Malaria in Democratic Republic of the Congo
In 2007, an estimated two-thirds of the population lived in areas with an average Plasmodium falciparum prevalence above 50%, making the Democratic Republic of the Congo (DRC) one of the most intense transmission areas of Africa. Twenty-nine percent of the population lived under conditions of mesoendemicity (parasite rates 10-50%) and only 0.2% of the country’s population lived in areas that would be classified as hypoendemic.
There has been a long-term reduction in malaria transmission in the DRC, but equally some areas remained in 2007 at similar levels of endemicity described over 60 years ago. Moreover, significant efforts have been made to expand the distribution of insecticide-treated nets (ITN) since 2007 and small, localised efforts to use indoor residual house-spraying at mining concessions. These activities may have changed the landscape of malaria transmission.
In 2014, an epidemiology profile of the DRC was produced by the KEMRI-Wellcome Trust's research team with help from the National Malaria Control Programme (Programme National de Lutte Contre le Paludisme - PNLP). As part of the Phase 2 work LINK has collated evidence from: 427 published articles or MSc/PhD theses and 55 implementation reports/policies.
Making data available
During this phase, data was systematically collated and compiled from online electronic databases and unpublished archived survey reports. The search strategy identified 1152 survey estimates unique locations where malaria infection prevalence had been recorded between June 1914 and September 2013. Of the 1140 unique time-space P. falciparum survey locations identified through the data search strategy described above, 564 (50%) were abstracted directly from journal publications, 298 (26%) derived from the national sample surveys of 2007, 194 (17%) were obtained through the provision of unpublished raw data, 182 (7%) were obtained from other reports or those developed by the Ministry of Health, 6 (0.5%) were obtained from a master's thesis and one from conference abstracts.
Estimating malaria risk over space
Malaria transmission intensity was stratified across DRC for 2007. The model predictions show that DRC experiences predominantly hyperendemic to holoendemic malaria epidemiology across the country. Approximately two-thirds of the population live in areas where the estimated prevalence of malaria is ≥50%. A small proportion (6%) of the population live in areas free from malaria and 0.2% of the population live in areas where malaria transmission is virtually absent. Areas of lowest transmission are located in the higher altitude eastern provinces bordering Rwanda and Burundi.