p = 0.223]. Gameto-cytaemia decreased by 82.5% [0.8% vs. 0.14%; p = 0.002. Similarly data comparing 2006 and 2010 post-rainy season showed that malaria prevalence decreased by 16.8% [40.4% vs. 33.6%; p < 0.001], fever decreased by 14% [5.0% vs. 4.3%; p = 0.347] and anaemia decreased by 64.2% [12% vs. 4.3%; p < 0.001]. The proportion of children with high density parasitaemia also reduced by 69.5% [10.5% vs. 3.2%; p < 0.001] and gametocytaemia decreased by 78.5% [0.8% vs. 0.17%; p = 0.008]. Conclusion: This study suggested that there was an association between the current intervention and reduction in the prevalence of malaria, fever and anaemia. High parasite density and gametocytaemia prevalence have also significantly reduced over the five years of the introduction of the control measures. There has also been a significant increase in the ownership and use of ITNs.

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Kweku, M. , Appiah, E. , Takramah, W. , Enuameh, Y. , Norman, I. and Binka, F. (2015) Effect of a Malaria Control Program on the Prevalence of Malaria, Fever and Anaemia in Children under Five Years in the Hohoe Municipality of Ghana: A Comparative Analysis of Cross-Sectional Surveys. Advances in Infectious Diseases, 5, 180-188. doi: 10.4236/aid.2015.54023.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Oresanya, O.B., Hoshen, M. and Sofola, O.T. (2008) Utilization of Insecticide-Treated Nets by Under-Five Children in Nigeria: Assessing Progress towards the Abuja Targets. Malaria Journal, 7, 145. http://dx.doi.org/10.1186/1475-2875-7-145
[2] Baume, C.A. and Marin, M.C. (2008) Gains in Awareness, Ownership and Use of Insecticide-Treated Nets in Nigeria, Senegal, Uganda and Zambia. Malaria Journal, 7, 153. http://dx.doi.org/10.1186/1475-2875-7-153
[3] (2007) Ghana Health Service/Ministry of Health Annual Report.
[4] (2008) Global Malaria Action Plan.
[5] (2007) World Malaria Report.
[6] (2008) World Health Organisation Report. Malaria Facts Sheet No. 94.
[7] (2014) Hohoe Municipal Health Directorate Annual Report.
[8] (2014) Hohoe Municipal Hospital Annual Report.
[9] Koram, K.A., Abuaku, B., Duah, N. and Quashie, N. (2005) Comparative Efficacy of Antimalarial Drugs including ACTs in the Treatment of Uncomplicated Malaria among Children under 5 Years in Ghana. Acta Tropica, 95, 194-203. http://dx.doi.org/10.1016/j.actatropica.2005.06.018
[10] (2005) Strategic Plan for Malaria Control in Ghana Handbook.
[11] (2008) Ghana Demographic and Health Survey.
[12] (2009) Ministry of Health Strategic Plan for Malaria Control in Ghana 2008-2015.
[13] (2009) Ministry of Health Anti-Malarial Drug Policy for Ghana.
[14] Binka, F. and Akweongo, P. (2006) Prevention of Malaria Using ITNs: Potential for Achieving the Millennium Development Goals. Current Molecular Medicine, 6, 261-267.
[15] Bhatttarai, A., Sali, A., Kachur, S.P., Martensson, A., Abbab, A.K., Khatid, R., Al-Mafazy, A.W., Ramsan, M., Rotllant, G., Gerstenmaier, J.F., Molteni, F., Abdulla, S., Montgomery, S., Kaneko, A. and Bjorkman, A. (2007) Impact of Artemisinin-Based Combination Therapy and Insecticide-Treated Nets on Malaria Burden in Zanziba. PLoS Medicine, 4, e309. http://dx.doi.org/10.1371/journal.pmed.0040309
[16] Delacollete, C., D’Souza, C., Chrstophel, E., Thimasaran, K., Abdur, R., Bell, D., Dai, T.C., Gopinath, D., Lu, S., Mendoza, R., Ortega, L., Rastrogi, R., Tantinimitkul, C. and Ehrenberg, J. (2009) Malaria Trends and Challenges in the Greater Mekoy Subregion. Southeast African Journal Tropical Medicine Public Health, 40, 674-691.
[17] Kweku, M., Liu, D., Adjuik, M., Binka, F., Seidu, M., Greenwood, B. and Chandramohan, D. (2008) Seasonal Intermittent Preventive Treatment for the Prevention of Anaemia and Malaria in Ghanaian Children: A Randomized, Placebo Controlled Trial. PLoS ONE, 3, e4000.
[18] (2010) Ghana National Population Census.
[19] Sievers, A.C., Lewey, J., Musafir, I.P., Fianke, M.F., Bucyibaruta, B.J., Stulac, S.N., Rich, M.L., Karema, C. and Daily, J.P. (2008) Reduced Paediadtic Hospitalizations for Malaria and Febrile Illness Patterns Following Implementation of Community-Based Malaria Control Programme in Rural Rwanda. Malaria Journal, 7, 167. http://dx.doi.org/10.1186/1475-2875-7-167
[20] Curtis, C.F., Maxwell, C.A., Magesa, S.M., Rwegoshora, R.T. and Wikes, T.J. (2006) Insecticide-Treated Bed-Nets for Malaria Mosquito Control. Journal of the American Mosquito Control Association, 22, 501-506. http://dx.doi.org/10.2987/8756-971X(2006)22[501:IBFMMC]2.0.CO;2
[21] Pardo, G., Descalzo, M.A., Molina, L., Custodio, E., Lwanga, M., Mangue, C., Obono, J., Nchama, A., Roche, J., Benito, A. and Cano, J. (2006) Impact of Different Strategies to Control Plasmodium Infection and Anaemia on the Island of Bioko (Equitorial Guinea). Malaria Journal, 5, 10.

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