Health Program Publications
Health Program Publications

Malaria Control Program – Articles by Carter Center Experts


March 26, 2014
Malaria Prevalence, Anemia and Baseline Intervention Coverage Prior to Mass Net Distributions in Abia and Plateau States, Nigeria (PDF)
Published by BMC Infectious Diseases, 2014; doi: 10.1186/1471-2334-14-168.
Authors: Gregory S Noland, Patricia M Graves, Adamu Sallau, Abel Eigege, Emmanuel Emukah, Amy E Patterson, Joseph Ajiji, Iheanyichi Okorofor, Oji Uka Oji, Mary Umar, Kal Alphonsus, James Damen, Jeremiah Ngondi, Masayo Ozaki, Elizabeth Cromwell, Josephine Obiezu, Solomon Eneiramo, Chinyere Okoro, Renn McClintic-Doyle, Olusola Oresanya, Emmanuel Miri, Paul M Emerson, and Frank O Richards. Nigeria suffers the world's largest malaria burden, with approximately 51 million cases and 207,000 deaths annually. As part of the country's aim to reduce by 50% malaria-related morbidity and mortality by 2013, it embarked on mass distribution of free long-lasting insecticidal nets (LLINs). This study's results reveal high Plasmodium prevalence and childhood anemia in Abia and Plateau states, low baseline coverage of IRS and LLINs, and sub-optimal net use — especially among age groups with highest observed malaria burden.

March 6, 2014
Estimation of Insecticide Persistence, Biological Activity and Mosquito Resistance to PermaNet® 2 Long-Lasting Insecticidal Nets Over Three to 32 Months of Use in Ethiopia (PDF)
Published by the Malaria Journal, 2014; doi: 10.1186/1475-2875-13-80.
Authors: Gedeon Yohannes Anshebo, Patricia M Graves, Stephen C Smith, Aprielle B Wills, Mesele Damte, Tekola Endeshaw, Estifanos Biru Shargie, Teshome Gebre, Aryc W Mosher, Amy E Patterson, and Paul M Emerson. Information is needed on the expected durability of insecticidal nets under operational conditions. The persistence of insecticidal efficacy is important to estimate the median serviceable life of nets under field conditions and to plan for net replacement.


July 15, 2013
Physical Durability of PermaNet 2.0 Long-Lasting Insecticidal Nets Over Three to 32 Months of Use in Ethiopia (PDF)
Published by the Malaria Journal, 2013; doi: 10.1186/1475-2875-12-242.
Authors: Aprielle B Wills, Stephen C Smith, Gedeon Y Anshebo, Patricia M Graves, Tekola Endeshaw, Estifanos B Shargie, Mesele Damte, Teshome Gebre, Aryc W Mosher, Amy E Patterson, Yohannes B Tesema, Frank O Richards, and Paul M Emerson. Ethiopia scaled up net distribution markedly starting in 2006. Information on expected net life under field conditions (physical durability and persistence of insecticidal activity) is needed to improve planning for net replacement. Standardization of physical durability assessment methods is lacking. This study found that net damage began quickly: more than half the nets had holes by three to six months of use, with 40% of holes being larger than 2 cm. Holes continued to accumulate until 92.5% of nets had holes by 26 to 32 months of use.


Jan. 3, 2013
Disease Eradication
New England Journal of Medicine, Vol 368 No. 1.pp. 53-64. Doi:10.1056/NEJMra1200391
Author: Donald R. Hopkins. Since the last case of naturally-occurring smallpox in 1977, there have been three major international conferences devoted to the concept of disease eradication. Several other diseases have been considered as potential candidates for eradication, but the World Health Organization (WHO) has targeted only two other diseases for global eradication after smallpox. In 1986, WHO's policy-making body, the World Health Assembly, adopted the elimination of dracunculiasis (Guinea worm disease) as a global goal, and it declared eradication of poliomyelitis a global goal in 1988. Although both diseases now appear to be close to eradication, the fact that neither goal has been achieved after more than two decades, and several years beyond the initial target dates for their eradication, underscores the daunting challenge of such efforts, as does the failure of previous attempts to eradicate malaria, hookworm, yaws and other diseases. "Disease Eradication" was published as part one of "A Global View of Health – An Unfolding Series."
Read the overview of the series >


