1
|
Abbas H, Sajid MS, Rizwan HM, Tahir UB, Farooqi SH, Iqbal Z, Malik MA, Yaseen K, Maqbool M, Raza FA, Raza M, Fouad D, Ataya FS. Exploring mosquito abundance and Plasmodium infection through nested-PCR: implications for disease surveillance and control. Sci Rep 2024; 14:9871. [PMID: 38684775 PMCID: PMC11058852 DOI: 10.1038/s41598-024-60662-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
The Plasmodium is responsible for malaria which poses a major health threat, globally. This study is based on the estimation of the relative abundance of mosquitoes, and finding out the correlations of meteorological parameters (temperature, humidity and rainfall) with the abundance of mosquitoes. In addition, this study also focused on the use of nested PCR (species-specific nucleotide sequences of 18S rRNA genes) to explore the Plasmodium spp. in female Anopheles. In the current study, the percentage relative abundance of Culex mosquitoes was 57.65% and Anopheles 42.34% among the study areas. In addition, the highest number of mosquitoes was found in March in district Mandi Bahauddin at 21 °C (Tmax = 27, Tmin = 15) average temperature, 69% average relative humidity and 131 mm rainfall, and these climatic factors were found to affect the abundance of the mosquitoes, directly or indirectly. Molecular analysis showed that overall, 41.3% of the female Anopheles pools were positive for genus Plasmodium. Among species, the prevalence of Plasmodium (P.) vivax (78.1%) was significantly higher than P. falciparum (21.9%). This study will be helpful in the estimation of future risk of mosquito-borne diseases along with population dynamic of mosquitoes to enhance the effectiveness of vector surveillance and control programs.
Collapse
Affiliation(s)
- Haider Abbas
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan.
- Department of Pathobiology (Parasitology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan.
| | - Muhammad S Sajid
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Hafiz M Rizwan
- Department of Pathobiology (Parasitology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Urfa B Tahir
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
| | - Shahid H Farooqi
- Department of Clinical Sciences (Medicine Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Zeeshan Iqbal
- Department of Animal Sciences (Livestock Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Muhammad A Malik
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Kashaf Yaseen
- Institute of Microbiology, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Mahvish Maqbool
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Faiz A Raza
- Health Research Institute, National Institute of Health, Research Centre, , King Edward Medical University, Lahore, 54000, Pakistan
| | - Mohsin Raza
- Department of Basic Sciences (Physiology Section), KBCMA College of Veterinary and Animal Sciences, Narowal, Sub-Campus, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan
| | - Dalia Fouad
- Department of Zoology, College of Science, King Saud University, PO Box 22452, Riyadh, 11495, Saudi Arabia
| | - Farid S Ataya
- Department of Biochemistry, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia
| |
Collapse
|
2
|
Haq IU, Mehmood Z, Khan GA, Kainat B, Ahmed B, Shah J, Sami A, Nazar MS, Xu J, Xiang H. Modeling the effect of climatic conditions and topography on malaria incidence using Poisson regression: a Retrospective study in Bannu, Khyber Pakhtunkhwa, Pakistan. Front Microbiol 2024; 14:1303087. [PMID: 38287956 PMCID: PMC10822983 DOI: 10.3389/fmicb.2023.1303087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024] Open
Abstract
Background Malaria has been identified as a crucial vector-borne disease around the globe. The primary aim of this study was to investigate the incidence of malaria in the district of Bannu and its relationship with climatic conditions such as temperature, rainfall, relative humidity, and topography. Methods Secondary data were obtained from the metrological office and government hospitals across the district for 5 years (2013-2017). A Poisson regression model was applied for the statistical analysis. Results and discussion The number of reported cases of malaria was 175,198. The regression analysis showed that temperature, relative humidity, and rainfall had a significant association (p < 0.05) with malaria incidence. In addition, the topographic variables were significantly associated (p < 0.05) with malaria incidence in the region. The percent variation in the odds ratio of incidence was 4% for every unit increase in temperature and 2% in humidity. In conclusion, this study indicated that the temperature, humidity, rainfall, and topographic variables were significantly associated with the incidence of malaria. Effective malaria control and interventions integrated with climatic factors must be considered to overcome the disease burden.
