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Njewa B, Eyong EEJ, Ebai CB. Malaria parasitaemia and its impact on biological parameters among children <16 years old attending the Nkwen District Hospital, Cameroon. MALARIAWORLD JOURNAL 2024; 15:3. [PMID: 38476708 PMCID: PMC10929319 DOI: 10.5281/zenodo.10731943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Introduction Malaria remains a major public health problem in children in endemic areas. This study aimed to determine its prevalence, intensity, and assess how biological parameters like RBC count, haemoglobin, haematocrit, glycaemia, platelet count and WBC count vary with respect to parasitaemia in children <16 years attending the Nkwen District Hospital, northwest Cameroon. Materials and Methods The study was a hospital-based cross-sectional study conducted between March-May 2023. Structured, closed-ended questionnaires were administered to obtain information. Patients' temperature was measured using an infrared forehead digital thermometer. Malaria was diagnosed by RDT and positive samples Giemsa-stained for parasitaemia. Full blood count was performed using a haemolyser and glycaemia measured using a glucometer. Results In total, 321 children were examined. Overall prevalence of malaria (all P. falciparum) was 22.7% (73/321), with 24.7% (18/73), 34.2% (25/73) and 41.1% (30/73) having low, moderate and high parasitaemias, respectively. Overall GMPD was 2.670.8±179.9/μL; children aged 6-10 years were hit hardest (5.377.7 ± 3.2/μL). Malaria-positive children had significantly lower RBC count, Hb concentration, Hct, blood sugar, WBC and platelet counts (p<0.05) compared to those that were negative. Among positive children, RBC count, Hct, Hb, lymphocyte and platelet count each showed a significant (p<0.05) decrease while total WBC and granulocyte count each showed a significant (p<0.05) increase with increasing levels of parasitaemia. Conclusions Changes in biological parameters during malaria are sensitive but poor specific indicators of malaria because they may overlap with symptoms of other infections. More attention should be given to children aged 6-10 years during strategic planning and design of malaria control programmes.
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Affiliation(s)
- Bertrand Njewa
- Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon
| | - Ebanga Echi Joan Eyong
- Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon
| | - Calvin Bissong Ebai
- Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon
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Jugha VT, Anchang JA, Taiwe GS, Kimbi HK, Anchang-Kimbi JK. Association between malaria and undernutrition among pregnant women at presentation for antenatal care in health facilities in the Mount Cameroon region. PLoS One 2023; 18:e0292550. [PMID: 37824491 PMCID: PMC10569528 DOI: 10.1371/journal.pone.0292550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023] Open
Abstract
In resource limited settings, malaria and undernutrition are major public health problems in pregnancy. Therefore, this study assessed the association between malaria infection and undernutrition among pregnant women in the Mount Cameroon area. This cross-sectional study enrolled 1,014 pregnant women consecutively over a year. A structured questionnaire was used to collect socio-demographic information and clinical data. Maternal nutrition was assessed using dietary diversity (DD). Peripheral blood samples collected were used for the diagnosis of malaria parasitaemia by microscopy whereas haemoglobin (Hb) levels were determined using an Hb meter. Logistic regression was used to determine factors associated with malaria and dietary diversity. The prevalence of malaria infection and undernutrition was 17.8% and 89.6% respectively. In addition, of those infected with malaria, geometric mean parasite density was 301/μL of blood (range: 40-9280) while mean DD score was 3.57±0.82 (range: 1-7). The odds of being infected with malaria parasitaemia was highest among women enrolled in the rainy season (OR = 1.58, P = 0.043), who were farmers (OR = 2.3, P = 0.030), had a household size of < 4 individuals (OR = 1.48, P = 0.026) and who were febrile (OR = 1.87, P < 0.001). Also, attending clinic visits in Mutengene Medical Centre (OR = 2.0, P = 0.012) or Buea Integrated Health Centre (OR = 2.9, P = < 0.001), being < 25 years (OR = 2.4, P = 0.002) and a farmer (OR = 10.6, P = 0.024) as well as < 4 clinic visits (OR = 1.62, P = 0.039) were identified as predictors of undernutrition. Furthermore, the association between malaria and DD was statistically significant (P = 0.015). In this study, undernutrition was highly frequent than malaria infection. Thus, there is an urgent need to improve maternal awareness through nutritional counselling and health campaigns on the benefits of consuming at least five food groups. Besides, improved maternal dietary nutrient intake is likely to have impact on the burden of malaria parasite infection.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Juliana Adjem Anchang
- International Centre for Agricultural Research in the Dry Areas, ICARDA, Cairo, Eygpt
| | | | - Helen Kuokuo Kimbi
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
- Department of Biomedical Sciences, University of Bamenda, Bamenda, Cameroon
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
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Sama SO, Taiwe GS, Teh RN, Njume GE, Chiamo SN, Sumbele IUN. Anaemia, iron deficiency and inflammation prevalence in children in the Mount Cameroon area and the contribution of inflammatory cytokines on haemoglobin and ferritin concentrations: a cross sectional study. BMC Nutr 2023; 9:94. [PMID: 37507740 PMCID: PMC10375674 DOI: 10.1186/s40795-023-00748-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Iron deficiency (ID) and anaemia of inflammation (AI) coexist where infections and nutritional deficiencies are common. The aim of this study was to determine burden of ID, anaemia, inflammation and AI in children in malaria endemic Limbe, Mount Cameroon as well as decipher the contribution of some inflammatory cytokines on the concentration of haemoglobin and ferritin. METHODS A total of 520 children aged ≤ 15 years old from the Limbe Health District (LHD) were randomly selected and examined in a cross-sectional study for iron deficiency, anaemia, inflammation and inflammation anaemia. Collected blood samples were used for full blood count and inflammatory marker analyses with the aid of a haemoanalyzer and ELISA machine, respectively. Spearman's rank correlation analysis was used to determine the correlation between cytokines and haemoglobin while multiple linear regression analysis was used to evaluate the effects of inflammatory cytokines on haemoglobin and ferritin concentrations. RESULTS The overall prevalence of anaemia, ID, IDA, inflammation and AI were respectively, 67.5%, 34.6%, 12.9%, 63.1% and 30.2%. Children aged 12‒15 years (P = 0.001), enrolled from the community (P < 0.001), whose parents are civil servants (P < 0.001), living in a home with 6‒10 occupants (P = 0.016), afebrile (P < 0.001) and malaria negative (P = 0.007) had the highest prevalence of ID while, children ≤ 5 years old (P = 0.001), with a family size of 1‒5 occupants (P = 0.033) had the highest prevalence of AI. Haemoglobin concentration positively correlated with concentrations of IFN-γ (P < 0.001), TNF-α (0.045) and ferritin (P < 0.001) while a negative correlation was observed with IL-10 (P = 0.003). In the multiple linear regression analysis only IL-6 significantly (P = 0.030) influenced haemoglobin concentration. CONCLUSIONS While IL-6 is of significance in the pathology of anaemia, iron deficiency and anaemia of inflammation are of moderate public health concerns in the Mount Cameroon area. Hence, appropriate intervention against anaemia, ID and AI should be directed at children ≤ 5 years and counterparts > 10 years old that bear the highest burden.
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Affiliation(s)
- Sharon Odmia Sama
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | | | - Rene Ning Teh
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon.
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Wynberg E, Commons RJ, Humphreys G, Ashurst H, Burrow R, Adjei GO, Adjuik M, Anstey NM, Anvikar A, Baird KJ, Barber BE, Barennes H, Baudin E, Bell DJ, Bethell D, Binh TQ, Borghini-Fuhrer I, Chu CS, Daher A, D’Alessandro U, Das D, Davis TME, de Vries PJ, Djimde AA, Dondorp AM, Dorsey G, Faucher JFF, Fogg C, Gaye O, Grigg M, Hatz C, Kager PA, Lacerda M, Laman M, Mårtensson A, Menan HIE, Monteiro WM, Moore BR, Nosten F, Ogutu B, Osorio L, Penali LK, Pereira DB, Rahim AG, Ramharter M, Sagara I, Schramm B, Seidlein L, Siqueira AM, Sirima SB, Starzengruber P, Sutanto I, Taylor WR, Toure OA, Utzinger J, Valea I, Valentini G, White NJ, William T, Woodrow CJ, Richmond CL, Guerin PJ, Price RN, Stepniewska K. Variability in white blood cell count during uncomplicated malaria and implications for parasite density estimation: a WorldWide Antimalarial Resistance Network individual patient data meta-analysis. Malar J 2023; 22:174. [PMID: 37280686 DOI: 10.1186/s12936-023-04583-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends that when peripheral malarial parasitaemia is quantified by thick film microscopy, an actual white blood cell (WBC) count from a concurrently collected blood sample is used in calculations. However, in resource-limited settings an assumed WBC count is often used instead. The aim of this study was to describe the variability in WBC count during acute uncomplicated malaria, and estimate the impact of using an assumed value of WBC on estimates of parasite density and clearance. METHODS Uncomplicated malaria drug efficacy studies that measured WBC count were selected from the WorldWide Antimalarial Resistance Network data repository for an individual patient data meta-analysis of WBC counts. Regression models with random intercepts for study-site were used to assess WBC count variability at presentation and during follow-up. Inflation factors for parasitaemia density, and clearance estimates were calculated for methods using assumed WBC counts (8000 cells/µL and age-stratified values) using estimates derived from the measured WBC value as reference. RESULTS Eighty-four studies enrolling 27,656 patients with clinically uncomplicated malaria were included. Geometric mean WBC counts (× 1000 cells/µL) in age groups < 1, 1-4, 5-14 and ≥ 15 years were 10.5, 8.3, 7.1, 5.7 and 7.5, 7.0, 6.5, 6.0 for individuals with falciparum (n = 24,978) and vivax (n = 2678) malaria, respectively. At presentation, higher WBC counts were seen among patients with higher parasitaemia, severe anaemia and, for individuals with vivax malaria, in regions with shorter regional relapse periodicity. Among falciparum malaria patients, using an assumed WBC count of 8000 cells/µL resulted in parasite density underestimation by a median (IQR) of 26% (4-41%) in infants < 1 year old but an overestimation by 50% (16-91%) in adults aged ≥ 15 years. Use of age-stratified assumed WBC values removed systematic bias but did not improve precision of parasitaemia estimation. Imprecision of parasite clearance estimates was only affected by the within-patient WBC variability over time, and remained < 10% for 79% of patients. CONCLUSIONS Using an assumed WBC value for parasite density estimation from a thick smear may lead to underdiagnosis of hyperparasitaemia and could adversely affect clinical management; but does not result in clinically consequential inaccuracies in the estimation of the prevalence of prolonged parasite clearance and artemisinin resistance.
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Madkhali AM, Mobarki AA, Ghzwani AH, Al-Mekhlafi HM, Zhranei A, Osais A, Sohel A, Othman B, Dobie G, Hamali HA. Elevated Levels of Procoagulant Microvesicles and Tissue-Factor Bearing Microvesicles in Malaria Patients. Int J Gen Med 2023; 16:1205-1215. [PMID: 37041799 PMCID: PMC10083009 DOI: 10.2147/ijgm.s402212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
Background Procoagulant microvesicles (MVs) are submicron membrane fragments released from activated cells and cells undergoing apoptosis. The procoagulant activity of MVs is enhanced in the presence of tissue factor (TF). MVs and TF are active mediators that induce pro-inflammatory response and prothrombotic tendency and have been linked to the severity of several disorders, including malaria infection. The current study aimed to measure the levels of circulating procoagulant MVs and TF-bearing MVs in malaria patients and correlate these levels with other hematological parameters and parasitemia. Materials and Methods Levels of MVs and TF-bearing MVs in the plasma of children and adult patients infected with Plasmodium falciparum were measured alongside matched healthy controls. Results Patients with Plasmodium falciparum infection had ~3.8 times MVs (p < 0.0001) and ~13.0 times TF-bearing MVs compared to the matched healthy controls. MVs showed inverse significant correlation with platelet count (p = 0.0055), hemoglobin (p = 0.0004) and parasitemia. Conclusion Elevated levels of MVs and TF-bearing MVs could be useful biomarkers to evaluate the procoagulant activity, inflammatory response and parasitemia levels in malaria infection, aiding in better management of the disease.