April 20, 2012
Performance of Local Light Microscopy and the ParaScreen Pan/Pf Rapid Diagnostic Test to Detect Malaria in Health Centers in Northwest Ethiopia (PDF)
PLoS ONE 7(4): e33014. doi:10.1371/journal.pone.0033014. This article was reprinted with permission.
Tekola Endeshaw, Patricia M. Graves, Berhan Ayele, Aryc W. Mosher, Teshome Gebre, Firew Ayalew, Asrat Genet, Alemayehu Mesfin, Estifanos Biru Shargie, Zerihun Tadesse, Tesfaye Teferi, Berhanu Melak, Frank O. Richards, Paul M. Emerson.
Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.


April 17, 2011
Which Nets Are Being Used: Factors Associated With Mosquito Net Use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia (PDF)
Published by the Malaria Journal, 2011; doi: 10.1186/1475-2875-10-92.
Authors: Jeremiah M Ngondi, Patricia M Graves, Teshome Gebre, Aryc W Mosher, Estifanos B Shargie, Paul M Emerson, Frank O Richards, and the Ethiopia Malaria Indicator Survey Working Group. There has been recent large scale-up of malaria control interventions in Ethiopia where transmission is unstable. While household ownership of long-lasting insecticidal nets (LLIN) has increased greatly, there are concerns about inadequate net use. This study aimed to investigate factors associated with net use at two time points, before and after mass distribution of nets.


July 21, 2010
Knowledge of Malaria and Its Association with Malaria-Related Behaviors—Results from the Malaria Indicator Survey, Ethiopia, 2007 (PDF)
PLoS ONE 5(7): e11692. doi:10.1371/journal.pone.0011692. Reprinted via PLoS One's open access policy.
Jimee Hwang, Patricia M. Graves, Daddi Jima, Richard Reithinger, S. Patrick Kachur, and the Ethiopia MIS Working Group. In 2005, the Ministry of Health in Ethiopia launched a major effort to distribute over 20 million long-lasting insecticidal nets, provide universal access to artemisinin-based combination therapy (ACTs), and train 30,000 village-based health extension workers.


July 19, 2010
Rapid Increase in Ownership and Use of Long-Lasting Insecticidal Nets and Decrease in Prevalence of Malaria in Three Regional States of Ethiopia, 2006-2007 (PDF)
Journal of Tropical Medicine, volume 2010, article ID 750978, 12 pages doi:10.1155/2010/750978. © Hindawi Publishing Corporation. Reprinted via Journal of Tropical Medicine's open access policy.
Estifanos Biru Shargie, Jeremiah Ngondi, Patricia M. Graves, Asefaw Getachew, Jimee Hwang,  Teshome Gebre, Aryc W. Mosher, Pietro Ceccato, Tekola Endeshaw, Daddi Jima, Zerihun Tadesse, Eskindir Tenaw, Richard Reithinger, Paul M. Emerson, Frank O. Richards Jr., and Tedros Adhanom Ghebreyesus. Following recent large scale-up of malaria control interventions in Ethiopia, this study aimed to compare ownership and use of long-lasting insecticidal nets (LLIN), and the change in malaria prevalence using two population-based household surveys in three regions of the country.


March 30, 2010
A Project for Haiti: The Eradication of Two Diseases
This letter to the editor of the New York Times by Carter Center Vice President for Health Programs Dr. Donald R. Hopkins was published March 30, 2010, in response to the March 28, 2010 editorial "Making Haiti Whole."
Two projects that the donors conference on Haiti should consider this week are the binational plan that Haiti and the Dominican Republic announced last October to eliminate malaria by 2020, and the plan that Haiti announced simultaneously to eliminate lymphatic filariasis (elephantiasis) by 2020 (the Dominican Republic expects to eliminate lymphatic filariasis this year).


