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Khan O, Ajadi JO, Hossain MP. Predicting malaria outbreak in The Gambia using machine learning techniques. PLoS One 2024; 19:e0299386. [PMID: 38753678 PMCID: PMC11098333 DOI: 10.1371/journal.pone.0299386] [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: 08/17/2023] [Accepted: 02/09/2024] [Indexed: 05/18/2024] Open
Abstract
Malaria is the most common cause of death among the parasitic diseases. Malaria continues to pose a growing threat to the public health and economic growth of nations in the tropical and subtropical parts of the world. This study aims to address this challenge by developing a predictive model for malaria outbreaks in each district of The Gambia, leveraging historical meteorological data. To achieve this objective, we employ and compare the performance of eight machine learning algorithms, including C5.0 decision trees, artificial neural networks, k-nearest neighbors, support vector machines with linear and radial kernels, logistic regression, extreme gradient boosting, and random forests. The models are evaluated using 10-fold cross-validation during the training phase, repeated five times to ensure robust validation. Our findings reveal that extreme gradient boosting and decision trees exhibit the highest prediction accuracy on the testing set, achieving 93.3% accuracy, followed closely by random forests with 91.5% accuracy. In contrast, the support vector machine with a linear kernel performs less favorably, showing a prediction accuracy of 84.8% and underperforming in specificity analysis. Notably, the integration of both climatic and non-climatic features proves to be a crucial factor in accurately predicting malaria outbreaks in The Gambia.
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Affiliation(s)
- Ousman Khan
- Department of Mathematics, College of Computing and Mathematics, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - Jimoh Olawale Ajadi
- Department of Mathematics, College of Computing and Mathematics, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
- Interdisciplinary Research Center for Refining & Advanced Chemicals, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - M. Pear Hossain
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
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Thomford NE, Kellermann T, Biney RP, Dixon C, Nyarko SB, Ateko RO, Ekor M, Kyei GB. Therapeutic efficacy of generic artemether-lumefantrine in the treatment of uncomplicated malaria in Ghana: assessing anti-malarial efficacy amidst pharmacogenetic variations. Malar J 2024; 23:125. [PMID: 38685044 PMCID: PMC11059713 DOI: 10.1186/s12936-024-04930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite efforts made to reduce morbidity and mortality associated with malaria, especially in sub-Saharan Africa, malaria continues to be a public health concern that requires innovative efforts to reach the WHO-set zero malaria agenda. Among the innovations is the use of artemisinin-based combination therapy (ACT) that is effective against Plasmodium falciparum. Generic artemether-lumefantrine (AL) is used to treat uncomplicated malaria after appropriate diagnosis. AL is metabolized by the cytochrome P450 family of enzymes, such as CYP2B6, CYP3A4 and CYP3A5, which can be under pharmacogenetic influence. Pharmacogenetics affecting AL metabolism, significantly influence the overall anti-malarial activity leading to variable therapeutic efficacy. This study focused on generic AL drugs used in malarial treatment as prescribed at health facilities and evaluated pharmacogenomic influences on their efficacy. METHODS Patients who have been diagnosed with malaria and confirmed through RDT and microscopy were recruited in this study. Blood samples were taken on days 1, 2, 3 and 7 for parasite count and blood levels of lumefantrine, artemisinin, desbutyl-lumefantrine (DBL), and dihydroartemisinin (DHA), the active metabolites of lumefantrine and artemether, respectively, were analysed using established methods. Pharmacogene variation analysis was undertaken using iPLEX microarray and PCR-RFLP. RESULTS A total of 52 patients completed the study. Median parasite density from day 1 to 7 ranged from 0-2666/μL of blood, with days 3 and 7 recording 0 parasite density. Highest median plasma concentration for lumefantrine and desbutyl lumefantrine, which are the long-acting components of artemisinin-based combinations, was 4123.75 ng/mL and 35.87 ng/mL, respectively. Day 7 plasma lumefantrine concentration across all generic ACT brands was ≥ 200 ng/mL which potentially accounted for the parasitaemia profile observed. Monomorphism was observed for CYP3A4 variants, while there were observed variations in CYP2B6 and CYP3A5 alleles. Among the CYP3A5 genotypes, significant differences in genotypes and plasma concentration for DBL were seen on day 3 between 1/*1 versus *1/*6 (p = 0.002), *1/*3 versus *1/*6 (p = 0.006) and *1/*7 versus *1/*6 (p = 0.008). Day 7 plasma DBL concentrations showed a significant difference between *1/*6 and *1/*3 (p = 0.026) expressors. CONCLUSIONS The study findings show that CYP2B6 and CYP3A5 pharmacogenetic variations may lead to higher plasma exposure of AL metabolites.
