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Shittu O, Oniya MO, Olusi TA. Predictors of Comorbidity of Malaria and Septicemia in Children Living in Malaria-Endemic Communities in Nigeria. Acta Parasitol 2024; 69:514-525. [PMID: 38217641 DOI: 10.1007/s11686-023-00781-z] [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: 08/25/2022] [Accepted: 12/12/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE The study attempted to identify possible overlap between serum cell-reactive proteins (C-rp) and hematological indices as predictors of comorbidity of malaria and septicemia among children attending primary healthcare facilities in Ilorin, Nigeria. METHODS One hundred and ninety-three children (aged: ≤ 1-15 years) presenting with symptoms suggestive of malaria were enrolled. Blood specimens were collected and screened for: Romanowsky, culture, serum C-RP and hematological indices. RESULTS One hundred and fifteen (59.6%) children had Plasmodium falciparum infections (female 69.0% and male 34.1%). Septicemia was common among 52 (26.9%), but malaria and septicemia co-infection was 42 (36.5%). C-rp levels were low (< 10 mg/L) in 41 (35.7%, OR 4.594, CI 2.463-8.571) and high (> 10 mg/L) in 74 (64.3%, OR 2.519, CI 1.681-3.775) among the malaria positives (p < 0.05). Children with low C-rp, 8 (15.4%, OR 9.413, CI 4.116-21.531) were positive for septicemia and high C-RP 44 (84.6%, OR 1.694, CI 1.396-2.055), but without malaria, respectively. Similarly, increased C-rp levels were significantly associated with clinical malaria; > 10,000 parasites/μL (OR 1.486, CI 1.076-2.054, P < 0.001). Malaria-positive versus negative showed that PCV, C-rp, hemoglobin, platelet, WBC, and neutrophil were statistically significant (P < 0.05). Two bacteria species were identified, viz; Staphylococcus aureus 39 (54.9%) and Escherichia coli 32 (45.1%). The trade-off between sensitivity and specificity occurred at 16.475 cut-off using C-rp and degree of malaria severity as the standard for AUROC. CONCLUSION C-rp are inflammatory markers, though non-specificity may be associated with malaria prognosis and severity during malaria-septicemia co-infection.
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Affiliation(s)
- Olalere Shittu
- Parasitology Unit, Department of Zoology, University of Ilorin, Ilorin, Nigeria.
- Department of Biology, Federal University of Technology, Akure, Nigeria.
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Lendongo Wombo JB, Ibinga E, Oyegue-Liabagui SL, Imboumy Limoukou RK, Okouga AP, Mounioko F, Maghendji-Nzondo S, Lekana-Douki JB, Ngoungou EB. Severe malaria in children and adolescents in Southeast Gabon. BMC Infect Dis 2023; 23:207. [PMID: 37024834 PMCID: PMC10080735 DOI: 10.1186/s12879-023-08133-y] [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: 10/15/2022] [Accepted: 03/02/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Malaria remains a significant public health problem in sub-Saharan Africa. Child mortality due to severe malaria remains high in developing countries despite improvements in malaria management and a better understanding of its pathophysiology. To address the lack of epidemiological studies on severe malaria in Gabon, this study describes the epidemiological aspects of severe malaria in rural, semi-rural, and urban areas of southeast Gabon. METHODS Demographic, clinical, and laboratory data for children and adolescents aged 0-18 years were collected in 2019 from hospital records at three health facilities in southeastern Gabon. The patients included in the study were positive for P falciparum malaria diagnosed by microscopy with at least one of the malaria severity criteria. RESULTS Severe malaria accounted for 18.8% (667/3552) of malaria cases. Children aged 0-5 years accounted for 71.8% (479/667) of all severe malaria cases. Adolescents over 15 years of age were the least affected by severe malaria with 4.2% (28/667). Across the study, severe anemia (49.0%, 327/667), convulsions (43.0%, 287/667), respiratory distress (5.1%, 34/667), and altered consciousness (4.8%, 32/667) were the most frequent clinical signs of severe malaria in children. Franceville was the locality most affected by severe malaria with 49.2% (328/667), followed by Koulamoutou with 42.0% (280/667) and Lastourville with 8.8% (59/667). Convulsions (50.6%, 166/328) and coma (6.1%, 20/328) were more frequent in children living in urban areas. In contrast, severe anemia (56.7%, 186/339) and jaundice (6.8%, 23/339) were more common in children living in semi-rural areas. CONCLUSION Severe malaria is more prevalent in urban areas in regions with a high malaria transmission intensity. However, in this study, the epidemiological characteristics of severe malaria were similar in the three settings (urban, rural, and semi-rural areas) despite different levels of urbanization. Nevertheless, the various signs of severity were more frequent in Franceville, an urban area. Children under 5 years of age remain the most vulnerable age group.
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Affiliation(s)
- Judicaël Boris Lendongo Wombo
- Department of Epidemiology, Biostatistics and Medical Informatic (DEBIM)/Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), Faculty of Medicine, University of Health Sciences (USS), Owendo, Libreville, Gabon.
- Center of Epidemiology, Biostatistics, and Research Methodology-Gabon (CEBIMER-Gabon), Higher Institute of Medical Biology (ISBM), University of Health Sciences (USS), Owendo, Libreville, Gabon.
