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Malaria Control and Elimination in Africa: Why are Some Countries Doing Better than Others?

Abstract

Objectives: To determine social, economic, biological and environmental factors critical to malaria control effectiveness in African countries that are with contrasting responses to the malaria control and elimination efforts, and use this information to inform the development of improved malaria control strategies in Africa.

Methods: A systematic analysis was conducted using longitudinally collected data from publically available data sources for the period of 2000 and 2016, for 8 African countries with contrasting malaria incidence dynamics. Single- and multivariable linear regression analyses were performed to determine the impact of various risk factors on malaria incidence. The risk factors included autocorrelation with a one year time lag, study country, and economic status, internal and external malaria control budgets, bednet coverage, indoor residual spray coverage, and insecticide resistance status.

Results: Malaria incidence exhibited highly significant autocorrelation. Per capita government funding for malaria control and insecticide resistance were the two significant factors correlating with malaria incidence.

Conclusions: This study indicates the significance of malaria control investment from African countries themselves and insecticide resistance management in malaria control and elimination in Africa.

Key Words: Malaria incidence, National government funding, Malaria control effectiveness, Insecticide resistance

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