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Affiliation(s)
- Aymen M Madkhali
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Abdullah A Mobarki
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Ahmad H Ghzwani
- Medical Research Center, Jazan University, Gizan, Saudi Arabia
| | | | - Ahmed Zhranei
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Abdulrahman Osais
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Ahmed Sohel
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Basim Othman
- Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi Arabia
| | - Gasim Dobie
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Hassan A Hamali
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
- Correspondence: Hassan A Hamali, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, P.O. Box 1906, Gizan, 45142, Saudi Arabia, Email
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Ngum NH, Fakeh NB, Lem AE, Mahamat O. Prevalence of malaria and associated clinical manifestations and myeloperoxidase amongst populations living in different altitudes of Mezam division, North West Region, Cameroon. Malar J 2023; 22:20. [PMID: 36658587 PMCID: PMC9850770 DOI: 10.1186/s12936-022-04438-6] [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: 11/05/2022] [Accepted: 12/31/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Malaria is a growing problem in Africa, with prevalence varies from areas to areas due to several factors including the altitude. This study aimed to investigate the malaria distribution and its relationship with level of some blood parameters and plasma myeloperoxidase (MPO) in population of three localities with different altitudes. METHODS A total of 150 participants were recruited in each locality and facial body temperature of each was measured using a forehead digital thermometer. Blood samples were collected and used diagnose malaria parasite using the rapid test followed by Giemsa stain microscopy and have the full blood count and MPO level using a colorimetric method. RESULTS The overall prevalence of falciparum malaria was 34.7%, with no difference between the three communities, but Bambili of high altitude had the highest prevalence (70.7%). A majority of the infected persons had mild malaria, with most cases being asymptomatic (temperature < 37.5 ºC). Patients had significant increase of geometric mean malaria parasite density (GMPD) in Bambili (1755 ± 216 parasites/µL) and Bamenda (1060 ± 2515 parasites/µL of blood) than patients in Santa (737 ± 799 parasites/µL). There was a significant risk to have malaria infection in Bambili (OR = 33.367, p = 0.021) than in Santa (OR = 2.309, p = 0.362). Bambili' participants of 6-10 years showed a high prevalence of malaria (85.7%). GMPD was significantly different between males (p = 0.010) as well as females (p = 0.000). Participants from Santa (11.2 ± 3.2 g/dL) and Bambili (12.6 ± 2.4 g/dL) had a high haemoglobin concentration than those from Bamenda (10.6 ± 2.1 g/dL). There was a significant difference in the WBC counts and platelet counts among infected participants in the study areas. MPO level had an increasing trend among infected participants in Santa (2.378 ± 0.250), Bambili (2.582 ± 0.482) and Bamenda (2.635 ± 0.466). CONCLUSION The results of the present study demonstrated that altitudinal variations significant impact the risk of population to have malaria with high parasitaemia and may contribute to the malaria prevalence and severity by affecting the haemoglobin concentration, WBC and platelet level and plasma MPO in population.
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Affiliation(s)
- Ntonifor Helen Ngum
- grid.449799.e0000 0004 4684 0857Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, N. W. Region Cameroon ,grid.442553.10000 0004 0622 6369African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun State Nigeria
| | - Ngahbort Belthine Fakeh
- grid.449799.e0000 0004 4684 0857Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, N. W. Region Cameroon
| | - Abongwa Edith Lem
- grid.449799.e0000 0004 4684 0857Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, N. W. Region Cameroon ,grid.442553.10000 0004 0622 6369African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun State Nigeria
| | - Oumar Mahamat
- grid.449799.e0000 0004 4684 0857Department of Biological Sciences, Faculty of Science, The University of Bamenda, BP 39, Bambili, N. W. Region Cameroon
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Muacevic A, Adler JR, Tonga C, Kangam L, Wepnje GB, Tchanga FC, Tomedi ME. Effects of Malaria and HIV Infection on Anemia and T-cells Levels in Children in Douala City, Cameroon. Cureus 2022; 14:e32074. [PMID: 36600836 PMCID: PMC9803394 DOI: 10.7759/cureus.32074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Human immunodeficiency virus (HIV) infection and malaria are priority health issues for sub-Saharan Africa. Both diseases worsen each other through their effect on the immune and hematological systems. This study aimed to determine the effects of HIV infection and asymptomatic malaria on anemia and T-cells counts in children in the city of Douala in the republic of Cameroon. Method From May to November 2016, 197 HIV infected and 98 HIV-free non-febrile children up to 19 years old (128 male and 167 female) participated in the study. All HIV-infected children were receiving antiretroviral treatment and co-trimoxazole. Malaria diagnosis was performed using Giemsa-stained thick blood film; immunological and hematological parameters were assessed through a flow cytometer and an automated analyzer respectively. Chi-squared or Fischer's exact tests was used to compare the proportions, Mann-Whitney and ANOVA tests were used for the means. Statistical significance was set at p˂0.05. Results The prevalence of malaria was 8.8%, and that of anemia was 40.7%. CD4+-T cells were higher in malaria-infected children, both in HIV positive and negative (p=0.049). No significant association was found between malaria parasitemia and CD8+-T cell levels, both in HIV-positive and negative children (p=0.41). Anemia was higher in HIV-positive children (p=0.019), especially in those with severe immunosuppression (p=0.001) and in younger children (p=0.0083). Children on HIV treatment presented lower malaria prevalence (8.6% versus 10.10%), though the difference was not significant (p=0.7068). Malaria infection was associated with lower hemoglobin levels (10.5±1.7 versus 11.2±1.4; p=0.016). Conclusion Malaria infection may enhance CD4+-T cells. Both malaria and HIV infection lead to a drop in hemoglobin levels. The HIV treatment protocol may reduce malaria prevalence.
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Workineh L, Lakew M, Dires S, Kiros T, Damtie S, Hailemichael W, Muleta D, Eyayu T. Prevalence of Malaria and Associated Factors Among Children Attending Health Institutions at South Gondar Zone, Northwest Ethiopia: A Cross-Sectional Study. Glob Pediatr Health 2022; 8:2333794X211059107. [PMID: 34993279 PMCID: PMC8724997 DOI: 10.1177/2333794x211059107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Malaria is a fatal disease among children in malaria-prone locations such as Addis Zemen and Woreta because of their weak immune systems. Despite the severity of the disease in children, the majority of research conducted in Ethiopia has focused on adult populations rather than children. Furthermore, there is no data on malaria prevalence, risk factors, or parasite density among children in the Addis Zemen and Woreta catchment areas. Therefore, this study was aimed at filling the above gap in the study area. About 422 children were enrolled in the study by systematic sampling technique. A capillary blood sample was collected from each child to do blood film. The overall prevalence of malaria among children attending South Gonder health institutions was 14.7%. The majority of parasite density was moderate parasitemia followed by low parasitemia, giving 71.0% and 16.0%, respectively. Malaria parasite infection was linked to a history of malaria and the presence of stagnant water near a home, but utilization of insecticide-treated bed nets was found to be protective against the infection. Therefore, health education should be strengthened on proper utilization of bed nets, indoor residual spraying, removing stagnant water by discarding old tires that may collect rainwater, and removing debris from streams so streams flow more freely.
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Affiliation(s)
| | | | - Shega Dires
- Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | | | | | | | | | - Tahir Eyayu
- Debre Tabor University, Debre Tabor, Amhara, Ethiopia
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Teh RN, Sumbele IUN, Meduke DN, Nkeudem GA, Ojong ST, Teh EA, Kimbi HK. Insecticide-treated net ownership, utilization and knowledge of malaria in children residing in Batoke-Limbe, Mount Cameroon area: effect on malariometric and haematological indices. Malar J 2021; 20:333. [PMID: 34325689 PMCID: PMC8320188 DOI: 10.1186/s12936-021-03860-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 07/20/2021] [Indexed: 11/15/2022] Open
Abstract
Background Insecticide-treated nets (ITNs) are the most widely used interventions for malaria control in Africa. The aim of this study was to assess the ownership and utilization of ITNs and the knowledge of malaria and their effects on malariometric and haematological indices in children living in the Mount Cameroon area. Methods A community-based cross-sectional study involving a total of 405 children aged between 6 months and 14 years living in Batoke–Limbe was carried out between July and October 2017. A semi-structured questionnaire was used to document demographic status, knowledge on malaria and ITN ownership and usage. Venous blood sample was collected from each child to determine the prevalence and intensity of parasitaemia by Giemsa-stained microscopy and full blood count by auto haematology analysis to obtain white blood cell (WBC) and red blood cell (RBC) counts, haemoglobin (Hb) level, haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). A multilinear regression model was used to determine the relationship between haematological parameter as dependent variable and the independent variables. Results The overall prevalence of parasitaemia, anaemia, knowledge about malaria, ITN ownership, usage and effective usage was 46.7%, 54.7%, 40.7%, 78.8%, 50.9% and 29.9%, respectively. The prevalence of parasitaemia was significantly higher (P < 0.001) in children who ineffectively utilized ITNs (54.9%) than effective users (27.3%). Having knowledge of malaria, negatively correlated with WBC counts (P = 0.005), but positively correlated with Hb levels (P < 0.001), RBC counts (P < 0.001), Hct (P < 0.001), MCV (P < 0.001) and MCH (P < 0.001). ITN use positively correlated with WBC counts (P = 0.005) but negatively with Hb levels (P = 0.004), RBC counts (P = 0.006), and MCH (P < 0.001). Meanwhile, parasitaemia negatively correlated with Hb levels (P = 0.004), RBC counts (P = 0.01), Hct (P = 0.04) and MCHC (P = 0.015). Conclusion There is need for more sensitization on the benefits of using the ITNs to meet up with the intended and expected impact of the free distribution of ITNs. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03860-6.
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Affiliation(s)
- Rene Ning Teh
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon. .,Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon.
| | - Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Microbiology and Immunology, Cornell College of Veterinary Medicine, Ithaca, NY, USA
| | | | - Gillian Asoba Nkeudem
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
| | - Samuel Takang Ojong
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon
| | - Exodus Akwa Teh
- Department of Microbiology, Kenyatta University, Nairobi, Kenya
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, The University of Bamenda, Bambili, Cameroon
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Confounding influences of malnutrition and Plasmodium falciparum and Schistosoma haematobium infections on haematological parameters in school children in Muyuka, Cameroon. BMC Infect Dis 2021; 21:477. [PMID: 34034666 PMCID: PMC8152139 DOI: 10.1186/s12879-021-06201-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/17/2021] [Indexed: 12/02/2022] Open
Abstract
Background School-aged children (SAC) are a high-risk demographic group for infectious diseases and malnutrition. The objective of this study was to assess the burden and the effect of Plasmodium falciparum and Schistosoma haematobium infections on the haematological indices in SAC and the confounding influence of malnutrition on the outcomes. Methods This cross-sectional study was conducted in SAC 4–14 years old living in Ikata, Bafia and Mile 14-Likoko in Muyuka, Cameroon. Anthropometric measures of malnutrition were obtained and blood samples collected were used for detection of malaria parasites by Giemsa-stained blood films using light microscopy and complete blood count analysis using an automated haematology analyser. Urine samples collected were used to detect micro haematuria with the aid of reagent strips and the eggs of S. haematobium by urine filtration technique. Multiple linear regression model was used to examine influence of independent variables on haematological parameters. Results Out of the 606 SAC examined, the prevalence of single infections with Plasmodium or S. haematobium and co-infection with both parasites was 16.2, 16.3 and 8.3%, respectively. Overall, malaria parasite (MP), urogenital schistosomiasis, malnutrition, anaemia, haematuria, microcytosis and thrombocytopenia was prevalent in 24.4, 24.6, 25.9, 74.4, 12.2, 45.4 and 11.1% of SAC, respectively. A significant linear decline (P = 0.023) in prevalence of P. falciparum infection with the severity of stunting was observed. Factors that significantly influenced haematological parameters included haemoglobin: age, stunting and MP; haematocrit: age and MP; white blood cell count: age; red blood cell count; age and MP; lymphocyte counts: stunting; mean cell volume: age; mean cell haemoglobin: age and stunting; mean cell haemoglobin concentration: sex, stunting and red cell distribution width-coefficient of variation: sex, age and stunting. Conclusions Malnutrition, Plasmodium and S. haematobium infections are common while anaemia is a severe public health problem in Muyuka, Cameroon. The interaction between haematological parameters with malaria parasites as well as linear growth index was negative and other interactions indicate systemic inflammation. While findings provide contextual intervention targets to ensure the judicious use of the limited resources, there is need for regular monitoring and proper treatment to improve the health of the underserved population. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06201-9.