- Unit of Evolution, Epidemiology and Parasite Resistance (UNEEREP), Franceville Interdisciplinary Center for Medical Research (CIRMF), Franceville, Gabon.
- Central African Regional Doctoral School in Tropical Infectiology (ECODRAC), Franceville, Gabon.
- Centre Interdisciplinaire de Recherches Medicales de Franceville (CIRMF), Université des Sciences de la Santé (USS), Libreville, Gabon.
| | - Euloge Ibinga
- Department of Epidemiology, Biostatistics and Medical Informatic (DEBIM)/Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), Faculty of Medicine, University of Health Sciences (USS), Owendo, Libreville, Gabon
- Center of Epidemiology, Biostatistics, and Research Methodology-Gabon (CEBIMER-Gabon), Higher Institute of Medical Biology (ISBM), University of Health Sciences (USS), Owendo, Libreville, Gabon
| | - Sandrine Lydie Oyegue-Liabagui
- Unit of Evolution, Epidemiology and Parasite Resistance (UNEEREP), Franceville Interdisciplinary Center for Medical Research (CIRMF), Franceville, Gabon
- Central African Regional Doctoral School in Tropical Infectiology (ECODRAC), Franceville, Gabon
- Department of Biology, Faculty of Science, Masuku University of Science and Technology (USTM), Franceville, Gabon
| | - Roméo Karl Imboumy Limoukou
- Unit of Evolution, Epidemiology and Parasite Resistance (UNEEREP), Franceville Interdisciplinary Center for Medical Research (CIRMF), Franceville, Gabon
| | - Alain Prince Okouga
- Unit of Evolution, Epidemiology and Parasite Resistance (UNEEREP), Franceville Interdisciplinary Center for Medical Research (CIRMF), Franceville, Gabon
| | - Franck Mounioko
- Centre Interdisciplinaire de Recherches Medicales de Franceville (CIRMF), Université des Sciences de la Santé (USS), Libreville, Gabon
- Department of Biology, Faculty of Science, Masuku University of Science and Technology (USTM), Franceville, Gabon
| | - Sydney Maghendji-Nzondo
- Department of Epidemiology, Biostatistics and Medical Informatic (DEBIM)/Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), Faculty of Medicine, University of Health Sciences (USS), Owendo, Libreville, Gabon
- Center of Epidemiology, Biostatistics, and Research Methodology-Gabon (CEBIMER-Gabon), Higher Institute of Medical Biology (ISBM), University of Health Sciences (USS), Owendo, Libreville, Gabon
| | - Jean Bernard Lekana-Douki
- Unit of Evolution, Epidemiology and Parasite Resistance (UNEEREP), Franceville Interdisciplinary Center for Medical Research (CIRMF), Franceville, Gabon
- Department of Parasitology-Mycology, University of Health Sciences (USS), Libreville, Gabon
| | - Edgard Brice Ngoungou
- Department of Epidemiology, Biostatistics and Medical Informatic (DEBIM)/Research Unit in Epidemiology of Chronic Diseases and Environmental Health (UREMCSE), Faculty of Medicine, University of Health Sciences (USS), Owendo, Libreville, Gabon
- Center of Epidemiology, Biostatistics, and Research Methodology-Gabon (CEBIMER-Gabon), Higher Institute of Medical Biology (ISBM), University of Health Sciences (USS), Owendo, Libreville, Gabon
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Omondi CJ, Ochwedo KO, Athiany H, Onyango SA, Odongo D, Otieno A, Orondo P, Ondeto BM, Lee MC, Kazura JW, Githeko AK, Yan G. Impact of Agricultural Irrigation on Anemia in Western Kenya. Am J Trop Med Hyg 2022; 107:484-491. [PMID: 35895424 PMCID: PMC9393467 DOI: 10.4269/ajtmh.21-0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 03/20/2022] [Indexed: 08/03/2023] Open
Abstract
Expanding agricultural irrigation efforts to enhance food security and socioeconomic development in sub-Saharan Africa may affect malaria transmission and socioeconomic variables that increase the risk of anemia in local communities. We compared the prevalence of anemia, Plasmodium falciparum infection, and indicators of socioeconomic status related to nutrition in communities in Homa Bay County, Kenya, where an agricultural irrigation scheme has been implemented, to that in nearby communities where there is no agricultural irrigation. Cross-sectional surveys conducted showed that anemia prevalence defined by WHO criteria (hemoglobin < 11 g/dL) was less in communities in the irrigated areas than in the non-irrigated areas during the wet season (38.9% and 51.5%, χ2 = 4.29, P = 0.001) and the dry season (25.2% and 34.1%, χ2 = 7.33, P = 0.007). In contrast, Plasmodium falciparum infection prevalence was greater during the wet season in irrigated areas than in non-irrigated areas (15.3% versus 7.8%, χ2 = 8.7, P = 0.003). There was, however, no difference during the dry season (infection prevalence, < 1.8%). Indicators of nutritional status pertinent to anemia pathogenesis such as weekly consumption of non-heme- and heme-containing foods and household income were greater in communities located within the irrigation scheme versus those outside the irrigation scheme (P < 0.0001). These data indicate that current agricultural irrigation schemes in malaria-endemic communities in this area have reduced the risk of anemia. Future studies should include diagnostic tests of iron deficiency, parasitic worm infections, and genetic hemoglobin disorders to inform public health interventions aimed at reducing community anemia burden.
