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Vijayan K, Wei L, Glennon EKK, Mattocks C, Bourgeois N, Staker B, Kaushansky A. Host-targeted Interventions as an Exciting Opportunity to Combat Malaria. Chem Rev 2021; 121:10452-10468. [PMID: 34197083 DOI: 10.1021/acs.chemrev.1c00062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Terminal and benign diseases alike in adults, children, pregnant women, and others are successfully treated by pharmacological inhibitors that target human enzymes. Despite extensive global efforts to fight malaria, the disease continues to be a massive worldwide health burden, and new interventional strategies are needed. Current drugs and vector control strategies have contributed to the reduction in malaria deaths over the past 10 years, but progress toward eradication has waned in recent years. Resistance to antimalarial drugs is a substantial and growing problem. Moreover, targeting dormant forms of the malaria parasite Plasmodium vivax is only possible with two approved drugs, which are both contraindicated for individuals with glucose-6-phosphate dehydrogenase deficiency and in pregnant women. Plasmodium parasites are obligate intracellular parasites and thus have specific and absolute requirements of their hosts. Growing evidence has described these host necessities, paving the way for opportunities to pharmacologically target host factors to eliminate Plasmodium infection. Here, we describe progress in malaria research and adjacent fields and discuss key challenges that remain in implementing host-directed therapy against malaria.
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Affiliation(s)
| | - Ling Wei
- Seattle Children's Research Institute, Seattle, Washington 98109, United States
| | | | - Christa Mattocks
- Department of Global Health, University of Washington, Seattle, Washington 98195, United States
| | - Natasha Bourgeois
- Seattle Children's Research Institute, Seattle, Washington 98109, United States.,Department of Global Health, University of Washington, Seattle, Washington 98195, United States
| | - Bart Staker
- Seattle Children's Research Institute, Seattle, Washington 98109, United States
| | - Alexis Kaushansky
- Seattle Children's Research Institute, Seattle, Washington 98109, United States.,Department of Global Health, University of Washington, Seattle, Washington 98195, United States.,Department of Pediatrics, University of Washington, Seattle, Washington 98105, United States.,Brotman Baty Institute for Precision Medicine, Seattle, Washington 98195, United States
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Arinaitwe E, Dorsey G, Nankabirwa JI, Kigozi SP, Katureebe A, Kakande E, Rek J, Rosenthal PJ, Drakeley C, Kamya MR, Staedke SG. Association Between Recent Overnight Travel and Risk of Malaria: A Prospective Cohort Study at 3 Sites in Uganda. Clin Infect Dis 2020; 68:313-320. [PMID: 29868722 DOI: 10.1093/cid/ciy478] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/31/2018] [Indexed: 11/14/2022] Open
Abstract
Background Human movement can undermine malaria control efforts. However, understanding of the association between travel and malaria infection in Africa is limited. We evaluated the association between recent overnight travel and malaria incidence in Uganda. Methods All children aged 0.5-10 years and 1 adult living in 266 randomly selected households within 3 different regions of Uganda were followed up prospectively. Information on overnight travel was collected in 2015-2016. Malaria, defined as fever with parasites detected by microscopy, was measured using passive surveillance. Results At least 1 overnight trip was reported by 64 of 275 (23.3%) participants in Walukuba, 37 of 317 (11.7%) in Nagongera, and 19 of 314 (6.1%) in Kihihi. Among individuals who traveled, the incidence of malaria was higher in the first 60 days after traveling, compared with periods without recent travel at all 3 sites (overall, 1.15 vs 0.33 episodes per person-year; incidence rate ratio, 3.53; 95% confidence interval, 1.85-6.73; P < .001). Risk factors for malaria within 60 days after overnight travel included young age (19.5% in children vs 4.9% in adults; odds ratio, 5.29; 95% confidence interval, 1.34-21.0; P = .02) and not using an insecticide-treated net during travel (18.0% for no use vs 4.1% for any use; 5.10; 1.07-24.5; P = .04). Conclusions Recent overnight travel was associated with a higher incidence of malaria. Individuals who travel may represent a high-risk group that could be targeted for malaria control interventions, particularly use of insecticide-treated nets.
