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Olagunju OJ, Ekwebene OC, Olagunju OE, Osanyinlusi O, Oyebanji OA, Egbo B. Malaria Parasitemia and Severe Health Complications in Children Under Five Years of Age in Nigeria: A Study Using the Demographic and Health Survey (DHS) Malaria Indicator Survey (MIS) 2021. Cureus 2024; 16:e58907. [PMID: 38800144 PMCID: PMC11118779 DOI: 10.7759/cureus.58907] [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: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND In Nigeria, 97% of the population is at risk of contracting malaria. It is transmitted by female Anopheles mosquitoes carrying the Plasmodium parasite and can be lethal. An estimated 55 million illnesses and 80,000 deaths per year result from it. Children under five are more likely to contract malaria. Efforts to control malaria in Nigeria include indoor residual spraying, insecticide-treated bed nets, and quick detection and treatment of confirmed cases with effective antimalarial medications. These attempts have been impeded by limited healthcare access, poor financing, and drug-resistant parasites. Thus, the study of the relationship between malaria complications and housing for children under five is essential. METHODS The Demographic and Health Survey (DHS) Malaria Indicator Survey (MIS) 2021, a nationally representative data set from developing countries on population and health, was used for this study. A sample size of 13,727 was employed (n=13,727). Logistic regression analyses were conducted to test the association between the type of place of residence and malaria complications (outcome). RESULTS Overall, 4.2% (n=570, weight HV005) of participants in the sample reported malaria complications. The results of the logistic regression revealed that children residing in urban settlements (aOR 0.37, 95% CI 0.37-0.37, p-value <0.001), children from the poorest class families (aOR 11.63, 95% CI 1.62-1.63, p-value 0.004), children from poorer class families (aOR 7.56, 95% CI 7.55-7.57, p-value <0.001), children from middle-class families (aOR 4.05, 95% CI 4.03-9.06, p-value <0.001), children from richer class families (aOR 1.22, 95% CI 2.21-2.23, p-value <0.001), children of mothers with primary education (aOR 0.42, 95% CI 2.32-4.112, p-value 0.001), children of mothers with secondary education (aOR 0.24, 95% CI 3.21-3.22, p-value <0.001), children of mothers with higher education (aOR 0.08, 95% CI 0.72-0.80, p-value <0.001), and children of the female gender (aOR 0.65, 95% CI 0.65-0.66, p-value <0.001) are all associated with severe malaria complications. CONCLUSIONS In conclusion, the study examined malaria complications in Nigerian children under five by residency. The findings imply that rural children are more likely to have serious malaria complications than urban children. This emphasizes the necessity for targeted malaria therapies in rural areas with limited healthcare access.
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Affiliation(s)
- Olajide J Olagunju
- Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Onyeka C Ekwebene
- Biostatistics and Epidemiology, East Tennessee State University, Johnson City, USA
| | | | - Olagoke Osanyinlusi
- Pulmonology, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Oladayo A Oyebanji
- Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Ben Egbo
- Radiology, Potiskum Medical Centre, Potiskum, NGA
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Casella A, Monroe A, Toso M, Hunter G, Underwood C, Pillai R, Hughes J, Van Lith LM, Cash S, Hwang J, Babalola S. Understanding psychosocial determinants of malaria behaviours in low-transmission settings: a scoping review. Malar J 2024; 23:15. [PMID: 38200574 PMCID: PMC10782749 DOI: 10.1186/s12936-023-04831-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Recent estimates show progress toward malaria elimination is slowing in many settings, underscoring the need for tailored approaches to fight the disease. In addition to essential structural changes, human behaviour plays an important role in elimination. Engagement in malaria behaviours depends in part on psychosocial determinants such as knowledge, perceived risk, and community norms. Understanding the state of research on psychosocial determinants in low malaria transmission settings is important to augment social and behaviour change practice. This review synthesizes research on psychosocial factors and malaria behaviours in low-transmission settings. METHODS A systematic search of peer-reviewed literature and supplemental manual search of grey literature was conducted using key terms and eligibility criteria defined a priori. Publications from 2000-2020 in the English language were identified, screened, and analysed using inductive methods to determine the relationship between the measured psychosocial factors and malaria behaviours. RESULTS Screening of 961 publications yielded 96 for inclusion. Nineteen articles collected data among subpopulations that are at increased risk of malaria exposure in low-transmission settings. Purposive and cluster randomized sampling were common sampling approaches. Quantitative, qualitative, and mixed-methods study designs were used. Knowledge, attitudes, and perceived risk were commonly measured psychosocial factors. Perceived response-efficacy, perceived self-efficacy, and community norms were rarely measured. Results indicate positive associations between malaria knowledge and attitudes, and preventive and care-seeking behaviour. Studies generally report high rates of correct knowledge, although it is comparatively lower among studies of high-risk groups. There does not appear to be sufficient extant evidence to determine the relationship between other psychosocial variables and behaviour. CONCLUSIONS The review highlights the need to deploy more consistent, comprehensive measures of psychosocial factors and the importance of reaching subpopulations at higher risk of transmission in low transmission contexts. Malaria-related knowledge is generally high, even in settings of low transmission. Programmes and research should work to better understand the psychosocial factors that have been positively associated with prevention and care-seeking behaviours, such as norms, perceived response efficacy, perceived self-efficacy, and interpersonal communication. These factors are not necessarily distinct from that which research has shown are important in settings of high malaria transmission. However, the importance of each factor and application to malaria behaviour change programming in low-transmission settings is an area in need of further research. Existing instruments and approaches are available to support more systematic collection of psychosocial determinants and improved sampling approaches and should be applied more widely. Finally, while human behaviour is critical, health systems strengthening, and structural interventions are essential to achieve malaria elimination goals.
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Affiliation(s)
- Albert Casella
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA.
| | - April Monroe
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Michael Toso
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Gabrielle Hunter
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Carol Underwood
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
- Department of Health, Behavior, & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ruchita Pillai
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Jayme Hughes
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Lynn M Van Lith
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Shelby Cash
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jimee Hwang
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stella Babalola
- Breakthrough ACTION Project, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
- Department of Health, Behavior, & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Woolley SD, Grigg MJ, Marquart L, Gower J, Piera K, Nair AS, Amante FM, Rajahram GS, William T, Frazer DM, Chalon S, McCarthy JS, Anstey NM, Barber BE. Longitudinal changes in iron homeostasis in human experimental and clinical malaria. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.19.23300265. [PMID: 38196596 PMCID: PMC10775340 DOI: 10.1101/2023.12.19.23300265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background The interaction between iron deficiency and malaria is incompletely understood. We evaluated longitudinal changes in iron homeostasis in volunteers enrolled in malaria volunteer infection studies (VIS) and in Malaysian patients with falciparum and vivax malaria. Methods We retrieved samples and associated data from 55 participants enrolled in malaria VIS, and 171 malaria patients and 30 healthy controls enrolled in clinical studies in Malaysia. Ferritin, hepcidin, erythropoietin, and soluble transferrin receptor (sTfR) were measured by ELISA. Results In the VIS, participants' parasitaemia was correlated with baseline mean corpuscular volume (MCV), but not iron status (ferritin, hepcidin or sTfR). Ferritin, hepcidin and sTfR all increased during the VIS. Ferritin and hepcidin normalised by day 28, while sTfR remained elevated. In VIS participants, baseline iron status (ferritin) was associated with post-treatment increases in liver transaminase levels. In Malaysian malaria patients, hepcidin and ferritin were elevated on admission compared to healthy controls, while sTfR increased following admission. Hepcidin normalised by day 28; however, ferritin and sTfR both remained elevated 4 weeks following admission. Conclusion Our findings demonstrate that parasitaemia is associated with an individual's MCV rather than iron status. The persistent elevation in sTfR 4 weeks post-infection in both malaria VIS and clinical malaria may reflect a causal link between malaria and iron deficiency.
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Affiliation(s)
- Stephen D Woolley
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - Matthew J Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Louise Marquart
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Jeremy Gower
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kim Piera
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Arya Sheela Nair
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Fiona M Amante
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - David M Frazer
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - James S McCarthy
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Victorian Infectious Diseases Institute, Peter Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Bridget E Barber
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Infectious Diseases Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Gaye A, Diongue AK, Komen LN, Diallo A, Sylla SN, Diarra M, Talla C, Loucoubar C. High-dimensional supervised classification in a context of non-independence of observations to identify the determining SNPs in a phenotype. Infect Dis Model 2023; 8:1079-1087. [PMID: 37727806 PMCID: PMC10505671 DOI: 10.1016/j.idm.2023.09.002] [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: 06/26/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 09/21/2023] Open
Abstract
This work addresses the problem of supervised classification for highly correlated high-dimensional data describing non-independent observations to identify SNPs related to a phenotype. We use a general penalized linear mixed model with a single random effect that performs simultaneous SNP selection and population structure adjustment in high-dimensional prediction models. Specifically, the model simultaneously selects variables and estimates their effects, taking into account correlations between individuals. Single nucleotide polymorphisms (SNPs) are a type of genetic variation and each SNP represents a difference in a single DNA building block, namely a nucleotide. Previous research has shown that SNPs can be used to identify the correct source population of an individual and can act in isolation or simultaneously to impact a phenotype. In this regard, the study of the contribution of genetics in infectious disease phenotypes is of great importance. In this study, we used uncorrelated variables from the construction of blocks of correlated variables done in a previous work to describe the most related observations of the dataset. The model was trained with 90% of the observations and tested with the remaining 10%. The best model obtained with the generalized information criterion (GIC) identified the SNP named rs2493311 located on the first chromosome of the gene called PRDM16 ((PR/SET domain 16)) as the most decisive factor in malaria attacks.
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Affiliation(s)
- Aboubacry Gaye
- Laboratory for Studies and Research in Statistics and Development, Gaston Berger University of Saint Louis, Senegal
- Epidemiology, Clinical Research and Data Science Unit, Institute Pasteur de Dakar, 220, Dakar, Senegal
| | - Abdou Ka Diongue
- Laboratory for Studies and Research in Statistics and Development, Gaston Berger University of Saint Louis, Senegal
| | | | - Amadou Diallo
- Epidemiology, Clinical Research and Data Science Unit, Institute Pasteur de Dakar, 220, Dakar, Senegal
| | - Seydou Nourou Sylla
- Information and Communication Technologies for Development, Alioune Diop University of Bambey, Senegal
| | - Maryam Diarra
- Epidemiology, Clinical Research and Data Science Unit, Institute Pasteur de Dakar, 220, Dakar, Senegal
| | - Cheikh Talla
- Epidemiology, Clinical Research and Data Science Unit, Institute Pasteur de Dakar, 220, Dakar, Senegal
| | - Cheikh Loucoubar
- Epidemiology, Clinical Research and Data Science Unit, Institute Pasteur de Dakar, 220, Dakar, Senegal
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Eshetu B, Bekele H, Debella A, Eyeberu A, Balis B, Habte S, Mardasa K, Wondimneh F, Teshager T, Ketema I. Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Front Glob Womens Health 2023; 4:1147583. [PMID: 38025984 PMCID: PMC10657856 DOI: 10.3389/fgwh.2023.1147583] [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: 01/18/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. Methods A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Results Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. Conclusion The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. Systematic Review Registration CRD42022304432.
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Affiliation(s)
- Bajrond Eshetu
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Bekele
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sisay Habte
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | | | - Fenta Wondimneh
- Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Teshager
- Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Indeshaw Ketema
- Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Gemechu T, Dedecha W, Gelchu M, Husen O, Jarso H. Asymptomatic Malaria During Pregnancy: Prevalence, Influence on Anemia and Associated Factors in West Guji Zone, Ethiopia - A Community-Based Study. Infect Drug Resist 2023; 16:6747-6755. [PMID: 37876858 PMCID: PMC10591643 DOI: 10.2147/idr.s431877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023] Open
Abstract
Background Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome. Objective This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia. Methods A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors. Results The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74-3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36-3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32-3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02-2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000). Conclusion Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.
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Affiliation(s)
- Tibeso Gemechu
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Miesa Gelchu
- Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Oliyad Husen
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Habtemu Jarso
- Department of Public Health, School of Health Science, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
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Febrer-Sendra B, Crego-Vicente B, Nindia A, Martínez-Campreciós J, Aixut S, Mediavilla A, Silgado A, Oliveira-Souto I, Salvador F, Molina I, Muro A, Sulleiro E, Fernández-Soto P. First field and laboratory evaluation of LAMP assay for malaria diagnosis in Cubal, Angola. Parasit Vectors 2023; 16:343. [PMID: 37789462 PMCID: PMC10548721 DOI: 10.1186/s13071-023-05942-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/22/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Malaria is a globally distributed infectious disease. According to the World Health Organization, Angola is one of the six countries that account for over half the global malaria burden in terms of both malaria cases and deaths. Diagnosis of malaria still depends on microscopic examination of thin and thick blood smears and rapid diagnostic tests (RDTs), which often lack analytical and clinical sensitivity. Molecular methods could overcome these disadvantages. The aim of this study was to evaluate, for the first time to our knowledge, the performance of a loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria in an endemic area in Cubal, Angola, and to assess the reproducibility at a reference laboratory. METHODS A total of 200 blood samples from patients attended at Hospital Nossa Senhora da Paz, Cubal, Angola, were analysed for Plasmodium spp. detection by microscopy, RDTs, and LAMP. LAMP assay was easily performed in a portable heating block, and the results were visualized by a simple colour change. Subsequently, the samples were sent to a reference laboratory in Spain to be reanalysed by the same colorimetric LAMP assay and also in real-time LAMP format. RESULTS In field tests, a total of 67/200 (33.5%) blood samples were microscopy-positive for Plasmodium spp., 98/200 RDT positive, and 112/200 (56%) LAMP positive. Using microscopy as reference standard, field LAMP detected more microscopy-positive samples than RDTs (66/67; 98% vs. 62/67; 92.5%). When samples were reanalysed at a reference laboratory in Spain using both colorimetric and real-time assays, the overall reproducibility achieved 84.5%. CONCLUSIONS This is the first study to our knowledge in which LAMP has been clinically evaluated on blood samples in a resource-poor malaria-endemic area. The colorimetric LAMP proved to be more sensitive than microscopy and RDTs for malaria diagnosis in field conditions. Furthermore, LAMP showed an acceptable level of reproducibility in a reference laboratory. The possibility to use LAMP in a real-time format in a portable device reinforces the reliability of the assay for molecular diagnosis of malaria in resource-poor laboratories in endemic areas.
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Affiliation(s)
- Begoña Febrer-Sendra
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Beatriz Crego-Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | | | - Joan Martínez-Campreciós
- Hospital Nossa Senhora da Paz, Cubal, Angola
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Alejandro Mediavilla
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Aroa Silgado
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira-Souto
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Elena Sulleiro
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain.