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Affiliation(s)
- Collince J. Omondi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Kenya
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
| | - Kevin O. Ochwedo
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
| | - Henry Athiany
- School of Mathematics and Physical Sciences, Jomo Kenyatta University of Agriculture and Technology, Kenya
| | - Shirley A. Onyango
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
| | - David Odongo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Kenya
| | - Antony Otieno
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Kenya
| | - Pauline Orondo
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
| | - Benyl M. Ondeto
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
| | - Ming-Chieh Lee
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, Homa Bay, Kenya
- Program in Public Health, University of California, Irvine, California
| | - James W. Kazura
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
| | - Andrew K. Githeko
- Sub-Saharan International Center of Excellence for Malaria Research, Tom Mboya University College, 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, University of California, Irvine, California
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Papaioannou I, Utzinger J, Vounatsou P. Malaria-anemia comorbidity prevalence as a measure of malaria-related deaths in sub-Saharan Africa. Sci Rep 2019; 9:11323. [PMID: 31383881 PMCID: PMC6683112 DOI: 10.1038/s41598-019-47614-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 07/18/2019] [Indexed: 11/12/2022] Open
Abstract
Different methods and data sources have been utilized to determine the relationship between malaria and mortality in endemic countries. Most of these efforts have focused on deaths directly attributed to malaria, while they overlooked causes of mortality that might be indirectly related to the disease, for instance anemia. We estimated the association of malaria parasitaemia, anemia, and malaria-anemia comorbidity with all-cause under-five mortality and evaluated the potential of malaria-anemia comorbidity prevalence to quantify malaria-related deaths in sub-Saharan Africa. We analysed data from Demographic and Health Surveys (DHS) and employed Bayesian geostatistical models. Mortality hazard obtained from malaria-anemia comorbidity prevalence was up to 3·5 times higher compared to the hazard related to Plasmodium parasitaemia only. Malaria parasite prevalence alone could not always capture a statistically important association with under-five mortality. Geographical variation of the malaria-anemia comorbidity effect was observed in most, but not all, countries. We concluded that the malaria burden in sub-Saharan Africa is considerably underestimated when anemia in not taken into account and that the malaria-anemia comorbidity prevalence provides a useful measure of the malaria-related deaths.
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Affiliation(s)
- Isidoros Papaioannou
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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Kabaghe AN, Chipeta MG, Terlouw DJ, McCann RS, van Vugt M, Grobusch MP, Takken W, Phiri KS. Short-Term Changes in Anemia and Malaria Parasite Prevalence in Children under 5 Years during One Year of Repeated Cross-Sectional Surveys in Rural Malawi. Am J Trop Med Hyg 2017; 97:1568-1575. [PMID: 28820717 PMCID: PMC5817775 DOI: 10.4269/ajtmh.17-0335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In stable transmission areas, malaria is the leading cause of anemia in children. Anemia in children is proposed as an added sensitive indicator for community changes in malaria prevalence. We report short-term temporal variations of malaria and anemia prevalence in rural Malawian children. Data from five repeated cross-sectional surveys conducted over 1 year in rural communities in Chikwawa District, Malawi, were analyzed. Different households were sampled per survey; all children, 6–59 months, in sampled household were tested for malaria parasitemia and hemoglobin levels using malaria rapid diagnostic tests (mRDT) and Hemocue 301, respectively. Malaria symptoms, recent treatment (2 weeks) for malaria, anthropometric measurements, and sociodemographic details were recorded. In total, 894 children were included from 1,377 households. The prevalences of mRDT positive and anemia (Hb < 11 g/dL) were 33.8% and 58.7%, respectively. Temporal trends in anemia and parasite prevalence varied differently. Overall, unadjusted and adjusted relative risks of anemia in mRDT-positive children were 1.31 (95% CI: 1.09–1.57) and 1.36 (1.13–1.63), respectively. Changes in anemia prevalence differed with short-term changes in malaria prevalence, although malaria is an important factor in anemia.