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Affiliation(s)
- Emmanuel Arinaitwe
- London School of Hygiene and Tropical Medicine, United Kingdom.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Grant Dorsey
- Department of Medicine, University of California, San Francisco
| | | | - Simon P Kigozi
- London School of Hygiene and Tropical Medicine, United Kingdom.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Elijah Kakande
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - John Rek
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Moses R Kamya
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sarah G Staedke
- London School of Hygiene and Tropical Medicine, United Kingdom
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Kusuma YS, Babu BV. Migration and health: A systematic review on health and health care of internal migrants in India. Int J Health Plann Manage 2018; 33:775-793. [PMID: 30074640 DOI: 10.1002/hpm.2570] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 01/20/2023] Open
Abstract
The objective of this paper is to review published studies on various health conditions and health care access of internal migrants in India. The guidelines under PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis were followed. We searched 3 databases-Web of Science, Medline (PubMed), and Google Scholar. By applying selection criteria, we identified a total of 42 papers to include in the review. These studies reported various health problems/morbid conditions, and some studies reported health care access. Major health issues of poor migrants included work-related injuries, noncommunicable diseases like diabetes and hypertension, and communicable diseases like malaria and HIV. In addition, behavioural risks such as the use of tobacco and alcohol are reported. Information on health care seeking and poor access to government health care system are available. This review demonstrates the need to improve the health status and health care access of poor migrants. As health systems-related factors also influence the health care seeking behaviour, they are to be considered along with improving the living conditions of this population. Thus, a comprehensive migrant-sensitive health care should be the part of the urban health care system.
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Affiliation(s)
- Yadlapalli S Kusuma
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Bontha V Babu
- Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
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Li N, Parker DM, Yang Z, Fan Q, Zhou G, Ai G, Duan J, Lee MC, Yan G, Matthews SA, Cui L, Wang Y. Risk factors associated with slide positivity among febrile patients in a conflict zone of north-eastern Myanmar along the China-Myanmar border. Malar J 2013; 12:361. [PMID: 24112638 PMCID: PMC3852943 DOI: 10.1186/1475-2875-12-361] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 09/21/2013] [Indexed: 12/02/2022] Open
Abstract
Background Malaria within the Greater Mekong sub-region is extremely heterogeneous. While China and Thailand have been relatively successful in controlling malaria, Myanmar continues to see high prevalence. Coupled with the recent emergence of artemisinin-resistant malaria along the Thai-Myanmar border, this makes Myanmar an important focus of malaria within the overall region. However, accurate epidemiological data from Myanmar have been lacking, in part because of ongoing and emerging conflicts between the government and various ethnic groups. Here the results are reported from a risk analysis of malaria slide positivity in a conflict zone along the China-Myanmar border. Methods Surveys were conducted in 13 clinics and hospitals around Laiza City, Myanmar between April 2011 and October 2012. Demographic, occupational and educational information, as well as malaria infection history, were collected. Logistic models were used to assess risk factors for slide positivity. Results Age patterns in Plasmodium vivax infections were younger than those with Plasmodium falciparum. Furthermore, males were more likely than females to have falciparum infections. Patients who reported having been infected with malaria during the previous year were much more likely to have a current vivax infection. During the second year of the study, falciparum infections among soldiers increased signficiantly. Conclusions These results fill some knowledge gaps with regard to risk factors associated with malaria slide positivity in this conflict region of north-eastern Myanmar. Since epidemiological studies in this region have been rare or non-existent, studies such as the current are crucial for understanding the dynamic nature of malaria in this extremely heterogeneous epidemiological landscape.
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Affiliation(s)
- Nana Li
- Department of Tropical Disease, Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
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Microsatellite analysis of chloroquine resistance associated alleles and neutral loci reveal genetic structure of Indian Plasmodium falciparum. INFECTION GENETICS AND EVOLUTION 2013; 19:164-75. [PMID: 23871774 DOI: 10.1016/j.meegid.2013.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/03/2013] [Accepted: 07/06/2013] [Indexed: 11/20/2022]
Abstract
Efforts to control malignant malaria caused by Plasmodium falciparum are hampered by the parasite's acquisition of resistance to antimalarial drugs, e.g., chloroquine. This necessitates evaluating the spread of chloroquine resistance in any malaria-endemic area. India displays highly variable malaria epidemiology and also shares porous international borders with malaria-endemic Southeast Asian countries having multi-drug resistant malaria. Malaria epidemiology in India is believed to be affected by two major factors: high genetic diversity and evolving drug resistance in P. falciparum. How transmission intensity of malaria can influence the genetic structure of chloroquine-resistant P. falciparum population in India is unknown. Here, genetic diversity within and among P. falciparum populations is analyzed with respect to their prevalence and chloroquine resistance observed in 13 different locations in India. Microsatellites developed for P. falciparum, including three putatively neutral and seven microsatellites thought to be under a hitchhiking effect due to chloroquine selection were used. Genetic hitchhiking is observed in five of seven microsatellites flanking the gene responsible for chloroquine resistance. Genetic admixture analysis and F-statistics detected genetically distinct groups in accordance with transmission intensity of different locations and the probable use of chloroquine. A large genetic break between the chloroquine-resistant parasite of the Northeast-East-Island group and Southwest group (FST=0.253, P<0.001) suggests a long period of isolation or a possibility of different origin between them. A pattern of significant isolation by distance was observed in low transmission areas (r=0.49, P=0.003, N=83, Mantel test). An unanticipated pattern of spread of hitchhiking suggests genetic structure for Indian P. falciparum population. Overall, the study suggests that transmission intensity can be an efficient driver for genetic differentiation at both neutral and adaptive loci across India.