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Adum P, Agyare VA, Owusu-Marfo J, Agyeman YN. Knowledge, attitude and practices of malaria preventive measures among mothers with children under five years in a rural setting of Ghana. Malar J 2023; 22:268. [PMID: 37700321 PMCID: PMC10498521 DOI: 10.1186/s12936-023-04702-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/02/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Malaria remains a major public health concern around the world, particularly in resource-constrained countries. Malaria still accounts for 40% of all Out-Patient Department (OPD) cases in Ghana, with children under the age of five being the most vulnerable group. The study assessed the knowledge, attitudes, and practices of malaria preventive measures among mothers with children under 5 years old in a rural setting in Ghana. METHODS A cross-sectional study design with a quantitative approach was used in this study. The study was facility based and involved the use of interviewer administered questionnaires to collect data from 281 mothers with children under the age of five. Simple random sampling method was used to select the respondents. The data collected was analysed using the statistical package for the social sciences (SPSS) version 22 and results presented in tables. RESULTS There were 281 mothers, with 59.4% having children at the age of a year. The findings revealed that the majority of participants have a high level of knowledge about malaria's causes, signs, and symptoms. Again, the majority of participants demonstrated a positive attitude toward malaria prevention, such as seeking treatment at a hospital within 24 h of suspecting their children had malaria and demonstrating good knowledge of malaria prevention practices. Despite this, 35.5% of respondents were not actively engaged in malaria prevention practices in a day prior to the interview. Respondents' occupation, level of education, and religion had a statistically significant association with mothers' attitude towards prevention (p-values < 0.05 and 0.01). CONCLUSION The study's findings clearly demonstrate that the majority of mothers were knowledgeable about the causes, signs and symptoms, and preventive measures of malaria in children under the age of five. There was also statistically significant association between mothers' demographic information, including level of education, occupation, religion, and their attitude towards malaria prevention. A keen interest should be directed toward the consistent application of low-cost preventive measures.
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Affiliation(s)
- Prince Adum
- Kintampo Municipal Government Hospital, Bono East Region, Kintampo, Ghana
| | - Veronica Adwoa Agyare
- Ghana College of Nurses and Midwives, Kumasi, Ashanti Region, Ghana
- Ministry of Health Training Institution, SDA Nursing & Midwifery Training College Kwadaso, Kumasi, Ghana
| | - Joseph Owusu-Marfo
- Department of Epidemiology, Biostatistics and Disease Control, School of Public Health, University for Development Studies, Tamale, Northern Region, Ghana.
| | - Yaa Nyarko Agyeman
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Northern Region, Ghana
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Omondi CJ, Odongo D, Otambo WO, Ochwedo KO, Otieno A, Lee MC, Kazura JW, Githeko AK, Yan G. Malaria diagnosis in rural healthcare facilities and treatment-seeking behavior in malaria endemic settings in western Kenya. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001532. [PMID: 37471336 PMCID: PMC10358955 DOI: 10.1371/journal.pgph.0001532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/10/2023] [Indexed: 07/22/2023]
Abstract
Accurate malaria diagnosis and timely treatment are requirements for effective management of the disease. However, treatment efficacy may be significantly reduced in resource-constrained healthcare facilities with poorly equipped laboratories and frequent drug and rapid diagnostic test kit (RDT) stock-outs. Furthermore, patient may avoid seeking treatment from such facilities. The study's goal was to determine treatment-seeking behavior, malaria diagnosis and treatment quality, and likely treatment-seeking determinants in the local population. Passive case detection, which targeted all patients with suspected malaria cases, was conducted in ten public healthcare facilities over a three-month period. Monthly malaria cases, methods of diagnosis and antimalarial drug availability were assessed. A household-based survey was also carried out. Structured questionnaires were used to collect knowledge, attitude and practice (KAP) data from household heads. Malaria knowledge, treatment seeking behavior, and predictors of malaria treatment-seeking were all determined. Three of the seven dispensaries lacked a laboratory to conduct microscopy- diagnosis. These three dispensaries also experienced frequent RDT stock-outs, which resulted in depending on clinical signs as diagnosis for malaria. The majority of local residents with fever (50.3%) purchased antimalarial drugs from a chemist. About 37% of fever patients sought treatment at healthcare facility while the remaining 12.7% did not treat their fevers. In irrigated areas, 45.5% (46/64) of fever patients sought treatment at healthcare facilities, compared to 25% (18/64) in non-irrigated areas (p = 0.009). Most children aged below 5 who had fever (77.7%) were taken to healthcare facility for treatment compared to 31.4% of children aged 5-14 years or 20.9% of adults (0.0001). Predictors of treatment seeking included access to healthcare facility (OR = 16.23, 95% CI: 2.74-96.12), and ability to pay hospital bills (OR = 10.6, 95% CI: 1.97-57). Other factors that influenced health-seeking behavior included the severity of symptoms, the age of the patient and knowledge of malaria symptoms.
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Affiliation(s)
- Collince J. Omondi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
| | - David Odongo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Wilfred O. Otambo
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Department of Zoology, Maseno University, Kisumu, Kenya
| | - Kevin O. Ochwedo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
| | - Antony Otieno
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Ming-Chieh Lee
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, California, United States of America
| | - James W. Kazura
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Andrew K. Githeko
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Climate and Human Health Research Unit, Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Guiyun Yan
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, California, United States of America
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Rahmalia A, Poespoprodjo JR, Landuwulang CUR, Ronse M, Kenangalem E, Burdam FH, Thriemer K, Devine A, Price RN, Peeters Grietens K, Ley B, Gryseels C. Adherence to 14-day radical cure for Plasmodium vivax malaria in Papua, Indonesia: a mixed-methods study. Malar J 2023; 22:162. [PMID: 37210520 PMCID: PMC10199529 DOI: 10.1186/s12936-023-04578-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/25/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Reducing the risk of recurrent Plasmodium vivax malaria is critical for malaria control and elimination. Primaquine (PQ) is the only widely available drug against P. vivax dormant liver stages, but is recommended as a 14-day regimen, which can undermine adherence to a complete course of treatment. METHODS This is a mixed-methods study to assess socio-cultural factors influencing adherence to a 14-day PQ regimen in a 3-arm, treatment effectiveness trial in Papua, Indonesia. The qualitative strand, consisting of interviews and participant observation was triangulated with a quantitative strand in which trial participants were surveyed using a questionnaire. RESULTS Trial participants differentiated between two types of malaria: tersiana and tropika, equivalent to P. vivax and Plasmodium falciparum infection, respectively. The perceived severity of both types was similar with 44.0% (267/607) perceiving tersiana vs. 45.1% (274/607) perceiving tropika as more severe. There was no perceived differentiation whether malaria episodes were due to a new infection or relapse; and 71.3% (433/607) acknowledged the possibility of recurrence. Participants were familiar with malaria symptoms and delaying health facility visit by 1-2 days was perceived to increase the likelihood of a positive test. Prior to health facility visits, symptoms were treated with leftover drugs kept at home (40.4%; 245/607) or bought over the counter (17.0%; 103/607). Malaria was considered to be cured with 'blue drugs' (referring to dihydroartemisinin-piperaquine). Conversely, 'brown drugs,' referring to PQ, were not considered malaria medication and instead were perceived as supplements. Adherence to malaria treatment was 71.2% (131/184), in the supervised arm, 56.9% (91/160) in the unsupervised arm and 62.4% (164/263) in the control arm; p = 0.019. Adherence was 47.5% (47/99) among highland Papuans, 51.7% (76/147) among lowland Papuans, and 72.9% (263/361) among non-Papuans; p < 0.001. CONCLUSION Adherence to malaria treatment was a socio-culturally embedded process during which patients (re-)evaluated the characteristics of the medicines in relation to the course of the illness, their past experiences with illness, and the perceived benefits of the treatment. Structural barriers that hinder the process of patient adherence are crucial to consider in the development and rollout of effective malaria treatment policies.
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Affiliation(s)
- Annisa Rahmalia
- Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Indonesia.
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
- Institute of Tropical Medicine, Antwerp, Belgium.
| | - Jeanne Rini Poespoprodjo
- Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Indonesia
- Mimika District Hospital, Timika, Indonesia
- Paediatric Research Office, Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Chandra U R Landuwulang
- Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Indonesia
| | - Maya Ronse
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Enny Kenangalem
- Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Indonesia
- Mimika Regency Health Authority, Timika, Papua, Indonesia
| | - Faustina H Burdam
- Timika Malaria Research Programme, Papuan Health and Community Development Foundation, Timika, Indonesia
- Mimika Regency Health Authority, Timika, Papua, Indonesia
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Angela Devine
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Ric N Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Koen Peeters Grietens
- Institute of Tropical Medicine, Antwerp, Belgium
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
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Tetteh J, Yorke E, Boima V, Yawson AE. Prevalence of malaria infection and the impact of mosquito bed net distribution among children aged 6-59 months in Ghana: Evidence from the Ghana demographic health and malarial indicator surveys. Parasite Epidemiol Control 2023; 21:e00302. [PMID: 37200871 PMCID: PMC10185735 DOI: 10.1016/j.parepi.2023.e00302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/20/2023] Open
Abstract
Objective To assess the prevalence of malaria infection and further quantify the impact of mosquito bed net distribution on malaria infection among children aged 6-59 months in Ghana. Methods A cross-sectional study using Ghana Demographic Health (GDHS) and Malaria Indicator (GMIS) surveys (2014 GDHS, 2016 GMIS, and 2019 GMIS). The exposure and the main outcomes were mosquito bed net use (MBU) and malaria infection (MI). Relative percentage change (Δ) and prevalence ratio (PR) were estimated to assess the changes and the risk of MI by MBU respectively. The Propensity-score matching treatment effect model was employed to estimate the average treatment effect (ATE) of MBU on MI. All analyses were performed using Stata 16.1 and p-value<0.05 was deemed significant. Results The study involved 8781 children aged 6-59 months. MI ranged from 25.8%(22.3-29.7) in 2019 GMIS to 40.6%(37.0-44.2) in 2014 GDHS and the prevalence was significantly high among children who used mosquito bed net. The relative percentage change in MI prevalence showed a significant reduction rate and was high among non-MBU (p-value<0.05). In all, the adjusted PR of MI among children exposed to MBU was 1.21(1.08-1.35), 1.13(1.01-1.28), and 1.50(1.20-1.75) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. The average MI among participants who slept in mosquito bed net significantly increased by 8%(0.04 to 0.12), 4%(0.003 to 0.08), and 7%(0.03 to 0.11) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. Conclusion Even though malaria infection prevalence among children aged 6-59 months is decreasing, the reduction rate seems not to be directly linked with mosquito bed nets distribution and/or use in Ghana. For a continued distribution of mosquito bed nets, and for Ghana to achieve her Malaria Strategic Plan (NMSP) 2021-2025, program managers should ensure effective use of the distributed nets in addition to other preventive measures and nuanced consideration of community behaviours in Ghana. The effective use and care of bed nets should be emphasized as part of the distribution.
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Affiliation(s)
- John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
- Corresponding author at: Department of Community Health, University of Ghana Medical School, College of Health Sciences, P.O. Box 4236, Accra, Ghana.
| | - Ernest Yorke
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Ashu FA, Fouet C, Ambadiang MM, Penlap-Beng V, Kamdem C. Vegetable oil surfactants are synergists that can bias neonicotinoid susceptibility testing in adult mosquitoes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.18.537421. [PMID: 37131639 PMCID: PMC10153115 DOI: 10.1101/2023.04.18.537421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background The standard operating procedure for testing the susceptibility of adult mosquitoes to clothianidin, a neonicotinoid, recommends using a vegetable oil ester as surfactant. However, it has not yet been determined if the surfactant is an inert ingredient or if it can act as a synergist and bias the test. Methodology/Principal Findings Using standard bioassays, we tested the synergistic effects of a vegetable oil surfactant on a spectrum of active ingredients including four neonicotinoids (acetamiprid, clothianidin, imidacloprid and thiamethoxam) and two pyrethroids (permethrin and deltamethrin). Three different formulations of linseed oil soap used as surfactant were far more effective than the standard insecticide synergist piperonyl butoxide in enhancing neonicotinoid activity in Anopheles mosquitoes. At the concentration used in the standard operating procedure (1% v/v), vegetable oil surfactants lead to more than 10-fold reduction in lethal concentrations, LC 50 and LC 99 , of clothianidin in a multi-resistant field population and in a susceptible strain of Anopheles gambiae . At 1% or 0.5% (v/v), the surfactant restored susceptibility to clothianidin, thiamethoxam and imidacloprid and increased mortality to acetamiprid from 43 ± 5.63% to 89 ± 3.25% (P<0.05) in resistant mosquitoes. By contrast, linseed oil soap had no effect on the level of resistance to permethrin and deltamethrin suggesting that the synergism of vegetable oil surfactants may be specific to neoniconoids. Conclusions/Significance Our findings indicate that vegetable oil surfactants are not inert ingredients in neonicotinoid formulations, and their synergistic effects undermine the ability of standard testing procedures to detect early stages of resistance.
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Ambadiang MM, Fouet C, Ashu FA, Penlap-Beng V, Kamdem C. Chronic exposure of mosquito larvae to pesticide residues endangers a new generation of agrochemicals repurposed for malaria prevention. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.18.537423. [PMID: 37131679 PMCID: PMC10153215 DOI: 10.1101/2023.04.18.537423] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Agrochemicals have been successfully repurposed to control mosquitoes worldwide, but pesticides used in agriculture challenge their effectiveness by contaminating surface waters and driving insecticide resistance in larval populations. Here we implemented a new experimental approach to predict the efficacy of agricultural pesticides newly repurposed for malaria vector control. We mimicked insecticide resistance selection as it occurs in contaminated aquatic habitats by rearing field-collected mosquito larvae in water containing a dose of insecticide at which 100% of individuals from a susceptible strain died within 24 h. We then simultaneously monitored short-term lethal toxicity within 24 h and sublethal effects for 7 days. We found that due to chronic exposure to agricultural pesticides some mosquito populations are currently predisposed to rapidly adapt to neonicotinoids if they were used in vector control. Larvae collected from rural and agricultural areas where neonicotinoid formulations are intensively used for insect pest management were able to survive, grow, pupate and emerge in lethal doses of acetamiprid, imidacloprid and clothianidin. These results emphasize the importance of addressing prior exposure of larvae to formulations used in agriculture before applying agrochemicals against malaria vectors.