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Affiliation(s)
- Alinune N Kabaghe
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael G Chipeta
- Malawi-Liverpool Wellcome Trust Clinical Research Program, Queen Elizabeth Central Hospital, College of Medicine, Blantyre, Malawi.,Lancaster University, Lancaster Medical School, Lancaster, United Kingdom.,School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Dianne J Terlouw
- Malawi-Liverpool Wellcome Trust Clinical Research Program, Queen Elizabeth Central Hospital, College of Medicine, Blantyre, Malawi.,School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.,Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Robert S McCann
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.,Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Michèle van Vugt
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Willem Takken
- Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Kamija S Phiri
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
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Malaria, Moderate to Severe Anaemia, and Malarial Anaemia in Children at Presentation to Hospital in the Mount Cameroon Area: A Cross-Sectional Study. Anemia 2016; 2016:5725634. [PMID: 27895939 PMCID: PMC5118524 DOI: 10.1155/2016/5725634] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/07/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022] Open
Abstract
Background. Malaria remains a major killer of children in Sub-Saharan Africa, while anaemia is a public health problem with significant morbidity and mortality. Examining the factors associated with moderate to severe anaemia (MdSA) and malarial anaemia as well as the haematological characteristics is essential. Methodology. Children (1–14 years) at presentation at the Regional Hospital Annex-Buea were examined clinically and blood samples were collected for malaria parasite detection and full blood count evaluation. Results. Plasmodium falciparum, anaemia, and malarial anaemia occurred in 33.8%, 62.0%, and 23.6% of the 216 children, respectively. Anaemia prevalence was significantly higher in malaria parasite positive children and those with fever than their respective counterparts. MdSA and moderate to severe malarial anaemia (MdSMA) were detected in 38.0% and 15.3% of the participants, respectively. The prevalence of MdSA was significantly higher in children whose household head had no formal education, resided in the lowland, or was febrile, while MdSMA was significantly higher in febrile children only. Children with MdSMA had significantly lower mean white blood cell, lymphocyte, and platelet counts while the mean granulocyte count was significantly higher. Conclusion. Being febrile was the only predictor of both MdSA and MdSMA. More haematological insult occurred in children with MdSMA compared to MdSA.
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7
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Maghendji-Nzondo S, Kouna LC, Mourembou G, Boundenga L, Imboumy-Limoukou RK, Matsiegui PB, Manego-Zoleko R, Mbatchi B, Raoult D, Toure-Ndouo F, Lekana-Douki JB. Malaria in urban, semi-urban and rural areas of southern of Gabon: comparison of the Pfmdr 1 and Pfcrt genotypes from symptomatic children. Malar J 2016; 15:420. [PMID: 27538948 PMCID: PMC4990874 DOI: 10.1186/s12936-016-1469-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/02/2016] [Indexed: 12/25/2022] Open
Abstract
Background Artesunate-amodiaquine (AS-AQ) and artemether-lumefantrine (AL) are first- and second-line treatments for uncomplicated Plasmodium falciparum malaria in Gabon. AL remains highly efficacious, but its widespread use has led to molecular selection of the NFD haplotype on Pfmdr1 and K76 in Pfcrt. In this study, plasmodial infection characteristics and the distribution of the Pfmdr1 and Pfcrt genotypes involved in reduced efficacy of artemisinin-based combination therapy (ACT) were investigated in four Gabonese localities. Methods A cross-sectional study was conducted in the paediatric units of rural (Lastourville and Fougamou), semi-urban (Koula-Moutou) and urban (Franceville) areas. Malaria was diagnosed with the rapid diagnostic test Optimal-IT® and confirmed by blood smear. Pfmdr1 codons 86, 184 and 1246 and Pfcrt codon 76 were genotyped by PCR–RFLP and sequencing. Results Among 1129 included children, the prevalence of plasmodial infection was 79.5 % at Lastourville, 53.6 % at Fougamou, 36.1 % at Koula-Moutou, and 21.2 % at Franceville. The prevalence was significantly higher among children over 60 months of age in both semi-urban (p = 0.01) and urban (p = 0.004) areas. The prevalence of Pfmdr1 wild-type N86 differed significantly between Lastourville (57.8 %) and Koula-Moutou (45.4 %) (p = 0.039). No difference in 184F-carrying parasites was found between Lastourville (73.8 %), Fougamou (81.6 %), Koula-Moutou (83.2 %), and Franceville (80.6 %) (p = 0.240). The prevalence of wild-type D1246 was significantly different between Lastourville (94.1 %), Koula-Moutou (85.6 %) and Franceville (87.3 %) (p = 0.01). The frequency of wild-type K76 was not significantly different across the four sites: Lastourville (16.5 %), Fougamou (27.8 %), Koula-Moutou (17.4 %), and Franceville (29.4 %) (p = 0.09). The mixed genotypes were only found in Lastourville and Franceville. The NFD, YFD and NYD haplotypes were mainly Lastourville (46.6, 25.8, 14.0 %), Fougamou (45.5, 9.1, 42.4 %), Koula-Moutou (35, 6.7, 40.4 %), and Franceville (40.0, 16.0, 32.0 %). Conclusion This study shows an increase in the prevalence of childhood plasmodial infection in Gabon according to the low socio-economic level, and a high frequency of markers associated with AL treatment failure. Close monitoring of ACT use is needed.
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Affiliation(s)
- Sydney Maghendji-Nzondo
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon.,Département de Biologie, Université des Sciences et Techniques de Masuku, BP: 901, Franceville, Gabon
| | - Lady-Charlène Kouna
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon
| | - Gaël Mourembou
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille, France
| | - Larson Boundenga
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon
| | - Romeo-Karl Imboumy-Limoukou
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon
| | | | | | - Bertrand Mbatchi
- Département de Biologie, Université des Sciences et Techniques de Masuku, BP: 901, Franceville, Gabon
| | - Didier Raoult
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille, France
| | - Fousseyni Toure-Ndouo
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution Epidémiologie Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon. .,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, B.P. 4009, Libreville, Gabon.