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O'Sullivan M, Kenilorea G, Yamaguchi Y, Bobogare A, Losi L, Atkinson JA, Vallely A, Whittaker M, Tanner M, Wijesinghe R. Malaria elimination in Isabel Province, Solomon Islands: establishing a surveillance-response system to prevent introduction and reintroduction of malaria. Malar J 2011; 10:235. [PMID: 21834995 PMCID: PMC3175476 DOI: 10.1186/1475-2875-10-235] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 08/11/2011] [Indexed: 12/02/2022] Open
Abstract
Background The Solomon Islands National Malaria Programme is currently focused on intensified control and progressive elimination. Recent control efforts in Isabel Province have reduced their malaria incidence to 2.6/1,000 population in 2009 [1] whereas most neighbouring provinces have much higher incidences. A malaria surveillance-response system that involves testing all travellers entering Isabel Province using rapid diagnostic tests (RDT) to prevent cases being imported had been proposed by local health authorities. This study provides information on the feasibility and acceptability of implementing a new approach of surveillance and response in the context of low levels of indigenous malaria transmission in Isabel Province. Methods A total of 13 focus group discussions (FGD) and 22 key informant interviews (KII) were conducted in Isabel Province, Solomon Islands. Key topics included: the travel patterns of people to, from and within Isabel Province; the acceptability, community perceptions, attitudes and suggestions towards the proposed surveillance programme; and management of suspected malaria cases. This information was triangulated with data obtained from port authorities, airlines and passenger ships travelling to and from Isabel Province in the preceding two years. Results Travel within Isabel Province and to and from other provinces is common with marked seasonality. The majority of inter-provincial travel is done on scheduled public transport; namely passenger ships and aircrafts. In Isabel Province there is a healthy community spirit as well as high concern regarding malaria and its importation and there is currently effective malaria passive case detection and management. Conducting malaria screening at ports and airports would be acceptable to the community. Conclusion A robust surveillance-response system is essential when moving towards malaria elimination. Many factors contribute positively towards the feasibility of an RDT based malaria surveillance system in Isabel Province. Due to financial and logistical restraints local health authorities have concluded that a system of community-based vigilance to identify new arrivals in villages and direct them to have malaria testing is more feasible than formal screening at ports and airports. A surveillance response system to prevent introduction of malaria into Isabel Province can be integrated into the National Malaria Control Programme provided the operational steps are carefully planned with regards to human and financial resources.
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Affiliation(s)
- Matthew O'Sullivan
- Pacific Malaria Initiative Support Centre, Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Brisbane, Australia.
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Montgomery CM, Munguambe K, Pool R. Group-based citizenship in the acceptance of indoor residual spraying (IRS) for malaria control in Mozambique. Soc Sci Med 2010; 70:1648-55. [DOI: 10.1016/j.socscimed.2010.01.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 12/16/2009] [Accepted: 01/11/2010] [Indexed: 11/15/2022]
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Atkinson JAM, Fitzgerald L, Toaliu H, Taleo G, Tynan A, Whittaker M, Riley I, Vallely A. Community participation for malaria elimination in Tafea Province, Vanuatu: Part I. Maintaining motivation for prevention practices in the context of disappearing disease. Malar J 2010; 9:93. [PMID: 20380748 PMCID: PMC2873527 DOI: 10.1186/1475-2875-9-93] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 04/12/2010] [Indexed: 12/02/2022] Open
Abstract
Background In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Method Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. Results The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. Conclusion In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination.