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Sama SO, Chiamo SN, Taiwe GS, Njume GE, Ngole Sumbele IU. Microcytic and Malarial Anaemia Prevalence in Urban Children ≤15 Years in the Mount Cameroon Area: A Cross-Sectional Study on Risk Factors. Anemia 2021; 2021:5712309. [PMID: 33927900 PMCID: PMC8049821 DOI: 10.1155/2021/5712309] [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: 07/07/2020] [Revised: 11/22/2020] [Accepted: 03/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Anaemia, a common nutritional deficiency, is a public health problem in the Mount Cameroon area. This study determined the prevalence and possible risk factors of microcytic and malarial anaemia in children less than ≤15 years residing in the Buea and Limbe municipalities in the Mount Cameroon area. METHODS A total of 566 children were clinically examined in a cross-sectional study from December 2018 to August 2019 for anaemia and malaria parasites. Blood samples collected were used in evaluating full blood count with the aid of an automated haemoanalyser, and malaria parasite was confirmed by microscopy. Anaemia was defined based on WHO standards while microcytic anaemia and malarial anaemia were defined as microcytosis + anaemia and malaria + anaemia, respectively. Factors that showed significance in the bivariate analysis were entered into a multinomial logistic regression to determine risk factors for microcytic and malarial anaemia. RESULTS The overall prevalence for anaemia, microcytosis, microcytic anaemia, and malarial anaemia was, respectively, 68.7%, 48.9%, 36.9%, and 19.6% with microcytic anaemia representing 53.7% of all anaemic cases. Risk factors for microcytic anaemia included child age of 1-5 years (P=0.007), forest ethnicity (P=0.019), parents being farmers (P=0.038) or jobless (P=0.009), and having moderate malaria parasitaemia (P=0.048) while those for malarial anaemia were child age of 6-10 years (P=0.008), parents' age of 26-35 years (P=0.049), parents being jobless (P=0.023), and consuming plantains 3-4 times (P=0.024) a week. CONCLUSION Microcytic anaemia is getting to be a severe public health concern while malarial anaemia is a mild public health issue in children residing in urban areas of Mount Cameroon. Parents' occupation was directly linked to all anaemia forms; hence, any intervention to curb anaemia should consider aspects that will raise the socioeconomic status of the population.
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Affiliation(s)
- Sharon Odmia Sama
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | | | | | | | - Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
- Department of Microbiology and Immunology, Cornell College of Veterinary Medicine, Ithaca, NY, USA
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Ntonifor HN, Chewa JS, Oumar M, Mbouobda HD. Intestinal helminths as predictors of some malaria clinical outcomes and IL-1β levels in outpatients attending two public hospitals in Bamenda, North West Cameroon. PLoS Negl Trop Dis 2021; 15:e0009174. [PMID: 33651792 PMCID: PMC7924769 DOI: 10.1371/journal.pntd.0009174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/24/2021] [Indexed: 11/19/2022] Open
Abstract
This study aimed at determining the impact of intestinal helminths on malaria parasitaemia, anaemia and pyrexia considering the levels of IL-1β among outpatients in Bamenda. A cohort of 358 consented participants aged three (3) years and above, both males and females on malaria consultation were recruited in the study. At enrolment, patients’ axillary body temperatures were measured and recorded. Venous blood was collected for haemoglobin concentration and malaria parasitaemia determination. Blood plasma was used to measure human IL-1β levels using Human ELISA Kit. The Kato-Katz technique was used to process stool samples. Five species of intestinal helminths Ascaris lumbricoides (6.4%), Enterobius vermicularis (5.0%), Taenia species (4.2%), Trichuris trichiura (1.1%) and hookworms (0.8%) were identified. The overall prevalence of Plasmodium falciparum and intestinal helminths was 30.4% (109/358) and 17.6% (63/358) respectively. The prevalence of intestinal helminths in malaria patients was 17.4% (19/109). Higher Geometric mean parasite density (GMPD ±SD) (malaria parasitaemia) was significantly observed in patients co-infected with Enterobius vermicularis (5548 ± 2829/μL, p = 0.041) and with Taenia species (6799 ± 4584/μL, p = 0.020) than in Plasmodium falciparum infected patients alone (651 ± 6076/ μL). Higher parasitaemia of (1393 ± 3031/μL) and (3464 ± 2828/μL) were recorded in patients co-infected with Ascaris lumbricoides and with hookworms respectively but the differences were not significant (p > 0.05). Anaemia and pyrexia prevalence was 27.1% (97/358) and 33.5% (120/358) respectively. Malaria patients co-infected with Enterobius vermicularis and Ascaris lumbricoides had increased risk of anaemia (OR = 13.712, p = 0.002 and OR = 16.969, p = 0.014) respectively and pyrexia (OR = 18.07, p = 0.001 and OR = 22.560, p = 0.007) respectively than their counterparts. Increased levels of IL-1β were significantly observed in anaemic (148.884 ± 36.073 pg/mL, t = 7.411, p = 0.000) and pyretic (127.737 ± 50.322 pg/mL, t = 5.028, p = 0.000) patients than in non-anaemic (64.335 ± 38.995pg/mL) and apyretic patients (58.479 ± 36.194pg/mL). Malaria patients co-infected with each species of intestinal helminths recorded higher IL-1β levels (IL-1β > 121.68 ± 58.86 pg/mL) and the overall mean (139.63 ± 38.33pg/mL) was higher compared with levels in malaria (121.68 ± 58.86 pg/mL) and helminth (61.78 ± 31.69pg/mL) infected patients alone. Intestinal helminths exacerbated the clinical outcomes of malaria in the patients and increased levels of IL-1β were observed in co-infected patients with anaemia, pyrexia and higher parasitaemia. Malaria and intestinal helminthiasis are endemic parasitic diseases in Sub Sahara Africa including Cameroon that has been associated with poverty. Humans are co-infected with these diseases. Intestinal helminths have been reported to improve or exacerbate malaria severities in co-infected patients. The precise mechanism through which they exert this is not well elucidated but there are speculations about possible immunological implications. It is therefore crucial to understand the mechanism how these neglected tropical disease (helminthiasis) impact malaria severities to develop robust integrated public health intervention strategies and treatment protocols that can effectively manage these diseases in endemic zones. In this study, we focused on the impact of these helminths on malaria parasitaemia, anaemia and pyrexia. We examined each patient for malaria and helminth infections while also measuring their haemoglobin concentrations and body temperatures. We found out that patients infected with intestinal helminths had increased risk of malaria infection and exacerbated malaria parasitaemia, anaemia and pyrexia in co-infected patients. We also observed that increased levels of IL-1β were higher in these co-infected patients than in patients infected with malaria parasite or helminths alone. Our study is informative about the possible involvement of intestinal helminths with the immune responses of the host that consequently affects malaria severity.
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Affiliation(s)
- Helen Ngum Ntonifor
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
- * E-mail:
| | - Julius Suh Chewa
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
| | - Mahamat Oumar
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
| | - Hermann Desire Mbouobda
- Department of Biology, Higher Teachers Training College, University of Bamenda, Bambili, North West Region, Cameroon
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Korzeniewski K, Bylicka-Szczepanowska E, Lass A. Prevalence of Asymptomatic Malaria Infections in Seemingly Healthy Children, the Rural Dzanga Sangha Region, Central African Republic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020814. [PMID: 33477889 PMCID: PMC7833374 DOI: 10.3390/ijerph18020814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/24/2023]
Abstract
According to the World Health Organization 94% of global malaria cases and 94% of global malaria deaths have been reported from Africa. Unfortunately, it is difficult to determine the exact prevalence of disease in some African countries due to a large number of asymptomatic cases. The aim of this study was to assess the prevalence of malaria infections in seemingly healthy children living in the Central African Republic (CAR). CareStartTM Malaria HRP2 rapid diagnostic test (RDT) targeting Plasmodium falciparum was used to test a group of 500 asymptomatic children aged 1-15 years old (330 settled Bantu and 170 semi-nomadic BaAka Pygmies) inhabiting the villages in the Dzanga Sangha region (south-west CAR) in March 2020. In total, 32.4% of asymptomatic Bantu and 40.6% of asymptomatic Pygmy children had a positive result of malaria RDT. Our findings allowed us to demonstrate the high prevalence of asymptomatic malaria infections in south-west CAR. RDTs seem to be a useful tool for the detection of Plasmodium falciparum in areas with limited possibilities of using other diagnostic methods, such as light microscopy and molecular biology.
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Affiliation(s)
- Krzysztof Korzeniewski
- Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, 128 Szaserów St., 04-141 Warsaw, Poland
- Department of Occupational, Metabolic and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9B Powstania Styczniowego St., 81-519 Gdynia, Poland
- Correspondence:
| | - Emilia Bylicka-Szczepanowska
- 4th Department of Infectious Diseases, Provincial Hospital for Infectious Diseases, 37 Wolska St., 01-201 Warsaw, Poland;
| | - Anna Lass
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 9B Powstania Styczniowego St., 81-519 Gdynia, Poland;
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Morakinyo OM, Adebowale AS, Obembe TA, Oloruntoba EO. Association between household environmental conditions and nutritional status of women of childbearing age in Nigeria. PLoS One 2020; 15:e0243356. [PMID: 33306726 PMCID: PMC7732090 DOI: 10.1371/journal.pone.0243356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 11/20/2020] [Indexed: 11/18/2022] Open
Abstract
Maternal undernutrition remains a leading cause of morbidity and mortality in Nigeria. Yet, most interventional programmes are focused on infant and child nutrition outcomes and not on maternal nutrition‐related outcomes. Evidence suggests that the integration of household environmental interventions into nutrition actions can make a difference in reducing the burden of maternal undernutrition. This study examined the influence of household environmental conditions (HHEC) on the nutritional status of women of childbearing age in Nigeria using secondary data from the 2013 Nigeria Demographic and Health Survey. The original sample of 38,948 women age 15–49 years was selected using multi-stage probability sampling. The sample for the current analysis was 23,344 after exclusion of women due to health status or provision of incomplete information. The dependent and main independent variables were undernutrition (defined as Body Mass Index below 18.5) and HHEC (generated from cooking fuel, toilet type, source of drinking water, and housing materials) respectively. Data were analysed using descriptive statistics, Chi-square, and logistic regression model at 5% level of significance. The prevalence of undernutrition among women living in houses with unimproved and improved HHEC was 17.2% and 7.2% respectively. The adjusted odds of undernutrition was significantly higher among women who lived in houses with unimproved HHEC (aOR = 2.02, C.I = 1.37–2.97, p <0.001). The odds of undernutrition are greater in young women (aOR = 2.38, C.I. = 1.88–3.00, p <0.001) compared to older, and those of lower wealth status (aOR = 2.14, CI = 1.69–2.71, p <0.001) compared to higher. Other predictors of undernutrition in women of reproductive age in Nigeria include the level of education, marital status, and working status. Living in a house with unimproved environmental conditions is a predictor of undernutrition in women. The integration of environmental and nutrition programmes could assist in addressing this burden in Nigeria.