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Affiliation(s)
- Nicholas Ekow Thomford
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
| | - Tracy Kellermann
- Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert Peter Biney
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Pharmacotherpaeutics and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Charné Dixon
- Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Samuel Badu Nyarko
- Pharmacogenomics and Genomic Medicine Group, Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richmond Owusu Ateko
- Department of Chemical Pathology, University of Ghana Medical School, University of Ghana, Legon, Accra, Ghana
- Division of Chemical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Martins Ekor
- Department of Pharmacology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - George B Kyei
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Moukénet A, Moudiné K, Ngarasta N, Hinzoumbe CK, Seck I. Malaria infection and predictor factors among Chadian nomads' children. BMC Public Health 2024; 24:918. [PMID: 38549091 PMCID: PMC10979592 DOI: 10.1186/s12889-024-18454-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In Chad, malaria remains a significant public health concern, particularly among nomadic populations. Geographical factors and the mobility of human populations have shown to be associated with the diversity of Plasmodium species. The study aims to describe the malaria prevalence among nomadic children and to investigate its associated factors. METHODS A cross-sectional study was conducted in February and October 2021 among nomadic communities in Chad. Blood sample were collected and tested from 187 Arab, Fulani and Dazagada nomadic children aged 3-59 months using malaria rapid diagnostic test (RDT). A structured electronic questionnaire was administered to their parents to collect information about the socio‑economic data. Malaria testing results were categorized according to the SD BIOLINE Malaria Ag Pf/Pan RDT procedures. Logistic regression analysis was used to determine key risk factors explaining the prevalence of malaria. STATA version IC 13 was used for statistical analysis. RESULTS The overall malaria prevalence in nomadic children was 24.60%, with 65.20% being Plasmodium falciparum species and 34.8% mixed species. Boys were twice as likely (COR = 1.83; 95% CI, 0.92-3.62; p = 0.083) to have malaria than girls. Children whose parents used to seek traditional drugs were five times more likely (AOR = 5.59; 95% CI, 1.40-22.30, p = 0.015) to have malaria than children whose parents used to seek health facilities. Children whose parents reported spending the last night under a mosquito net were one-fifth as likely (AOR = 0.17; 95% CI, 0.03-0.90, p = 0.037) to have malaria compared to children whose parents did not used a mosquito net. Furthermore, Daza children were seventeen times (1/0.06) less likely (AOR = 0.06; 95% CI, 0.01-0.70, p = 0.024) to have malaria than Fulani children and children from households piped water as the main source were seven times more likely (AOR = 7.05; 95% CI, 1.69-29.45; p = 0.007) to have malaria than those using surface water. CONCLUSIONS Malaria remains a significant public health issue in the nomadic communities of Chad. Community education and sensitization programs within nomad communities are recommended to raise awareness about malaria transmission and control methods, particularly among those living in remote rural areas. The National Malaria Control Program (NMCP) should increase both the coverage and use of long-lasting insecticidal nets (LLINs) and seasonal malaria chemoprevention (SMC) in addition to promoting treatment-seeking behaviors in nomadic communities.
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Affiliation(s)
- Azoukalné Moukénet
- Cheikh Anta Diop University, Dakar, Senegal.
- University of Ndjamena, Ndjamena, Chad.