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Affiliation(s)
- Jo-An M Atkinson
- Pacific Malaria Initiative Support Centre, Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Brisbane, Australia.
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Abstract
The Asia-Pacific region has at least 50% of its population at risk for malaria. In Malaysia, indigenous malaria is largely concentrated among the Orang Asli in Peninsular Malaysia. A cross-sectional study was conducted in an Orang Asli community in the district of Raub, Pahang, to determine the predictors of malaria. Age, seldom/never wearing protective clothing while in the jungle, going out at night, ever staying in another village, and living in bamboo-walled homes were found to be associated with malaria (crude odds ratio = 1.8-4.5; 95% confidence interval [CI] = 1.1-9.1) After adjusting for confounding, major predictors of malaria were age ≤12 years (adjusted odds ratio [aOR] = 4.3;95% CI = 2.2-8.4),), never/seldom wearing protective clothing while in the jungle (aOR = 3.8; 95% CI = 1.8-8.0), and going out at night (aOR = 2.5; 95% CI = 1.4-4.8). The findings lend support for intensifying behaviour modification in this population.
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Affiliation(s)
- Gurpreet Kaur
- Institute for Public Health, Ministry of Health, Jalan
Bangsar, Kuala Lumpur, Malaysia,
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Guthmann JP, Hall AJ, Jaffar S, Palacios A, Lines J, Llanos-Cuentas A. Environmental risk factors for clinical malaria: a case-control study in the Grau region of Peru. Trans R Soc Trop Med Hyg 2001; 95:577-83. [PMID: 11816424 DOI: 10.1016/s0035-9203(01)90084-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The role of environmental risk factors in clinical malaria has been studied mainly in Africa and Asia, few investigations have been carried out in Latin America. Field observations in northern coastal Peru, where the prevalence of malaria is high during the agricultural season, suggested that the risk of disease varied according to the characteristics of the house and the house environment. Environmental determinants of the risk of clinical malaria were therefore investigated through a case-control study: 323 clinical cases of malaria, recruited through community-based active case-finding, and 969 age-, sex- and village-matched controls were recruited into the study over a period of 12 months ending June 1997. Residual spraying of houses in the previous 6 months, living more than 100 m from a canal, a level of education equal to primary school or above and working in agriculture conferred significant protection from the risk of developing clinical malaria. The presence of spaces between the wall and roof in the subject's bedroom (eaves) and a house aged > 4 years statistically significantly increased the risk of disease. Based on these results we discuss possible control measures for malaria in this area of the country.
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Affiliation(s)
- J P Guthmann
- Department of Infectious and Tropical Disease, Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, UK.
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Abstract
Reports of malaria are increasing in many countries and in areas thought free of the disease. One of the factors contributing to the reemergence of malaria is human migration. People move for a number of reasons, including environmental deterioration, economic necessity, conflicts, and natural disasters. These factors are most likely to affect the poor, many of whom live in or near malarious areas. Identifying and understanding the influence of these population movements can improve prevention measures and malaria control programs.
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Affiliation(s)
- P Martens
- Internatonal Centre for Integrative Studies, Maastricht University, the Netherlands.
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Abstract
Imported malaria is a growing problem in the world. In part this is a result of greatly increased and more rapid travel and in part a result of a resurgence of malaria in areas partially or completely cleared. Migrants, either refugees or those looking for better opportunities in life, have contributed to the movement of malaria to previously free areas. Failure of travellers to take appropriate action to prevent infection has contributed to the increased incidence of imported malaria. Vectors of malaria may also become travellers and thus contribute to the spread of infection.
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Affiliation(s)
- M G Schultz
- Global EIS Division, Centers for Disease Control, Atlanta, Georgia 30333
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Abstract
Population mobility can bring people into contact with disease agents, and transfer these agents to new populations. This paper suggests ways in which population movements are implicated in the transmission of one communicable disease, guinea worm or dracunculiasis, a parasitic disease affecting 5-15 million people every year in Africa, India and Pakistan. A typology of population mobility which distinguishes between rural and urban sectors, and between circulation and uni-directional permanent migration is used. An understanding of population movements associated with guinea worm, and with other communicable diseases, can also provide useful guidelines for effective disease control strategies.
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Affiliation(s)
- S J Watts
- Department of Anthropology and Geography, Rhode Island College, Providence 02908
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