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9
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Totino PRR, Pinna RA, Oliveira ACAXD, Banic DM, Daniel-Ribeiro CT, Ferreira-da-Cruz MDF. Apoptosis of non-parasitised red blood cells in Plasmodium yoelii malaria. Mem Inst Oswaldo Cruz 2014; 108:686-90. [PMID: 24037189 PMCID: PMC3970687 DOI: 10.1590/0074-0276108062013003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/03/2013] [Indexed: 11/22/2022] Open
Abstract
Recently, while studying erythrocytic apoptosis during Plasmodium
yoelii infection, we observed an increase in the levels of
non-parasitised red blood cell (nRBC) apoptosis, which could be related to
malarial anaemia. Therefore, in the present study, we attempted to investigate
whether nRBC apoptosis is associated with the peripheral RBC count, parasite
load or immune response. To this end, BALB/c mice were infected with P.
yoelii 17XL and nRBC apoptosis, number of peripheral RBCs,
parasitaemia and plasmatic levels of cytokines, nitric oxide and anti-RBC
antibodies were evaluated at the early and late stages of anaemia. The apoptosis
of nRBCs increased at the late stage and was associated with parasitaemia, but
not with the intensity of the immune response. The increased percentage of nRBC
apoptosis that was observed when anaemia was accentuated was not related to a
reduction in peripheral RBCs. We conclude that nRBC apoptosis in P.
yoelii malaria appears to be induced in response to a high parasite
load. Further studies on malaria models in which acute anaemia develops during
low parasitaemia are needed to identify the potential pathogenic role of nRBC
apoptosis.
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Affiliation(s)
- Paulo Renato Rivas Totino
- Laboratório de Pesquisas em Malária, Escola Nacional de Saúde Pública, Fiocruz, Rio de JaneiroRJ, Brasil
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Austin N, Adikaibe E, Ethelbert O, Chioma U, Ekene N. Prevalence and Severity of Malaria Parasitemia among Children Requiring Emergency Blood Transfusion in a Tertiary Hospital in Imo State, Nigeria. Ann Med Health Sci Res 2014; 4:619-23. [PMID: 25221716 PMCID: PMC4160692 DOI: 10.4103/2141-9248.139349] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Malaria is one of the most serious and complex health problems in Sub Saharan Africa. Anemia in Children with malaria may require blood transfusion and has been be associated with high mortality rates. Aim: The aim of this study is to evaluate the prevalence, pattern, and severity of malaria parasitemia among children 6 months to 14 years old, requiring blood transfusion. Subjects and Methods: This is a cross-sectional study carried out at the children emergency unit of the Imo state University Teaching Hospital South East Nigeria. Data were analyzed using SPSS version 21, Chicago Il, USA Results: A total of 409 children were recruited into the study. The overall rate of malaria parasitemia was 83.1% (340/409) lower in males 81.6% (228/276) than in females 86.3% (112/133). The peak of parasitemia is similar in both sexes (5-9 years). Most of the children had medium levels of parasitemia, which decreased with increasing age. The proportion of children transfused also decreased with increasing age. At medium and high levels of parasitemia; in children below 5 years, 92.8% (132/142) were transfused while in 5 years and above only 79.6% (39/49) of the children were transfused. At medium level parasitemia the proportion of children transfused was significantly higher than those not transfused (P < 0.001). Conclusion: Most children 6 months to 14 years with medium level of parasitemia may require blood transfusion. Targeted measures toward primary prevention of malaria in children should be intensified as this will not only reduce morbidity and mortality of malaria, but will reduce the economic burden of the disease in Semi-rural and rural dwellers in Sub Saharan Africa.
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Affiliation(s)
- Nir Austin
- Department of Microbiology and Parasitology, Imo State University Teaching Hospital Umunna, Imo State, Nigeria
| | - Eab Adikaibe
- Department of Medicine, University of Nigeria Teaching Hospital Enugu, Enugu State, Nigeria
| | - Oo Ethelbert
- Accident and Emergency Unit, Imo State University Teaching Hospital Umunna, Imo State, Nigeria
| | - Ue Chioma
- Department of Hematology and Blood Transfusion, Imo State University Teaching Hospital Umunna, Imo State, Nigeria
| | - Nu Ekene
- Department of Science Laboratory Technology, Imo State Polytechnic Umuagwo, Ohaji, Imo State, Nigeria
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Defining the malaria burden in Nchelenge District, northern Zambia using the World Health Organization malaria indicators survey. Malar J 2014; 13:220. [PMID: 24902708 PMCID: PMC4067379 DOI: 10.1186/1475-2875-13-220] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is considered as one of the major public health problems and among the diseases of poverty. In areas of stable and relatively high transmission, pregnant women and their newborn babies are among the higher risk groups. A multicentre trial on the safety and efficacy of several formulations of artemisinin-based combination therapy (ACT) during pregnancy is currently on-going in four African countries, including Zambia, whose study site is in Nchelenge district. As the study outcomes may be influenced by the local malaria endemicity, this needs to be characterized. A cross-sectional survey to determine the prevalence and intensity of infection among <10 years old was carried out in March-April 2012 in Nchelenge district. METHODS The sampling unit was the household where all children < 10 years of age were included in the survey using simple random household selection on a GPS coded list. A blood sample for determining haemoglobin concentration and identifying malaria infection was collected from each recruited child. RESULTS Six hundred thirty households were selected and 782 children tested for malaria and anaemia. Prevalence of malaria infection was 30.2% (236/782), the large majority (97.9%, 231/236) being Plasmodium falciparum and the remaining ones (2.1%, 5/236) Plasmodium malariae. Anaemia, defined as haemoglobin concentration <11 g/dl, was detected in 51.2% (398/782) children. CONCLUSION In Zambia, despite the reported decline in malaria burden, pockets of high malaria endemicity, such as Nchelenge district, still remain. This is a border area and significant progress can be achieved only by concerted efforts aimed at increasing coverage of current control interventions across the border.