Collapse
Affiliation(s)
- Ijaz Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Zafar Mehmood
- Department of Maths, Stats & Computer Science, The University of Agriculture Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Gausal Azam Khan
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia
| | - Bushra Kainat
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Bilal Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jahan Shah
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Amtul Sami
- Department of Health Biotechnology, Women University, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Subhan Nazar
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Jielian Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - He Xiang
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
3
|
Zehra A, Syed B, Masood F. RTS,S/AS01 Malaria Vaccine - The Next Step for a Developing Country. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E130-E131. [PMID: 35647385 PMCID: PMC9121669 DOI: 10.15167/2421-4248/jpmh2022.63.1.2379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Asmat Zehra
- Dow University of Health Sciences, Baba-e-Urdu Road Karachi, Pakistan
| | - Bushra Syed
- Dow University of Health Sciences, Baba-e-Urdu Road Karachi, Pakistan
| | - Fareeha Masood
- Dow University of Health Sciences, Baba-e-Urdu Road Karachi, Pakistan
| |
Collapse
|
4
|
Nadeem MF, Khattak AA, Zeeshan N, Zahid H, Awan UA, Yaqoob A, Ashraf NM, Gul S, Alam S, Ahmed W. Surveillance of molecular markers of antimalarial drug resistance in Plasmodium falciparum and Plasmodium vivax in Federally Administered Tribal Area (FATA), Pakistan. Rev Inst Med Trop Sao Paulo 2021; 63:e59. [PMID: 34407160 PMCID: PMC8323834 DOI: 10.1590/s1678-9946202163059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 11/22/2022] Open
Abstract
This molecular epidemiological study was designed to determine the antimalarial
drug resistance pattern, and the genetic diversity of malaria isolates collected
from a war-altered Federally Administered Tribal Area (FATA), in Pakistan.
Clinical isolates were collected from Bajaur, Mohmand, Khyber, Orakzai and
Kurram agencies of FATA region between May 2017 and May 2018, and they underwent
DNA extraction and amplification. The investigation of gene polymorphisms in
drug resistance genes (dhfr, dhps, crt, and
mdr1) of Plasmodium falciparum and
Plasmodium vivax was carried out by pyrosequencing and
Sanger sequencing, respectively. Out of 679 PCR-confirmed malaria samples, 523
(77%) were P. vivax, 121 (18%) P. falciparum,
and 35 (5%) had mixed-species infections. All P. falciparum
isolates had pfdhfr double mutants (C59R+S108N), while
pfdhfr/pfdhps triple mutants (C59R+S108N+A437G) were
detected in 11.5% of the samples. About 97.4% of P. falciparum
isolates contained pfcrt K76T mutation, while
pfmdr1 N86Y and Y184F mutations were present in 18.2% and
10.2% of the samples. P. vivax pvdhfr S58R mutation was present
in 24.9% of isolates and the S117N mutation in 36.2%, while no mutation in the
pvdhps gene was found. Pvmdr1 F1076L
mutation was found in nearly all samples, as it was observed in 98.9% of
isolates. No significant anti-folate and chloroquine resistance was observed in
P. vivax; however, mutations associated with
antifolate-resistance were found, and the chloroquine-resistant gene has been
observed in 100% of P. falciparum isolates. Chloroquine and
sulphadoxine-pyrimethamine resistance were found to be high in P.
falciparum and low in P. vivax. Chloroquine could
still be used for P. vivax infection but need to be tested
in vivo, whereas a replacement of the artemisinin
combination therapy for P. falciparum appears to be
justified.