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Affiliation(s)
- Oyewale Mayowa Morakinyo
- Faculty of Public Health, Department of Environmental Health Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- * E-mail:
| | - Ayo Stephen Adebowale
- Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Taiwo Akinyode Obembe
- Faculty of Public Health, Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Elizabeth Omoladun Oloruntoba
- Faculty of Public Health, Department of Environmental Health Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Alwajeeh TS, Abdul-Ghani R, Allam AF, Farag HF, Khalil SSM, Shehab AY, El-Sayad MH, Alharbi RA, Almalki SSR, Azazy AA. Uncomplicated falciparum malaria among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen: association with anaemia and underweight. Malar J 2020; 19:358. [PMID: 33028361 PMCID: PMC7542704 DOI: 10.1186/s12936-020-03431-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria, malnutrition and anaemia are major public health problems in Yemen, with Hodeidah being the most malaria-afflicted governorate. To address the lack of relevant studies, this study was conducted to determine the prevalence of Plasmodium falciparum and its relation to nutritional status and haematological indices among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen. METHODS A cross-sectional study was conducted among 400 schoolchildren selected randomly from four schools in Bajil district. Data about demographic characteristics, risk factors and anthropometric measurements of age, height and weight were collected. Duplicate thick and thin blood films were prepared, stained with Giemsa and examined microscopically for malaria parasites. The density of P. falciparum asexual stages was estimated on thick films. EDTA-blood samples were examined for the haematological indices of haemoglobin (Hb) and blood cell counts. RESULTS Plasmodium falciparum was prevalent among 8.0% (32/400) of schoolchildren with a mean parasite density of 244.3 ± 299.3/µL of blood and most infections showing low-level parasitaemia, whereas Plasmodium vivax was detected in one child (0.25%). Residing near water collections was a significant independent predictor of falciparum malaria [adjusted odds ratio (AOR) = 2.6, 95.0% CI 1.20-5.72; p = 0.016] in schoolchildren. Mild anaemia was prevalent among more than half of P. falciparum-infected schoolchildren and significantly associated with falciparum malaria (AOR = 5.8, 95.0% CI 2.39-14.17; p < 0.001), with a mean Hb concentration of 10.7 ± 1.0 g/dL. Although the mean values of the total white blood cells, monocytes and platelets were significantly lower in infected than non-infected schoolchildren, they were within normal ranges. More than half of the children were malnourished, with stunting (39.3%) and underweight (36.0%) being the most prevalent forms of malnutrition; 6.3% of children were wasted. Underweight (AOR = 5.3, 95.0% CI 2.09-13.62; p < 0.001) but not stunting or wasting, was a significant predictor of falciparum malaria among schoolchildren. CONCLUSION Asymptomatic falciparum malaria is prevalent among schoolchildren in Bajil district of Hodeidah Governorate, with predominance of low parasitaemic infections and significant association with mild anaemia and underweight. Residence near water collection is a significant predictor of infection with falciparum malaria among schoolchildren. Further studies among children with severe malaria and those with high parasite densities are recommended.
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Affiliation(s)
- Talal S Alwajeeh
- Laboratory Department, Kuwait University Hospital, Sana'a University, Sana'a, Yemen
| | - Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. .,Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen.
| | - Amal F Allam
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Hoda F Farag
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Safia S M Khalil
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Amel Y Shehab
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mona H El-Sayad
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Raed A Alharbi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, Saudi Arabia
| | - Shaia S R Almalki
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, Saudi Arabia
| | - Ahmed A Azazy
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, Saudi Arabia
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Nsiah K, Bahaah B, Afranie BO, Acheampong E. Evaluation of red blood cell count as an ancillary index to hemoglobin level in defining the severe falciparum malarial anemia among Ghanaian children in low-resource communities. Heliyon 2020; 6:e04605. [PMID: 32904347 PMCID: PMC7452483 DOI: 10.1016/j.heliyon.2020.e04605] [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: 05/19/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 01/15/2023] Open
Abstract
Our study evaluated red blood cell count as supporting hematological index to hematocrit level in predicting severe malarial anemia instead of the hemoglobin levels among malaria-infected children in Ghana. This case-control study was conducted at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. The study recruited 139 children, of which 45 were Controls (C), 43 with severe malaria (SM), and 51 with mild malaria (MM). Validated questionnaires were administered to obtain the socio-demographic data from each respondent. Venous blood was obtained for parasitemia count and to determine the hematological profile of each participant. With point of observation, data analysis was done. The mean age of the children was 4.22 ± 2.65 years. Median levels of hemoglobin (Hb) decreased in the order; C > MM > SM (P < 0.0001). There was a reduction in median levels of hematocrit (HCT) (P < 0.0001), RBC (red blood cells count) (<0.0001), from the MM to the SM. Among patients with severe malaria, there were a positive significant spearmen's co-efficient correlations between median levels of RBC (r = 0.652, P = 0.005) and HB (r = 0.640, P = 0.006) individually against HCT. However among the mild malaria patients only RBC (r = 0.884, P < 0.001) was positively correlated against HCT. At a cut-off of <4.0×106/uL for RBC and <8.8 g/dL for Hb, RBC (90.4%) recorded a slightly high accuracy in predicting severe falciparum malarial anemia than Hb (86.9%) among the cases. Red blood cell count may be a promising indicator to support hematocrit (<15%) in defining severe malarial anemia than hemoglobin level (<5 g/dL) among malaria-infected children from endemic areas in Ghana.
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Affiliation(s)
- Kwabena Nsiah
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Bahaah
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bright Oppong Afranie
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Kotepui M, Kotepui KU, Milanez GD, Masangkay FR. Reduction in total leukocytes in malaria patients compared to febrile controls: A systematic review and meta-analysis. PLoS One 2020; 15:e0233913. [PMID: 32574170 PMCID: PMC7310711 DOI: 10.1371/journal.pone.0233913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Leukocyte alterations are a common hematological alteration among malaria patients. OBJECTIVES This systematic review and meta-analysis aimed to provide data and evidence comparing alterations in total leukocyte counts in malaria patients compared to febrile/healthy subjects at baseline before treatment. A systematic review was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. DATA SOURCES Web of Science (ISI), Scopus, and Medline. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS All published articles reporting a total leukocyte count of patients infected with malaria, non-malaria (febrile or healthy group) at baseline before treatment before August 27, 2019, were retrieved, and data were extracted by two main reviewers independently. STUDY APPRAISAL AND SYNTHESIS METHODS We used a forest plot, heterogeneity test (Cochran's Q), and the degree of heterogeneity (I2) to test whether the included studies were heterogeneous. The quality of the included studies was determined by a quality assessment guide based on the quality assessment tool developed by the Newcastle-Ottawa Scale (NOS). Cochran's Q (Chi-square) and Moran's I2 were used to evaluate heterogeneity. Meta-regression using STATA software was conducted to find the source of heterogeneity. A funnel plot with Egger's test was used to examine the significance of publication bias among the included studies. The mean differences were estimated using a random-effects model. RESULTS Out of the 2,261 articles screened, 29 articles were included in this systematic review and meta-analysis. The heterogeneity test indicated that there was heterogeneity among the included studies with no publication bias. The meta-analysis demonstrated that the total leukocyte count was significantly lower in patients with malaria (n = 4,619) than in those without malaria (n = 10,056) (Z = 4.0, P-value < 0.00001, mean difference = -1.38, 95% CI = -2.06-(-0.71)). Leukocyte differential alterations, low lymphocyte counts (P-value <0.0001, mean difference = -1.03, 95% CI = -1.53-(-0.53)) and a high NL ratio were found in the malaria group (n = 1,579) compared to the non-malaria group (n = 4,991) (P-value <0.0001, mean difference = 0.6, 95% CI = 0.32-0.88). The subgroup analysis indicated that there was a significantly lower total leukocyte count in the malaria group (n = 3,545) than in the febrile group (n = 8,947) (Z = 1.33, P-value < 0.0001, mean difference = -1.76, 95% CI = -2.56-(-0.96)), but no significant difference was found between the malaria group (n = 1,232) and the healthy group (n = 1,679) (P-value > 0.05). LIMITATIONS As the specific diagnoses in the febrile groups were not reported in the included studies so that the results of the present study need to be carefully interpreted. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS This systematic review demonstrated that the total leukocyte count was affected by malarial infection at baseline despite the heterogeneity of the included studies. Future work must aim to understand the treatment-related total leukocyte reduction during follow-up or post-treatment outcomes in malaria-endemic settings.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Giovanni D. Milanez
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University, Manila, Philippines
| | - Frederick R. Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University, Manila, Philippines
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Haematological Parameters and Spleen Rate of Asymptomatic and Malaria Negative Children in Edo South District, Nigeria. Ann Glob Health 2020; 86:62. [PMID: 32587812 PMCID: PMC7304450 DOI: 10.5334/aogh.2458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Malaria is commonly associated with alteration in haematologic cells of infected individuals in both the acute uncomplicated and severe phases. Whether this alteration occurs in the asymptomatic phase of the disease is still being investigated. Objectives: To examine the haematocrit, thrombocytes, and monocytes levels of children with asymptomatic malaria compared with age/sex-matched controls who are malaria parasite negative and living in a stable malaria endemic region. It also set out to identify spleen rate of the children and to compare it with that observed in malaria negative controls. Methods: One hundred well-nourished children 2–9 years old with asymptomatic malaria parasitaemia and 100 age- and sex-matched malaria negative controls were recruited by multi-stage sampling from schools in a malaria endemic region of Nigeria. Malaria diagnosis was by microscopy, and each haematologic parameter was analysed following standard protocols. Results: Mean (±) monocyte count of 2.25 ± 0.9 × 109 cells/L observed in asymptomatic malaria children was significantly higher than 1.34 ± 0.5 × 109 cells/L observed in those with no malaria (p = 0.00). Mean (±) thrombocyte count was significantly lower (asymptomatic 203.64 ± 45.90 × 109 cells/L Vs no malaria 230.91 ± 57.40 × 109 cells/L) (p = 0.00). Spleen rate in the children was 15.5%. Presence of splenomegaly was not statistically significantly fewer in children with asymptomatic malaria parasitaemia (ASMP) (14/31) when compared to those who were malaria parasite negative (17/31) (χ2 = 0.34, p = 0.57). Similarly, there was no significant difference in the mean [±] spleen length of children with ASMP (n = 14; 2.86 ± 0.9 cm) and those who were malaria negative (n = 17; 2.53 ± 0.6 cm) (t = 1.22, p = 0.23). Conclusion: Thrombocytopaenia and monocytosis could be pointers to malaria parasitaemia in asymptomatic phase in a stable malaria region.
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Chipwaza B, Sumaye RD. High malaria parasitemia among outpatient febrile children in low endemic area, East-Central Tanzania in 2013. BMC Res Notes 2020; 13:251. [PMID: 32448376 PMCID: PMC7247273 DOI: 10.1186/s13104-020-05092-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/16/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigated the prevalence and distribution patterns of malaria in Kilosa district as part of non-malaria causes of febrile illnesses in children study. We enrolled febrile patients aged 2-13 years presenting at the outpatient department during the rainy and dry seasons, in 2013. For each participant, we tested for malaria parasites and identified parasite species using microscopy. We then calculated parasite density and estimated geometric mean parasite density. RESULTS The overall malaria prevalence in febrile children was 23.7% (n = 609). Plasmodium falciparum accounted for 98.6% of malaria positives. There was a heterogeneous distribution of malaria cases among the 17 wards constituting the catchment area. A high proportion (69.4%, n = 144) of malaria positive individuals had high parasite densities. Individuals who were enrolled in the rainy season had higher geometric mean parasite density (15415.1 parasites/µl, 95% CI 10735.3-22134.9) compared to the dry season (6115.3 parasites/µl, 95% CI 4237.8-8824.6). The relatively high malaria prevalence recorded in Kilosa, an area considered low endemicity, calls for concerted effort in documenting malaria burden at fine geographical scales and tailor preventive and control strategies that target hotspots of high malaria transmission.
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Affiliation(s)
- Beatrice Chipwaza
- St Francis University College of Health and Allied Sciences, P.O. Box 175, Ifakara, Tanzania. .,Ifakara Health Institute, Ifakara, P.O. Box 53, Ifakara, Tanzania.
| | - Robert D Sumaye
- Ifakara Health Institute, Ifakara, P.O. Box 53, Ifakara, Tanzania
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Sandie SM, Sumbele IUN, Tasah MM, Kimbi HK. Malaria parasite prevalence and Haematological parameters in HIV seropositive patients attending the regional hospital Limbe, Cameroon: a hospital-based cross-sectional study. BMC Infect Dis 2019; 19:988. [PMID: 31752719 PMCID: PMC6873725 DOI: 10.1186/s12879-019-4629-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Malaria and the human immunodeficiency virus (HIV) infection constitute public health problems in Cameroon including the South West Region (SWR). This study determined the prevalence of malaria parasites and haematological abnormalities in HIV positive patients in Limbe, Cameroon from April–July 2014. Methods The study was cross-sectional and involved 411 participants who were administered structured questionnaires to record socio-demographic and clinical data. Three hundred and nine (309) HIV positive patients and one hundred and two (102) HIV negative individuals were examined clinically and venous blood collected for malaria parasite detection, HIV infection diagnosis and full blood count analysis. Results Overall malaria parasite prevalence was 14.1% (58/411). This prevalence was significantly higher (P < 0.001) in the HIV negative participants (33.3%, 34/102) compared to the HIV positive patients (7.8%, 24/309). Amongst HIV positive participants, malaria parasite prevalence was significantly higher in female patients (P = 0.003), febrile patients (P < 0.001), anaemic patients (P = 0.015) and in patients who were not on antiretroviral treatment (ART) (P = 0.03) when compared with their respective counterparts. Among the HIV negative group, though not significant, malaria parasite prevalence was higher in females, febrile and anaemic patients when compared with their respective counterparts. Overall anaemia prevalence was 52.1% (214/309) and was significantly higher (P = 0.004) in HIV positive patients (56%, 173) than in HIV negative participants (40.2%, 41). Malaria/HIV co-infected patients had a significantly lower mean value of Hb (P = 0.002), RBC (P = 0.002) and Hct (P = 0.001) when compared with HIV-infected patients. Conclusion HIV negative participants had a higher prevalence of malaria parasites than their HIV positive counterparts. Anaemia prevalence was higher in HIV positive patients than in HIV negative participants. Malaria/HIV co-infected patients presented with more red blood cell abnormalities than HIV-infected patients.
