The burden of Malaria in Zambia remains a challenge, with the entire population at risk of contracting this infectious disease. Despite concerted efforts by African countries, including Zambia, to implement malaria policies and strategies aimed at reducing case incidence, the region faces significant hurdles, especially with emerging pandemics such as COVID-19. The efforts to control malaria were impacted by the constraints imposed to curb its transmission during the COVID-19 pandemic. The aim of the study was to assess the effect of the COVID-19 pandemic on malaria cases in Zambia and the factors associated by comparing the COVID-19 period and the pre-COVID-19 era. This was a cross-sectional panel study in which routinely collected programmatic data on malaria was used. The data were extracted from the Health Management Information System (HMIS) for the period January 2018 to January 2022. The period 2018 to 2022 was selected purely due to the availability of data and to avoid the problem of extrapolating too far away from the period of interest of the study. A summary of descriptive statistics was performed in which the number of cases were stratified by province, age group, and malaria cases. The association of these variables with the COVID-19 era was checked using the Wilcoxon rank-sum test and Kruskal‒Wallis test as applicable. In establishing the factors associated with the number of malaria cases, a mixed-effect multilevel model using the Poisson random intercept and random slope of the COVID-19 panel. The model was employed to deal with the possible correlation of the number of cases in the non-COVID-19 panel and the expected correlation of the number of cases in the COVID-19 panel. A total of 18,216 records were extracted from HMIS from January 2018 to January 2022. Stratifying this by the COVID-19 period/era, it was established that 8,852 malaria cases were recorded in the non-COVID-19 period, whereas 9,364 cases were recorded in the COVID-19 era. Most of the people with malaria were above the age of 15 years. Furthermore, the study found a significant increase in the relative incidence of the COVID-19 panel period compared to the non-COVID-19 panel period of 1.32, 95% CI (1.18, 1.48, p < 0.0001). The observed numbers, as well as the incident rate ratio, align with the hypothesis of this study, indicating an elevated incidence rate ratio of malaria during the COVID-19 period. This study found that there was an increase in confirmed malaria cases during the COVID-19 period compared to the non-COVID-19 period. The study also found Age, Province, and COVID-19 period to be significantly associated with malaria cases.

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COVID-19 对赞比亚疟疾病例的影响：混合效应多级分析

赞比亚的疟疾负担仍然是一个挑战，全体人民都面临感染这种传染病的风险。尽管包括赞比亚在内的非洲国家共同努力实施旨在减少病例发生率的疟疾政策和战略，但该地区仍面临重大障碍，特别是在新出现的流行病（例如 COVID-19）方面。控制疟疾的努力受到了 COVID-19 大流行期间为遏制疟疾传播而施加的限制的影响。该研究的目的是通过比较 COVID-19 时期和 COVID-19 之前的时期，评估 COVID-19 大流行对赞比亚疟疾病例的影响以及相关因素。这是一项横断面小组研究，其中使用了常规收集的疟疾规划数据。这些数据是从健康管理信息系统（HMIS）中提取的2018年1月至2022年1月期间的数据。选择2018年至2022年期间纯粹是因为数据的可用性，并避免与该期间推断太远的问题。研究兴趣。对描述性统计进行汇总，其中病例数按省份、年龄组和疟疾病例进行分层。使用 Wilcoxon 秩和检验和 Kruskal-Wallis 检验（如适用）检查这些变量与 COVID-19 时代的关联。在建立与疟疾病例数相关的因素时，使用了 COVID-19 面板的泊松随机截距和随机斜率的混合效应多级模型。该模型用于处理非 COVID-19 组中病例数的可能相关性和 COVID-19 组中病例数的预期相关性。从 2018 年 1 月到 2022 年 1 月，从 HMIS 中总共提取了 18,216 条记录。按 COVID-19 时期/时代进行分层，确定非 COVID-19 时期记录了 8,852 例疟疾病例，而记录了 9,364 例疟疾病例在 COVID-19 时代。大多数疟疾患者年龄在 15 岁以上。此外，研究发现，与非 COVID-19 组期间相比，COVID-19 组期间的相对发生率显着增加，为 1.32，95% CI（1.18，1.48，p < 0.0001）。观察到的数字以及发病率与本研究的假设相符，表明 COVID-19 期间疟疾的发病率较高。这项研究发现，与非 COVID-19 期间相比，COVID-19 期间确诊的疟疾病例有所增加。研究还发现年龄、省份和 COVID-19 时期与疟疾病例显着相关。