Collapse
Affiliation(s)
- Muhammad Faisal Nadeem
- University of Gujrat, Department of Biochemistry & Biotechnology, Gujrat, Punjab, Pakistan
| | - Aamer Ali Khattak
- The University of Haripur, Department of Medical Laboratory Technology, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Nadia Zeeshan
- University of Gujrat, Department of Biochemistry & Biotechnology, Gujrat, Punjab, Pakistan
| | - Hamza Zahid
- Sandeman Provincial Hospital, Department of Surgery, Quetta, Balochistan, Pakistan
| | - Usman Ayub Awan
- The University of Haripur, Department of Medical Laboratory Technology, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Adnan Yaqoob
- University of Gujrat, Department of Biochemistry & Biotechnology, Gujrat, Punjab, Pakistan
| | - Naeem Mahmood Ashraf
- University of Gujrat, Department of Biochemistry & Biotechnology, Gujrat, Punjab, Pakistan
| | - Sana Gul
- National University of Medical Sciences, Department of Biological Sciences, Rawalpindi, Pujab, Pakistan
| | - Sadia Alam
- The University of Haripur, Department of Microbiology, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Waqas Ahmed
- The University of Haripur, Department of Microbiology, Haripur, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
5
|
Nadeem MF, Khattak AA, Zeeshan N, Zahid H, Awan UA, Yaqoob A, Ashraf NM, Gul S, Alam S, Ahmed W. Surveillance of molecular markers of antimalarial drug resistance in Plasmodium falciparum and Plasmodium vivax in Federally Administered Tribal Area (FATA), Pakistan. Rev Inst Med Trop Sao Paulo 2021. [DOI: 10.1590/s1678-994620216305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Sana Gul
- National University of Medical Sciences, Pakistan
| | | | | |
Collapse
|
6
|
Qureshi NA, Fatima H, Afzal M, Khattak AA, Nawaz MA. Occurrence and seasonal variation of human Plasmodium infection in Punjab Province, Pakistan. BMC Infect Dis 2019; 19:935. [PMID: 31694574 PMCID: PMC6836532 DOI: 10.1186/s12879-019-4590-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/23/2019] [Indexed: 11/26/2022] Open
Abstract
Background Malaria is the fifth leading cause of death worldwide. Pakistan is considered as a moderate malaria-endemic country but still, 177 million individuals are at risk of malaria. Roughly 60% of Pakistan’s population, live in malaria-endemic regions. The present study is based upon the survey of various health care centers in 10 major cities of Northern and Southern Punjab to find out the malarial infection patterns in 2015. The diagnosis, seasonal variations, age and gender-wise distribution of Plasmodium spp. circulating in the study area were also included in the objectives. Methods The malaria-suspected patients ‘16075’ were enrolled for malaria diagnosis using microscopy, out of which 925 were malaria positive which were processed for molecular analysis using nested PCR. The 18S rRNA genes of Plasmodium species were amplified, sequenced, blast and the phylogenetic tree was constructed based on sequences using online integrated tool MEGA7. Results The 364 cases recruited from Northern Punjab with the highest incidence in Rawalpindi (25.5%) and lowest in Chakwal (15.9%). From Southern Punjab 561 cases were enlisted Rajanpur (21.4%) maximum and lowest from Multan and Rahim Yar Khan (18%). The slide positivity rate, annual parasite incidence, and annual blood examination rates were 5.7 per 1000 population, 0.1, and 0.2% respectively. The only P. vivax (66.7%), P. falciparum (23.7%) and mixed infection by these two species (9.6%) were diagnosed. The same trend (P. vivax > P. falciparum > mixed infection) in species identification %age was confirmed from molecular analysis. However, the occurrence of malaria was higher in Southern Punjab (5.5%) as compared to the Northern Punjab (4.0%). The overall malaria percentage occurrence of treatment-seeking patients in all recruited cities of Punjab was 4.9%. The age-group of 1–20 and males among genders were more affected by malaria. The comparison of different seasons showed that the malaria infection was at a peak in Summer and post-monsoon. Conclusion The incidence of malaria was high in the flood infected rural areas of Southern Punjab, Summer, and post-monsoon. The age group (1–20) and gender-wise males were more affected by malaria.