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Tetteh JA, Djissem PE, Manyeh AK. Prevalence, trends and associated factors of malaria in the Shai-Osudoku District Hospital, Ghana. Malar J 2023; 22:131. [PMID: 37087510 PMCID: PMC10122813 DOI: 10.1186/s12936-023-04561-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: 03/04/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Even though malaria is easily preventable and treatable, it continues to have a devastating impact on people's health and livelihoods around the world. Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. This study seeks to assess the prevalence, trends and factors associated with malaria in the Shai-Osudoku District Hospital, Ghana. METHODS A cross-sectional study was conducted to determine the prevalence, trend, and factors associated with malaria in the Shai-Osudoku District Hospital; a 10-month secondary data was extracted from February to November 2020. The extracted data were entered into Epi Data version 6 and analysed using STATA version 16. Descriptive analysis was performed to determine the prevalence, trend and socio-demographic characteristics of study participants. Simple logistic regression at a 95% confidence level was performed to investigate socio-demographic factors associated with malaria infection. Tables and charts with summary statistics were used to present the results. RESULTS Secondary data from 3896 individuals were included in the study. The age of the participants range from 0.8 to 101 years with a mean age of 32.5. The estimated prevalence of malaria during the study period is 20.9%. A majority (79.1%) of the participants who presented signs and symptoms of malaria were negative after testing. The prevalence of malaria cases increased progressively from 6.7 to 55.4% across the ten months. The simple logistic regression at a 95% confidence level revealed that age group, sex, residential status, religion, occupation and marital status were statistically significantly associated with malaria. The results shows that persons who tested positive for malaria were mostly treated with artemether-lumefantrine (46.1%), some malaria positive cases were given artesunate injection (11.6%), dihydroartemisinin-piperaquine (16.2%) and oral artemether-lumefantrine (6.5%). Surprisingly 19.6% of the malaria-positive cases were not given any form of malaria medication. CONCLUSION Factors found to influence malaria infection in the Shai-Osudoku District Hospital include participant's age, sex, residential status, religious affiliation occupation and marital status. The findings of this study showed that malaria remains a serious public health problem in the Shai Osudoku District Hospital. The information obtained from this study can guide the implementation of malaria prevention, control and elimination strategies in Ghana.
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Affiliation(s)
- Jessica Ashiakie Tetteh
- Fred N Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Volta Region, Ghana
| | - Patrick Elorm Djissem
- Fred N Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Volta Region, Ghana
| | - Alfred Kwesi Manyeh
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana.
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Alenou LD, Nwane P, Mbakop LR, Piameu M, Ekoko W, Mandeng S, Bikoy EN, Toto JC, Onguina H, Etang J. Burden of mosquito-borne diseases across rural versus urban areas in Cameroon between 2002 and 2021: prospective for community-oriented vector management approaches. Parasit Vectors 2023; 16:136. [PMID: 37076896 PMCID: PMC10114431 DOI: 10.1186/s13071-023-05737-w] [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: 12/16/2022] [Accepted: 03/12/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Over the past two decades, Cameroon has recorded one of the highest rates of urban population growth in sub-Saharan Africa. It is estimated that more than 67% of Cameroon's urban population lives in slums, and the situation is far from improving as these neighbourhoods are growing at an annual rate of 5.5%. However, it is not known how this rapid and uncontrolled urbanization affects vector populations and disease transmission in urban versus rural areas. In this study, we analyse data from studies conducted on mosquito-borne diseases in Cameroon between 2002 and 2021 to determine the distribution of mosquito species and the prevalence of diseases they transmit with regards to urban areas versus rural areas. METHODS A search of various online databases, such as PubMed, Hinari, Google and Google Scholar, was conducted for relevant articles. A total of 85 publications/reports were identified and reviewed for entomological and epidemiological data from the ten regions of Cameroon. RESULTS Analysis of the findings from the reviewed articles revealed 10 diseases transmitted by mosquitoes to humans across the study regions. Most of these