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EGBE CA, ENABULELE OI. Aetiologic Agents of Fevers of Unknown Origin among Patients in Benin City, Nigeria. Malays J Med Sci 2014; 21:37-43. [PMID: 24639610 PMCID: PMC3952337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 10/12/2013] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Malaria parasitaemia is an important predictor of bacteremia, concomitant invasive bacterial infections and malaria parasitaemia are strongly associated with death. METHODS Blood samples were collected from 500 patients (281 males and 219 females) with fevers of unknown origin. The blood samples were processed to diagnose malaria and bacterial septicaemia using standard microbiological techniques. RESULTS The prevalence of concomitant bacterial septicaemia and malaria parasitaemia was 7.8%. The prevalence of malaria parasitaemia alone (26.2%) was significantly (P < 0.0001) higher than that of bacterial septicaemia (13%). Patients 61 years old and older had higher prevalences of malaria parasitaemia, bacterial septicaemia, and concomitant infections. The most prevalent organism causing bacterial septicaemia were of the Klebsiella species, while ceftriaxone and ceftazidime were the most effective antibacterial agents. CONCLUSION Overall prevalence of malaria parasitaemia, septicaemia and concomitant malaria parasitaemia, and bacterial septicaemia were 26.2%, 13%, and 7.8%, respectively. Bacteria from the Klebsiella species were the most common bacteria causing septicaemia. Although ceftriaxone and ceftazidime are the recommended treatments, there is need for urgent treatment of concomitant infections due to their poor prognosis.
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Affiliation(s)
- Christopher Aye EGBE
- Department of Medical Microbiology University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria
| | - Onaiwu Idahosa ENABULELE
- Department of Microbiology, Faculty of Life Sciences, University of Benin, PMB 1154, Benin City, Nigeria
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Pondei K, Kunle-Olowu OE, Peterside O. The aetiology of non-malarial febrile illness in children in the malaria-endemic Niger Delta Region of Nigeria. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2013. [DOI: 10.1016/s2222-1808(13)60012-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bouyou-Akotet MK, Mawili-Mboumba DP, Kendjo E, Eyang Ekouma A, Abdou Raouf O, Engohang Allogho E, Kombila M. Complicated malaria and other severe febrile illness in a pediatric ward in Libreville, Gabon. BMC Infect Dis 2012; 12:216. [PMID: 22973831 PMCID: PMC3520876 DOI: 10.1186/1471-2334-12-216] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 09/05/2012] [Indexed: 11/10/2022] Open
Abstract
Background Although a substantial decline of Plasmodium falciparum infection is observed in Africa following implementation of new control strategies, malaria is still considered as the major cause of febrile illness in hospitalized African children. The present study was designed to assess the management of febrile illness and to determine the proportion of children with febrile illness hospitalized for primary diagnosis of malaria who had confirmed complicated malaria after implementation of new malaria control strategies in Libreville, Gabon. Methods Demographic, clinical and biological data from hospitalized children with fever or a history of fever, with a primary diagnosis of clinical malaria, aged less than 18 years old, who benefited from hematological measurements and microscopic malaria diagnosis, were recorded and analyzed during a prospective and observational study conducted in 2008 in the Centre Hospitalier de Libreville. Results A total of 418 febrile children were admitted at hospital as malaria cases. Majority of them (79.4%) were aged below five years. After medical examination, 168 were diagnosed and treated as clinical malaria and, among them, only 56.7% (n = 95) had Plasmodium falciparum positive blood smears. Age above five years, pallor, Blantyre Coma Score ≤2 and thrombocytopenia were predictive of malaria infection. Respiratory tract infections were the first leading cause of hospitalization (41.1%), followed by malaria (22.7%); co-morbidities were frequent (22%). Less than 5% of suspected bacterial infections were confirmed by culture. Global case fatality rate was 2.1% and 1% for malaria. Almost half (46%) of the children who received antimalarial therapy had negative blood smears. Likewise, antibiotics were frequently prescribed without bacteriological confirmation. Conclusions The use of clinical symptoms for the management of children febrile illness is frequent in Gabon. Information, training of health workers and strengthening of diagnosis tools are necessary to improve febrile children care.