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Khan MI, Qureshi H, Bae SJ, Khattak AA, Anwar MS, Ahmad S, Hassan F, Ahmad S. Malaria prevalence in Pakistan: A systematic review and meta-analysis (2006-2021). Heliyon 2023; 9:e15373. [PMID: 37123939 PMCID: PMC10133748 DOI: 10.1016/j.heliyon.2023.e15373] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Malaria is one of the major public health issues globally. Malaria infection spreads through mosquito bites from infected female Anopheles mosquitoes. This study aims to conduct a systematic review and meta-analysis on malaria prevalence in Pakistan from 2006 to 2021. We searched PubMed, Science Direct, EMBASE, EMCare, and Google Scholar to acquire data on the prevalence of malaria infections. We performed a meta-analysis with a random-effects model to obtain the pooled prevalence of malaria, Plasmodium vivax, and Plasmodium falciparum. Meta-analysis was computed using R 4.1.2 Version statistical software. I2 and time series analysis were performed to identify a possible source of heterogeneity across studies. A funnel plot and the Freeman-Tukey Double Arcsine Transformed Proportion were used to evaluate the presence of publication bias. Out of the 315 studies collected, only 45 full-text articles were screened and included in the final measurable meta-analysis. Pooled malaria prevalence in Pakistan was 23.3%, with Plasmodium vivax, Plasmodium falciparum, and mixed infection rates of 79.13%, 16.29%, and 3.98%, respectively. Similarly, the analysis revealed that the maximum malaria prevalence was 99.79% in Karachi and the minimum was 1.68% in the Larkana district. Amazingly, this systematic review and meta-analysis detected a wide variation in malaria prevalence in Pakistan. Pakistan's public health department and other competent authorities should pay close attention to the large decrease in mosquito populations to curb the infection rate.
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Affiliation(s)
- Muhammad Imran Khan
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
| | - Humera Qureshi
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
| | - Suk Joo Bae
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
- Corresponding author.
| | - Aamer Ali Khattak
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Shahid Anwar
- Department of AI and Software Gachon University Seongnam-si 13120, South Korea
- Corresponding author.
| | - Sadique Ahmad
- EIAS, Data Science and Blockchain Laboratory, College of Computer and Information Sciences, Prince Sultan University, Riyadh, Saudi Arabia
| | - Fazal Hassan
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Shabir Ahmad
- IT Convergence Engineering, Gachon University, Gyonggi-do, Seongnam-si, Sujeong-gu, 13120, Republic of Korea
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Thet MM, Khaing MNT, Zin SS, Thein ST, Tesfazghi K. Choice of health providers and health-seeking behaviour among forest goer population in Myanmar: findings from a cross-sectional household survey. Malar J 2022; 21:382. [PMID: 36517905 PMCID: PMC9749299 DOI: 10.1186/s12936-022-04356-7] [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: 03/22/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In Myanmar, malaria still poses a significant burden for vulnerable populations particularly forest goers even though impressive progress has been made over the past decade. Limited evidence existed related to forest goers' health-seeking behaviour and factors that drive decision making for providers' choice to support national malaria programmes towards elimination. In response to that, this research is conducted to identify who they preferred and what are the factors associated with providers' choice in malaria febrile illness and Rapid Diagnostic Testing (RDT). METHODS A cross-sectional study applying quantitative household survey was completed with 479 forest goer households in 20 malaria endemic townships across Myanmar. The household data was collected with the types of providers that they consulted for recent and previous febrile episodes. To identify the factors associated with providers' choices, univariate and multivariate multinomial logistic regressions were done using Stata version 14.1. Statistical significance was set as p = 0.05. RESULTS A total of 307 individuals experienced fever within one month and 72.3% sought care from providers. Also, a total of 509 forest goers reported that they had a previous febrile episode and 62.6% received care from a provider. Furthermore, 56.2% said that they had RDT testing during these previous febrile illnesses. They consulted public facilities and public health staff, private facilities, private and semi-private providers, community health volunteers or workers in their residing village and those located outside their villages but majority preferred those within their villages. On multivariate analyses, second richest quintile (public, RRR = 12.9) (semi-private, RRR = 17.9), (outside, RRR = 8.4) and access to 4 and above nearby providers (public, RRR = 30.3) (semi-private, RRR = 1.5) (outside, RRR = 0.5) were found to be significantly associated with provider choice for recent fever episode. Similar findings were also found for previous febrile illness and RDT testing among forest goers. CONCLUSIONS It was highlighted in this study that in forest goer households, they preferred nearby providers and the decision to choose providers seemed to be influenced by their access to number of nearby providers and socio-economic status when they sought care from a provider regardless of fever occurrence location. It was important that the national programmes considere involving these nearby providers in elimination efforts.
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Affiliation(s)
- May Me Thet
- Population Services International Myanmar, No.16, West Shwe Gone Dine 4Th Street, Bahan Township, 11201 Yangon, Myanmar
| | - Myat Noe Thiri Khaing
- Population Services International Myanmar, No.16, West Shwe Gone Dine 4Th Street, Bahan Township, 11201 Yangon, Myanmar
| | - Su Su Zin
- Population Services International Myanmar, No.16, West Shwe Gone Dine 4Th Street, Bahan Township, 11201 Yangon, Myanmar
| | - Si Thu Thein
- Population Services International Myanmar, No.16, West Shwe Gone Dine 4Th Street, Bahan Township, 11201 Yangon, Myanmar
| | - Kemi Tesfazghi
- Greater Mekong Subregion Elimination of Malaria Through Surveillance (GEMS+), 1120 19Th St NW #600, Washington, DC 20036 USA
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Bamou R, Tchuinkam T, Kopya E, Awono-Ambene P, Njiokou F, Mwangangi J, Antonio-Nkondjio C. Knowledge, attitudes, and practices regarding malaria control among communities living in the south Cameroon forest region. IJID REGIONS 2022; 5:169-176. [PMID: 36467507 PMCID: PMC9713328 DOI: 10.1016/j.ijregi.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This study assessed knowledge, attitudes, and practices (KAP) regarding malaria among communities living in the equatorial forest region of south Cameroon. METHODS The study was conducted in Olama and Nyabessan. Interviews were undertaken using a semi-structured questionnaire for data collection on KAP, while malaria rapid diagnostic testing, using SD BIOLINE kits, was employed for malaria parasite detection. RESULTS In total, 186 heads of households (HoH), comprising 105 (56.45%) males and 81 (43.45%) females, were interviewed. The majority of HoH demonstrated good knowledge of malaria (86.56%; n = 161) and control measures, with a high proportion of long-lasting insecticidal net (LLIN) ownership (96.8%; n = 180). More than two-thirds (81.1%; n = 151) of households owned at least one LLIN for two people. The majority of HoH (85.40%) declared visiting hospitals or clinics in cases of suspected malaria. Malaria parasite prevalence was high in the two study sites (63.9% in Nyabessan and 48.65% in Olama), and varied according to age, house type, and sleeping time. CONCLUSION The study indicated that despite good knowledge of malaria, high possession and utilization of control measures by population, transmission of malaria still persist in the area. The study stress the need for implementing additional control measures to improve the fight against malaria in the area.
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Key Words
- Cameroon
- HoH, head of household
- IRS, indoor residual spraying
- KAP
- KAP, knowledge, attitude, and practice
- LLIN, long-lasting insecticidal net
- MoH, Ministry of Health. PBO, piperonyl butoxide
- NMCP, National Malaria Control Program
- WHO, World Health Organization
- forested area
- mRDT, malaria rapid diagnostic test
- malaria determinants
- malaria prevalence
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Affiliation(s)
- Roland Bamou
- Vector Borne Diseases Laboratory of the Applied Biology and Ecology Research Unit (VBID-URBEA), Department of Animal Biology, Faculty of Science of the University of Dschang
- Organisation de Coordination pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon
| | - Timoléon Tchuinkam
- Vector Borne Diseases Laboratory of the Applied Biology and Ecology Research Unit (VBID-URBEA), Department of Animal Biology, Faculty of Science of the University of Dschang
| | - Edmond Kopya
- Organisation de Coordination pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon
- Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Parfait Awono-Ambene
- Organisation de Coordination pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon
| | - Flobert Njiokou
- Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Joseph Mwangangi
- Center for Geographic Medicine Research, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Centre for Vector Disease Control, Kenya Medical Research Institute (KEMRI), Kwale, Kenya
| | - Christophe Antonio-Nkondjio
- Organisation de Coordination pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaounde, Cameroon
- Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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Mugenzi LMJ, Akosah-Brempong G, Tchouakui M, Menze BD, Tekoh TA, Tchoupo M, Nkemngo FN, Wondji MJ, Nwaefuna EK, Osae M, Wondji CS. Escalating pyrethroid resistance in two major malaria vectors Anopheles funestus and Anopheles gambiae (s.l.) in Atatam, Southern Ghana. BMC Infect Dis 2022; 22:799. [PMID: 36284278 PMCID: PMC9597992 DOI: 10.1186/s12879-022-07795-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aggravation of insecticide resistance in malaria vectors is threatening the efforts to control malaria by reducing the efficacy of insecticide-based interventions hence needs to be closely monitored. This study investigated the intensity of insecticide resistance of two major malaria vectors An. funestus sensu stricto (s.s.) and An. gambiae sensu lato (s.l.) collected in southern Ghana and assessed the bio-efficacy of several long-lasting insecticidal nets (LLINs) against these mosquito populations. METHODS The insecticide susceptibility profiles of Anopheles funestus s.s. and Anopheles gambiae s.l. populations from Obuasi region (Atatam), southern Ghana were characterized and the bio-efficacy of some LLINs was assessed to determine the impact of insecticide resistance on the effectiveness of these tools. Furthermore, molecular markers associated with insecticide resistance in both species were characterized in the F0 and F1 populations using PCR and qPCR methods. RESULTS Anopheles funestus s.s. was the predominant species and was resistant to pyrethroids, organochlorine and carbamate insecticides, but fully susceptible to organophosphates. An. gambiae s.l. was resistant to all four insecticide classes. High intensity of resistance to 5 × and 10 × the discriminating concentration (DC) of pyrethroids was observed in both species inducing a considerable loss of efficacy of long-lasting insecticidal nets (LLINs). Temporal expression analysis revealed a massive 12-fold increase in expression of the CYP6P4a cytochrome P450 gene in An. funestus s.s., initially from a fold change of 41 (2014) to 500 (2021). For both species, the expression of candidate genes did not vary according to discriminating doses. An. gambiae s.l. exhibited high frequencies of target-site resistance including Vgsc-1014F (90%) and Ace-1 (50%) while these mutations were absent in An. funestus s.s. CONCLUSIONS The multiple and high intensity of resistance observed in both malaria vectors highlights the need to implement resistance management strategies and the introduction of new insecticide chemistries.
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Affiliation(s)
- Leon M J Mugenzi
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon.
| | - Gabriel Akosah-Brempong
- African Regional Postgraduate Program in Insect Science, University of Ghana, Legon, Accra, Ghana
- Biotechnology and Nuclear Agriculture Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
| | - Magellan Tchouakui
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
| | - Benjamin D Menze
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
| | - Theofelix A Tekoh
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
| | - Micareme Tchoupo
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
| | - Francis N Nkemngo
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
| | - Murielle J Wondji
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Ekene K Nwaefuna
- Biotechnology and Nuclear Agriculture Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
| | - Michael Osae
- Biotechnology and Nuclear Agriculture Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
| | - Charles S Wondji
- Centre for Research in Infectious Diseases (CRID), P.O. Box 13501, Yaoundé, Cameroon.
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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18
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Saluja K, Reddy KS, Wang Q, Zhu Y, Li Y, Chu X, Li R, Hou L, Horsley T, Carden F, Bartolomeos K, Hatcher Roberts J. Improving WHO's understanding of WHO guideline uptake and use in Member States: a scoping review. Health Res Policy Syst 2022; 20:98. [PMID: 36071468 PMCID: PMC9449928 DOI: 10.1186/s12961-022-00899-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022] Open
Abstract
Background WHO publishes public health and clinical guidelines to guide Member States in achieving better health outcomes. Furthermore, WHO’s Thirteenth General Programme of Work for 2019–2023 prioritizes strengthening its normative functional role and uptake of normative and standard-setting products, including guidelines at the country level. Therefore, understanding WHO guideline uptake by the Member States, particularly the low- and middle-income countries (LMICs), is of utmost importance for the organization and scholarship. Methods We conducted a scoping review using a comprehensive search strategy to include published literature in English between 2007 and 2020. The review was conducted between May and June 2021. We searched five electronic databases including CINAHL, the Cochrane Library, PubMed, Embase and Scopus. We also searched Google Scholar as a supplementary source. The review adhered to the PRISMA-ScR (PRISMA extension for scoping reviews) guidelines for reporting the searches, screening and identification of evaluation studies from the literature. A narrative synthesis of the evidence around key barriers and challenges for WHO guideline uptake in LMICs is thematically presented.
Results The scoping review included 48 studies, and the findings were categorized into four themes: (1) lack of national legislation, regulations and policy coherence, (2) inadequate experience, expertise and training of healthcare providers for guideline uptake, (3) funding limitations for guideline uptake and use, and (4) inadequate healthcare infrastructure for guideline compliance. These challenges were situated in the Member States’ health systems. The findings suggest that governance was often weak within the existing health systems amongst most of the LMICs studied, as was the guidance provided by WHO’s guidelines on governance requirements. This challenge was further exacerbated by a lack of accountability and transparency mechanisms for uptake and implementation of guidelines. In addition, the WHO guidelines themselves were either unclear and were technically challenging for some health conditions; however, WHO guidelines were primarily used as a reference by Member States when they developed their national guidelines. Conclusions The challenges identified reflect the national health systems’ (in)ability to allocate, implement and monitor the guidelines. Historically this is beyond the remit of WHO, but Member States could benefit from WHO implementation guidance on requirements and needs for successful uptake and use of WHO guidelines. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00899-y.
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Affiliation(s)
- Kiran Saluja
- Bruyere Research Institute, Ottawa, Canada.,Science Division, World Health Organization, Geneva, Switzerland
| | - K Srikanth Reddy
- Bruyere Research Institute, Ottawa, Canada. .,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada. .,Using Evidence Inc., Ottawa, Canada. .,Science Division, World Health Organization, Geneva, Switzerland.