diseases were recorded in the Northwest Region, followed by the North, Far North and Eastern Regions. Data were collected from 37 urban and 28 rural sites. In the urban areas, dengue prevalence increased from 14.55% (95% confidence interval [CI] 5.2-23.9%) in 2002-2011 to 29.84% (95% CI 21-38.7%) in 2012-2021. In rural areas, diseases such as Lymphatic filariasis and Rift valley fever, which were not present in 2002-2011, appeared in 2012-2021, with a prevalence of 0.4% (95% CI 0.0- 2.4%) and 10% (95% CI 0.6-19.4%), respectively. Malaria prevalence remained the same in urban areas (67%; 95% CI 55.6-78.4%) between the two periods, while it significantly decreased in rural areas from 45.87% (95% CI 31.1-60.6%) in 2002-2011 to 39% (95% CI 23.7-54.3%) in the 2012-2021 period (*P = 0.04). Seventeen species of mosquitoes were identified as involved in the transmission of these diseases, of which 11 were involved in the transmission of malaria, five in the transmission of arboviruses and one in the transmission of malaria and lymphatic filariasis. The diversity of mosquito species was greater in rural areas than in urban areas during both periods. Of the articles reviewed for the 2012-2021 period, 56% reported the presence of Anopheles gambiae sensu lato in urban areas compared to 42% reported in 2002-2011. The presence of Aedes aegypti increased in urban areas in 2012-2021 but this species was absent in rural areas. Ownership of long-lasting insecticidal nets varied greatly from one setting to another. CONCLUSIONS The current findings suggest that, in addition to malaria control strategies, vector-borne disease control approaches in Cameroon should include strategies against lymphatic filariasis and Rift Valley fever in rural areas, and against dengue and Zika viruses in urban areas.
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Affiliation(s)
- Leo Dilane Alenou
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701, Douala, Cameroon.
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon.
| | - Philippe Nwane
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Lili Ranaise Mbakop
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
| | - Michael Piameu
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- School of Health Sciences, Catholic University of Central Africa, P.O. Box 1110, Yaounde, Cameroon
| | - Wolfgang Ekoko
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Biology and Physiology, University of Bamenda, Bambili, P.O. Box 39, Douala, Cameroon
| | - Stanislas Mandeng
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Elisabeth Ngo Bikoy
- Department of Animal Biology and Physiology, Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Jean Claude Toto
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
| | - Hugues Onguina
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon
| | - Josiane Etang
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701, Douala, Cameroon.
- Malaria Research Laboratory, Yaoundé Research Institute (IRY), Organization for the Coordination of Endemic Diseases' Control in Central Africa (OCEAC), P.O. Box 288, Yaoundé, Cameroon.
- Department of Insect Biotechnology in Plant Protection, Institute for Insect Biotechnology, Faculty 09-Agricultural Sciences, Nutritional Sciences and Environmental Management, Justus-Liebig-University Gießen, Winchester Str. 2, 35394, Giessen, Germany.
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Mbacham HF, Mosume DM, Apinjoh TO, Ntui VN, Moyeh MN, Kalaji LN, Wepnje GB, Ghogomu SM, Dionne JA, Tita AT, Achidi EA, Anchang-Kimbi JK. Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine-pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region. Malar J 2023; 22:73. [PMID: 36864514 PMCID: PMC9979436 DOI: 10.1186/s12936-023-04485-7] [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: 10/13/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Plasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area. METHODS Consenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. The dhps mutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined. RESULTS Among the women, the prevalence of microscopic and sub-microscopic P. falciparum infection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29-6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31-3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77-5.13), primigravidity (AOR = 0.45; 95% CI 0.21-0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27-0.90). Of the145 P. falciparum isolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59-19.42), to report history of fever (AOR = 2.6; 95% CI 1.07-6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85-23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07-6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection. CONCLUSION The occurrence of sub-microscopic P. falciparum parasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical.