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[Frequency of severe anemia in children aged 2 months to 15 years at Mother and Child Centre of the Chantal Biya Foundation Yaounde, Cameroon]. Pan Afr Med J 2012; 12:46. [PMID: 22937186 PMCID: PMC3428166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 05/07/2012] [Indexed: 11/17/2022] Open
Abstract
Introduction Les anémies sévères constituent une cause importante de décès d’enfants. Une analyse épidémiologique et clinique permettrait d’estimer la morbidité et mortalité y relatives afin lutter efficacement contre les causes. Méthodes Notre étude rétrospective et descriptive porte sur les anémies sévères chez les enfants de 2 mois à 15 ans de juillet 2005 à juillet 2011. Les drépanocytaires et les enfants souffrant de néoplasie étaient exclus. Toutes les admissions de janvier 2008 à juillet 2011 et les décès totaux, qui répondaient aux critères ci-dessus ont été également répertoriés. Résultats Ont été analysés 4735 cas d’anémie sévère dont 215 décès (4,5%). Entre janvier 2008 et juillet 2011, sur 12879 enfants hospitalisés 2456 souffraient d’anémie sévère dont 96 sont décédés, soit une mortalité spécifique de 0,7% et une létalité de 4,0%. Au total, 22,4% d’anémies sévères survenaient dans la tranche d’âge de moins de 12 mois. Celles de 12 à 59 mois et de plus de 5 ans représentaient respectivement 64,4% et 13,2% des cas. Le paludisme était l’étiologie évoquée chez 89,0% des cas, suivi du sepsis (9,4%). Les décès concernaient les enfants sévèrement anémiés âgés de 12 à 59 mois dans 67,2% de cas. La plupart de patients (84,8%) résidaient à Yaoundé (P = 0,004). Conclusion Les anémies sévères restent fréquentes à Yaoundé. La mise en œuvre de da politique de gratuité des antipaludiques et l’utilisation des moustiquaires doivent être effectives. Le renforcement de ces mesures dès le début des saisons pluvieuses préviendrait les flambées d’anémies.
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Vinnemeier CD, Schwarz NG, Sarpong N, Loag W, Acquah S, Nkrumah B, Huenger F, Adu-Sarkodie Y, May J. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area. PLoS One 2012; 7:e36678. [PMID: 22574213 PMCID: PMC3344934 DOI: 10.1371/journal.pone.0036678] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/05/2012] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. METHODS In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD) of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART) model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. RESULTS Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001) associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI) algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. CONCLUSIONS Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace presumptive treatment or laboratory diagnosis.
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High prevalence of malaria in Zambezia, Mozambique: the protective effect of IRS versus increased risks due to pig-keeping and house construction. PLoS One 2012; 7:e31409. [PMID: 22363640 PMCID: PMC3282725 DOI: 10.1371/journal.pone.0031409] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/10/2012] [Indexed: 11/19/2022] Open
Abstract
Background African countries are scaling up malaria interventions, especially insecticide treated nets (ITN) and indoor residual spraying (IRS), for which ambitious coverage targets have been set. In spite of these efforts infection prevalence remains high in many parts of the continent. This study investigated risk factors for malaria infection in children using three malaria indicator surveys from Zambezia province, Mozambique. The impact of IRS and ITNs, the effects of keeping farm animals and of the construction material of roofs of houses and other potential risk factors associated with malaria infection in children were assessed. Methods Cross-sectional community-based surveys were conducted in October of 2006, 2007 and 2008. A total of 8338 children (ages 1–15 years) from 2748 households were included in the study. All children were screened for malaria by rapid diagnostic tests. Caregiver interviews were used to assess household demographic and wealth characteristics and ITN and IRS coverage. Associations between malaria infection, vector control interventions and potential risk factors were assessed. Results Overall, the prevalence of malaria infection was 47.8% (95%CI: 38.7%–57.1%) in children 1–15 years of age, less than a quarter of children (23.1%, 95%CI: 19.1%–27.6%) were sleeping under ITN and almost two thirds were living in IRS treated houses (coverage 65.4%, 95%CI: 51.5%–77.0%). Protective factors that were independently associated with malaria infection were: sleeping in an IRS house without sleeping under ITN (Odds Ratio (OR) = 0.6; 95%CI: 0.4–0.9); additional protection due to sleeping under ITN in an IRS treated house (OR = 0.5; 95%CI: 0.3–0.7) versus sleeping in an unsprayed house without a ITN; and parental education (primary/secondary: OR = 0.6; 95%CI: 0.5–0.7) versus parents with no education. Increased risk of infection was associated with: current fever (OR = 1.2; 95%CI: 1.0–1.5) versus no fever; pig keeping (OR = 3.2; 95%CI: 2.1–4.9) versus not keeping pigs; living in houses with a grass roof (OR = 1.7; 95%CI: 1.3–2.4) versus other roofing materials and bigger household size (8–15 people: OR = 1.6; 95%CI: 1.3–2.1) versus small households (1–4 persons). Conclusion Malaria infection among children under 15 years of age in Zambezia remained high but conventional malaria vector control methods, in particular IRS, provided effective means of protection. Household ownership of farm animals, particularly pigs, and living in houses with a grass roof were independently associated with increased risk of infection, even after allowing for household wealth. To reduce the burden of malaria, national control programs need to ensure high coverage of effective IRS and promote the use of ITNs, particularly in households with elevated risks of infection, such as those keeping farm animals, and those with grass roofs.