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Ying Zhu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Yanfei Li
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiajing Chu
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Rui Li
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Liangying Hou
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | | | | | - Janet Hatcher Roberts
- WHO Collaborating Centre for Knowledge Translation and Health Impact Assessment in Health Equity, Bruyere Research Institute, University of Ottawa, Ottawa, Canada
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19
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Sivaradjy M, Hamide A, Krishnamoorthy S, Rajkumari N, Mohan V, Sharmila FM. Assessment of Plasmodium falciparum histidine rich protein 2 and /3 ( pfhrp 2&/ pfhrp 3) gene deletion or mutation in Plasmodium falciparum positive blood samples in a tertiary care centre in South India. J Parasit Dis 2022; 46:729-743. [PMID: 36091262 PMCID: PMC9458806 DOI: 10.1007/s12639-022-01492-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022] Open
Abstract
Rapid diagnostic card tests (RDTs) enable timely and appropriate diagnosis of malaria especially in remote areas. Plasmodium falciparum histidine rich protein 2 (PFHRP2) is the most targeted antigen for the detection of Plasmodium falciparum infections by rapid diagnostic card test. Genetic mutations and gene deletions are important emerging factors for false-negative RDTs, which may delay the provision of life-saving treatment for the patients. Hence, we would like to evaluate for the existence of pfhrp2/3 gene deleted P. falciparum parasites in our health care setting. This study was conducted for a period of 2 years in a tertiary care centre in South India. Blood samples that are microscopically confirmed as P. falciparum but negative by RDT were assessed for the presence of pfhrp2, pfhrp3, and their flanking genes using conventional PCR. Follow up of the clinical outcomes were also done for these patients. Of the 63 positive samples collected (50 /63) 79.4% were P.vivax and (13/63) 20.6% were P.falciparum by PCR. Among the 13 P. falciparum positive samples, 4 samples (4/13), (95% CI -10.36% to 61.11%) were found to be RDT negative but microscopically positive.Pfhrp2,pfhrp3 and their flanking genes were amplified for these 4 samples. All 4 samples were found to be negative for both pfhrp2-2 & pfhrp2-3 exon regions and also varying patterns of flanking gene deletions were also noted.This study provides molecular evidence for the existence of pfhrp2 & pfhrp3 deleted P. falciparum parasites in a tertiary care centre in South India warranting periodic evaluation of pfhrp2 based RDT use. Only pfhrp2/3 RDT based decision on diagnosis of P.falciparum malaria should always be reconsidered especially in remote areas.
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Affiliation(s)
- Monika Sivaradjy
- Department of Microbiology, JIPMER, Dhanvantri nagar, Puducherry, India
| | - Abdoul Hamide
- Department of Medicine, JIPMER, Dhanvantri nagar, Puducherry, India
| | | | - Nonika Rajkumari
- Department of Microbiology, JIPMER, Dhanvantri nagar, Puducherry, India
| | - Vamsi Mohan
- Department of Microbiology, JIPMER, Dhanvantri nagar, Puducherry, India
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20
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Hu J, Sun M, Qi N, Abuzeid AM, Li J, Cai H, Lv M, Lin X, Liao S, Li G. Inhibitory effect of morin on aldolase 2 from Eimeria tenella. Int J Parasitol Drugs Drug Resist 2022; 20:1-10. [PMID: 35952522 PMCID: PMC9385451 DOI: 10.1016/j.ijpddr.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/14/2022]
Abstract
Eimeria tenella (E. tenella) is a protozoal parasite that can cause severe cecal lesions and death in chickens, seriously harming the chicken industry. Conventional control strategies mainly rely on anticoccidial drugs. However, the emerging problems of anticoccidial resistance and drug residues necessitate exploring potential drug targets for developing new anticoccidial drugs. Fructose-1,6-bisphosphate aldolase (ALD) is an essential enzyme for parasite energy metabolism that has been considered a potential drug target. In this study, we analyzed the molecular and biochemical properties of E. tenella ALD2 (EtALD2). EtALD2 mRNA expression was highest in second-generation merozoites, whereas the protein level was highest in unsporulated oocysts. Indirect immunofluorescence showed that EtALD2 was mainly distributed in sporozoite' cytoplasm. The natural product inhibitor (morin) was screened by computer-aided drug screening. Enzyme kinetic and inhibition kinetic assays showed that morin had a good inhibitory effect on EtALD2 activity (IC50 = 10.37 μM, Ki = 48.97 μM). In vitro inhibition assay demonstrated that morin had an inhibitory effect on E. tenella development, with an IC50 value of 3.98 μM and drug selection index of 177.49. In vivo, morin significantly improved cecal lesions (p < 0.05) and reduced oocyst excretion (p < 0.05) in E. tenella-infected chickens compared with the untreated group. The anticoccidial index of the group receiving 450 mg morin per kg feed was 162, showing a good anticoccidial effect. These findings suggest that EtALD2 could be a novel drug target for E. tenella treatment, and morin should be further evaluated as a therapeutic candidate for chicken coccidiosis.
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Affiliation(s)
- Junjing Hu
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510542, China,Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Mingfei Sun
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Nanshan Qi
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Asmaa M.I. Abuzeid
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510542, China,Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Juan Li
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Haiming Cai
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Minna Lv
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Xuhui Lin
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China
| | - Shenquan Liao
- Zhaoqing Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Maoming Branch Center of Guangdong Laboratory for Lingnan Modern Agricultural Science and Technology, Key Laboratory of Livestock Disease Prevention of Guangdong Province, Scientific Observation and Experiment Station of Veterinary Drugs and Diagnostic Techniques of Guangdong Province, Ministry of Agriculture and Rural Affairs, Key Laboratory of Avian Influenza and Other Major Poultry Diseases Prevention and Control, Ministry of Agriculture and Rural Affairs, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, 510640, Guangdong, PR China,Corresponding author.
| | - Guoqing Li
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510542, China,Corresponding author.
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21
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Hussein H, Shamsipour M, Yunesian M, Hassanvand MS, Agordoh PD, Seidu MA, Fotouhi A. Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana. BMJ Open 2022; 12:e058343. [PMID: 35914909 PMCID: PMC9345073 DOI: 10.1136/bmjopen-2021-058343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana. DESIGN This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana. OUTCOME MEASURES Low birth weight (LBW), preterm birth and perinatal death. RESULTS A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section. CONCLUSION This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.
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Affiliation(s)
- Hawawu Hussein
- Department of Statistical Sciences, Faculty of Applied Science and Technology, Tamale Technical University, Tamale, Ghana
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Center for Air Pollution Research (CAPR), Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Percival Delali Agordoh
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Akbar Fotouhi
- Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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22
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Naserrudin NA, Culleton R, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. Exploring the key anthropological drivers of and barriers to zoonotic malaria preventative behaviour in a community exposed to Plasmodium knowlesi infection in Malaysia: protocol for a qualitative study with a participatory research design. BMJ Open 2022; 12:e060866. [PMID: 35772825 PMCID: PMC9247694 DOI: 10.1136/bmjopen-2022-060866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Plasmodium knowlesi malaria is a zoonotic mosquito-borne disease with complex epidemiology. According to the WHO, the prevention and control of vector-borne diseases require community participation to increase coherence between malaria interventions and sustainable public health programmes. We describe a participatory research (PR) design for a study aimed at exploring the key anthropological drivers of and barriers to zoonotic malaria preventive behaviour among communities exposed to P. knowlesi infection in Malaysia. Participatory approaches can facilitate policymakers in designing future zoonotic malaria control programmes by investigating community perspectives and concerns about zoonotic malaria in a local context. METHODS AND ANALYSIS The PR will be conducted over a period of 12 months, from March 2022 to March 2023, among adults (>18 years old) who are permanent residents in a rural village exposed to P. knowlesi malaria in Sabah, Malaysia. We will select patients who were diagnosed with P. knowlesi infection from January to December 2021 for focus group discussions (FGDs), as they can provide perspectives on the disease from the point of view of those previously diagnosed with infection. In-depth interviews (IDIs) with people of importance in the community, such as village heads, will also be conducted. Both FGDs and IDIs will be conducted from March 2022 until June 2022. Concurrently, a photovoice with adults over 18 years old who reside in the community will be conducted. The target sample sizes for FGDs, IDIs and photovoice are 6-8, 12 and 10-15 participants, respectively. We will use a study framework as a theoretical lens to guide the exploration of the beliefs, social contexts, barriers and drivers surrounding zoonotic malaria preventive behaviour. ETHICS AND DISSEMINATION This study has been approved by the Medical Research and Ethics Committee Ministry of Health Malaysia (NMRR ID-21-01980-JEH) and the Research and Innovation Secretariat, Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2021-462). All participants will provide consent prior to participation. The results will be reported in international peer-reviewed journals and presented at conferences and on other platforms.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
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A Cross-Sectional Survey on the Malaria Control and Prevention Knowledge, Attitudes, and Practices of Caregivers of Children Under-5 in the Western Area of Sierra Leone. Trop Med Infect Dis 2022; 7:tropicalmed7070120. [PMID: 35878132 PMCID: PMC9319430 DOI: 10.3390/tropicalmed7070120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Children under 5 years of age are the most vulnerable to malaria infection, and they suffer serious complications. Sierra Leone is one of the countries with the highest malaria burden in the world. This study aimed to assess the knowledge, attitudes, and practices (KAPs) toward malaria control and prevention among caregivers of children under 5 in the Western Area of Sierra Leone. (2) Methods: A cross-sectional survey was conducted among caregivers of children under-5 visiting the out-patient department of six selected hospitals/community health centers. Data were collected via questionnaire interviews with 350 caregivers. (3) Results: A total of 97.1% of the respondents were women and the majority of them were young mothers; 46.3% of respondents were unemployed; and 27.1% received no education. Only 1.4% accessed malaria related information from the internet/social media. This KAPs survey indicated that a misconception of the cause, transmission, and clinical symptoms of malaria; unawareness of its lethality and its severity; and inappropriate prevention and treatment behaviors, such as self-medicating, were still in existence among some caregivers. However, a positive correlation in knowledge−attitudes (rs = 0.13, p < 0.05) and in attitudes−practices (rs = 0.45, p < 0.001) was revealed. The caregivers, being mothers and having at least a secondary education, demonstrated positive attitudes and practices. Meanwhile, more urban caregivers (79.8%) followed a complete malaria treatment course of artemisinin-based combination therapies than the rural (63.3%), but in view of insecticide treated net use, more rural caregivers presented positive attitudes (85.3%) and practices (70.1%) than the urban (69.9%, 52.0%). (4) Conclusions: For better protection of children under-5 against lethal malaria, it is essential to provide better guidance at the community level for their caregivers, especially young mothers, in order to reduce some misconceptions and inappropriate behaviors. An increase in education and employment opportunities for women, establishment of an accessible community-based malaria counselling service, and construction of an effective communication channel are also needed.
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Kibwana E, Kapulu M, Bejon P. Controlled Human Malaria Infection Studies in Africa-Past, Present, and Future. Curr Top Microbiol Immunol 2022. [PMID: 35704094 DOI: 10.1007/82_2022_256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Controlled human infection studies have contributed significantly to the understanding of pathogeneses and treatment of infectious diseases. In malaria, deliberately infecting humans with malaria parasites was used as a treatment for neurosyphilis in the early 1920s. More recently, controlled human malaria infection (CHMI) has become a valuable, cost-effective tool to fast-track the development and evaluation of new anti-malarial drugs and/or vaccines. CHMI studies have also been used to define host/parasite interactions and immunological correlates of protection. CHMI involves infecting a small number of healthy volunteers with malaria parasites, monitoring their parasitemia and providing anti-malarial treatment when a set threshold is reached. In this review we discuss the introduction, development, and challenges of modern-day Plasmodium falciparum CHMI studies conducted in Africa, and the impact of naturally acquired immunity on infectivity and vaccine efficacy. CHMIs have shown to be an invaluable tool particularly in accelerating malaria vaccine research. Although there are limitations of CHMI studies for estimating public health impacts and for regulatory purposes, their strength lies in proof-of-concept efficacy data at an early stage of development, providing a faster way to select vaccines for further development and providing valuable insights in understanding the mechanisms of immunity to malarial infection.
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Affiliation(s)
- Elizabeth Kibwana
- Bioscience Department, KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | - Melissa Kapulu
- Bioscience Department, KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.
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Brown R, Salgado-Lynn M, Jumail A, Jalius C, Chua TH, Vythilingam I, Ferguson HM. Exposure of Primate Reservoir Hosts to Mosquito Vectors in Malaysian Borneo. ECOHEALTH 2022; 19:233-245. [PMID: 35553290 PMCID: PMC9276546 DOI: 10.1007/s10393-022-01586-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/05/2022] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
Several vector-borne pathogens of primates have potential for human spillover. An example is the simian malaria Plasmodium knowlesi which is now a major public health problem in Malaysia. Characterization of exposure to mosquito vectors is essential for assessment of the force of infection within wild simian populations, however few methods exist to do so. Here we demonstrate the use of thermal imaging and mosquito magnet independence traps (MMIT) to assess the abundance, diversity and infection rates in mosquitoes host seeking near long-tailed macaque (Macaca fasicularis) sleeping sites in the Lower Kinabatangan Wildlife Sanctuary, Malaysian Borneo. The primary Plasmodium knowlesi vector, Anopheles balabacensis, was trapped at higher abundance near sleeping sites than control trees. Although none of the An. balabacensis collected (n = 15) were positive for P. knowlesi by PCR screening, two were infected with another simian malaria Plasmodium inui. Analysis of macaque stools from sleeping sites confirmed a high prevalence of Plasmodium infection, suspected to be P. inui. Recently, natural transmission of P. inui has been detected in humans and An. cracens in Peninsular Malaysia. The presence of P. inui in An. balabacensis here and previously in human-biting collections highlight its potential for spillover from macaques to humans in Sabah. We advocate the use of MMITs for non-invasive sampling of mosquito vectors that host seek on wild simian populations.
