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Factsheet - Zambia

A survey in Zambia also found a substantially higher prevalence of malaria infection among the poorest population groups. Poor families live in dwellings that offer little protection against mosquitoes and are less able to afford insecticide-treated nets. Poor people are also less likely to be able to pay either for effective malaria treatment or for transportation to a health facility capable of treating the disease.

Figures:

  • endemic throughout entire country (present in a community at all times but in relatively low frequency) (epidemic: an outbreak of a contagious disease that spreads rapidly and widely)
  • 50,000 deaths each year due to malaria
  • 4.8 million clinical cases of malaria
  • average resistance to chloroquine: 47% (range: lowest 10.5% / highest 64%)
  • average resistance to sulfadoxine + pyrimethamine (SP): 14% (range: lowest: 14% / highest 19%)
  • has rolled out ACT to 28 out of 72 districts and aims to supply all districts with ACT by 2004 with further grant money from Round 1.
  • 1.94 million treatment courses received to date with Global Fund money
  • health system baseline study: less than 30% of all health workers have undergone any formal health training
  • Global Fund compliance study: 65% of patients had taken Coartem correctly
  • local name given to Coartem: iwatemwa ("we are happy")

Challenges:

  • any country choosing ACT faces the challenge of guaranteeing sustainable funding for a drug which is still more expensive than current treatment
  • how to involve the private sector: 60% of sick people in Zambia go to private doctors or the pharmacy and not to public health centres. The challenge here is to find a means to control the price charged by the private sector to the end user
  • community health workers have not received ACT yet (there are legal questions around community health workers being in a position to perform diagnosis as "lay" health workers) despite them being the most immediate people to whom people turn when they fall sick
  • ensuring all health centres get laboratories equipped with microscopes for more accurate diagnosis to avoid the emergence of drug resistance



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