Collapse
Affiliation(s)
- Naveeda Akhtar Qureshi
- Department of Animal Science, Faculty of Biological Science, Quaid-i-Azam University, Islamabad, 45320, Pakistan.
| | - Huma Fatima
- Department of Animal Science, Faculty of Biological Science, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Muhammad Afzal
- Department of Animal Science, Faculty of Biological Science, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Aamer Ali Khattak
- Department of Medical Laboratory Technology, University of Haripur, Haripur, Khyber Pakhtunkhwa, 26220, Pakistan
| | - Muhammad Ali Nawaz
- Department of Animal Science, Faculty of Biological Science, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| |
Collapse
|
7
|
Jahan F, Khan NH, Wahid S, Ullah Z, Kausar A, Ali N. Malaria epidemiology and comparative reliability of diagnostic tools in Bannu; an endemic malaria focus in south of Khyber Pakhtunkhwa, Pakistan. Pathog Glob Health 2019; 113:75-85. [PMID: 30894081 DOI: 10.1080/20477724.2019.1595904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The present study was aimed at elucidation of malaria epidemiology and comparing performance of several diagnostic procedures in Bannu, a highly endemic district of Khyber Pakhtunkhwa, Pakistan. Dried blood spots were collected from patients suspected of malaria visiting a hospital and two private laboratories in district Bannu and processed for species-specific PCR (rRNA). Patients were also screened for malaria through microscopy and RDT. A well-structured questionnaire was used to collect patient information to assess risk factors for malaria. Of 2033 individuals recruited, 21.1% (N = 429) were positive for malaria by at least one method. Overall, positivity detected by PCR was 30.5% (95/311) followed by 17.7% by microscopy (359/2033) and 16.4% by RDT (266/1618). Plasmodium vivax (16.9%, N = 343) was detected as the dominant species followed by Plasmodium falciparum (2.3%, N = 47) and mixed infections (1.2%, N = 39). Microscopy and RDT (Cohen's kappa k = 0.968, p = <0.0001, McNemar test p = 0.069) displayed significant agreement with each other. Satisfactory health, sleeping indoors, presence of health-care facility in vicinity (at an accessible range from home), living in upper middle class and in concrete houses significantly reduced malaria risk; whereas, low literacy level, presence of domestic animals indoors and malaria diagnosis recommended by clinician increased the disease risk. Overall, findings from the study provide reasonable basis for use of RDT as a cost-effective screening tool in field and for clinicians who can proceed with timely treatment of malaria patients. Appropriate management of identified risk factors could contribute to reduction of malaria prevalence in Bannu and its peripheries.
Collapse
Affiliation(s)
- Fatima Jahan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Nazma Habib Khan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Sobia Wahid
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Zaki Ullah
- b Department of Pharmacy , University of Peshawar , Peshawar , Pakistan
| | - Aisha Kausar
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Naheed Ali
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| |
Collapse
|
8
|
Howard N, Guinness L, Rowland M, Durrani N, Hansen KS. Cost-effectiveness of adding indoor residual spraying to case management in Afghan refugee settlements in Northwest Pakistan during a prolonged malaria epidemic. PLoS Negl Trop Dis 2017; 11:e0005935. [PMID: 29059179 PMCID: PMC5695615 DOI: 10.1371/journal.pntd.0005935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 11/02/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Financing of malaria control for displaced populations is limited in scope and duration, making cost-effectiveness analyses relevant but difficult. This study analyses cost-effectiveness of adding prevention through targeted indoor residual spraying (IRS) to case management in Afghan refugee settlements in Pakistan during a prolonged malaria epidemic. Methods/Findings An intervention study design was selected, taking a societal perspective. Provider and household costs of vector control and case management were collected from provider records and community survey. Health outcomes (e.g. cases and DALYs averted) were derived and incremental cost-effectiveness ratios (ICERs) for cases prevented and DALYs averted calculated. Population, treatment cost, women’s time, days of productivity lost, case fatality rate, cases prevented, and DALY assumptions were tested in sensitivity analysis. Malaria incidence peaked at 44/1,000 population in year 2, declining to 14/1,000 in year 5. In total, 370,000 malaria cases, 80% vivax, were diagnosed and treated and an estimated 67,988 vivax cases and 18,578 falciparum and mixed cases prevented. Mean annual programme cost per capita was US$0.56. The additional cost of including IRS over five years per case prevented was US$39; US$50 for vivax (US$43 in years 1–3, US$80 in years 4–5) and US$182 for falciparum (US$139 in years 1–3 and US$680 in years 4–5). Per DALY averted this was US$266 (US$220 in years 1–3 and US$486 in years 4–5) and thus ‘highly cost-effective’ or cost-effective using WHO and comparison thresholds. Conclusions Adding IRS was cost-effective in this moderate endemicity, low mortality setting. It was more cost-effective when transmission was highest, becoming less so as transmission reduced. Because vivax was three times more common than falciparum and the case fatality rate was low, cost-effectiveness estimations for cases prevented appear reliable and more definitive for vivax malaria. We conducted a cost-effectiveness analysis of adding malaria prevention to routine malaria diagnosis and treatment in Afghan refugee settlements in Pakistan during a five-year malaria epidemic. We found that malaria incidence peaked at 44 per 1,000 in year 2 and declined to 14 per 1,000 in year 5, with an average annual programme cost per capita of US$0.56 in 2015 currency. Cost per case prevented averaged US$88 (US$111 for vivax, US$442 for falciparum), per death prevented averaged US$316,734, and per DALY averted averaged US$601. The additional cost of including IRS over five years per case prevented was US$39 (US$50 for vivax and US$182 for falciparum malaria case prevented) and per DALY averted was US$266. While our cost-effectiveness results were relatively high, when compared with internationally recognised cost-effectiveness thresholds both prevention and case management were highly cost-effective, indicating the relevance of an integrated approach for epidemic malaria control and global malaria elimination.