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Affiliation(s)
- Harry F. Mbacham
- grid.29273.3d0000 0001 2288 3199Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Diange M Mosume
- grid.29273.3d0000 0001 2288 3199Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Tobias O. Apinjoh
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Vincent N. Ntui
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Marcel N. Moyeh
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Laken N. Kalaji
- grid.29273.3d0000 0001 2288 3199Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Godlove B. Wepnje
- grid.29273.3d0000 0001 2288 3199Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Stephen M Ghogomu
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Jodie A Dionne
- grid.265892.20000000106344187Department of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Alan T.N. Tita
- grid.265892.20000000106344187Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, USA
| | - Eric A. Achidi
- grid.29273.3d0000 0001 2288 3199Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Judith K. Anchang-Kimbi
- grid.29273.3d0000 0001 2288 3199Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
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Effects of Age, Gender and Soil-Transmitted Helminth Infection on Prevalence of Plasmodium Infection among Population Living in Bata District, Equatorial Guinea. Trop Med Infect Dis 2023; 8:tropicalmed8030149. [PMID: 36977150 PMCID: PMC10059851 DOI: 10.3390/tropicalmed8030149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction: Malaria and soil-transmitted helminth (STH) co-infection is an important parasitic infection affecting populations in co-endemic countries including Equatorial Guinea. To date, the health impact of STH and malaria co-infection is inconclusive. The current study aimed to report the malaria and STH infection epidemiology in the continental region of Equatorial Guinea. Methods: We performed a cross-sectional study between October 2020 and January 2021 in the Bata district of Equatorial Guinea. Participants aged 1–9 years, 10–17 years and above 18 were recruited. Fresh venous blood was collected for malaria testing via mRDTs and light microscopy. Stool specimens were collected, and the Kato–Katz technique was used to detect the presence of Ascaris lumbricoides, Trichuris trichiura, hookworm spp. and intestinal Schistosoma eggs. Results: A total of 402 participants were included in this study. An amount of 44.3% of them lived in urban areas, and only 51.9% of them reported having bed nets. Malaria infections were detected in 34.8% of the participants, while 50% of malaria infections were reported in children aged 10–17 years. Females had a lower prevalence of malaria (28.8%) compared with males (41.7%). Children of 1–9 years carried more gametocytes compared with other age groups. An amount of 49.3% of the participants infected with T. trichiura had malaria parasites compared with those infected with A. lumbricoides (39.6%) or both (46.8%). Conclusions: The overlapping problem of STH and malaria is neglected in Bata. The current study forces the government and other stakeholders involved in the fight against malaria and STH to consider a combined control program strategy for both parasitic infections in Equatorial Guinea.
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Ochwedo KO, Omondi CJ, Magomere EO, Olumeh JO, Debrah I, Onyango SA, Orondo PW, Ondeto BM, Atieli HE, Ogolla SO, Githure J, Otieno ACA, Githeko AK, Kazura JW, Mukabana WR, Guiyan Y. Hyper-prevalence of submicroscopic Plasmodium falciparum infections in a rural area of western Kenya with declining malaria cases. Malar J 2021; 20:472. [PMID: 34930283 PMCID: PMC8685826 DOI: 10.1186/s12936-021-04012-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The gold standard for diagnosing Plasmodium falciparum infection is microscopic examination of Giemsa-stained peripheral blood smears. The effectiveness of this procedure for infection surveillance and malaria control may be limited by a relatively high parasitaemia detection threshold. Persons with microscopically undetectable infections may go untreated, contributing to ongoing transmission to mosquito vectors. The purpose of this study was to determine the magnitude and determinants of undiagnosed submicroscopic P. falciparum infections in a rural area of western Kenya. METHODS A health facility-based survey was conducted, and 367 patients seeking treatment for symptoms consistent with uncomplicated malaria in Homa Bay County were enrolled. The frequency of submicroscopic P. falciparum infection was measured by comparing the prevalence of infection based on light microscopic inspection of thick blood smears versus real-time polymerase chain reaction (RT-PCR) targeting P. falciparum 18S rRNA gene. Long-lasting insecticidal net (LLIN) use, participation in nocturnal outdoor activities, and gender were considered as potential determinants of submicroscopic infections. RESULTS Microscopic inspection of blood smears was positive for asexual P. falciparum parasites in 14.7% (54/367) of cases. All of these samples were confirmed by RT-PCR. 35.8% (112/313) of blood smear negative cases were positive by RT-PCR, i.e., submicroscopic infection, resulting in an overall prevalence by RT-PCR alone of 45.2% compared to 14.7% for blood smear alone. Females had a higher prevalence of submicroscopic infections (35.6% or 72 out of 202 individuals, 95% CI 28.9-42.3) compared to males (24.2%, 40 of 165 individuals, 95% CI 17.6-30.8). The risk of submicroscopic infections in LLIN users was about half that of non-LLIN users (OR = 0.59). There was no difference in the prevalence of submicroscopic infections of study participants who were active in nocturnal outdoor activities versus those who were not active (OR = 0.91). Patients who participated in nocturnal outdoor activities and use LLINs while indoors had a slightly higher risk of submicroscopic infection than those who did not use LLINs (OR = 1.48). CONCLUSION Microscopic inspection of blood smears from persons with malaria symptoms for asexual stage P. falciparum should be supplemented by more sensitive diagnostic tests in order to reduce ongoing transmission of P. falciparum parasites to local mosquito vectors.
