Fig. 2

Malaria cases per month, from January 2005 up to September 2015, reported from health facilities throughout Afghanistan. a Adjusted for monthly cases per 10,000 outpatient clients, as reported from health facilities. b Unadjusted monthly malaria cases. c Total number of outpatient cases, reflecting trends health services utilization and reporting. Although the unadjusted data do not exhibit any trend beyond seasonality, because fewer centers were reporting at the beginning of the period (around 1000 centers compared to well over 2000 in 2015 [42]) and health services utilization increased substantially and proportionally for all parts of the country, adjustment was necessary to account for under-reporting. Subsequent analyses were performed using the adjusted rates