Children aged <5 years who received any antimalarial for fever (percentage)
Rationale for use
Prompt treatment with effective antimalarial drugs for children with fever in malaria-risk areas is a key intervention to reduce mortality. In addition to being listed as a global Millennium Development Goals Indicator under Goal 6, effective treatment for malaria is also identified by WHO, UNICEF, and the World Bank as one of the four main interventions to reduce the burden of malaria in Africa:
- Use of insecticide-treated nets (ITNs);
- Prompt access to effective treatments in or near the home;
- Providing antimalarial drugs to symptom-free pregnant women in stable transmission areas; and
- Improved forecasting, prevention and response, which are essential to respond quickly and effectively to malaria epidemics.
In areas of sub-Saharan Africa with stable levels of malaria transmission, it is essential that prompt access to treatment is ensured. This requires drug availability at household or community level and, for complicated cases, availability of transport to the nearest equipped facility. Reserve stocks of drugs, transport, and hospital capacity are needed to mount an appropriate response and to prevent the degeneration of malaria from its onset to a highly lethal complicated picture.
Definition
Percentage of the population in malaria-risk areas aged less than 5 years with fever being treated with effective antimalarial drugs.
Numerator (N): the number of children aged less than 5 years in malaria-risk areas with fever being treated with effective antimalarial drugs.
Denominator (D): the number of children aged less than 5 years in malaria-risk areas.
Associated terms
Malaria-risk include areas where malaria transmission is stable (or endemic, allowing the development of some level of immunity) and areas where malaria transmission is unstable (or epidemic, as seasonal and less predictable transmission impedes the development of effective immunity).
Methods of estimation
For prevention, the indicator is calculated as the percentage of children aged less than 5 years who received effective antimalarial drugs during a fever episode. The information is obtained directly from household surveys. The empirical values are reported directly without further estimation.
Data sources
Household surveys such as DHS, MICS, Malaria Indicator Surveys (MIS), and 'rider' questions on other representative population-based surveys that include questions on whether children aged less than 5 years slept under an ITN the previous night.
Effective antimalarial drugs (WHO, 2003): consistent with WHO recommendations, countries in which malaria is endemic and that are experiencing high levels of resistance to currently-used antimalarial drugs such as chloroquine and sulfadoxine/pyrimethamine (SP) are changing treatment policies from monotherapies to combined therapies including available drugs (SP and amidioquine). The purpose of drug combinations is to produce a therapy that acts at more than one stage of the parasitic cycle. Artemisinin-based combination treatments (ACTs) (WHO, 2001) are considered to be the most effective combinations. However, they cannot be broadly recommended because artemisinin-based drugs are not necessarily available owing to production limitations. ACTs combine an artemisinin compound with a partner antimalarial drug to which there is little or no resistance in the country or situation in which the ACT is to be deployed. The advantages of ACTs relate to the properties of artemisinin compounds, which include rapid reduction of the parasite biomass with fast resolution of clinical symptoms, effectiveness against multidrug-resistant falciparum malaria, no documented resistance, and a good safety profile.
Malaria stand-alone surveys (community component) for ITNs and also access to treatment.
Disaggregation
By age, sex, location (urban/rural, major regions/provinces), and socioeconomic characteristics (e.g. level of education, wealth quintile).
References
- WHO/Roll Back Malaria
-
World malaria report 2005
WHO and UNICEF. World malaria report 2005. Geneva, New York, World Health Organization, 2005. -
The Africa Malaria Report 2003
WHO/UNICEF. The Africa Malaria Report 2003. Geneva, New York, World Health Organization and United Nations Children Fund, 2004. -
An update on quality assurance and procurement through WHO for improving access to artemisinin-based combination treatments (ACTs) for malaria
WHO, Malaria Control Department. An update on quality assurance and procurement through WHO for improving access to artemisinin-based combination treatments (ACTs) for malaria. Geneva, World Health Organization, 2003. -
Antimalarial drug combination therapy. Report of a WHO technical consultation
WHO. , 4–5 April. Geneva, World Health Organization, 2001 (WHO/CDS/RBM/2001.35).
Database
Comments
The accuracy of reporting in household surveys may vary.