DOI: 10.5061/dryad.76r00
title: Data from: Impact of the Mass Drug Administration for malaria in response to the Ebola outbreak in Sierra Leone

description: BACKGROUND: As emergency response to the Ebola epidemic, the Government of
 Sierra Leone and its partners implemented a large-scale Mass Drug
 Administration (MDA) with artesunate-amodiaquine (ASAQ) covering
 &gt;2.7 million people in the districts hardest hit by Ebola during
 December 2014-January 2015. The World Health Organization (WHO) and the
 National Malaria Control Programme (NMCP) evaluated the impact of the MDA
 on malaria morbidity at health facilities and the number of Ebola alerts
 received at District Ebola Command Centres. METHODS: The coverage of the
 two rounds of MDA with ASAQ was estimated by relating the number
 anti-malarial medicines distributed to the estimated resident population.
 Segmented time-series analysis was applied to weekly data collected from
 49 primary health units (PHUs) and 11 hospitals performing malaria
 parasitological testing during the study period, to evaluate trends of
 malaria cases and Ebola alerts during the post-MDA weeks compared to the
 pre-MDA weeks in MDA- and non-MDA-cheifdoms. RESULTS: After two rounds of
 the MDA, the number of suspected cases tested with rapid diagnostic test
 (RDT) decreased significantly by 43 % (95 % CI 38-48 %) at week 1 and
 remained low at week 2 and 3 post-first MDA and at week 1 and 3
 post-second MDA; RDT positive cases decreased significantly by 47 % (41-52
 %) at week 1 post-first and remained lower throughout all post-MDA weeks;
 and the RDT test positivity rate (TPR) declined by 35 % (32-38 %) at week
 2 and stayed low throughout all post-MDA weeks. The total malaria
 (clinical + confirmed) cases decreased significantly by 45 % (39-52 %) at
 week 1 and were lower at week 2 and 3 post-first MDA; and week 1
 post-second MDA. The proportion of confirmed malaria cases (out of
 all-outpatients) fell by 33 % (29-38 %) at week 1 post-first MDA and were
 lower during all post-MDA weeks. On the contrary, the non-malaria
 outpatient cases (cases due to other health conditions) either remained
 unchanged or fluctuated insignificantly. The Ebola alerts decreased by 30
 % (13-46 %) at week 1 post-first MDA and much lower during all the weeks
 post-second MDA. CONCLUSIONS: The MDA achieved its goals of reducing
 malaria morbidity and febrile cases that would have been potentially
 diagnosed as suspected Ebola cases with increased risk of nosocomial
 infections. The intervention also helped reduce patient case-load to the
 severely strained health services at the peak of the Ebola outbreak and
 malaria transmission. As expected, the effect of the MDA waned in a matter
 of few weeks and malaria intensity returned to the pre-MDA levels.
 Nevertheless, the approach was an appropriate public health intervention
 in the context of the Ebola epidemic even in high malaria transmission
 areas of Sierra Leone.
description: Weekly data in MDA and
 non-MDA chiefdomsThe dataset contains
 weekly aggragated data in MDA and non-MDA chiefdoms. Main data elements
 include all-cause outpatients, all-cause admissions, outpatient malaria
 cases, malaria admissions, microscopically tested cases, microscopically
 positive cases, RDT tested cases, RDT positive cases, Slide positivity
 rate (mic), test positivity rate (RDT), non-malaria outpatient cases,
 non-malaria inpatient cases, proportion of malaria (of all outpatients),
 proportion of malaria admissions (of all admissions), Ebola alerts. All
 the above are categorized in two groups: MDA-chiefdoms and non-MDA
 chiefdoms.WeeklyDataMDA.xlsx