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Affiliation(s)
- Rebecca Brown
- Department of Vector Biology, Liverpool School of Tropical Medicine and Hygiene, Liverpool, L3 5QA, UK.
| | - Milena Salgado-Lynn
- Danau Girang Field Centre C/O Sabah Wildlife Department, Wisma Muis, Kota Kinabalu, Sabah, Malaysia
- School of Biosciences and Sustainable Places Research Institute, Cardiff University, Cardiff, UK
- Wildlife Health, Genetic and Forensic Laboratory, Kampung Potuki, Kota Kinabalu, Sabah, Malaysia
| | - Amaziasizamoria Jumail
- Danau Girang Field Centre C/O Sabah Wildlife Department, Wisma Muis, Kota Kinabalu, Sabah, Malaysia
| | - Cyrlen Jalius
- Wildlife Health, Genetic and Forensic Laboratory, Kampung Potuki, Kota Kinabalu, Sabah, Malaysia
| | - Tock-Hing Chua
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Graham Kerr Building, University Avenue, Glasgow, G12 8QQ, UK
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Kaboré JMT, Siribié M, Hien D, Soulama I, Barry N, Nombré Y, Dianda F, Baguiya A, Tiono AB, Burri C, Tchouatieu AM, Sirima SB. Attitudes, practices, and determinants of community care-seeking behaviours for fever/malaria episodes in the context of the implementation of multiple first-line therapies for uncomplicated malaria in the health district of Kaya, Burkina Faso. Malar J 2022; 21:155. [PMID: 35637506 PMCID: PMC9153091 DOI: 10.1186/s12936-022-04180-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Malaria case management relies on World Health Organization (WHO)-recommended artemisinin-based combination therapy (ACT), and a continuous understanding of local community knowledge, attitudes, and practices may be a great support for the success of malaria disease control efforts. In this context, this study aimed to identify potential facilitators or barriers at the community level to inform a health district-wide implementation of multiple first-line therapies (MFT) as a new strategy for uncomplicated malaria case management. Methods A community-based cross-sectional study using a mixed-method design was carried out from November 2018 to February 2019, in the health district (HD) of Kaya in Burkina Faso. Quantitative data were collected using a standardized questionnaire from 1394 individuals who had fever/malaria episodes four weeks prior to the survey. In addition, 23 focus group discussions (FGDs) were conducted targeting various segments of the community. Logistic regression models were used to assess the predictors of community care-seeking behaviours. Results Overall, 98% (1366/1394) of study participants sought advice or treatment, and 66.5% did so within 24 h of fever onset. 76.4% of participants preferred to seek treatment from health centres as the first recourse to care, 5.8% were treated at home with remaining drug stock, and 2.3% preferred traditional healers. Artemether-lumefantrine (AL) was by far the most used anti-malarial drug (98.2%); reported adherence to the 3-day treatment regimen was 84.3%. Multivariate analysis identified less than 5 km distance travelled for care (AOR = 2.7; 95% CI 2.1–3.7) and education/schooling (AOR = 1.8; 95% CI 1.3–2.5) as determinants of prompt care-seeking for fever. Geographical proximity (AOR = 1.5, 95% CI 1.2–2.1), having a child under five (AOR = 4.6, 95% CI 3.2–6.7), being pregnant (AOR = 6.5, 95% CI 1.9–22.5), and living in an urban area (AOR = 2.8, 95% CI 1.8–4.2) were significant predictors for visiting health centres. The FGDs showed that participants had good knowledge about malaria symptoms, prevention tools, and effective treatment. Behaviour change regarding malaria treatment and free medication for children under five were the main reasons for participants to seek care at health centres. Conclusions The study showed appropriate knowledge about malaria and positive community care-seeking behaviour at health centres for fever/malaria episodes. This could potentially facilitate the implementation of a MFT pilot programme in the district. ClinicalTrials.gov Identifier: NCT04265573.
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Asale A, Kassie M, Abro Z, Enchalew B, Belay A, Sangoro PO, Tchouassi DP, Mutero CM. The combined impact of LLINs, house screening, and pull-push technology for improved malaria control and livelihoods in rural Ethiopia: study protocol for household randomised controlled trial. BMC Public Health 2022; 22:930. [PMID: 35538444 PMCID: PMC9088127 DOI: 10.1186/s12889-022-12919-1] [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: 07/30/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used malaria interventions that target indoor Anopheles vectors. Recent studies on the effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition, complementary interventions are needed to curb co-occurring pest populations which pose menace to agricultural crop productivity and food security. However, interventions that impact malaria mainly centre on public health strategies, overlooking subtle but important component of agricultural measures. Addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities. Methods A four-armed household, cluster-randomized, controlled study will be conducted to assess the combined impact of HS, LLINs and push-pull agricultural technology (PPT) against clinical malaria in children in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 838 households will be enrolled in this study. In this trial 246 households will receive LLINs and HS, 250 will receive LLINs, HS and PPT, 175 households will receive LLINs and PPT. The remaining 167 houses which receive LLINs only will be used as control. One child aged ≤14 years will be enrolled per household in each treatment and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Discussion Episodes of clinical malaria, density of indoor biting malaria vectors, sporozoite infection rate, improved crop infestation rate, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Documenting the combined impact of LLINs, HS and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind. Trial registration Pan African Clinical Trials Registry, PACTR202006878245287. 24/06/2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=11101. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12919-1.
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Affiliation(s)
- Abebe Asale
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia.
| | - Menale Kassie
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Zewdu Abro
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia
| | - Bayu Enchalew
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia
| | - Aklilu Belay
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya.,University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Peter O Sangoro
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - David P Tchouassi
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Clifford M Mutero
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya.,University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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de Haan F, Boon WPC, Amaratunga C, Dondorp AM. Expert perspectives on the introduction of Triple Artemisinin-based Combination Therapies (TACTs) in Southeast Asia: a Delphi study. BMC Public Health 2022; 22:864. [PMID: 35490212 PMCID: PMC9055751 DOI: 10.1186/s12889-022-13212-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triple Artemisinin-based Combination Therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in Southeast Asia. However, the desirability, timing and practical feasibility of introducing TACTs in Southeast Asia is subject to debate. This study systematically assesses perspectives of malaria experts towards the introduction of TACTs as first-line treatment for uncomplicated falciparum malaria in Southeast Asia. METHODS A two-round Delphi study was conducted. In the first round, 53 malaria experts answered open-ended questions on what they consider the most important advantages, disadvantages, and implementation barriers for introducing TACTs in Southeast Asia. In the second round, the expert panel rated the relevance of each statement on a 5-point Likert scale. RESULTS Malaria experts identified 15 advantages, 15 disadvantages and 13 implementation barriers for introducing TACTs in Southeast Asia in the first round of data collection. In the second round, consensus was reached on 13 advantages (8 perceived as relevant, 5 as not-relevant), 12 disadvantages (10 relevant, 2 not-relevant), and 13 implementation barriers (all relevant). Advantages attributed highest relevance related to the clinical and epidemiological rationale of introducing TACTs. Disadvantages attributed highest relevance related to increased side-effects, unavailability of fixed-dose TACTs, and potential cost increases. Implementation barriers attributed highest relevance related to obtaining timely regulatory approval, timely availability of fixed-dose TACTs, and generating global policy support for introducing TACTs. CONCLUSIONS The study provides a structured oversight of malaria experts' perceptions on the major advantages, disadvantages and implementation challenges for introducing TACTs in Southeast Asia, over current practices of rotating ACTs when treatment failure is observed. The findings can benefit strategic decision making in the battle against drug-resistant malaria.
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Affiliation(s)
- Freek de Haan
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3484 CB, Utrecht, the Netherlands.
| | - Wouter P C Boon
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3484 CB, Utrecht, the Netherlands
| | - Chanaki Amaratunga
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Ratchathewi DistrictBangkok, 10400, Thailand
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Ratchathewi DistrictBangkok, 10400, Thailand
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Feng X, Huang F, Yin J, Wang R, Xia Z. Key takeaways from China's success in eliminating malaria: leveraging existing evidence for a malaria-free world. BMJ Glob Health 2022; 7:bmjgh-2021-008351. [PMID: 35487673 PMCID: PMC9058700 DOI: 10.1136/bmjgh-2021-008351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/27/2022] [Indexed: 12/16/2022] Open
Abstract
Although the total number of malaria cases and fatalities have declined globally since 2010, there were still 241 million malaria cases identified across 85 countries and territories in 2020. As the global malaria eradication process accelerates, more countries have launched their own initiatives of elimination. Notably, China achieved this goal by 2021, ending thousands of years of endemic. Undoubtedly, tremendous experience and vital lessons have been accrued en route to the malaria-free goal in malaria-eliminated countries including China. To enhance prospects of a malaria-free world by bridging the key evidence from a malaria-eliminated country to the contexts of affected, this personal view highlights concerted commitments and universal investment in healthcare, improved surveillance and response system, constant capacity building, demand-oriented scientific research, and multiway cooperation, which have helped China to eliminate this ancient scourge. We discuss how these key takeaways could be leveraged to different contexts. We also argue the long-term challenges and barriers on the pathway to malaria elimination and underline the needs for consistent efforts to maintain zero indigenous cases and prevent re-introduction of malaria. Through concerted efforts from global collaboration, a malaria-free world can become a reality.
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Affiliation(s)
- Xinyu Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Jianhai Yin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Rubo Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Zhigui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
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30
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Naserrudin NA, Monroe A, Culleton R, Hod R, Jeffree MS, Ahmed K, Hassan MR. Reimagining zoonotic malaria control in communities exposed to Plasmodium knowlesi infection. J Physiol Anthropol 2022; 41:14. [PMID: 35413881 PMCID: PMC9004057 DOI: 10.1186/s40101-022-00288-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/31/2022] [Indexed: 12/21/2022] Open
Abstract
Plasmodium knowlesi malaria infection in humans has been reported throughout southeast Asia. The communities at risk are those living in areas where Macaque monkeys and Anopheles mosquito are present. Zoonotic malaria control is challenging due to the presence of the reservoir host and the possibility of human-vector-human transmission. Current control measures, including insecticide-treated nets (ITNs) and indoor residual spraying (IRS), are insufficient to address this threat due to gaps in protection associated with outdoor and early evening vector biting and social and economic activities, such as agricultural and forest work. Understanding the challenges faced by affected communities in preventing mosquito bites is important for reducing disease transmission. This opinion paper discusses opportunities to improve P. knowlesi malaria control through understanding the challenges faced by communities at risk and increasing community engagement and ownership of control measures. The paper highlights this issue by describing how the concept of reimagining malaria can be adapted to zoonotic malaria control measures including identifying current gaps in vector control, understanding interactions between environmental, economic, and human behavioral factors, and increasing community participation in and ownership of control measures.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.,Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Richard Culleton
- Department of Molecular Parasitology, Proteo-Science Centre, Ehime University, Matsuyama, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Muhammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
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Klu D, Aberese-Ako M, Manyeh AK, Immurana M, Doegah P, Dalaba M, Acquah E, Alhassan RK, Ansah EK. Mixed effect analysis of factors influencing the use of insecticides treated bed nets among pregnant women in Ghana: evidence from the 2019 Malaria Indicator Survey. BMC Pregnancy Childbirth 2022; 22:258. [PMID: 35346098 PMCID: PMC8958761 DOI: 10.1186/s12884-022-04586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 03/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Malaria during pregnancy is a major cause of maternal morbidity globally and leads to poor birth outcomes. The World Health Organization has recommended the use of insecticide treated bed nets (ITN) as one of the effective malaria preventive strategies among pregnant women in malaria endemic areas. This study, therefore, seeks to examine the individual and household factors associated with the use of ITNs among pregnant women in Ghana. Methods Data for this study was obtained from the 2019 Ghana Malaria Indicator Survey (GMIS) conducted between September 25 and November 24, 2019. The weighted sample comprised 353 pregnant women aged 15–49 years. Data was analyzed with SPSS version 22 using both descriptive and multilevel logistics regression modelling. Statistically significant level was set at p < 0.05. Results The study found that 49.2% of pregnant women in Ghana use ITN to prevent malaria. Pregnant women aged 35–49 years (AOR = 3.403, CI: 1.191–9.725), those with no formal education (AOR = 5.585, CI = 1.315–23.716), and those who had secondary education (AOR = 3.509, CI = 1.076–11.440) had higher odds of using ITN. Similarly, higher odds of ITN usage was found among who belonged to the Akan ethnic group (AOR = 7.234, CI = 1.497–34.955), dwell in male-headed households (AOR = 2.232, CI = 1.105–4.508) and those whose household heads are aged 60–69 years (AOR = 4.303, CI = 1.160–15.966). However, pregnant women who resided in urban areas (AOR = 0.355, CI = 0.216–0.582), those whose household heads aged 40–49 years (AOR = 0.175, CI = 0.066–0.467) and those who belonged to richer (AOR =0.184, CI = 0.050–0.679) and richest (AOR = 0.107, CI = 0.021–0.552) households had lower odds of using ITN for malaria prevention. Conclusions Individual socio-demographic and household factors such as pregnant women’s age, educational level, place of residence, ethnicity, sex and age of household head, and household wealth quintile are associated with the use of ITN for malaria prevention among pregnant women. These factors ought to be considered in strengthening malaria prevention campaigns and develop new interventions to help increase ITN utilization among vulnerable population living in malaria- endemic areas.
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Cassy A, Chicumbe S, Saifodine A, Zulliger R. Factors associated with malaria care seeking among children under 5 years of age in Mozambique: a secondary analysis of the 2018 Malaria Indicator Survey. Malar J 2022; 21:100. [PMID: 35331247 PMCID: PMC8944006 DOI: 10.1186/s12936-022-04128-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mozambique is ranked fourth in a list of the 29 countries that accounted for 95% of all malaria cases globally in 2019. The aim of this study was to identify factors associated with care seeking for fever, to determine the association between knowledge about malaria and care seeking and to describe the main reasons for not seeking care among children under five years of age in Mozambique. Methods This is a quantitative, observational study based on a secondary data analysis of the 2018 Malaria Indicator Survey. This weighted analysis was based on data reported by surveyed mothers or caregivers of children aged 0–59 months who had fever in the two weeks prior to the survey. Results Care was reportedly sought for 69.1% [95% CI 63.5–74.2] of children aged 0–59 months old with fever. Care-seeking was significantly higher among younger children, < 6 months old (AOR = 2.47 [95% CI 1.14–5.31]), 6–11 months old (AOR = 1.75 [95% CI 1.01–3.04]) and 12–23 months old (AOR = 1.85 [95% CI 1.19–2.89]), as compared with older children (48–59 months old). In adjusted analysis, mothers from the middle (AOR = 1.66 [95% CI 0.18–3.37]) and richest (AOR = 3.46 [95% CI 1.26–9.49]) wealth quintiles were more likely to report having sought care for their febrile children than mothers from the poorest wealth quintile. Additionally, mothers with secondary or higher education level were more likely to seek care (AOR = 2.16 [95% CI 1.19–3.93]) than mothers with no education. There was no association between maternal malaria knowledge or reported exposure to malaria messages and care-seeking behaviours. The main reasons reported for not seeking care included distance to health facility (46.3% of respondents), the perception that the fever was not severe (22.4%) and the perception that treatment was not available at the health facility (15%). Conclusion Health facility access and socioeconomic barriers continue to be important constraints to malaria service utilization in Mozambique.