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Affiliation(s)
| | | | - Martin Mih Tasah
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, University of Bamenda, Bambili, Cameroon
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Njumkeng C, Apinjoh TO, Anchang-Kimbi JK, Amin ET, Tanue EA, Njua-Yafi C, Achidi EA. Coverage and usage of insecticide treated nets (ITNs) within households: associated factors and effect on the prevalance of malaria parasitemia in the Mount Cameroon area. BMC Public Health 2019; 19:1216. [PMID: 31481054 PMCID: PMC6724238 DOI: 10.1186/s12889-019-7555-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 08/27/2019] [Indexed: 12/03/2022] Open
Abstract
Background Insecticide-treated nets (ITNs) are a widely used tool that has been proven to be effective in the prevention and control of malaria in malaria endemic countries. However, usage varies among households and can greatly affect the benefits of ITNs as a control tool for malaria transmission. This study determined the coverage and usage of ITNS as well as associated factors and the effect of coverage and usage on the prevalence of malaria parasitemia within households in the Mount Cameroon area. Methods A cross-sectional survey was conducted between August and September 2014 in six communities within the Mount Cameroon area. Households within the communities were enrolled through multistage sampling and household survey was done using a structured questionnaire. Capillary blood was collected for malaria parasite determination. Data was analysed using SPSS version 20 for windows. Differences in proportions were assessed using the Chi-square test while factors affecting ITNs usage were assessed in multivariate logistic regression at a statistical significance of P ≤ 0.05. Results A total of 504 households were surveyed, 1564 bed spaces reported while 915(58.5, 95% CI: 56.1–60.9) of the bed spaces had nets and 391(77.6, 95% CI, 74.0–80.2) of the households had at least one bed net. The odds of using ITNs was 2 folds higher (OR = 2.41; 95% CI 1.58–3.69 p = 0.001) and 3 folds higher (OR = 3.149, 95% CI 1.53–6.47 p = 0.002) among houses with 5 to 9 occupants and above 10 occupants respectively when compared to houses with less than 5 occupants. In addition, Individuals living in cement block houses were less likely to use ITNs. Compared to those living in wooden houses (OR = 0.488, 95% CI: 0.269–0.885; p = 0 .018). Rural communities had lower ITN coverage compared to semi-urban communities (p = 0.0001). Increase in ITNs coverage significantly reduces malaria prevalence (correlation − 0.899, p = 0.015). Conclusion Despite the efforts made to scale up ITN distribution so that universal coverage can be attained, coverage remains low. Increasing coverage and putting in place a mechanism to replace torn nets will go a long way reduce the prevalence of malaria parasitemia. Electronic supplementary material The online version of this article (10.1186/s12889-019-7555-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charles Njumkeng
- Global Research Education and health Foundation Buea, Molyko, P.O. BOX 356, Buea, South West Region, Cameroon. .,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | | | - Elvis T Amin
- Global Research Education and health Foundation Buea, Molyko, P.O. BOX 356, Buea, South West Region, Cameroon
| | - Elvis A Tanue
- Global Research Education and health Foundation Buea, Molyko, P.O. BOX 356, Buea, South West Region, Cameroon.,Department of Public Health and Hygiene, University of Buea, Buea, Cameroon
| | - Clarisse Njua-Yafi
- Department of Animal Biology and Physiology, University of Yaounde I, Yaounde, Cameroon.,College of Technology, University of Bamenda, Bamenda, Cameroon
| | - Eric A Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
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Asoba GN, Sumbele IUN, Anchang-Kimbi JK, Metuge S, Teh RN. Influence of infant feeding practices on the occurrence of malnutrition, malaria and anaemia in children ≤5 years in the Mount Cameroon area: A cross sectional study. PLoS One 2019; 14:e0219386. [PMID: 31318896 PMCID: PMC6638998 DOI: 10.1371/journal.pone.0219386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/22/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the influence of different infant feeding habits on the occurrence of malnutrition, Plasmodium falciparum parasitaemia and anaemia in children ≤5 years in the Mount Cameroon area. METHODOLOGY A total of 1227 children ≤5 years of age were recruited in a descriptive cross-sectional study. Socio demographic data and information on the different infant feeding habits was obtained by the use of semi-structured questionnaire. Nutritional status was assessed by the use of anthropometric measurements. Plasmodium was detected by light microscopy and haemoglobin was measured by use of an auto-haematology analyser. Anaemia as well as its severity was classified based on WHO standards. The associations between variables were assessed using logistic regression analysis. RESULTS The prevalence of exclusive breast feeding (EBF) was 22.6%, mixed feeding (MF) was 60.1% and those not breastfed (NBF) at all was 17.3%. The prevalence of malnutrition, P. falciparum parasitaemia and anaemia was 32.6%, 30.4% and 77.3% respectively. Children who had EBF had significantly lower (P <0.001) prevalence of malaria parasite (16.2%) than those NBF at all (61.3%). The prevalence of anaemia was significantly higher (P <0.001) in children who had MF (80.5%) while, severe and moderate anaemia was highest in those NBF at all (6.6%, 67.1% respectively; P = 0.029) than their counterparts. The significant predictors of anaemia were age group (P <0.001), marital status (P <0.001) and educational level of parent (P <0.001), that for malaria parasitaemia was infant feeding habit (MF: P< 0.001 and NBF: P <0.001) and malnutrition was age group (≤2 years: P <0.008 and 2.1-4.0 years: P = 0.028). CONCLUSION The infant feeding habit significantly influenced the occurrence of malaria parasite infection and not malnutrition and anaemia, hence EBF should be encouraged in malaria endemic zones.
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Affiliation(s)
- Gillian Nkeudem Asoba
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
| | | | | | - Samuel Metuge
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
| | - Rene Ning Teh
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
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Tabi ESB, Cumber SN, Juma KO, Ngoh EA, Akum EA, Eyong EM. A cross-sectional survey on the prevalence of anaemia and malnutrition in primary school children in the Tiko Health District, Cameroon. Pan Afr Med J 2019; 32:111. [PMID: 31223401 PMCID: PMC6560948 DOI: 10.11604/pamj.2019.32.111.15728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 02/15/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. Methods A cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results The overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). Conclusion This study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented.
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Affiliation(s)
- Egbe Sarah Balle Tabi
- Center for Research on filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Department of Microbiology and Parasitology, Faculty of Science, University of Buéa, Buéa, Cameroon
| | - Samuel Nambile Cumber
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health Faculty of Health Sciences, University of Pretoria Private Bag X323, Gezina, Pretoria, 0001, Pretoria, South Africa
| | | | - Elvis Akwo Ngoh
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Yaoundé, Cameroon
| | - Eric Achidi Akum
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buéa, Buéa, Cameroon
| | - Esum Mathias Eyong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buéa, Buéa, Cameroon
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Teh RN, Sumbele IUN, Asoba Nkeudem G, Meduke DN, Ojong ST, Kimbi HK. Concurrence of CareStart™ Malaria HRP2 RDT with microscopy in population screening for Plasmodium falciparum infection in the Mount Cameroon area: predictors for RDT positivity. Trop Med Health 2019; 47:17. [PMID: 30867636 PMCID: PMC6397448 DOI: 10.1186/s41182-019-0145-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
Background Malaria remains a diagnostic challenge in many endemic communities. Although rapid diagnostic tests (RDTs) are presently widely used for malaria diagnosis, there is a dearth of information on post-marketing surveillance on its efficacy in Cameroon. The present study evaluated the performance characteristics of CareStart™ Malaria HRP2 (histidine-rich protein 2) antigen (Ag) RDT in diagnosing Plasmodium falciparum infection in the Mount Cameroon area and predictors associated with RDT positivity. Methods The CareStart™ Malaria HRP2 Plasmodium falciparum (G0141) Ag RDT was evaluated in a cross-sectional community-based survey involving 491 children of both sexes aged 6 months to 14 years between April and May 2018. Malaria parasitaemia was confirmed by light microscopy. Sensitivity (Se), specificity (Sp), positive (PPV) and negative (NPV) predictive values of the RDT, and the corresponding accuracy and Kappa value (κ) were determined using microscopy as the gold standard. Haemoglobin (Hb) concentration was obtained using an auto-haematology analyser. Results were compared using the chi-square test and associations between predictor variables, and RDT results were assessed using logistic regression analysis. Results Microscopically confirmed malaria parasite prevalence was 27.7%, and geometric mean density was 187 parasites/μL of blood (range 70-1162). Se, Sp, PPV, NPV and accuracy were 82.4, 76.6, 57.4, 91.9 and 78.2%, respectively. Sensitivity depended on parasitaemia and reached 96.1% at densities ≥ 200 parasites/μL of blood. The accuracy of malaria parasitaemia (as assessed by the area under the receiver operating characteristic curve) to predict malaria by RDT was 75.4% (95% CI 70.6-80.1). The agreement between microscopy and RDT was moderate (κ = 0.52). RDT positivity was significantly associated with fever (P < 0.001), children less than 5 years (P = 0.02), history of fever within a month (P < 0.001) and anaemia (P = 0.002). Conclusion The overall concurrence of CareStart™ Malaria HRP2 pf Ag RDT with microscopy in the detection of P. falciparum infection is moderate and is most useful at parasitaemia ≥ 200 parasites/μL of blood and presentation with fever. While RDT is effective as a diagnostic test for confirmation of clinical cases of malaria, its applications in population screening with a higher proportion of asymptomatic cases are limited.
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Affiliation(s)
- Rene Ning Teh
- 1Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | | | - Gillian Asoba Nkeudem
- 1Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,2Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, P.O. Box 249, Kumba, Cameroon
| | - Derick Ndelle Meduke
- 1Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Samuel Takang Ojong
- 1Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,3Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon
| | - Helen Kuokuo Kimbi
- 1Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,4Department of Medical Laboratory Sciences, The University of Bamenda, Bambili, Cameroon
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Teh RN, Sumbele IUN, Meduke DN, Ojong ST, Kimbi HK. Malaria parasitaemia, anaemia and malnutrition in children less than 15 years residing in different altitudes along the slope of Mount Cameroon: prevalence, intensity and risk factors. Malar J 2018; 17:336. [PMID: 30249261 PMCID: PMC6154899 DOI: 10.1186/s12936-018-2492-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/21/2018] [Indexed: 12/20/2022] Open
Abstract
Background Malaria, anaemia and malnutrition are frequently co-existing diseases that cause significant morbidity and mortality particularly among children. This study measured the prevalence, intensity and evaluated risk factors for malaria parasitaemia, anaemia and malnutrition among children living at low versus high altitude settings in the Mount Cameroon area. Methods A cross-sectional community based survey involving 828 children aged 6 months to 14 years was conducted between July and November 2017. Malaria parasitaemia was confirmed by light microscopy, haemoglobin concentration was measured using an auto haematology analyser, nutritional status was determined from the anthropometric measurements collected, and socioeconomic status related variables by the use of questionnaire. Anaemia and malnutrition were defined according to World Health Organization standards. Associations between predictor variables and primary outcomes were assessed using logistic regression analysis. Results Malaria parasite and anaemia were prevalent in 41.7% and 56.2% of the children, respectively while, malnutrition prevalence was 34.8% with wasting, underweight and stunting occurring in 25.7%, 19.9% and 23.7% of them respectively. Overall malaria parasite geometric mean density was 413/µL of blood (range 100–27,060). The odds of having malaria parasitaemia was highest in children 5–9 years of age [odd ratio (OR) = 1.69, P = 0.006], living in lowland (OR = 1.48, P = 0.008) as well as those whose domestic water was collected from an open source (streams/springs) (OR = 1.81, P = 0.005) than their counterparts. Being < 5 years (OR = 3.15, P = < 0.001) or 5–9 years (OR = 2.20, P < 0.001) of age, having malaria parasite (OR = 2.07, P = < 0.001) and fever in the past 2 days (OR = 1.52, P < 0.04) were identified as significant risk factors of anaemia while the age group < 5 years was the only significant risk (OR = 3.09, P = < 0.001) associated with malnutrition. Conclusion While age specific attention should be given in the control of malaria (5–9 years), anaemia (< 10 years) and malnutrition (< 5 years), the existing malaria control programmes should be revised to integrate anaemia and malnutrition control strategies so as to improve upon the health of the children.
