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Ompad DC, Padhan TK, Kessler A, Tozan Y, Jones AM, van Eijk AM, Sullivan SA, Haque MA, Pradhan MM, Mohanty S, Carlton JM, Sahu PK. The effectiveness of malaria camps as part of the malaria control program in Odisha, India. Sci Rep 2023; 13:22998. [PMID: 38155156 PMCID: PMC10754896 DOI: 10.1038/s41598-023-46220-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: 01/10/2023] [Accepted: 10/30/2023] [Indexed: 12/30/2023] Open
Abstract
Durgama Anchalare Malaria Nirakaran (DAMaN) is a multi-component malaria intervention for hard-to-reach villages in Odisha, India. The main component, malaria camps (MCs), consists of mass screening, treatment, education, and intensified vector control. We evaluated MC effectiveness using a quasi-experimental cluster-assigned stepped-wedge study with a pretest-posttest control group in 15 villages: six immediate (Arm A), six delayed (Arm B), and three previous interventions (Arm C). The primary outcome was PCR + Plasmodium infection prevalence. The time (i.e., baseline vs. follow-up 3) x study arm interaction term shows that there were statistically significant lower odds of PCR + Plasmodium infection in Arm A (AOR = 0.36, 95% CI = 0.17, 0.74) but not Arm C as compared to Arm B at the third follow-up. The cost per person ranged between US$3-8, the cost per tested US$4-9, and the cost per treated US$82-1,614, per camp round. These results suggest that the DAMaN intervention is a promising and financially feasible approach for malaria control.
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Affiliation(s)
- Danielle C Ompad
- School of Global Public Health, New York University, New York, NY, 10003, USA.
| | - Timir K Padhan
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Yesim Tozan
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Abbey M Jones
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mohammed A Haque
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Madan Mohan Pradhan
- Department of Health and Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, Odisha, 751001, India
| | - Sanjib Mohanty
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Jane M Carlton
- School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Global Public Health, Baltimore, MD, 21205, USA
| | - Praveen K Sahu
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
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Ompad DC, Padhan TK, Kessler A, Mohanty S, Tozan Y, Jones AM, van Eijk AM, Sullivan SA, Haque MA, Pradhan MM, Mohanty S, Carlton JM, Sahu PK. The effectiveness of malaria camps as part of the malaria control program in Odisha, India. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.18.23284743. [PMID: 36711482 PMCID: PMC9882634 DOI: 10.1101/2023.01.18.23284743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Durgama Anchalare Malaria Nirakaran (DAMaN) is a multi-component malaria intervention for hard-to-reach villages in Odisha, India. The main component, Malaria Camps (MCs), consists of mass screening, treatment, education, and intensified vector control. We evaluated MC effectiveness using a quasi-experimental cluster-assigned stepped-wedge study with a pretest-posttest control group in 15 villages: six immediate (Arm A), six delayed (Arm B), and three previous interventions (Arm C). The primary outcome was PCR+ Plasmodium infection prevalence. Across all arms, the odds of PCR+ malaria were 54% lower at the third follow-up compared to baseline. A time (i.e., visit) x study arm interaction revealed significantly lower odds of PCR+ malaria in Arm A versus B at the third follow-up. The cost per person ranged between US$3-8, the cost per tested US$4-7, and the cost per treated US$82-1,614, per camp round. These results suggest that the DAMaN intervention is a promising, financially feasible approach for malaria control.
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Affiliation(s)
- Danielle C Ompad
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Timir K Padhan
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Stuti Mohanty
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Yesim Tozan
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Abbey M Jones
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mohammed A Haque
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Madan Mohan Pradhan
- Department of Health & Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, Odisha, 751001, India
| | - Sanjib Mohanty
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Jane M Carlton
- School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Praveen K Sahu
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
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Carlton JM, Sahu PK, Wassmer SC, Mohanty S, Kessler A, Eapen A, Tomko SS, Walton C, Joshi PL, Das D, Albert S, Peter BK, Pradhan MM, Dash AP, Das A. The Impact, Emerging Needs, and New Research Questions Arising from 12 Years of the Center for the Study of Complex Malaria in India. Am J Trop Med Hyg 2022; 107:90-96. [PMID: 36228922 PMCID: PMC9662226 DOI: 10.4269/ajtmh.21-1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
The Center for the Study of Complex Malaria in India (CSCMi) was launched in 2010 with the overall goal of addressing major gaps in our understanding of "complex malaria" in India through projects on the epidemiology, transmission, and pathogenesis of the disease. The Center was mandated to adopt an integrated approach to malaria research, including building capacity, developing infrastructure, and nurturing future malaria leaders while conducting relevant and impactful studies to assist India as it moves from control to elimination. Here, we will outline some of the interactions and impacts the Center has had with malaria policy and control counterparts in India, as well as describe emerging needs and new research questions that have become apparent over the past 12 years.
