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Montiel Ishino FA, Rowan C, Talham C, Villalobos K, Poudel D, Rajbhandari-Thapa J, Ambikile JS, Williams F. Household profiles of neglected tropical disease symptoms among children: A latent class analysis of built-environment features of Tanzanian households using the Demographic and Health Survey. J Glob Health 2022; 12:04067. [PMID: 36057837 PMCID: PMC9441010 DOI: 10.7189/jogh.12.04067] [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] [Indexed: 11/29/2022] Open
Abstract
Background While malaria and neglected tropical disease (NTD) morbidity and mortality rates among children <5 years old have decreased through public health efforts in the United Republic of Tanzania, associations between household environments and disease outcomes are relatively unknown. Methods We conducted latent class analysis (LCA) on 2015-2016 Tanzania Demographic Health Survey data from mothers with children <5 years old (N = 10 233) to identify NTD household risk profiles. The outcome of child NTD was assessed by mothers’ reports of recent diarrhoea, cough, treatment for enteric parasites, and fever symptoms. Household-built environment indicators included urban/rural designation, electricity access, water source, cooking fuel, flooring, wall, and roofing materials. External environmental covariates were considered to further differentiate profiles. Results Five profiles were identified in the sample: rural finished walls households (40.2%) with the lowest NTD risk; rural rudimentary households (20.9%) with intermediate-low NTD risk; finished material households (22.5%) with intermediate NTD risk; urban households (14.4%) with intermediate-high NTD risk and high likelihood of enteric parasites; rural finished roof/walls households (2.1%) with the highest overall NTD risk. Conclusions This study is among the first to use LCA to examine household environment characteristics to assess child NTD risk in Tanzania. This paper serves as a framework for community-level rapid NTD risk assessment for targeted health promotion interventions.
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Affiliation(s)
- Francisco A Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Claire Rowan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Charlotte Talham
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Dikshit Poudel
- Department of Agricultural and Applied Economics, College of Agricultural and Environmental Science, University of Georgia, Athens, Georgia, USA
| | - Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Joel Seme Ambikile
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Rejeki DSS, Solikhah S, Wijayanti SPM. Risk Factors Analysis of Malaria Transmission at Cross-Boundaries Area in Menoreh Hills, Java, Indonesia. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1816-1824. [PMID: 34722377 PMCID: PMC8542814 DOI: 10.18502/ijph.v50i9.7054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/17/2020] [Indexed: 12/04/2022]
Abstract
Background: Risk factors of Malaria transmission at cross-boundaries area is important to be identified. This study aimed to identify the risk factors of Malaria transmission at cross-boundaries area in Menoreh Hills, Java, Indonesia. Methods: The design of the study was an observational study with a case-control design. Data on malaria cases and controls were obtained from the Primary Health Care in Menoreh. All malaria positive patients with clinical and laboratory examinations recorded in health services during 1 Jan 2015–31 Dec 2015. Overall, 138 cases and 138 controls were included. Several variables were collected such as altitude, night out behavior, the use of mosquito nets, nighttime bed, travel history, mosquito bite prevention activities, cattle ownership, distance to mosquito breeding site, etc. Data were obtained by structured questionnaires and observation. Data were analyzed by univariate, bivariate and multivariate Results: The altitude of house >500 m above sea level proved to be influential as a risk factor for Malaria (OR 3.62, 95% CI 1.61–8.16, P=0.002). Several variables were identified as a risk factor of Malaria such as the wall of the house from bamboo/wood, no insecticide and distance of house <100 m from mosquito breeding site. Conclusion: An awareness for the local health sector particularly to provide a recommendation for house construction to protect a community from Malaria transmission.
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Affiliation(s)
- Dwi Sarwani Sri Rejeki
- Department of Public Health, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Siwi Pramatama M Wijayanti
- Department of Public Health, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
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Mohan I, Kodali NK, Chellappan S, Karuppusamy B, Behera SK, Natarajan G, Balabaskaran Nina P. Socio-economic and household determinants of malaria in adults aged 45 and above: analysis of longitudinal ageing survey in India, 2017-2018. Malar J 2021; 20:306. [PMID: 34233690 PMCID: PMC8265067 DOI: 10.1186/s12936-021-03840-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Even though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016–2030) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid India’s malaria elimination efforts. Methods The data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017–2018) survey comprising 70,671 respondents ≥ 45 years across all the States and Union Territories were used for the analysis. Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables. Results The major socio-economic variables that increase the likelihood of malaria are caste (‘scheduled tribes’), low education levels and rural residence. The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5–2.1). Respondents with high school education (6–12 grade) (AOR: 0.7; 95% CI: 0.6–0.8) and college education (AOR: 0.5; 95% CI: 0.4–0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥ 6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling. Conclusions The study has identified the major socio-economic and housing factors associated with malaria in adults aged 45 and above. In addition to vector and parasite control strategies in the tribal dominated regions of India, improving literacy and housing conditions may help India’s malaria elimination efforts.