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Affiliation(s)
- Rene Ning Teh
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | | | | | - Samuel Takang Ojong
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Bamenda, Bamenda, Cameroon
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Roman DNR, Anne NNR, Singh V, Luther KMM, Chantal NEM, Albert MS. Role of genetic factors and ethnicity on the multiplicity of Plasmodium falciparum infection in children with asymptomatic malaria in Yaoundé, Cameroon. Heliyon 2018; 4:e00760. [PMID: 30186982 PMCID: PMC6120745 DOI: 10.1016/j.heliyon.2018.e00760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/10/2018] [Accepted: 08/23/2018] [Indexed: 12/22/2022] Open
Abstract
In this cross-sectional study, we investigated host genetic factors and ethnic variation in circulating Plasmodium falciparum merozoite surface protein 2 (msp-2) clones among children with asymptomatic malaria. Isolates from seventy two asymptomatic malaria children were used for genotyping block 3 of msp-2 gene by nested polymerase chain reaction (PCR). Sickle cell trait and glucose-6-phosphate dehydrogenase (G6PD) deficiency were analysed by restriction fragment length polymorphism of DNA products from PCR targeting codons 6 and 68 of the beta-globin (HBB) and G6PD genes respectively. ABO blood group was typed by agglutination method. A total of forty two msp-2 genotypes (20 for 3D7 and 22 for FC27) were detected for an average (standard error of mean) multiplicity of infection (MOI) of 2.45 (0.16). The MOI was statistically the same among the five identified ethnic groups (P = 0.83). The overall prevalence of sickle cell trait and G6PD deficiency were 12.50 % and 22.22 % respectively. MOI was similar between children with Hb AA and Hb AS genotypes (P = 0.42). MOI was significantly high among children with a mutant G6PD genotype (P = 0.017). MOI was significantly higher in blood group O than group A (P = 0.03). Our findings show that although ethnicity and sickle cell trait have no association with MOI, the association was observed with G6PD genotype and ABO group. The results suggest the need for extension and expansion of the current study in order to investigate the mechanisms involved.
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Affiliation(s)
- Dongang Nana Rodrigue Roman
- Department of Biochemistry, Faculty of Sciences, University of Douala, P.O Box 24157, Douala, Cameroon
- Institute of Medical Research and Medicinal Plants Studies (IMPM), P.O Box 13033, Yaoundé, Cameroon
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India
| | - Ngono Ngane Rosalie Anne
- Department of Biochemistry, Faculty of Sciences, University of Douala, P.O Box 24157, Douala, Cameroon
| | - Vineeta Singh
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India
- Corresponding author.
| | | | - Ngonde Essome Marie Chantal
- Institute of Medical Research and Medicinal Plants Studies (IMPM), P.O Box 13033, Yaoundé, Cameroon
- University Hospital Centre, P.O Box 1364, Yaoundé, Cameroon
| | - Mouelle Sone Albert
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O Box 24157, Douala, Cameroon
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Morakinyo OM, Balogun FM, Fagbamigbe AF. Housing type and risk of malaria among under-five children in Nigeria: evidence from the malaria indicator survey. Malar J 2018; 17:311. [PMID: 30153834 PMCID: PMC6114872 DOI: 10.1186/s12936-018-2463-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/23/2018] [Indexed: 12/22/2022] Open
Abstract
Background Malaria remains one of the major causes of morbidity and mortality among under-five (U5) children in Nigeria. Though different environmental factors have been assessed to influence the distribution and transmission of malaria vectors, there is a dearth of information on how housing type may influence malaria transmission among U5 children in Nigeria. This study assessed the relationship between housing type and malaria prevalence among U5s in Nigeria. Methods A cross-sectional analysis of the nationally representative 2015 Nigeria malaria indicator survey data was done. A representative sample of 8148 households in 329 clusters was selected for the survey. Children aged 6–59 months in the selected households were tested for anaemia and malaria using the rapid diagnostic test (RDT) and the microscopy. Data were analysed using descriptive statistics, Pearson Chi square (χ2) and logistic regression models at 5% level of significance. Results The odds of malaria infection was significantly higher among older children aged 24–59 months (aOR = 4.8, CI 2.13–10.99, p < 0.001), and children who lived in houses built completely with unimproved materials (aOR = 1.4, CI 1.08–1.80, p = 0.01). Other predictors of malaria infection include living in a rural area (aOR = 1.5, CI 1.25–1.91, p = 0.01), ever slept under a long-lasting insecticide-treated net (aOR = 1.1, CI 0.26–4.79, p = 0.89) and in a room not sprayed with insecticide (aOR = 1.2, CI 0.64–2.31, p = 0.56). Children who were malaria positive showed a higher prevalence of severe anaemia on RDT (87.6%) and Microscopy (67.4%) than those who were not anaemic (RDT = 31.6%, Microscopy = 12.9%). Conclusions Non-improved housing predicted malaria infection among U5s in Nigeria. Improved housing is a promising means to support a more integrated and sustainable approach to malaria prevention. Education of the Nigerian people on the role of improved housing on malaria protection and empowerment of the public to adopt improved housing as well as overall enlightenment on ways to prevent malaria infection can help to augment the current malaria control measures among U5 children.
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Affiliation(s)
- Oyewale M Morakinyo
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Folusho M Balogun
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Adeniyi F Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Massoda Tonye SG, Kouambeng C, Wounang R, Vounatsou P. Challenges of DHS and MIS to capture the entire pattern of malaria parasite risk and intervention effects in countries with different ecological zones: the case of Cameroon. Malar J 2018; 17:156. [PMID: 29625574 PMCID: PMC5889563 DOI: 10.1186/s12936-018-2284-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 03/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2011, the demographic and health survey (DHS) in Cameroon was combined with the multiple indicator cluster survey. Malaria parasitological data were collected, but the survey period did not overlap with the high malaria transmission season. A malaria indicator survey (MIS) was also conducted during the same year, within the malaria peak transmission season. This study compares estimates of the geographical distribution of malaria parasite risk and of the effects of interventions obtained from the DHS and MIS survey data. METHODS Bayesian geostatistical models were applied on DHS and MIS data to obtain georeferenced estimates of the malaria parasite prevalence and to assess the effects of interventions. Climatic predictors were retrieved from satellite sources. Geostatistical variable selection was used to identify the most important climatic predictors and indicators of malaria interventions. RESULTS The overall observed malaria parasite risk among children was 33 and 30% in the DHS and MIS data, respectively. Both datasets identified the Normalized Difference Vegetation Index and the altitude as important predictors of the geographical distribution of the disease. However, MIS selected additional climatic factors as important disease predictors. The magnitude of the estimated malaria parasite risk at national level was similar in both surveys. Nevertheless, DHS estimates lower risk in the North and Coastal areas. MIS did not find any important intervention effects, although DHS revealed that the proportion of population with an insecticide-treated nets access in their household was statistically important. An important negative relationship between malaria parasitaemia and socioeconomic factors, such as the level of mother's education, place of residence and the household welfare were captured by both surveys. CONCLUSION Timing of the malaria survey influences estimates of the geographical distribution of disease risk, especially in settings with seasonal transmission. In countries with different ecological zones and thus different seasonal patterns, a single survey may not be able to identify all high risk areas. A continuous MIS or a combination of MIS, health information system data and data from sentinel sites may be able to capture the disease risk distribution in space across different seasons.
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Affiliation(s)
- Salomon G Massoda Tonye
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,National Malaria Control Programme, Yaoundé, Cameroon
| | | | | | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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Apinjoh TO, Mugri RN, Miotto O, Chi HF, Tata RB, Anchang-Kimbi JK, Fon EM, Tangoh DA, Nyingchu RV, Jacob C, Amato R, Djimde A, Kwiatkowski D, Achidi EA, Amambua-Ngwa A. Molecular markers for artemisinin and partner drug resistance in natural Plasmodium falciparum populations following increased insecticide treated net coverage along the slope of mount Cameroon: cross-sectional study. Infect Dis Poverty 2017; 6:136. [PMID: 29110722 PMCID: PMC5674235 DOI: 10.1186/s40249-017-0350-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/09/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Drug resistance is one of the greatest challenges of malaria control programmes, with the monitoring of parasite resistance to artemisinins or to Artemisinin Combination Therapy (ACT) partner drugs critical to elimination efforts. Markers of resistance to a wide panel of antimalarials were assessed in natural parasite populations from southwestern Cameroon. METHODS Individuals with asymptomatic parasitaemia or uncomplicated malaria were enrolled through cross-sectional surveys from May 2013 to March 2014 along the slope of mount Cameroon. Plasmodium falciparum malaria parasitaemic blood, screened by light microscopy, was depleted of leucocytes using CF11 cellulose columns and the parasite genotype ascertained by sequencing on the Illumina HiSeq platform. RESULTS A total of 259 participants were enrolled in this study from three different altitudes. While some alleles associated with drug resistance in pfdhfr, pfmdr1 and pfcrt were highly prevalent, less than 3% of all samples carried mutations in the pfkelch13 gene, none of which were amongst those associated with slow artemisinin parasite clearance rates in Southeast Asia. The most prevalent haplotypes were triple mutants Pfdhfr I 51 R 59 N 108 I 164(99%), pfcrt- C72V73 I 74 E 75 T 76 (47.3%), and single mutants PfdhpsS436 G 437K540A581A613(69%) and Pfmdr1 N86 F 184D1246 (53.2%). CONCLUSIONS The predominance of the Pf pfcrt CVIET and Pf dhfr IRN triple mutant parasites and absence of pfkelch13 resistance alleles suggest that the amodiaquine and pyrimethamine components of AS-AQ and SP may no longer be effective in their role while chloroquine resistance still persists in southwestern Cameroon.