Collapse
Affiliation(s)
- Natasha Howard
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Lorna Guinness
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mark Rowland
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- HealthNet-TPO, Peshawar, Pakistan
| | | | - Kristian S. Hansen
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
9
|
Rab MA, Freeman TW, Durrani N, Poerck DD, Rowland MW. Resistance ofPlasmodium falciparummalaria to chloroquine is widespread in eastern Afghanistan. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.2001.11813613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
10
|
Rowland M, Nosten F. Malaria epidemiology and control in refugee camps and complex emergencies. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.2001.11813694] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
11
|
Ghanchi NK, Shakoor S, Thaver AM, Khan MS, Janjua A, Beg MA. Current situation and challenges in implementing Malaria control strategies in Pakistan. Crit Rev Microbiol 2014; 42:588-93. [DOI: 10.3109/1040841x.2014.973368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- N. K. Ghanchi
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan and
| | - S. Shakoor
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan and
| | - A. M. Thaver
- Medical College, Aga Khan University, Karachi, Pakistan
| | - M. S. Khan
- Medical College, Aga Khan University, Karachi, Pakistan
| | - A. Janjua
- Medical College, Aga Khan University, Karachi, Pakistan
| | - M. A. Beg
- Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan and
| |
Collapse
|
12
|
Alegana VA, Wright JA, Nahzat SM, Butt W, Sediqi AW, Habib N, Snow RW, Atkinson PM, Noor AM. Modelling the incidence of Plasmodium vivax and Plasmodium falciparum malaria in Afghanistan 2006-2009. PLoS One 2014; 9:e102304. [PMID: 25033452 PMCID: PMC4102516 DOI: 10.1371/journal.pone.0102304] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/16/2014] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Identifying areas that support high malaria risks and where populations lack access to health care is central to reducing the burden in Afghanistan. This study investigated the incidence of Plasmodium vivax and Plasmodium falciparum using routine data to help focus malaria interventions. METHODS To estimate incidence, the study modelled utilisation of the public health sector using fever treatment data from the 2012 national Malaria Indicator Survey. A probabilistic measure of attendance was applied to population density metrics to define the proportion of the population within catchment of a public health facility. Malaria data were used in a Bayesian spatio-temporal conditional-autoregressive model with ecological or environmental covariates, to examine the spatial and temporal variation of incidence. FINDINGS From the analysis of healthcare utilisation, over 80% of the population was within 2 hours' travel of the nearest public health facility, while 64.4% were within 30 minutes' travel. The mean incidence of P. vivax in 2009 was 5.4 (95% Crl 3.2-9.2) cases per 1000 population compared to 1.2 (95% Crl 0.4-2.9) cases per 1000 population for P. falciparum. P. vivax peaked in August while P. falciparum peaked in November. 32% of the estimated 30.5 million people lived in regions where annual incidence was at least 1 case per 1,000 population of P. vivax; 23.7% of the population lived in areas where annual P. falciparum case incidence was at least 1 per 1000. CONCLUSION This study showed how routine data can be combined with household survey data to model malaria incidence. The incidence of both P. vivax and P. falciparum in Afghanistan remain low but the co-distribution of both parasites and the lag in their peak season provides challenges to malaria control in Afghanistan. Future improved case definition to determine levels of imported risks may be useful for the elimination ambitions in Afghanistan.
