{
  "abstract": "BACKGROUND: Malaria remains a major cause of childhood morbidity and mortality in Cameroon. The COVID-19 pandemic disrupted access to healthcare and the continuity of malaria control programmes; however, its impact on reported incidence among children under 5 years of age, and its regional heterogeneity, remain insufficiently studied. We aimed to estimate the impact of the COVID-19-related interruption on reported malaria incidence among children under five years of age in Cameroon, nationally and by region, using routine DHIS2 surveillance data from 2017 to 2022. METHODS: We conducted an interrupted time series (ITS) study using monthly DHIS2 data from January 2017 to December 2022. Reported malaria incidence among children under 5 years of age was modelled using negative binomial regression (NB2) with a population offset. Two interruption points were defined a priori: March 2020 and January 2022. The model controlled for monthly fixed effects, long-lasting insecticidal net (LLIN) distribution activity, seasonal malaria chemoprevention (SMC) activity, the paediatric consultation rate, and one-month lagged rainfall. Inference relied on Newey-West HAC-robust standard errors (lag = 12). Regional ITS models, counterfactual analysis, and sensitivity analyses complemented the primary analysis. RESULTS: In March 2020, reported incidence showed an immediate 36.9% decline relative to the pre-pandemic trend (D1: IRR = 0.631; 95% CI 0.539-0.738; p < 0.001), followed by a positive slope change of 3.1% per month (P1: IRR = 1.031; 95% CI 1.017-1.045; p < 0.001). The second interruption point was not associated with any significant change in level or slope. The LLIN distribution indicator was inversely associated with reported incidence (IRR = 0.978; 95% CI 0.960-0.997; p = 0.024). Counterfactual analysis estimated a deficit of 69,708 notifications over 2020-2021, followed by an excess of 74,831 in 2022. Marked regional heterogeneity was observed, with particularly severe initial declines in the Centre (IRR = 0.467) and East (IRR = 0.544) regions. CONCLUSIONS: The COVID-19 pandemic was associated with a substantial initial disruption in reported childhood malaria incidence in Cameroon, followed by a progressive recovery with marked territorial disparities. These findings support strengthening the continuity of malaria services during crises and maintaining high-quality surveillance systems to enable regionally tailored programmatic decision-making.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Léa Melataguia Mekontchou"
    },
    {
      "name": "Georges Nguefack-Tsague"
    },
    {
      "name": "Alice Verdiane Koudjou Sonegueng"
    },
    {
      "name": "Paul Yvan Deffo"
    },
    {
      "name": "Emtom Sepde"
    },
    {
      "name": "Sékou Samadoulougou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7kfz35r7118x4.bib",
  "cited_by": 1,
  "doi": "10.1186/s12936-026-05958-1",
  "fulltext_url": null,
  "id": "7kfz35r7118x4",
  "issns": [
    "1475-2875"
  ],
  "landing_url": "https://hal.science/hal-05732579v1",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "1.sdv.mp"
    ],
    [
      "hal",
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    [
      "openalex",
      "2739|Malaria Research and Control"
    ]
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  "openalex": "W7162860625",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-05-30",
  "publisher": "BioMed Central",
  "ris": "https://research.draconitic.com/paper/7kfz35r7118x4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:21Z",
      "native_id": "hal-05732579",
      "source": "hal",
      "url": "https://hal.science/hal-05732579v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.mp",
      "subfield": "microbiology"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.mi",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Impact of the COVID-19 pandemic on reported malaria incidence in children under five years of age in Cameroon: an interrupted time series analysis with regional heterogeneity (2017–2022)",
  "title_text": "Impact of the COVID-19 pandemic on reported malaria incidence in children under five years of age in Cameroon: an interrupted time series analysis with regional heterogeneity (2017–2022)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:21Z",
  "url": "https://research.draconitic.com/paper/7kfz35r7118x4",
  "venue": "Malaria Journal",
  "versions": []
}