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Affiliation(s)
- Tobias O. Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Regina N. Mugri
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Olivo Miotto
- Mahidol-Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Hanesh F. Chi
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Rolland B. Tata
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | | | - Eleanor M. Fon
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Delphine A. Tangoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | - Robert V. Nyingchu
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | | | - Roberto Amato
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, CB10 1SA UK
| | | | | | - Eric A. Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
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Sumbele IUN, Nkemnji GB, Kimbi HK. Soil-transmitted helminths and plasmodium falciparum malaria among individuals living in different agroecosystems in two rural communities in the mount Cameroon area: a cross-sectional study. Infect Dis Poverty 2017; 6:67. [PMID: 28302147 PMCID: PMC5353792 DOI: 10.1186/s40249-017-0266-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 02/17/2017] [Indexed: 11/30/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) and Plasmodium falciparum infections remain public health problems in Cameroon. A cross-sectional study was carried out in the Mount Cameroon area to determine the prevalence and intensity of STHs and P. falciparum infections in individuals living in different agroecosystems; to assess the influence of these infections on haematological parameters; and to identify the risk factors associated with STH infections. Methods STH and malaria parasites were detected using the Kato-Katz method and Giemsa staining of blood films, respectively. Complete blood count values were obtained using an automatic haematology analyser. Soil samples were analysed using the sucrose floatation sedimentation method. Categorical and continuous variables were compared as required and logistic regression models were used to assess the risk factors for STH infections and anaemia. Results Of the 450 participants examined, STHs, P. falciparum and mixed co-infections were detected in 14.0, 33.3 and 5.6% of participants, respectively. Significantly higher prevalences of Ascaris (18.8%) and Trichuris (7.9%) infections were observed in participants from tea plantation areas compared to those from banana and palm plantation areas, with similar trends in egg density. P. falciparum prevalence and parasite density were comparable between the different agroecosystems. The overall prevalence of anaemia was 64.2%. The prevalence of haematological manifestations such as moderate (48.0%) and severe (8.0%) anaemia, leucopenia (26.9%) and microcytosis (30.8%) was significantly higher among Plasmodium-STH co-infected participants. Soil samples from plantations showed the highest prevalences of STH eggs compared to soil samples from areas around pit toilets and public water taps. Living in a tea plantation area (OR = 3.07), age (AOR = 1.49) and lack of access to potable water (OR = 2.25) were identified as risk factors for STH infections, while the age groups 15–25 years (OR = 2.928) and 26–35 years (OR = 2.832), and being female (OR = 2.671) were significant risk factors for anaemia. Conclusions STHs, malaria and anaemia are still of public health concern in plantation communities. Co-infections negatively influence haematological parameters. The tea farming agroecosystem, age and lack of access to potable water were identified as significant risk factors for STH infections. Trial registration Not applicable. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0266-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Bamenda, Bamenda, Cameroon
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Roman DNR, Rosalie NNA, Kumar A, Luther KMM, Singh V, Albert MS. Asymptomatic Plasmodium malariae infections in children from suburban areas of Yaoundé, Cameroon. Parasitol Int 2017; 67:29-33. [PMID: 28263883 DOI: 10.1016/j.parint.2017.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 11/25/2022]
Abstract
The gold standard for malaria diagnosis is the microscopic examination of Giemsa stained thick blood smears though microscopy mostly may not detect the presence of Plasmodium species infections in asymptomatic samples. In the reported study, we used two diagnostic methods viz. the conventional microscopic examination and polymerase chain reaction (PCR) assay to analyse the asymptomatic malaria samples. PCR assay amplifying 18S small-subunit ribosomal RNA (SSU rRNA) gene of Plasmodium in 122 samples confirmed 68% of isolates as asymptomatic P. falciparum infections; with 87.9% mono-infections. We observed that the P. malariae positive samples were not diagnosed in microscopic examination of the blood smears but the PCR based diagnostic method revealed the presence of 12% P. malariae infections in asymptomatic samples from Yaoundé region of Cameroon where no official cases of P. malariae have been reported for over a decade. The sequence analysis further confirmed the presence of 12% P. malariae in malaria positive samples with three base pair deletions and five substitutions in the SSU rRNA gene.
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Affiliation(s)
- Dongang Nana Rodrigue Roman
- Department of Biochemistry, Faculty of Sciences, University of Douala, P.O Box 24157, Douala, Cameroon; National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Institute of Medical Research and Medicinal Plants studies (IMPM), P.O Box 13033, Yaoundé, Cameroon
| | - Ngono Ngane Annie Rosalie
- Department of Biochemistry, Faculty of Sciences, University of Douala, P.O Box 24157, Douala, Cameroon
| | - Amit Kumar
- National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India
| | | | - Vineeta Singh
- National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India.
| | - Mouelle Sone Albert
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O Box 24157, Douala, Cameroon
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Iqbal SA, Botchway F, Badu K, Wilson NO, Dei-Adomakoh Y, Dickinson-Copeland CM, Chinbuah H, Adjei AA, Wilson M, Stiles JK, Driss A. Hematological Differences among Malaria Patients in Rural and Urban Ghana. J Trop Pediatr 2016; 62:477-486. [PMID: 27318111 PMCID: PMC5141942 DOI: 10.1093/tropej/fmw038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Scarce studies have addressed hematological differences of malaria in urban and rural regions. METHODS Full or complete blood cell counts from 46 and 75 individuals (age range from < 1 to 92 years) with uncomplicated malaria infection living in urban (Accra) and rural (Dodowa) Ghana, respectively, were assessed. Sickle cell trait and patients were excluded from the study. RESULTS Between overall groups, patients from Accra had significantly lower parasite count (p < 0.0001) and granulocyte number (p = 0.026). Children in Accra had a significantly lower parasitemia (p = 0.0013), hemoglobin (p = 0.0254), platelet count (p = 0.0148) and red blood cell levels (p = 0.0080) when compared with the children of Dodowa. In adults, mean cell hemoglobin (p = 0.0086) and parasite count (p < 0.0001) were significantly higher in Dodowa. CONCLUSION These results indicate that children living in urban setting may experience a greater anemic effect to malaria as compared with those living in a rural setting.
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Affiliation(s)
- Shareen A. Iqbal
- Department of Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA 30310–1495
| | - Felix Botchway
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Kingsley Badu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Nana O. Wilson
- Department of Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA 30310–1495
| | - Yvonne Dei-Adomakoh
- Department of Haematology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | | | - Helena Chinbuah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Andrew A. Adjei
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Michael Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Jonathan K. Stiles
- Department of Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA 30310–1495
| | - Adel Driss
- Department of Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA 30310-1495
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Malaria, Moderate to Severe Anaemia, and Malarial Anaemia in Children at Presentation to Hospital in the Mount Cameroon Area: A Cross-Sectional Study. Anemia 2016; 2016:5725634. [PMID: 27895939 PMCID: PMC5118524 DOI: 10.1155/2016/5725634] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/07/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022] Open
Abstract
Background. Malaria remains a major killer of children in Sub-Saharan Africa, while anaemia is a public health problem with significant morbidity and mortality. Examining the factors associated with moderate to severe anaemia (MdSA) and malarial anaemia as well as the haematological characteristics is essential. Methodology. Children (1–14 years) at presentation at the Regional Hospital Annex-Buea were examined clinically and blood samples were collected for malaria parasite detection and full blood count evaluation. Results. Plasmodium falciparum, anaemia, and malarial anaemia occurred in 33.8%, 62.0%, and 23.6% of the 216 children, respectively. Anaemia prevalence was significantly higher in malaria parasite positive children and those with fever than their respective counterparts. MdSA and moderate to severe malarial anaemia (MdSMA) were detected in 38.0% and 15.3% of the participants, respectively. The prevalence of MdSA was significantly higher in children whose household head had no formal education, resided in the lowland, or was febrile, while MdSMA was significantly higher in febrile children only. Children with MdSMA had significantly lower mean white blood cell, lymphocyte, and platelet counts while the mean granulocyte count was significantly higher. Conclusion. Being febrile was the only predictor of both MdSA and MdSMA. More haematological insult occurred in children with MdSMA compared to MdSA.
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Bate A, Kimbi HK, Lum E, Lehman LG, Onyoh EF, Ndip LM, Njabi CM, Tonga C, B Wempnje G, Ndip RN, Bessong PO. Malaria infection and anaemia in HIV-infected children in Mutengene, Southwest Cameroon: a cross sectional study. BMC Infect Dis 2016; 16:523. [PMID: 27682438 PMCID: PMC5041210 DOI: 10.1186/s12879-016-1853-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is one of the leading causes of morbidity and mortality in children and HIV infection as well as other factors may worsen the situation. This study was aimed at determining the factors influencing malaria parasite prevalence and density as well as anaemia in HIV-infected children in Mutengene, Cameroon from November, 2012 to April, 2013. METHODS A semi-structured questionnaire was used to record information on socio-demographic factors and use of preventive measures by caregivers of HIV-infected children aged 1-15 years and of both sexes. Venous blood was collected; blood films were prepared and Giemsa-stained for parasite detection and speciation. Haemoglobin concentration was measured and the anaemic status determined. Data was analysed using Epi Info 7 software. RESULTS A total of 234 children were studied. The overall malaria parasite prevalence was 24.8 % (58) and was significantly higher (31.9 %, P = 0 .004) in females, those who did not implement any preventive measure at all (66.7 %, P = 0.03) and children who used antiretroviral therapy (ART) (28.6 %, P = 0.02) when compared with their respective counterparts. Geometric mean parasite density (GMPD) was significantly higher (3098.4, P = 0.02) in children who presented with fever, had CD4 T cells ≥500 cells/μL (491.3, P = 0.003) and those with moderate anaemia (1658.8, P = 0.03) than their respective counterparts. Although there was no significant difference, GMPD was however higher in males (549.0); those not on ART (635.0) and highest in children <5 years old (633.0) than their respective counterparts. The overall prevalence of anaemia was 49.6 % (116). The value was significantly highest (58.3 %, P = 0.01) in the 11-15 years age group; those with CD4 T cell level 200-499 (72.7 %, P = 0.001) and children with fever (85.7 %, P = 0.01). CONCLUSION Implementation of proper and integrated malaria preventive measures as well as frequent monitoring of anaemia on prescription of ART could likely improve the health conditions of HIV-infected children thus avoiding malaria-related morbidity and mortality.
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Affiliation(s)
- Ayukenchengamba Bate
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon.
| | - Helen K Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon.,Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, P.O. Box 39, Bambili, NWR, Cameroon
| | - Emmaculate Lum
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon.,Department of Biological Sciences, Higher Teachers' Training College, University of Yaounde I, P.O. Box 47, Yaounde, Centre Region, Cameroon
| | - Leopold G Lehman
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 2701, Douala, Littoral Region, Cameroon
| | - Elias F Onyoh
- AIDS Care and Prevention Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Lucy M Ndip
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon
| | - Conica M Njabi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon
| | - Calvin Tonga
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 2701, Douala, Littoral Region, Cameroon
| | - Godlove B Wempnje
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon
| | - Roland N Ndip
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, P.O. Box 63, Buea, SWR, Cameroon.,Department of Biochemistry and Microbiology, Faculty of Science and Agriculture, University of Fort Hare, PMB X1314, Alice, 5700, South Africa
| | - Pascal O Bessong
- HIV/AIDS and Global Health Research Programme, Department of Microbiology, University of Venda, Thohoyandou, 0950, South Africa
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Margono S, Lubis B, Pasaribu S, Wijaya H, Pasaribu AP. The correlation between platelet count and parasite density in children with malaria infection. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(15)61013-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sumbele IUN, Bopda OSM, Kimbi HK, Ning TR, Nkuo-Akenji T. Nutritional status of children in a malaria meso endemic area: cross sectional study on prevalence, intensity, predictors, influence on malaria parasitaemia and anaemia severity. BMC Public Health 2015; 15:1099. [PMID: 26541669 PMCID: PMC4635657 DOI: 10.1186/s12889-015-2462-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 10/30/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The contradictory results on the interaction between nutritional status and malaria warrants further investigation in various epidemiological settings, to assert the antagonistic or synergistic relationship. This study examines the prevalence, severity and predictors of malnutrition and its influence on malaria parasitaemia and anaemia severity in children in the Mount Cameroon area. METHODS A cross-sectional study involving 454 children ≤ 14 years was carried out from February to May 2013 in Muea community. Anthropometric measures of malnutrition (z-scores < -2 standard deviations below mean) were obtained and spleen size assessed. The prevalence and density of malaria parasites were determined and haemoglobin concentration and white blood cell count obtained using an automated haematology analyzer. Univariate and multivariate analyses were used to evaluate influence of malnutrition on anaemia, malaria parasitaemia and predictors respectively. RESULTS The overall prevalence of malnutrition was 22.8 %, with stunting being the most common form (17.1 %), followed by underweight (8.2 %) and wasting (5.5 %). Stunting was significantly higher (P < 0.01) in males (23.1 %) than in females (11.9 %). The prevalence of malnutrition was significantly highest (P = 0.03) in children ≤5 years old (29.5 %) than their counterparts. Severe stunting, wasting and underweight were prevalent in 4.9 %, 1.6 % and 1.8 % of the children respectively. Clinical malaria parasitaemia was significantly higher (P = 0.01) in children who were stunted (16.9 %) and underweight (21.6 %) than their normal counterparts (7.5 %; 8.2 % respectively). The model demonstrated sex (P = 0.006) and age group 1.1-3 years (P = 0.03) as significant predictors of malnutrition. In children who were malaria parasite negative, the prevalence of anaemia as well as severities were significantly higher (P = 0.04 and P = 0.001 respectively) in those malnourished. CONCLUSIONS The presence of stunting in the community significantly augmented the prevalence and clinical presentation of Plasmodium infection. Malnutrition enhanced the severity of anaemia in malaria parasite negative children hence, their health and growth potential needs to be improved upon.