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Affiliation(s)
- Kevin O. Ochwedo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Collince J. Omondi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Edwin O. Magomere
- Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya
| | - Julius O. Olumeh
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Isaiah Debrah
- West Africa Centre for Cell Biology of Infectious Pathogen, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Shirley A. Onyango
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Pauline W. Orondo
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Benyl M. Ondeto
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Harrysone E. Atieli
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Sidney O. Ogolla
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - John Githure
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Antony C. A. Otieno
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Andrew K. Githeko
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - James W. Kazura
- Centre for Global Health and Diseases, Case Western Reserve University, Cleveland, OH USA
| | - Wolfgang R. Mukabana
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya
| | - Yan Guiyan
- Program in Public Health, College of Health Sciences, University of California, Irvine, USA
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Awosolu OB, Yahaya ZS, Farah Haziqah MT. Prevalence, Parasite Density and Determinants of Falciparum Malaria Among Febrile Children in Some Peri-Urban Communities in Southwestern Nigeria: A Cross-Sectional Study. Infect Drug Resist 2021; 14:3219-3232. [PMID: 34434052 PMCID: PMC8380643 DOI: 10.2147/idr.s312519] [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: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Malaria remains a serious public health problem worldwide, particularly in tropical and subtropical regions, including Nigeria. This study investigates the prevalence, parasite density and determinants of malaria among symptomatic children in some peri-urban communities in southwestern Nigeria. Methods This was a randomized cross-sectional and hospital-based study. The standard method of microscopy was employed. Thick and thin films were prepared and viewed under a light microscope to identify and quantify malaria parasites. A well-structured and pre-tested questionnaire was used to obtain the subject’s information on the demographic, socio-economic and environmental variables. Results A total of 380 (71.7%) participants were infected with Plasmodium falciparum with a mean parasite density of 1857.11 parasite/µL of blood. Malaria prevalence and mean parasite density were significantly higher among male compared to their female counterparts [80.3% vs 61.4% and 2026.46 vs 1619.63 parasite/µL of blood]. Similarly, age group ≤5 years had the highest malaria prevalence (92.2%) and mean parasite density (2031.66 parasite/µL of blood) than other age groups (AOR 2.281, 95% CI: 1.187–4.384, P < 0.05). The multivariate logistic analysis showed that malaria disease is significantly associated with having mother with no formal education (AOR 12.235, 95% CI: 3.253–46.021, P < 0.05), having well and river as a major source of household water supply (AOR 13.810, 95% CI: 3.012–63.314, P < 0.05 vs AOR 5.639, 95% CI: 1.455–21.853, P < 0.05) and presence of stagnant water around home (AOR 5.22, 95% CI: 2.921–9.332, P < 0.05). Furthermore, protective factors observed include ownership of mosquito bed net (AOR 0.474, 95% CI: 0.223–1.008, P < 0.05) and distance of home to hospital (AOR 0.279, 95% CI: 0.158–0.493, P < 0.05). Conclusion Malaria remains a serious public health problem in the study area. Adopting integrated malaria control measures including educating parents on malaria prevention and control strategies, distributing mosquito bed nets, and establishing larvae source management program is highly imperative.
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Affiliation(s)
- Oluwaseun Bunmi Awosolu
- School of Biological Sciences, Universiti Sains Malaysia, Penang, 11800 USM, Malaysia.,Department of Biology, Federal University of Technology, Akure, Nigeria
| | - Zary Shariman Yahaya
- School of Biological Sciences, Universiti Sains Malaysia, Penang, 11800 USM, Malaysia
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