Feb. 24, 2010
Malaria Indicator Survey 2007, Ethiopia: Coverage and Use of Major Malaria Prevention and Control Interventions (PDF)
Published by the Malaria Journal 2010, 9:58.
Daddi Jima, Asefaw Getachew, Hana Bilak, Richard W Steketee, Paul M Emerson, Patricia M Graves, Teshome Gebre, Richard Reithinger*, Jimee Hwang, the Ethiopia Malaria Indicator Survey Working Group. In 2005, a nationwide survey estimated that 6.5 percent of households in Ethiopia owned an insecticide-treated net (ITN), 17 percent of households had been sprayed with insecticide, and 4 percent of children under five years of age with a fever were taking an anti-malarial drug.


June 1, 2009
Systemic Reviews in Malaria: Global Policies Need Global Reviews (PDF)
Published in June 2009 in the Infectious Disease Clinics of North America, volume 23, Issue 2 , pages 387-404. This peer reviewed version is reprinted with permission.
Paul Garner, MB, BS, MD, FFPHM, Hellen Gelband, MHS, Patricia Graves, MSPH, PhD, Katharine Jones, MBChB, MRCGP, DTM&H, Harriet MacLehose, BSc, PhD, MA, and Piero Olliaro, MD, PhD, on behalf of the Editorial Board, Cochrane Infectious Diseases Group. This article highlights systematic reviews of malaria research and what has been learned about applying methods of research synthesis in this particular infectious disease over the last 15 years. It illustrates how systematic reviews have been used to guide policy, shows what has been learned about synthesizing research in this area, and reflects on how best to maximize their uptake in policy and practice.


Nov. 3, 2008
Individual, household and environmental risk factors for malaria infection in Amhara, Oromia and SNNP regions of Ethiopia (PDF)
This article was published in the November 2009 edition of Transactions of the Royal Society of Tropical Medicine and Hygiene and reprinted with permission.
Transactions of the Royal Society of Tropical Medicine and Hygiene (c) 2008, doi:10.1016/j.trstmh.2008.11.016. Graves et. al. The authors assessed malaria infection in relation to age, altitude, rainfall, socio-economic factors and coverage of control measures in a representative sample of 11 437 people in Amhara, Oromia and SNNP regions of Ethiopia in December 2006—January 2007. Surveys were conducted in 224 randomly selected clusters of 25 households (overall sample of 27 884 people in 5708 households).


Sept. 21, 2008
Malaria prevalence and mosquito net coverage in Oromia and SNNPR regions of Ethiopia (PDF)
BMC Public Health; 8:321. (C) 2008 Shargie et al. Malaria transmission in Ethiopia is unstable and seasonal, with the majority of the country's population living in malaria-prone areas. Results from DHS 2005 indicate that the coverage of key malaria interventions was low. The government of Ethiopia has set the national goal of full population coverage with a mean of 2 long-lasting insecticidal nets (LLINs) per household through distribution of about 20 million LLIN by the end of 2007. The aim of this study was to generate baseline information on malaria parasite prevalence and coverage of key malaria control
interventions in Oromia and SNNPR and to relate the prevalence survey findings to routine
surveillance data just before further mass distribution of LLINs.


July 3, 2008
Evaluation of light microscopy and rapid diagnostic test for the detection of malaria under operational field conditions: a household survey in Ethiopia (PDF)
Malaria Journal; 7:118. (C) 2008. Endeshaw et al. In most resource-poor settings, malaria is usually diagnosed based on clinical signs and symptoms and not by detection of parasites in the blood using microscopy or rapid diagnostic tests (RDT). In population-based malaria surveys, accurate diagnosis is important: microscopy provides the gold standard, whilst RDTs allow immediate findings and treatment. The concordance between RDTs and microscopy in low or unstable transmission areas has not been evaluated.


March 19, 2008
Integrating an NTD with One of ''The Big Three'': Combined Malaria and Trachoma Survey in Amhara Region of Ethiopia (PDF)
PLoS Neglected Tropical Diseases; Volume 2, Issue 3, e197. ©2008 Emerson et al. Amhara Regional State of Ethiopia has a population of approximately 19.6 million, is prone to unstable and epidemic malaria, and is severely affected by trachoma. An integrated malaria and trachoma control program is being implemented by the Regional Health Bureau. To provide baseline data, a survey was conducted during December 2006 to estimate malaria parasite prevalence, malaria indicators, prevalence of trachoma, and trachoma risk factors in households and people of all ages in each of the ten zones of the state, excluding three urban centers (0.4% of the population).


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