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Sicuri E, Biao P, Hutton G, Tediosi F, Menendez C, Lell B, Kremsner P, Conteh L, Grobusch MP. Cost-effectiveness of intermittent preventive treatment of malaria in infants (IPTi) for averting anaemia in Gabon: a comparison between intention to treat and according to protocol analyses. Malar J 2011; 10:305. [PMID: 22004614 PMCID: PMC3224361 DOI: 10.1186/1475-2875-10-305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 10/17/2011] [Indexed: 11/12/2022] Open
Abstract
Background In Gabon, the impact of intermittent preventive treatment of malaria in infants (IPTi) was not statistically significant on malaria reduction, but the impact on moderate anaemia was, with some differences between the intention to treat (ITT) and the according to protocol (ATP) trial analyses. Specifically, ATP was statistically significant, while ITT analysis was borderline. The main reason for the difference between ITT and ATP populations was migration. Methods This study estimates the cost-effectiveness of IPTi on the reduction of anaemia in Gabon, comparing results of the ITT and the ATP clinical trial analyses. Threshold analysis was conducted to identify when the intervention costs and protective efficacy of IPTi for the ATP cohort equalled the ITT cost-effectiveness ratio. Results Based on IPTi intervention costs, the cost per episode of moderate anaemia averted was US$12.88 (CI 95% 4.19, 30.48) using the ITT analysis and US$11.30 (CI 95% 4.56, 26.66) using the ATP analysis. In order for the ATP results to equal the cost-effectiveness of ITT, total ATP intervention costs should rise from 118.38 to 134 US$ ATP or the protective efficacy should fall from 27% to 18.1%. The uncertainty surrounding the cost-effectiveness ratio using ITT trial results was higher than using ATP results. Conclusions Migration implies great challenges in the organization of health interventions that require repeat visits in Gabon. This was apparent in the study as the cost-effectiveness of IPTp-SP worsened when drop out from the prevention was taken into account. Despite such challenges, IPTi was both inexpensive and efficacious in averting cases of moderate anaemia in infants.
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Affiliation(s)
- Elisa Sicuri
- Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, (Rosselló 132), Barcelona (08036), Spain.
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Abstract
Severe anaemia is common in Africa. It has a high mortality and particularly affects young children and pregnant women. Recent research provides new insights into the mechanisms and causes of severe acquired anaemia and overturns accepted dogma. Deficiencies of vitamin B12 and vitamin A, but not of iron or folic acid, are associated with severe anaemia. Bacterial infections and, in very young children, hookworm infections are also common in severe anaemia. Irrespective of the aetiology, the mechanism causing severe anaemia is often red cell production failure. Severe anaemia in Africa is therefore a complex multi-factorial syndrome, which, even in an individual patient, is unlikely to be amenable to a single intervention. Policies and practices concerning anaemia diagnosis, treatment and prevention need to be substantially revised if we are to make a significant impact on the huge burden of severe anaemia in Africa.
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Affiliation(s)
- Michael B van Hensbroek
- Emma Children's Hospital, Amsterdam Medical Centre, Amsterdam, NetherlandsLiverpool School of Tropical Medicine, Liverpool, UK
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Mourou JR, Coffinet T, Jarjaval F, Pradines B, Amalvict R, Rogier C, Kombila M, Pagès F. Malaria transmission and insecticide resistance of Anopheles gambiae in Libreville and Port-Gentil, Gabon. Malar J 2010; 9:321. [PMID: 21070655 PMCID: PMC2995799 DOI: 10.1186/1475-2875-9-321] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 11/11/2010] [Indexed: 11/20/2022] Open
Abstract
Background Urban malaria is a major health priority for civilian and militaries populations. A preliminary entomologic study has been conducted in 2006-2007, in the French military camps of the two mains towns of Gabon: Libreville and Port-Gentil. The aim was to assess the malaria transmission risk for troops. Methods Mosquitoes sampled by human landing collection were identified morphologically and by molecular methods. The Plasmodium falciparum circumsporozoïte (CSP) indexes were measured by ELISA, and the entomological inoculation rates (EIR) were calculated for both areas. Molecular assessments of pyrethroid knock down (kdr) resistance and of insensitive acetylcholinesterase resistance were conducted. Results In Libreville, Anopheles gambiae s.s. S form was the only specie of the An. gambiae complex present and was responsible of 9.4 bites per person per night. The circumsporozoïte index was 0.15% and the entomological inoculation rate estimated to be 1.23 infective bites during the four months period. In Port-Gentil, Anopheles melas (75.5% of catches) and An. gambiae s.s. S form (24.5%) were responsible of 58.7 bites per person per night. The CSP indexes were of 1.67% for An. gambiae s.s and 0.28% for An. melas and the EIRs were respectively of 1.8 infective bites per week and of 0.8 infective bites per week. Both kdr-w and kdr-e mutations in An. gambiae S form were found in Libreville and in Port-Gentil. Insensitive acetylcholinesterase has been detected for the first time in Gabon in Libreville. Conclusion Malaria transmission exists in both town, but with high difference in the level of risk. The co-occurrence of molecular resistances to the main families of insecticide has implications for the effectiveness of the current vector control programmes that are based on pyrethroid-impregnated bed nets.
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Affiliation(s)
- Jean-Romain Mourou
- Département de Parasitologie-mycologie, Faculté de médecine, Université des Sciences de la Santé, B.P. 4009 Libreville, Gabon
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Africa's 9th malaria day celebration in 2009 and its bearing on most vulnerable groups. ASIAN PAC J TROP MED 2010. [DOI: 10.1016/s1995-7645(10)60072-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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