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Affiliation(s)
- Annette Cassy
- Instituto Nacional de Saúde, Maputo, Mozambique. .,Observatório Nacional de Saúde, Maputo, Mozambique.
| | - Sérgio Chicumbe
- Instituto Nacional de Saúde, Maputo, Mozambique.,Observatório Nacional de Saúde, Maputo, Mozambique
| | | | - Rose Zulliger
- U.S. President's Malaria Initiative, USAID, Washington, DC, USA
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Kumari V, Prasad KM, Kalia I, Sindhu G, Dixit R, Rawat DS, Singh OP, Singh AP, Pandey KC. Dissecting The role of Plasmodium metacaspase-2 in malaria gametogenesis and sporogony. Emerg Microbes Infect 2022; 11:938-955. [PMID: 35264080 PMCID: PMC8973346 DOI: 10.1080/22221751.2022.2052357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The family of apicomplexan specific proteins contains caspases–like proteins called “metacaspases”. These enzymes are present in the malaria parasite but absent in human; therefore, these can be explored as potential drug targets. We deleted the MCA-2 gene from Plasmodium berghei genome using a gene knockout strategy to decipher its precise function. This study has identified that MCA-2 plays an important role in parasite transmission since it is critical for the formation of gametocytes and for maintaining an appropriate number of infectious sporozoites required for sporogony. It is noticeable that a significant reduction in gametocyte, oocysts, ookinete and sporozoites load along with a delay in hepatocytes invasion were observed in the MCA-2 knockout parasite. Furthermore, a study found the two MCA-2 inhibitory molecules known as C-532 and C-533, which remarkably inhibited the MCA-2 activity, abolished the in vitro parasite growth, and also impaired the transmission cycle of P. falciparum and P. berghei in An. stephensi. Our findings indicate that the deletion of MCA-2 hampers the Plasmodium development during erythrocytic and exo-erythrocytic stages, and its inhibition by C-532 and C-533 critically affects the malaria transmission biology.
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Affiliation(s)
- Vandana Kumari
- ICMR-National Institute of Malaria Research, New Delhi, India
| | | | | | | | - Rajnikant Dixit
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Diwan S Rawat
- Depatment of Chemistry, University of Delhi, New Delhi, India
| | - O P Singh
- ICMR-National Institute of Malaria Research, New Delhi, India
| | - Agam P Singh
- National Institute of Immunology, New Delhi, India
| | - Kailash C Pandey
- ICMR-National Institute of Malaria Research, New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad Uttar Pradesh, UP, India
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Guntur RD, Kingsley J, Islam FMA. Malaria treatment-seeking behaviour and its associated factors: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia. PLoS One 2022; 17:e0263178. [PMID: 35120136 PMCID: PMC8815915 DOI: 10.1371/journal.pone.0263178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The World Health Organization recommends seeking medical treatment within 24 hours after transmission of malaria to reduce the risk of severe complications and its onwards spread. However, in some parts of Indonesia, including East Nusa Tenggara Province (ENTP), this adherence is not achieved for a range of reasons including delays in visiting health centres. This study aims to determine factors related to the poor understanding of appropriate malaria treatment-seeking behaviour (AMTSB) of rural adults in ENTP. AMTSB was defined as seeking treatment at professional health facilities within 24 hours of the onset of malaria symptoms. Methods A cross-sectional study was conducted in the East Sumba, Belu, and East Manggarai district of ENTP between October and December 2019. A multi-stage cluster sampling procedure was applied to enrol 1503 participants aged between 18 and 89 years of age. Data were collected through face-to-face interviews. Multivariable logistic regression analyses were used to assess significant factors associated with the poor understanding of AMTSB. Results Eighty-six percent of participants were found to be familiar with the term malaria. However, poor understanding level of AMTSB in rural adults of ENTP achieved 60.4% with a 95% confidence interval (CI): 56.9–63.8. Poor understanding of AMTSB was significantly higher for adults with no education (adjusted odds ratio (AOR) 3.42, 95% CI: 1.81, 6.48) compared to those with a diploma or above education level; having low SES (AOR: 1.87, 95% CI: 1.19, 2.96) compared to those having high SES; residing at least three kilometres (km) away from the nearest health facilities (AOR: 1.73, 95% CI: 1.2, 2.5) compared to those living within one km from the nearest health service; and working as farmer (AOR: 1.63, 95% CI: 1.01–2.63) compared to those working at government or non-government sector. Whilst, other factors such as ethnicity and family size were not associated with the poor understanding of AMTSB. Conclusion The proportion of rural adults having a poor understanding of AMTSB was high leading to ineffective implementation of artemisinin-based combination therapies as the method to treat malaria in ENTP. Improving awareness of AMTSB for rural adults having low level education, low SES, working as a farmer, and living at least three km from the nearest health facilities is critical to support the efficacy of malaria treatment in ENTP. This method will support the Indonesian government’s objective to achieve malaria elimination by 2030.
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Affiliation(s)
- Robertus Dole Guntur
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Department of Mathematics, Faculty of Science and Engineering, Nusa Cendana University, Kupang, NTT, Indonesia
- * E-mail:
| | - Jonathan Kingsley
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Centre of Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Fakir M. Amirul Islam
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Afolabi MO, Sougou NM, Diaw A, Sow D, Manga IA, Mbaye I, Greenwood B, Ndiaye JLA. Caregivers' perception of risk for malaria, helminth infection and malaria-helminth co-infection among children living in urban and rural settings of Senegal: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000525. [PMID: 36962392 PMCID: PMC10021862 DOI: 10.1371/journal.pgph.0000525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/24/2022] [Indexed: 11/18/2022]
Abstract
The parasites causing malaria, soil-transmitted helminthiasis and schistosomiasis frequently co-exist in children living in low-and middle-income countries, where existing vertical control programmes for the control of these diseases are not operating at optimal levels. This gap necessitates the development and implementation of strategic interventions to achieve effective control and eventual elimination of these co-infections. Central to the successful implementation of any intervention is its acceptance and uptake by caregivers whose perception about the risk for malaria-helminth co-infection has been little documented. Therefore, we conducted a qualitative study to understand the caregivers' perspectives about the risk as well as the behavioural and social risk factors promoting malaria-helminth co-infection among pre-school and school-age children living in endemic rural and urban communities in Senegal. In June and December 2021, we conducted individual and group interviews, and participant observations, among 100 primary caregivers of children recruited from Saraya villages in southeast Senegal and among leaders and teachers of Koranic schools in Diourbel, western Senegal. Our findings showed that a majority of the study participants in the two settings demonstrated a high level of perception of risk for malaria and acceptable awareness about handwashing practices, but had misconceptions that malaria-helminth co-infection was due to a combination of excessive consumption of sugary food and mosquito bites. Our observations revealed many factors in the house structures, toilet practices and handwashing with ashes and sands, which the caregivers did not consider as risks for malaria-helminth co-infections. These findings underscore the need to promote caregivers' awareness about the existence and risk of malaria-helminth co-infection in children. This approach would assist in addressing the caregivers' misconceptions about the occurrence of the co-infection and could enhance their uptake of the strategic interventions targeted at achieving control and subsequent elimination of malaria and helminth co-infection.
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Affiliation(s)
| | | | | | - Doudou Sow
- Université Gaston Berger de Saint-Louis, Saint-Louis, Senegal
| | | | | | - Brian Greenwood
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Neal AT. Distribution of clones among hosts for the lizard malaria parasite Plasmodium mexicanum. PeerJ 2021; 9:e12448. [PMID: 34760403 PMCID: PMC8570175 DOI: 10.7717/peerj.12448] [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: 01/28/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022] Open
Abstract
Background Malaria parasites reproduce asexually, leading to the production of large numbers of genetically identical parasites, here termed a clonal line or clone. Infected hosts may harbor one or more clones, and the number of clones in a host is termed multiplicity of infection (MOI). Understanding the distribution of parasite clones among hosts can shed light on the processes shaping this distribution and is important for modeling MOI. Here, I determine whether the distribution of clones of the lizard malaria parasite Plasmodium mexicanum differ significantly from statistical distributions commonly used to model MOI and logical extensions of these models. Methods The number of clones per infection was assessed using four microsatellite loci with the maximum number of alleles at any one locus used as a simple estimate of MOI for each infection. I fit statistical models (Poisson, negative binomial, zero-inflated models) to data from four individual sites to determine a best fit model. I also simulated the number of alleles per locus using an unbiased estimate of MOI to determine whether the simple (but potentially biased) method I used to estimate MOI influenced model fit. Results The distribution of clones among hosts at individual sites differed significantly from traditional Poisson and negative binomial distributions, but not from zero-inflated modifications of these distributions. A consistent excess of two-clone infections and shortage of one-clone infections relative to all fit distributions was also observed. Any bias introduced by the simple method for estimating of MOI did not appear to qualitatively alter the results. Conclusions The statistical distributions used to model MOI are typically zero-truncated; truncating the Poisson or zero-inflated Poisson yield the same distribution, so the reasonable fit of the zero-inflated Poisson to the data suggests that the use of the zero-truncated Poisson in modeling is adequate. The improved fit of zero-inflated distributions relative to standard distributions may suggest that only a portion of the host population is located in areas suitable for transmission even at small sites (<1 ha). Collective transmission of clones and premunition may also contribute to deviations from standard distributions.
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Affiliation(s)
- Allison T Neal
- Department of Biology, Norwich University, Northfield, VT, United States of America
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Ameyaw EK, Njue C, Amoah RM, Appiah F, Baatiema L, Ahinkorah BO, Seidu AA, Ganle JK, Yaya S. Is improvement in indicators of women's empowerment associated with uptake of WHO recommended IPTp-SP levels in sub-Saharan Africa? A multilevel approach. BMJ Open 2021; 11:e047606. [PMID: 34716158 PMCID: PMC8559097 DOI: 10.1136/bmjopen-2020-047606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The global burden of malaria has reduced considerably; however, malaria in pregnancy remains a major public health problem in sub-Saharan Africa (SSA), where about 32 million pregnant women are at risk of acquiring malaria. The WHO has recommended that pregnant women in high malaria transmission locations, including SSA, have intermittent preventive treatment of malaria during pregnancy with at least three doses of sulphadoxine-pyrimethamine (IPTp-SP). Therefore, we investigated the prevalence of IPTp-SP uptake and associated individual-level, community-level and country-level predictors in SSA. DESIGN A cross-sectional survey was conducted using recent Demographic and Health Surveys datasets of 20 SSA countries. A total of 96 765 women were included. Optimum uptake of IPTp-SP at most recent pregnancy was the outcome variable. We fitted three-level multilevel models: individual, community and country parameters at 95% credible interval. RESULTS In all, 29.2% of the women had optimal IPTp-SP uptake ranging from 55.1% (in Zambia) to 6.9% (in Gambia). The study revealed a high likelihood of optimum IPTp-SP uptake among women with high knowledge (aOR=1.298, Crl 1.206 to 1.398) relative to women with low knowledge. Women in upper-middle-income countries were more than three times likely to have at least three IPTp-SP doses compared with those in low-income countries (aOR=3.268, Crl 2.392 to 4.098). We found that community (σ2=1.999, Crl 1.088 to 2.231) and country (σ2=1.853, Crl 1.213 to 2.831) level variations exist in optimal uptake of IPTp-SP. According to the intracluster correlation, 53.9% and 25.9% of the variation in optimum IPTp-SP uptake are correspondingly attributable to community-level and country-level factors. CONCLUSIONS The outcome of our study suggests that low-income SSA countries should increase budgetary allocation to maternal health, particularly for IPTp-SP interventions. IPTp-SP advocacy behavioural change communication strategies must focus on women with low knowledge, rural dwellers, married women and those who do not meet the minimum of eight antenatal care visits.
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Affiliation(s)
- Edward Kwabena Ameyaw
- Faculty of Health, The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Carolyne Njue
- Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Francis Appiah
- Department of Social Sciences, Berekum College of Education, Berekum, Ghana
| | - Linus Baatiema
- Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Central, Ghana
| | - Bright Opoku Ahinkorah
- Faculty of Health, The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Central, Ghana
| | - John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, University of Ghana, Legon, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Nwaneri DU, Sadoh AE. Effect of health seeking behaviour of caregivers on severe malaria outcome in under-fives seen in a tertiary health institution in Nigeria. Ghana Med J 2021; 54:156-163. [PMID: 33883760 PMCID: PMC8042797 DOI: 10.4314/gmj.v54i3.6] [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] [Indexed: 11/21/2022] Open
Abstract
Background Recognition of the symptoms and seeking prompt treatment in a health facility is a major means of reducing morbidity and prevention of mortality from severe malaria in under-fives. Objectives To document the effect of health-seeking behaviour of caregivers and severe malaria outcome in underfives seen in a tertiary health institution in Nigeria. Design A descriptive cross-sectional study carried out from July 2012 – June 2013. Data were obtained using a researcher-administered questionnaire. Subjects Caregivers and children (6 – 59 months) who presented with features of severe malaria according to World Health Organization criteria. Results Of the 120 caregivers mean [SD] age (31.4 [7.0] years) /child pairs (24 [14.7] months), 35 (29%) caregivers had appropriate health-seeking behaviour. The commonest place visited for initial healthcare before presentation was the patent medicine vendors by 87 (73%) caregivers. Seventy-seven per cent of caregivers who did not have appropriate health-seeking behaviour were from the lower family social class (p = 0.03). Caregivers whose children presented with severe anaemia were significantly more likely to have appropriate health-seeking behaviour (p =0.00). The mortality rate of severe malaria was 15 per 1000; of which 94% were children whose caregivers did not have appropriate health-seeking behaviour. Age younger than 2 years (p = 0.02), cerebral malaria (p = 0.01) and jaundice (p = 0.03) significantly predicted mortality in the children irrespective of the caregivers' health-seeking behaviour status. Conclusion Less than a third of the caregivers had appropriate health-seeking behaviour for their under-fives with severe malaria, and the majority of these were from the lower family social class. Cerebral malaria and jaundice significantly predicted mortality in children with severe malaria irrespective of caregivers' health-seeking behaviour status. Funding The study was self-sponsored by the authors
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Affiliation(s)
- Damian U Nwaneri
- Department of Child Health, University Of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria)
| | - Ayebo E Sadoh
- Department of Child Health, University Of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria)
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Population size estimation of seasonal forest-going populations in southern Lao PDR. Sci Rep 2021; 11:14816. [PMID: 34285321 PMCID: PMC8292394 DOI: 10.1038/s41598-021-94413-z] [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: 03/24/2021] [Accepted: 06/02/2021] [Indexed: 11/09/2022] Open
Abstract
Forest-going populations are key to malaria transmission in the Greater Mekong Sub-region (GMS) and are therefore targeted for elimination efforts. Estimating the size of this population is essential for programs to assess, track and achieve their elimination goals. Leveraging data from three cross-sectional household surveys and one survey among forest-goers, the size of this high-risk population in a southern province of Lao PDR between December 2017 and November 2018 was estimated by two methods: population-based household surveys and capture-recapture. During the first month of the dry season, the first month of the rainy season, and the last month of the rainy season, respectively, 16.2% [14.7; 17.7], 9.3% [7.2; 11.3], and 5.3% [4.4; 6.1] of the adult population were estimated to have engaged in forest-going activities. The capture-recapture method estimated a total population size of 18,426 [16,529; 20,669] forest-goers, meaning 61.0% [54.2; 67.9] of the adult population had engaged in forest-going activities over the 12-month study period. This study demonstrates two methods for population size estimation to inform malaria research and programming. The seasonality and turnover within this forest-going population provide unique opportunities and challenges for control programs across the GMS as they work towards malaria elimination.