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Affiliation(s)
| | | | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.
| | - Teh Rene Ning
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.
| | - Theresa Nkuo-Akenji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
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Anchang-Kimbi JK, Nkweti VN, Ntonifor HN, Apinjoh TO, Tata RB, Chi HF, Achidi EA. Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area. BMC Infect Dis 2015; 15:439. [PMID: 26494140 PMCID: PMC4619095 DOI: 10.1186/s12879-015-1211-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 10/13/2015] [Indexed: 11/15/2022] Open
Abstract
Background Pregnant women in malaria endemic areas are at high risk of P. falciparum infection and its complications. This study investigated the prevalence and risk factors for P. falciparum infection and malaria among pregnant women reporting for first antenatal care (ANC) clinic visit in the mount Cameroon area. Methods Venous blood samples from consented pregnant women were screened for malaria parasitaemia by light microscopy. Haemoglobin levels, white blood cell (WBC) counts, lymphocyte counts and percentage were determined using an automated haematology analyser. Socio-demographic/economic data, environmental factors and use of malaria control measures were documented. Univariate and multivariate statistical analyses were used. Results Sixty-eight (22.4 %; N = 303) of the women enrolled were positive for P. falciparum parasitaemia. Malaria parasitaemia was significantly (P < 0.001) associated with febrile illness. The overall prevalence of malaria and asymptomatic infection was 16.0 % (95 % CI = 11-20 %) and 10.5 % (95 % CI = 7.3-15 %) respectively. A greater proportion of the malaria cases (61 %) reported at the clinic during unscheduled days meanwhile women with asymptomatic parasitaemia mostly (92.8 %) seek for ANC during scheduled clinic days. Lower lymphocyte percentage was significantly associated with increase parasite density (r = − 0.34; P = 0.011) and febrile status (MU = 2.46; P = 0.014). While age and gravidity were significant factors associated with P. falciparum infection and/or malaria, the presence of bush and/or standing water around human residence was an independent risk factor of P. falciparum parasitaemia (OR = 3.3: 95 % CI = 1.6 – 7.0; P = 0.002) and malaria ( OR = 5.2: 95 % CI = 2.0 – 14; P = 0.001). Being unmarried was significantly associated with increase risk (OR = 2.6:95 % CI = 1.1 – 6.0; P = 0.032) of P. falciparum parasitaemia. Similarly, single women (938) had a significantly higher (t = 2.70; P = 0.009) geometric mean parasite density (GMPD) compared with married women (338). Conclusion Marital status and human residence in areas with bushes and/or standing water modify risk of P. falciparum infection and malaria. Education on early ANC attendance and environmental sanitation are important public health targets for malaria control in pregnancy in this setting.
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Affiliation(s)
| | - Vera Ngenwie Nkweti
- Department of Zoology and Animal Physiology, University of Buea, Buea, 63, Cameroon.
| | - Helen Ngum Ntonifor
- Department of Biological Sciences, University of Bamenda, Bamenda, Cameroon.
| | - Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon.
| | - Rolland Bantar Tata
- Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon.
| | - Hanesh Fru Chi
- Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon.
| | - Eric Akum Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon.
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Mwesigwa J, Okebe J, Affara M, Di Tanna GL, Nwakanma D, Janha O, Opondo K, Grietens KP, Achan J, D'Alessandro U. On-going malaria transmission in The Gambia despite high coverage of control interventions: a nationwide cross-sectional survey. Malar J 2015; 14:314. [PMID: 26268225 PMCID: PMC4535679 DOI: 10.1186/s12936-015-0829-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/03/2015] [Indexed: 11/13/2022] Open
Abstract
Background As indicators of burden of malaria have substantially decreased in The Gambia, reaching a pre-elimination status may be attainable. Achieving this goal requires in-depth understanding of the current burden of Plasmodium falciparum infection. Methods A nationwide cross-sectional survey was conducted in 2012 to determine the prevalence of P.falciparum infection, and to describe its heterogeneity and associated risk factors. Finger-prick blood samples were collected for microscopy, species-specific PCR and haemoglobin measurement. Results A total of 9,094 participants were included and median
age was 11.9 years (IQR 5, 28). Overall prevalence of P. falciparum was 16.01 % with marked heterogeneity between sites (4.32–36.75 %) and within villages in each site (1.63–49.13 %). Across all sites, 51.17 % (745/1,456) of infections were asymptomatic and 35.61 % (448/1,258) were sub-microscopic. The odds of P. falciparum infection were higher in older children; 5–15 years (OR = 1.90; 95 % CI 1.60–2.26), adults (OR = 1.48; 95 % CI 1.24–1.78) and participants with moderate anaemia (OR = 1.62; 95 % CI 1.32–1.99). Conclusions The current malaria control interventions are not sufficient to interrupt transmission in The Gambia as malaria prevalence is still relatively high in the eastern part of the country. New interventions aiming at interrupting transmission are needed and should be urgently evaluated.
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Affiliation(s)
- Julia Mwesigwa
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Joseph Okebe
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Muna Affara
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | | | - Davis Nwakanma
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Omar Janha
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Kevin Opondo
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Koen Peeters Grietens
- Institute of Tropical Medicine, Antwerp, Belgium. .,School of International Health Development, Nagasaki University, Nagasaki, Japan. .,Partners for Applied Social Sciences (PASS) International, Tessenderlo, Belgium.
| | - Jane Achan
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia.
| | - Umberto D'Alessandro
- Medical Research Council Unit, PO Box 273, Banjul, The Gambia. .,London School of Hygiene and Tropical Medicine, London, UK. .,Institute of Tropical Medicine, Antwerp, Belgium.
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Sumbele IUN, Kimbi HK, Ndamukong-Nyanga JL, Nweboh M, Anchang-Kimbi JK, Lum E, Nana Y, Ndamukong KKJ, Lehman LG. Malarial anaemia and anaemia severity in apparently healthy primary school children in urban and rural settings in the Mount Cameroon area: cross sectional survey. PLoS One 2015; 10:e0123549. [PMID: 25893500 PMCID: PMC4403990 DOI: 10.1371/journal.pone.0123549] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/04/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children. METHODS A cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11 g/dL); mild MA (Hb of 8-10.9 g/dL); moderate MA (Hb of 6.1-7.9 g/dL) and severe MA (Hb≤6 g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors. RESULTS Out of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6 years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia. CONCLUSIONS Malarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.
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Affiliation(s)
- Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
- * E-mail:
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Judith Lum Ndamukong-Nyanga
- Department of Biological Sciences, Higher Teachers Training College, University of Yaoundé I, Yaoundé, Cameroon
| | - Malaika Nweboh
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
| | | | - Emmaculate Lum
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Yannick Nana
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Kenneth K. J. Ndamukong
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Leopold G. Lehman
- Department of Biological Sciences, Faculty of Science, University of Douala, Douala, Cameroon
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Kimbi HK, Nkesa SB, Ndamukong-Nyanga JL, Sumbele IUN, Atashili J, Atanga MBS. Socio-demographic factors influencing the ownership and utilization of insecticide-treated bed nets among malaria vulnerable groups in the Buea Health District, Cameroon. BMC Res Notes 2014; 7:624. [PMID: 25204352 PMCID: PMC4167508 DOI: 10.1186/1756-0500-7-624] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria remains a public health problem and the use of insecticide-treated bed nets (ITNs) against it in vulnerable groups (pregnant women and children <5 years) is recommended in Cameroon. This study was aimed at assessing the socio-demographic factors influencing the ownership and utilization of ITNs among vulnerable groups in the Buea Health District (BHD). METHODS In a cross-sectional survey a questionnaire was administered in households with at least a child <5 years and/pregnant woman in five health areas of the BHD. Information on demographic variables, household composition, mosquito bed net (MBN) ownership, utilization and factors influencing ownership and utilization was recorded. RESULTS A total of 443 respondents were recruited and 208 (47.0%) possessed at least one MBN (total = 275 MBNs) with a median of 1.33 nets. Of the 275 nets found in households, 89 (32%) were potent ITNs and others had never been retreated/treated. Purchase of MBNs from the market was associated with marital status (P = 0.010) and urban settlement (P = 0.045). The number of respondents who did not know where to retreat/treat ITNs was significantly higher (P = 0.005) in urban than rural dwellers. The proportion of rural respondents who had once taken their MBNs for re-treatment was significantly higher (P = 0.002) than that of urban dwellers. MBN utilisation was 69.7% (95% confidence interval; CI = .63.2-75.6%). A total of 83.4%, 13.8% and 3.4% used MBNs throughout the year, during the rainy and dry seasons respectively. MBN use in children under five was associated with being from an urban area (P = 0.01). MBN use in pregnant women was associated with living in block-louver houses than in block-pane houses (P = 0.047). CONCLUSIONS Utilization of MBN needs to be encouraged to match ownership while free distribution of ITNs to vulnerable groups needs to be continuous and consistent.
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Affiliation(s)
| | | | | | - Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, PO Box 63, Buea, SWR, Cameroon.
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Kimbi HK, Nkesa SB, Ndamukong-Nyanga JL, Sumbele IUN, Atashili J, Atanga MBS. Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District, Cameroon. BMC Public Health 2014; 14:883. [PMID: 25163481 PMCID: PMC4159509 DOI: 10.1186/1471-2458-14-883] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/21/2014] [Indexed: 11/25/2022] Open
Abstract
Background Malaria is a public health problem especially in vulnerable groups such as pregnant women and children under five years in Cameroon including the Buea Health District (BHD). Misconceptions concerning it exist. This study assessed the level of knowledge and perceptions towards malaria control among pregnant women and mothers/caretakers of under-fives in the BHD. Methods A community-based cross-sectional study was conducted in the BHD in August, 2011 in five health areas. A questionnaire was used to collect data on demographic variables, knowledge and perceptions towards malaria control from 443 respondents aged 15–73 years. Results Of the 443 respondents interviewed, 99% had heard about malaria. Awareness of malaria was similar in rural (98.04%) and urban (98.97%) areas. The health facility was the most popular source of information (74%). The radio, television, tracts/posters and the community relay agents (CRAs) all informed significantly higher proportions of respondents in the urban than rural communities (P <0.05). Overall, 92% of respondents had the right perception of malaria and 88% knew at least one correct sign/symptom of malaria. The most recognised sign of malaria was fever. When all aspects of malaria were considered, majority (88%) of respondents had good levels of knowledge on malaria. The level of good knowledge in respondents with ≥ secondary school education (91%) was significantly higher (P = 0.01) than in those with ≤ primary school level (83%). Overall, 99% had heard about insecticide treated nets (ITNs); 99% perceived ITNs as a good means to prevent malaria; most respondents (57%) used ITNs mainly for protection against mosquito bites while 48% used them for protection against malaria. Conclusion Respondents with no formal education had a poor level of knowledge on malaria. Hence, new strategies for sensitization messages involving their active participation need to be developed.
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Affiliation(s)
| | | | | | - Irene U N Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.
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Nankabirwa J, Brooker SJ, Clarke SE, Fernando D, Gitonga CW, Schellenberg D, Greenwood B. Malaria in school-age children in Africa: an increasingly important challenge. Trop Med Int Health 2014; 19:1294-309. [PMID: 25145389 PMCID: PMC4285305 DOI: 10.1111/tmi.12374] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
School-age children have attracted relatively little attention as a group in need of special measures to protect them against malaria. However, increasing success in lowering the level of malaria transmission in many previously highly endemic areas will result in children acquiring immunity to malaria later in life than has been the case in the past. Thus, it can be anticipated that in the coming years there will be an increase in the incidence of both uncomplicated and severe malaria in school-age children in many previously highly endemic areas. In this review, which focuses primarily on Africa, recent data on the prevalence of malaria parasitaemia and on the incidence of clinical malaria in African school-age children are presented and evidence that malaria adversely effects school performance is reviewed. Long-lasting insecticide treated bednets (LLIN) are an effective method of malaria control but several studies have shown that school-age children use LLINs less frequently than other population groups. Antimalarial drugs are being used in different ways to control malaria in school-age children including screening and treatment and intermittent preventive treatment. Some studies of chemoprevention in school-age children have shown reductions in anaemia and improved school performance but this has not been the case in all trials and more research is needed to identify the situations in which chemoprevention is likely to be most effective and, in these situations, which type of intervention should be used. In the longer term, malaria vaccines may have an important role in protecting this important section of the community from malaria. Regardless of the control approach selected, it is important this is incorporated into the overall programme of measures being undertaken to enhance the health of African school-age children.
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