Collapse
Affiliation(s)
- Victor A. Alegana
- Spatial Health Metrics Group, Department of Public Health, KEMRI-Wellcome Trust, Nairobi, Kenya
- Centre for Geographical Health Research, Geography and Environment, University of Southampton, Highfield Southampton, United Kingdom
| | - Jim A. Wright
- Centre for Geographical Health Research, Geography and Environment, University of Southampton, Highfield Southampton, United Kingdom
| | - Sami M. Nahzat
- National Malaria and Leishmaniasis Control Programme, Ministry of Public Health, Kabul, Afghanistan
| | - Waqar Butt
- Malaria and Leishmaniasis, WHO Office, Kabul, Afghanistan
| | - Amad W. Sediqi
- National Malaria and Leishmaniasis Control Programme, Ministry of Public Health, Kabul, Afghanistan
| | - Naeem Habib
- Malaria and Leishmaniasis, WHO Office, Kabul, Afghanistan
| | - Robert W. Snow
- Spatial Health Metrics Group, Department of Public Health, KEMRI-Wellcome Trust, Nairobi, Kenya
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Peter M. Atkinson
- Centre for Geographical Health Research, Geography and Environment, University of Southampton, Highfield Southampton, United Kingdom
| | - Abdisalan M. Noor
- Spatial Health Metrics Group, Department of Public Health, KEMRI-Wellcome Trust, Nairobi, Kenya
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
13
|
Malik M, Hassali MA, Shafie AA, Hussain A. A qualitative study exploring perspectives towards rational use of medicines in Pakistan's Malaria Control Program (MCP). BRAZ J PHARM SCI 2013. [DOI: 10.1590/s1984-82502013000200014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Malaria is one of the most important global public health problems threatening the health of the population owing to prevailing socio-economic conditions and epidemiological reasons in Pakistan. This qualitative study has focused on the perspectives held towards the rational use of medicine intervention among malaria control program officials. Eight semi-structured interviews with all officials working for the malaria control program in Islamabad were conducted. The interviews, which were audio-taped and transcribed verbatim, were evaluated by thematic content analysis and by all authors. All respondents agreed on successful implementation of the malaria control program in Pakistan for controlling malaria by improving diagnostic and treatment facilities and promoting rational case management through training of prescribers. However, funding is still the major challenge faced by the program for its future implementation.
Collapse
Affiliation(s)
| | | | | | - Azhar Hussain
- Universiti Sains Malaysia, Malaysia; Hamdard University, Pakistan
| |
Collapse
|
14
|
Kolaczinski K, Leslie T, Ali I, Durrani N, Lee S, Barends M, Beshir K, Ord R, Hallett R, Rowland M. Defining Plasmodium falciparum treatment in South West Asia: a randomized trial comparing artesunate or primaquine combined with chloroquine or SP. PLoS One 2012; 7:e28957. [PMID: 22303437 PMCID: PMC3269419 DOI: 10.1371/journal.pone.0028957] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 11/17/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Antimalarial resistance has led to a global policy of artemisinin-based combination therapy. Despite growing resistance chloroquine (CQ) remained until recently the official first-line treatment for falciparum malaria in Pakistan, with sulfadoxine-pyrimethamine (SP) second-line. Co-treatment with the gametocytocidal primaquine (PQ) is recommended for transmission control in South Asia. The relative effect of artesunate (AS) or primaquine, as partner drugs, on clinical outcomes and gametocyte carriage in this setting were unknown. METHODS A single-blinded, randomized trial among Afghan refugees in Pakistan compared six treatment arms: CQ; CQ+(single-dose)PQ; CQ+(3 d)AS; SP; SP+(single-dose)PQ, and SP+(3 d)AS. The objectives were to compare treatment failure rates and effect on gametocyte carriage, of CQ or SP monotherapy against the respective combinations (PQ or AS). Outcomes included trophozoite and gametocyte clearance (read by light microscopy), and clinical and parasitological failure. FINDINGS A total of 308 (87%) patients completed the trial. Failure rates by day 28 were: CQ 55/68 (81%); CQ+AS 19/67 (28%), SP 4/41 (9.8%), SP+AS 1/41 (2.4%). The addition of PQ to CQ or SP did not affect