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Orondo PW, Nyanjom SG, Atieli H, Githure J, Ondeto BM, Ochwedo KO, Omondi CJ, Kazura JW, Lee MC, Zhou G, Zhong D, Githeko AK, Yan G. Insecticide resistance status of Anopheles arabiensis in irrigated and non-irrigated areas in western Kenya. Parasit Vectors 2021; 14:335. [PMID: 34174946 PMCID: PMC8235622 DOI: 10.1186/s13071-021-04833-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria control in Kenya is based on case management and vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). However, the development of insecticide resistance compromises the effectiveness of insecticide-based vector control programs. The use of pesticides for agricultural purposes has been implicated as one of the sources driving the selection of resistance. The current study was undertaken to assess the status and mechanism of insecticide resistance in malaria vectors in irrigated and non-irrigated areas with varying agrochemical use in western Kenya. METHODS The study was carried out in 2018-2019 in Homa Bay County, western Kenya. The bioassay was performed on adults reared from larvae collected from irrigated and non-irrigated fields in order to assess the susceptibility of malaria vectors to different classes of insecticides following the standard WHO guidelines. Characterization of knockdown resistance (kdr) and acetylcholinesterase-inhibiting enzyme/angiotensin-converting enzyme (Ace-1) mutations within Anopheles gambiae s.l. species was performed using the polymerase chain reaction (PCR) method. To determine the agricultural and public health insecticide usage pattern, a questionnaire was administered to farmers, households, and veterinary officers in the study area. RESULTS Anopheles arabiensis was the predominant species in the irrigated (100%, n = 154) area and the dominant species in the non-irrigated areas (97.5%, n = 162), the rest being An. gambiae sensu stricto. In 2018, Anopheles arabiensis in the irrigated region were susceptible to all insecticides tested, while in the non-irrigated region reduced mortality was observed (84%) against deltamethrin. In 2019, phenotypic mortality was decreased (97.8-84% to 83.3-78.2%). In contrast, high mortality from malathion (100%), DDT (98.98%), and piperonyl butoxide (PBO)-deltamethrin (100%) was observed. Molecular analysis of the vectors from the irrigated and non-irrigated areas revealed low levels of leucine-serine/phenylalanine substitution at position 1014 (L1014S/L1014F), with mutation frequencies of 1-16%, and low-frequency mutation in the Ace-1R gene (0.7%). In addition to very high coverage of LLINs impregnated with pyrethroids and IRS with organophosphate insecticides, pyrethroids were the predominant chemical class of pesticides used for crop and animal protection. CONCLUSION Anopheles arabiensis from irrigated areas showed increased phenotypic resistance, and the intensive use of pesticides for crop protection in this region may have contributed to the selection of resistance genes observed. The susceptibility of these malaria vectors to organophosphates and PBO synergists in pyrethroids offers a promising future for IRS and insecticide-treated net-based vector control interventions. These findings emphasize the need for integrated vector control strategies, with particular attention to agricultural practices to mitigate mosquito resistance to insecticides.
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Affiliation(s)
- Pauline Winnie Orondo
- Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya. .,International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya.
| | - Steven G Nyanjom
- Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Harrysone Atieli
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya.,School of Public Health and Community Development, Maseno University, Kisumu, Kenya
| | - John Githure
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Benyl M Ondeto
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Kevin O Ochwedo
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Collince J Omondi
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - James W Kazura
- Center for Global Health & Diseases, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Ming-Chieh Lee
- Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, USA
| | - Guofa Zhou
- Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, USA
| | - Daibin Zhong
- Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, USA
| | - Andrew K Githeko
- International Center of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya. .,Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
| | - Guiyun Yan
- Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, USA.
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Topazian HM, Gumbo A, Brandt K, Kayange M, Smith JS, Edwards JK, Goel V, Mvalo T, Emch M, Pettifor AE, Juliano JJ, Hoffman I. Effectiveness of a national mass distribution campaign of long-lasting insecticide-treated nets and indoor residual spraying on clinical malaria in Malawi, 2018-2020. BMJ Glob Health 2021; 6:bmjgh-2021-005447. [PMID: 33947708 PMCID: PMC8098915 DOI: 10.1136/bmjgh-2021-005447] [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: 02/18/2021] [Revised: 04/06/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Malawi’s malaria burden is primarily assessed via cross-sectional national household surveys. However, malaria is spatially and temporally heterogenous and no analyses have been performed at a subdistrict level throughout the course of a year. The WHO recommends mass distribution of long-lasting insecticide-treated bed nets (LLINs) every 3 years, but a national longitudinal evaluation has never been conducted in Malawi to determine LLIN effectiveness lifespans. Methods Using District Health Information Software 2 (DHIS2) health facility data, available from January 2018 to June 2020, we assessed malaria risk before and after a mass distribution campaign, stratifying by age group and comparing risk differences (RDs) by LLIN type or annual application of indoor residual spraying (IRS). Results 711 health facilities contributed 20 962 facility reports over 30 months. After national distribution of 10.7 million LLINs and IRS in limited settings, malaria risk decreased from 25.6 to 16.7 cases per 100 people from 2018 to 2019 high transmission seasons, and rebounded to 23.2 in 2020, resulting in significant RDs of −8.9 in 2019 and −2.4 in 2020 as compared with 2018. Piperonyl butoxide (PBO)-treated LLINs were more effective than pyrethroid-treated LLINs, with adjusted RDs of −2.3 (95% CI −2.7 to −1.9) and −1.5 (95% CI −2.0 to −1.0) comparing 2019 and 2020 high transmission seasons to 2018. Use of IRS sustained protection with adjusted RDs of −1.4 (95% CI −2.0 to −0.9) and −2.8% (95% CI −3.5 to −2.2) relative to pyrethroid-treated LLINs. Overall, 12 of 28 districts (42.9%) experienced increases in malaria risk in from 2018 to 2020. Conclusion LLINs in Malawi have a limited effectiveness lifespan and IRS and PBO-treated LLINs perform better than pyrethroid-treated LLINs, perhaps due to net repurposing and insecticide-resistance. DHIS2 provides a compelling framework in which to examine localised malaria trends and evaluate ongoing interventions.
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Affiliation(s)
- Hillary M Topazian
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Austin Gumbo
- National Malaria Control Programme, Malawi Ministry of Health, Lilongwe, Malawi
| | - Katerina Brandt
- Department of Geography, University of North Carolina at Chapel Hill Graduate School, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Kayange
- National Malaria Control Programme, Malawi Ministry of Health, Lilongwe, Malawi
| | - Jennifer S Smith
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Jessie K Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Varun Goel
- Department of Geography, University of North Carolina at Chapel Hill Graduate School, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tisungane Mvalo
- University of North Carolina Project-Malawi, Lilongwe, Malawi.,Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Michael Emch
- Department of Geography, University of North Carolina at Chapel Hill Graduate School, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Audrey E Pettifor
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jonathan J Juliano
- Division of Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Irving Hoffman
- University of North Carolina Project-Malawi, Lilongwe, Malawi.,Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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Chiu C, Hunter LA, McCoy SI, Mfaume R, Njau P, Liu JX. Sales and pricing decisions for HIV self-test kits among local drug shops in Tanzania: a prospective cohort study. BMC Health Serv Res 2021; 21:434. [PMID: 33957903 PMCID: PMC8101213 DOI: 10.1186/s12913-021-06432-1] [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: 01/14/2021] [Accepted: 04/22/2021] [Indexed: 11/14/2022] Open
Abstract
Background Public health initiatives must look for ways to cost-effectively scale critical interventions to achieve high coverage. Private sector distribution channels, can potentially distribute preventive healthcare products to hard-to-reach populations, decongest public healthcare systems, and increase the sustainability of programs by getting customers to share costs. However, little is known about how sellers set prices for new products. By introducing a new product, HIV self-test kits, to local drug shops, we observed whether shops experimented with pricing, charged different buyers different prices, and whether prices converged within the local market over our study period. Methods From August to December 2019, we provided free HIV self-test kits, a new product, to 26 drug shops in Shinyanga, Tanzania to sell to the local community. We measured sales volume, price, customer age and sex using shop records. Using a multiple linear regression model, we conducted F-tests to determine whether shop, age, sex, and time (week) respectively were associated with price. We measured willingness-to-pay to restock test kits at the end of the study. Results 514 test kits were sold over 18 weeks; 69% of buyers were male, 40% were aged 25–34 and 32% aged 35–44. Purchase prices ranged from 1000 to 6000 Tsh (median 3000 Tsh; ~$1.30 USD). Within shops, prices were 11.3% higher for 25–34 and 12.7% higher for 45+ year olds relative to 15–19-year olds (p = 0.029) and 13.5% lower for men (p = 0.023) on average. Although prices varied between shops, prices varied little within shops over time, and did not converge over the study period or cluster geospatially. Mean maximum willingness-to-pay to restock was 2000 Tsh per kit. Conclusions Shopkeepers charged buyers different prices depending on buyers’ age and sex. There was limited variation in prices within shops over time and low demand among shopkeepers to restock at the end of the study. Given the subsidized global wholesale price ($2 USD or ~ 4600 Tsh), further demand creation and/or cost-reduction is required before HIV self-test kits can become commercially viable in drug shops in this setting. Careful consideration is needed to align the motivations of retailers with public health priorities while meeting their private for-profit needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06432-1.
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Affiliation(s)
- Calvin Chiu
- School of Public Health, University of California, 2121 Berkeley Way, Berkeley, 94704, CA, USA.
| | - Lauren A Hunter
- School of Public Health, University of California, 2121 Berkeley Way, Berkeley, 94704, CA, USA
| | - Sandra I McCoy
- School of Public Health, University of California, 2121 Berkeley Way, Berkeley, 94704, CA, USA
| | - Rashid Mfaume
- Shinyanga Regional Medical Office, Shinyanga, Tanzania
| | - Prosper Njau
- Health for a Prosperous Nation, Dar es Salaam, Tanzania.,National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly, and Children, Dar es Salaam, Tanzania
| | - Jenny X Liu
- Institute for Health and Aging; Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USA
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Hinne IA, Attah SK, Mensah BA, Forson AO, Afrane YA. Larval habitat diversity and Anopheles mosquito species distribution in different ecological zones in Ghana. Parasit Vectors 2021; 14:193. [PMID: 33827667 PMCID: PMC8025514 DOI: 10.1186/s13071-021-04701-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Understanding the ecology of larval malaria and lymphatic filariasis mosquitoes in a changing environment is important in developing effective control tools or programmes. This study characterized the breeding habitats of Anopheles mosquitoes in rural communities in different ecological zones in Ghana during the dry and rainy seasons. Methods The spatio-temporal distribution, species composition, and abundance of larval Anopheles mosquitoes in breeding habitats were studied in five locations in three ecological zones of Ghana. These were Anyakpor (coastal savannah area), Duase (forest area), and Libga, Pagaza, and Kpalsogu (Sahel savannah area). Larvae were collected using standard dippers and were raised in the insectary for identification. Results Out of a total of 7984 mosquito larvae collected, 2152 (27.26%) were anophelines and were more abundant in the rainy season (70.82%) than in the dry season (29.18%). The anophelines comprised 2128 (98.88%) An. gambiae s.l., 16 (0.74%) An. rufipes, and 8 (0.37%) An. pharoensis. In the coastal savannah and forest zones, dug-out wells were the most productive habitat during the dry (1.59 larvae/dip and 1.47 larvae/dip) and rainy seasons (11.28 larvae/dip and 2.05 larvae/dip). Swamps and furrows were the most productive habitats in the Sahel savannah zone during the dry (0.25 larvae/dip) and rainy (2.14 larvae/dip) seasons, respectively. Anopheles coluzzii was the most abundant sibling species in all the ecological zones. Anopheles melas and An. arabiensis were encountered only in the coastal savannah and the Sahel savannah areas, respectively. Larval habitat types influenced the presence of larvae as well as larval density (p < 0.001). The land-use type affected the presence of Anopheles larvae (p = 0.001), while vegetation cover influenced larval density (p < 0.05). Conclusion The most productive habitats were dug-out wells in the coastal savannah and forest zones, and furrows from irrigated canals in the Sahel savannah zone. Anopheles coluzzii was the predominant vector species in all the ecological zones. The abundance of Anopheles breeding habitats and larvae were influenced by anthropogenic activities. Encouraging people whose activities create the larval habitats to become involved in larval source management such as habitat manipulation to stop mosquito breeding will be important for malaria and lymphatic filariasis control. Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04701-w.
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Affiliation(s)
- Isaac A Hinne
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Simon K Attah
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Benedicta A Mensah
- Department of Epidemiology, Noguchi Memorial Institute of Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Akua O Forson
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Yaw A Afrane
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana.
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Adugna T, Yewhelew D, Getu E. Bloodmeal sources and feeding behavior of anopheline mosquitoes in Bure district, northwestern Ethiopia. Parasit Vectors 2021; 14:166. [PMID: 33741078 PMCID: PMC7977575 DOI: 10.1186/s13071-021-04669-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mosquito bloodmeal sources determine the feeding rates, adult survival, fecundity, hatching rates, and developmental times. Only the female Anopheles mosquito takes bloodmeals from humans, birds, mammals, and other vertebrates for egg development. Studies of the host preference patterns in blood-feeding anopheline mosquitoes are crucial to determine malaria vectors. However, the human blood index, foraging ratio, and host preference index of anopheline mosquitoes are not known so far in Bure district, Ethiopia. METHODS The origins of bloodmeals from all freshly fed and a few half-gravid exophagic and endophagic females collected using Centers for Disease Control and Prevention light traps were identified as human and bovine using enzyme-linked immunosorbent assay. The human blood index, forage ratio, and host feeding index were calculated. RESULTS A total of 617 specimens belonging to An. arabiensis (n = 209), An. funestus (n = 217), An. coustani (n = 123), An. squamosus (n = 54), and An. cinereus (n = 14) were only analyzed using blood ELISA. Five hundred seventy-five of the specimens were positive for blood antigens of the host bloods. All anopheline mosquitoes assayed for a bloodmeal source had mixed- rather than single-source bloodmeals. The FR for humans was slightly > 1.0 compared to bovines for all Anopheles species. HFI for each pair of vertebrate hosts revealed that humans were the slightly preferred bloodmeal source compared to bovines for all species (except An. squamosus), but there was no marked host selection. CONCLUSIONS All anopheline mosquitoes assayed for bloodmeal ELISA had mixed feeds, which tends to diminish the density of gametocytes in the mosquito stomach, thereby reducing the chance of fertilization of the female gamete and reducing the chances of a malaria vector becoming infected. Moreover, An. coustani was the only species that had only human bloodmeals, meaning that this species has the potential to transmit the disease. Therefore, combination zooprophylaxis should be reinforced as a means of vector control because the study sites are mixed dwellings.