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Affiliation(s)
- Jane M. Carlton
- Department of Biology, Center for Genomics and Systems Biology, New York University, New York, New York
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
- Address correspondence to Jane M. Carlton, Center for Genomics and Systems Biology, New York University, 12 Waverly Place, New York, NY 10003. E-mail:
| | - Praveen K. Sahu
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, India
| | - Samuel C. Wassmer
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sanjib Mohanty
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, India
| | - Anne Kessler
- Department of Biology, Center for Genomics and Systems Biology, New York University, New York, New York
| | - Alex Eapen
- IDVC Field Unit, National Institute of Malaria Research, Indian Council of Medical Research, National Institute of Epidemiology Campus, Chennai, India
| | - Sheena Shah Tomko
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Catherine Walton
- Department of Earth and Environmental Sciences, School of Natural Sciences, University of Manchester, Manchester, United Kingdom
| | - Pyare L. Joshi
- Joint Scientific Advisory Committee, Indian Council of Medical Research, and Malaria No More, India Programme, New Delhi, India
| | - Deben Das
- District Headquarters Hospital, Keonjhar, India
| | - Sandra Albert
- Indian Institute of Public Health—Shillong, Shillong, India
- Martin Luther Christian University, Shillong, India
| | | | - Madan M. Pradhan
- Department of Health and Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, India
| | - Aditya P. Dash
- Asian Institute of Public Health University, Bhubaneswar, India
| | - Aparup Das
- National Institute of Research in Tribal Health, Indian Council of Medical Research, Jabalpur, India
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Sarkar R, Kessler A, Mawkhlieng B, Sullivan SA, Wilson ML, Carlton JM, Albert S. Household and individual level risk factors associated with declining malaria incidence in Meghalaya, India: implications for malaria elimination in low-endemic settings. Malar J 2021; 20:460. [PMID: 34895233 PMCID: PMC8665616 DOI: 10.1186/s12936-021-03982-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/12/2021] [Indexed: 01/02/2023] Open
Abstract
Background A detailed analysis of household and individual level Plasmodium infection patterns in two low-endemic districts of Meghalaya was undertaken to better understand the epidemiology of malaria in northeast India. Methods Socio-demographic and behavioural information from residents (aged 1–69 years) of households were collected through pre-tested, questionnaire conducted in 2018 and 2019. Blood samples collected from participants were tested for Plasmodium falciparum and/or Plasmodium vivax infection using rapid diagnostic test, microscopy and PCR. Plasma samples from a subset of participants were analysed for antibodies against thirteen P. falciparum and four P. vivax antigens. Associations between household and individual level risk factors, and Plasmodium infections were evaluated using multilevel logistic regression models. Results A total of 2753 individuals from 827 households were enrolled in 2018, and 834 individuals from 222 households were enrolled in 2019. Of them, 33 (1.2%) were positive by PCR for P. falciparum in 2018 and none were positive for P. vivax. In 2019, no PCR-positive individuals were detected. All, but one, infections were asymptomatic; all 33 infections were sub-microscopic. Reported history of malaria in the past 12 months (OR = 8.84) and history of travel in the past 14 days (OR = 10.06) were significantly associated with Plasmodium infection. A significant trend of increased seropositivity with age was noted for all 17 antigens. Although adults (≥ 18 years) consistently had the highest seropositivity rates, a sizeable proportion of under-five children were also found to be seropositive. Almost all individuals (99.4%) reported sleeping under an insecticide-treated bed-net, and household indoor residual spray coverage in the 12 months preceding the survey was low (23%). Most participants correctly identified common signs and symptoms of malaria, i.e., fever (96.4%), headache (71.2%), chills (83.2%) and body-ache (61.8%). Almost all participants (94.3%) used government-provided services for treatment of malaria. Conclusion This study explored the epidemiology of malaria in two communities in Meghalaya, India, in the context of declining transmission. The presence of widespread asymptomatic infections and seropositivity among under-five children suggest that low-level Plasmodium transmission persists in this region. Implications of the study findings for malaria elimination efforts in low-transmission settings are discussed.
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Affiliation(s)
- Rajiv Sarkar
- Indian Institute of Public Health - Shillong, Shillong, Meghalaya, 793001, India. .,Martin Luther Christian University, Shillong, Meghalaya, 793006, India.
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | | | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mark L Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,Department of Epidemiology, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Sandra Albert
- Indian Institute of Public Health - Shillong, Shillong, Meghalaya, 793001, India.,Martin Luther Christian University, Shillong, Meghalaya, 793006, India
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