failure rates (CQ+PQ 49/67 (73%) failed; SP+PQ 5/33 (16%) failed). AS was superior to PQ at clearing gametocytes; gametocytes were seen on d7 in 85% of CQ, 40% of CQ+PQ, 21% of CQ+AS, 91% of SP, 76% of SP+PQ and 23% of SP+AS treated patients. PQ was more effective at clearing older gametocyte infections whereas AS was more effective at preventing emergence of mature gametocytes, except in cases that recrudesced. CONCLUSIONS CQ is no longer appropriate by itself or in combination. These findings influenced the replacement of CQ with SP+AS for first-line treatment of uncomplicated falciparum malaria in the WHO Eastern Mediterranean Region. The threat of SP resistance remains as SP monotherapy is still common. Three day AS was superior to single-dose PQ for reducing gametocyte carriage. TRIAL REGISTRATION ClinicalTrials.gov NCT00959517.
Collapse
Affiliation(s)
- Kate Kolaczinski
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Unless new strategies are deployed to combat malaria, the already enormous health and economic burden related to the disease in tropical countries is bound to worsen. The main obstacle to malaria control is the emergence of drug resistant strains of Plasmodium falciparum. As for HIV/AIDS and tuberculosis, the use of combinations of antimalarial drugs reduces the risk of selecting for resistant mutants of the plasmodial parasites. In large field trials, the combination of an artemisinin derivative and a partner drug with an unrelated mode of action (in this case mefloquine), has shown a remarkable double effect: preventing the emergence and spread of drug resistance, and interrupting the transmission of P. falciparum. This has opened the way for a new approach to the deployment of antimalarial drugs. Coupled with early detection and confirmed diagnosis, this strategy represents the only way forward in the chemotherapy of malaria. Massive economic assistance will be needed to detect and treat adequately the estimated 500 million cases of malaria per year, but without radical action there is no prospect of 'Rolling Back' malaria.
Collapse
|
16
|
Wallace MR, Hale BR, Utz GC, Olson PE, Earhart KC, Thornton SA, Hyams KC. Endemic infectious diseases of Afghanistan. Clin Infect Dis 2002; 34:S171-207. [PMID: 12019465 DOI: 10.1086/340704] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The current crisis in Afghanistan has resulted in an influx of Western military personnel, peacekeepers, humanitarian workers, and journalists. At the same time, unprecedented numbers of internally displaced persons and refugees have overwhelmed much of the already fragile infrastructure, setting the stage for outbreaks of infectious diseases among both foreigners and local populations. This review surveys the literature concerning the infectious diseases of Afghanistan and south-central Asia, with particular emphasis on diseases not typically seen in the Western world.
Collapse
|
17
|
Sharp TW, Burkle FM, Vaughn AF, Chotani R, Brennan RJ. Challenges and opportunities for humanitarian relief in Afghanistan. Clin Infect Dis 2002; 34:S215-28. [PMID: 12019467 DOI: 10.1086/340706] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Afghanistan is in the midst of a profound humanitarian crisis resulting primarily from long-standing armed conflict, a devastating drought, and massive population migration. The economy, government, and health care system are in shambles. Currently, as many as 5 million Afghans are in camps either as refugees in neighboring countries or as internally displaced persons within Afghanistan. Much of the rest of the population is in dire need of basic essentials such as food, water, shelter, and basic medical care. Those attempting to carry out humanitarian relief face many daunting challenges, such as reaching remote locations, coping with a dangerous security situation, and working with limited resources. However, there are opportunities in the short run to save many lives and substantially improve the plight of Afghans by carrying out appropriate and effective emergency relief programs. Over the long term, effective medical and public health relief efforts will be an essential part of rehabilitating and rebuilding this devastated country.
Collapse
Affiliation(s)
- Trueman W Sharp
- Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| | | | | | | | | |
Collapse
|