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Affiliation(s)
- Tilahun Adugna
- Debre Tabor University, P.O. Box 272, Debre Tabor, Ethiopia
| | | | - Emana Getu
- Addis Ababa University, P.O. Box 2003, Addis Ababa, Ethiopia
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Soma DD, Zogo B, Taconet P, Somé A, Coulibaly S, Baba-Moussa L, Ouédraogo GA, Koffi A, Pennetier C, Dabiré KR, Moiroux N. Quantifying and characterizing hourly human exposure to malaria vectors bites to address residual malaria transmission during dry and rainy seasons in rural Southwest Burkina Faso. BMC Public Health 2021; 21:251. [PMID: 33516197 PMCID: PMC7847557 DOI: 10.1186/s12889-021-10304-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background To sustain the efficacy of malaria vector control, the World Health Organization (WHO) recommends the combination of effective tools. Before designing and implementing additional strategies in any setting, it is critical to monitor or predict when and where transmission occurs. However, to date, very few studies have quantified the behavioural interactions between humans and Anopheles vectors in Africa. Here, we characterized residual transmission in a rural area of Burkina Faso where long lasting insecticidal nets (LLIN) are widely used. Methods We analysed data on both human and malaria vectors behaviours from 27 villages to measure hourly human exposure to vector bites in dry and rainy seasons using a mathematical model. We estimated the protective efficacy of LLINs and characterised where (indoors vs. outdoors) and when both LLIN users and non-users were exposed to vector bites. Results The percentage of the population who declared sleeping under a LLIN the previous night was very high regardless of the season, with an average LLIN use ranging from 92.43 to 99.89%. The use of LLIN provided > 80% protection against exposure to vector bites. The proportion of exposure for LLIN users was 29–57% after 05:00 and 0.05–12% before 20:00. More than 80% of exposure occurred indoors for LLIN users and the estimate reached 90% for children under 5 years old in the dry cold season. Conclusions LLINs are predicted to provide considerable protection against exposure to malaria vector bites in the rural area of Diébougou. Nevertheless, LLIN users are still exposed to vector bites which occurred mostly indoors in late morning. Therefore, complementary strategies targeting indoor biting vectors in combination with LLIN are expected to be the most efficient to control residual malaria transmission in this area. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10304-y.
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Affiliation(s)
- D D Soma
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso. .,Université Nazi Boni (UNB), Bobo-Dioulasso, Burkina Faso. .,MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France.
| | - B Zogo
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France.,Institut Pierre Richet (IPR), Bouaké, Côte d'Ivoire.,Université d'Abomey Calavi, Abomey-Calavi, Benin
| | - P Taconet
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso.,MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France
| | - A Somé
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | - S Coulibaly
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - G A Ouédraogo
- Université Nazi Boni (UNB), Bobo-Dioulasso, Burkina Faso
| | - A Koffi
- Institut Pierre Richet (IPR), Bouaké, Côte d'Ivoire
| | - C Pennetier
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France.,Institut Pierre Richet (IPR), Bouaké, Côte d'Ivoire
| | - K R Dabiré
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | - N Moiroux
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso.,MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France
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Jelínková L, Jhun H, Eaton A, Petrovsky N, Zavala F, Chackerian B. An epitope-based malaria vaccine targeting the junctional region of circumsporozoite protein. NPJ Vaccines 2021; 6:13. [PMID: 33479242 PMCID: PMC7820318 DOI: 10.1038/s41541-020-00274-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/11/2020] [Indexed: 01/29/2023] Open
Abstract
A malaria vaccine that elicits long-lasting protection and is suitable for use in endemic areas remains urgently needed. Here, we assessed the immunogenicity and prophylactic efficacy of a vaccine targeting a recently described epitope on the major surface antigen on Plasmodium falciparum sporozoites, circumsporozoite protein (CSP). Using a virus-like particle (VLP)-based vaccine platform technology, we developed a vaccine that targets the junctional region between the N-terminal and central repeat regions of CSP. This region is recognized by monoclonal antibodies, including mAb CIS43, that have been shown to potently prevent liver invasion in animal models. We show that CIS43 VLPs elicit high-titer and long-lived anti-CSP antibody responses in mice and is immunogenic in non-human primates. In mice, vaccine immunogenicity was enhanced by using mixed adjuvant formulations. Immunization with CIS43 VLPs conferred partial protection from malaria infection in a mouse model, and passive transfer of serum from immunized macaques also inhibited parasite liver invasion in the mouse infection model. Our findings demonstrate that a Qβ VLP-based vaccine targeting the CIS43 epitope combined with various adjuvants is highly immunogenic in mice and macaques, elicits long-lasting anti-CSP antibodies, and inhibits parasite infection in a mouse model. Thus, the CIS43 VLP vaccine is a promising pre-erythrocytic malaria vaccine candidate.
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Affiliation(s)
- Lucie Jelínková
- grid.266832.b0000 0001 2188 8502Department of Molecular Genetics and Microbiology, University of New Mexico School of Medicine, Albuquerque, New Mexico USA
| | - Hugo Jhun
- grid.21107.350000 0001 2171 9311W. Harry Feinstone Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Allison Eaton
- grid.21107.350000 0001 2171 9311W. Harry Feinstone Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Nikolai Petrovsky
- grid.451447.7Vaxine Pty Ltd, 11 Walkley Avenue, Warradale, Adelaide, SA 5046 Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, SA 5042 Australia
| | - Fidel Zavala
- grid.21107.350000 0001 2171 9311W. Harry Feinstone Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Bryce Chackerian
- grid.266832.b0000 0001 2188 8502Department of Molecular Genetics and Microbiology, University of New Mexico School of Medicine, Albuquerque, New Mexico USA
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Guglielmo F, Sanou A, Churcher T, Ferguson HM, Ranson H, Sherrard-Smith E. Quantifying individual variability in exposure risk to mosquito bites in the Cascades region, Burkina Faso. Malar J 2021; 20:44. [PMID: 33461560 PMCID: PMC7814650 DOI: 10.1186/s12936-020-03538-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background The Cascades region, Burkina Faso, has a high malaria burden despite reported high insecticide-treated mosquito net (ITN) use. Human and vector activities outside the hours when indoor interventions offer direct protection from infectious bites potentially increase exposure risk to bites from malaria-transmitting Anopheles mosquitoes. This work investigated the degree of variation in human behaviour both between individuals and through time (season) to quantify how it impacts exposure to malaria vectors. Methods Patterns in human overnight activity (18:00–06:00) to quantify time spent using an ITN across 7 successive nights in two rural communities, Niakore (N = 24 participants) and Toma (71 participants), were observed in the dry and rainy seasons, between 2017 and 2018. Hourly human landing Anopheles mosquito catches were conducted in Niakore specifically, and Cascades region generally, between 2016 and 2017. Data were statistically combined to estimate seasonal variation in time spent outdoors and Anopheles bites received per person per night (bpppn). Results Substantial variability in exposure to outdoor Anopheles bites was detected within and between communities across seasons. In October, when Anopheles densities are highest, an individual’s risk of Anopheles bites ranged from 2.2 to 52.2 bites per person per night (bpppn) within the same week with variable risk dependent on hours spent indoors. Comparably higher outdoor human activity was observed in April and July but, due to lower Anopheles densities estimated, bpppn were 0.2–4.7 and 0.5–32.0, respectively. Males and people aged over 21 years were predicted to receive more bites in both sentinel villages. Conclusion This work presents one of the first clear descriptions of the degree of heterogeneity in time spent outdoors between people and across the year. Appreciation of sociodemographic, cultural and entomological activities will help refine approaches to vector control.
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Affiliation(s)
- Federica Guglielmo
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Antoine Sanou
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK. .,Centre National de Recherche et de Formation sur le Paludisme, BP 2208, Ouagadougou 01, Burkina Faso.
| | - Thomas Churcher
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Hilary Ranson
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Ellie Sherrard-Smith
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
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Gama A, Banda I, Kapaya F, Ingwe MM, Chiwaula J, Yeta A, Kawesha EC, Hamainza B, Chongwe G. Factors associated with private health facilities reporting malaria in the national health management information system in Zambia: a cross sectional study. Pan Afr Med J 2020; 37:203. [PMID: 33505572 PMCID: PMC7813650 DOI: 10.11604/pamj.2020.37.203.18829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/22/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Zambia has moved from accelerated malaria burden reduction to malaria elimination which requires the national malaria surveillance system to capture all cases from both the public and private sector. This study investigated challenges and factors associated with private health facilities reporting malaria in the national health management information system (HMIS). METHODS a structured questionnaire was administered to the heads of 139 private health facilities in three provinces where approximately 85% of private health facilities are found in Zambia. Logistic regression was performed, and the outcome variable was reporting malaria in the HMIS. Epi Info® version 7 was used to conduct multivariable logistic regression to determine factors associated with private facilities reporting malaria in HMIS. RESULTS private health facilities that had been operating for more than 20 years had three (3) times increased odds of reporting malaria in HMIS (AOR = 3.22, 95% CI: 1.23, 8.42; P-value = 0.02) compared to those that had been operating for less than 20 years. The private facilities that had staff who were aware about malaria surveillance (AOR = 2.06 95% CI: 1.38, 3.99, P-value = 0.01) had two times greater odds to report malaria in HMIS compared to those that were not aware. Lack of information and training in surveillance was identified as the main barrier for private facilities to report malaria in HMIS. CONCLUSION as Zambia progresses towards malaria elimination, there is need to increase awareness and training of private providers on malaria surveillance to improve reporting in HMIS.
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Affiliation(s)
- Angela Gama
- Zambia Field Epidemiology Training Programme (ZFETP), Ministry of Health, Lusaka, Zambia
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Ignatius Banda
- Zambia National Malaria Elimination Centre, Lusaka, Zambia
| | - Fred Kapaya
- Zambia Field Epidemiology Training Programme (ZFETP), Ministry of Health, Lusaka, Zambia
- Zambia National Public Health Institute, Lusaka, Zambia
| | | | | | - Anthony Yeta
- Zambia National Malaria Elimination Centre, Lusaka, Zambia
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Rural-urban disparities and factors associated with delayed care-seeking and testing for malaria before medication use by mothers of under-five children, Igabi LGA, Kaduna Nigeria. Malar J 2020; 19:294. [PMID: 32811529 PMCID: PMC7436948 DOI: 10.1186/s12936-020-03371-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fever in under-five children (U5) is the commonest presenting complaint in general practice and mothers' recognition is an entry point for fever treatment, including malaria. This study describes rural-urban disparity in fever prevalence in U5, mothers' malaria knowledge, care-seeking, testing for malaria before anti-malarial medication and the associated factors. METHODS A cross-sectional survey was conducted among 630 mother-child pairs [rural (300) and urban (330)] selected randomly using a multi-stage sampling from 63 villages in Igabi LGA, Kaduna State, Nigeria. Trained female data collectors administered a pre-tested structured questionnaire to collect information on mother-child demographic profiles, malaria knowledge, fever episodes in birth order last child in two weeks prior to survey, blood testing before anti-malarial use, and delayed care-seeking defined as care sought for fever > 48 h of onset. Malaria knowledge was categorized into good, average, and poor if the final scores were ≥ 75th, 50th-74th, and < 50th percentiles, respectively. Frequency, proportions, and odds ratio were calculated. Statistically significant was set at p-value < 0.05. RESULTS The median age (interquartile range) of rural mothers was 30 (IQR, 10) years compared to 27 (IQR, 6) years in urban. Of the 70.0% (441/629) U5 children with fever, 58.5% (258/441) were in rural settlements. A third of the mothers whose child had fever sought care. Mothers in rural settlements were 2.8 (adjusted OR: 2.8, CI 1.8-4.2, p < 0.01) times more likely to delay care-seeking for fever. Other significant factors were poor or no knowledge of malaria transmission, poor perception of malaria as a major health problem, and household size > 5. Also, mothers who had no formal education were four times more likely to receive anti-malarial medications without testing for malaria compared to their educated counterpart (adjusted OR: 4.0, 95% CI 1.6-9.9, p < 0.000). CONCLUSIONS Rural-urban disparities existed between fever prevalence in U5 children, care-seeking practices by their mothers, and factors associated with delayed care-seeking and testing the fever for malaria before anti-malarial medication. Fever treatment for high impact malaria elimination in Nigeria needs a context-specific intervention rather than 'one-size-fits-all' approach.
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Biswas B, Naskar NN, Basu K, Dasgupta A, Basu R, Paul B. Health seeking behavior of β-thalassemia major children and its attributes: An epidemiological study in Eastern India. J Family Med Prim Care 2020; 9:3586-3592. [PMID: 33102334 PMCID: PMC7567284 DOI: 10.4103/jfmpc.jfmpc_243_20] [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: 02/10/2020] [Revised: 03/13/2020] [Accepted: 05/02/2020] [Indexed: 11/04/2022] Open
Abstract
Background Health seeking behaviour (HSB) of thalassemic children is one of the rarely explored entity. Aim To explore HSB of β-Thalassemia Major (β-TM) children and its attributes. Materials and Methods It was a cross-sectional design, observational study, conducted among 328 β-TM children and their caregivers attending a tertiary care health facility of Kolkata; West Bengal situated in Eastern India in between May 2016 and April 2017 with a structured schedule. The data were analyzed using SPSS 16.0 version. Results At the disease onset, 79.6% of them consulted an allopathic doctor. In multivariable logistic regression model, those who were residing in urban area [adjusted odds ratio, AOR: 3.2 (1.2-8.7)], Hindu by religion[AOR: 3.0 (1.2-7.4)], had educated parents [AOR: 3.2 (1.1-9.2)], no family history of the disease [AOR: 3.6 (1.5-8.5)], belonged to higher socio-economic status (Class II, III and IV) [AOR: 2.9 (1.2-6.8)] and had caregiver with satisfactory knowledge related to the disease (≥4)[AOR: 12.2 (5.1-29.6)] were significantly more likely to seek healthcare from an allopathic doctor at onset of the disease. When we consider their HSB till date, 61.0% continued to consult allopathic doctors only. The multivariable determinants of satisfactory HSB till date were place of residence [AOR: 2.7 (1.4-5.2)], caste [AOR: 3.3 (1.6-6.7)], religion [AOR: 3.4 (1.7-6.9)], family history of the disease [AOR: 2.3 (1.2-4.6)] and caregiver's knowledge related to the disease [AOR: 5.3 (3.1-9.2)]. Conclusions HSB of the study participants were significantly associated with their caregiver's knowledge regarding the disease, parents' educational level, socio-economic status, caste, religion and family history of the disease.
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Affiliation(s)
- Bijit Biswas
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Narendra Nath Naskar
- Department of Public Health Administration, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
| | - Aparajita Dasgupta
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Rivu Basu
- Department of Community Medicine, R.G.Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Bobby Paul
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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