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Affiliation(s)
- Indumathi Mohan
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Naveen Kumar Kodali
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | | | | | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Gopalan Natarajan
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Praveen Balabaskaran Nina
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India.
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Sharma RK, Rajvanshi H, Bharti PK, Nisar S, Jayswar H, Mishra AK, Saha KB, Shukla MM, Das A, Kaur H, Wattal SL, Lal AA. Socio-economic determinants of malaria in tribal dominated Mandla district enrolled in Malaria Elimination Demonstration Project in Madhya Pradesh. Malar J 2021; 20:7. [PMID: 33402186 PMCID: PMC7786971 DOI: 10.1186/s12936-020-03540-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023] Open
Abstract
Background Malaria is known as a disease of poverty because of its dominance in poverty-stricken areas. Madhya Pradesh state in central India is one of the most vulnerable states for malaria morbidity and mortality. Socio-economic, environmental and demographic factors present challenges in malaria control and elimination. As part of the Malaria Elimination Demonstration Project in the tribal district of Mandla in Madhya Pradesh, this study was undertaken to assess the role of different social-economic factors contributing to malaria incidence. Methods The study was conducted in the 1233 villages of district Mandla, where 87% population resides in rural areas. The data was collected using the android based mobile application—SOCH for a period of 2 years (September 2017 to August 2019). A wealth index was computed along with analysis of the socio-economic characteristics of houses with malaria cases. Variables with significant variation in malaria cases were used in logistic regression. Results More than 70% of houses in Mandla are Kuccha (made of thatched roof or mud), 20% do not have any toilet facilities, and only 11% had an annual income of more than 50,000 INR, which converts to about $700 per year. Households with younger heads, male heads, more number of family members were more likely to have malaria cases. Kuccha construction, improper water supply, low household income houses were also more likely to have a malaria case and the odds doubled in houses with no toilet facilities. Conclusion Based on the results of the study, it has been found that there is an association between the odds of having malaria cases and different household variables such as age, gender, number of members, number of rooms, caste, type of house, toilet facilities, water supply, cattle sheds, agricultural land, income, and vector control interventions. Therefore, a better understanding of the association of various risk factors that influence the incidence of malaria is required to design and/or deploy effective policies and strategies for malaria elimination. The results of this study suggest that appropriate economic and environmental interventions even in low-income and poverty-stricken tribal areas could have huge impact on the success of the national malaria elimination goals.
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Affiliation(s)
- Ravendra K Sharma
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
| | - Harsh Rajvanshi
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Praveen K Bharti
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Sekh Nisar
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Himanshu Jayswar
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal, India
| | - Ashok K Mishra
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Kalyan B Saha
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Man Mohan Shukla
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Aparup Das
- Indian Council of Medical Research-National Institute of Research in Tribal Health, (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Harpreet Kaur
- Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | - Suman L Wattal
- National Vector Borne Disease Control Program, Ministry of Health and Family Welfare, New Delhi, India
| | - Altaf A Lal
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India.,Foundation for Disease Elimination and Control of India, Mumbai, Maharashtra, India
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Maseko A, Nunu WN. Risk factors associated with high malaria incidence among communities in selected wards in Binga district, Zimbabwe: a case-control study. SCIENTIFIC AFRICAN 2020. [DOI: 10.1016/j.sciaf.2020.e00473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Jahan F, Khan NH, Wahid S, Ullah Z, Kausar A, Ali N. Malaria epidemiology and comparative reliability of diagnostic tools in Bannu; an endemic malaria focus in south of Khyber Pakhtunkhwa, Pakistan. Pathog Glob Health 2019; 113:75-85. [PMID: 30894081 DOI: 10.1080/20477724.2019.1595904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The present study was aimed at elucidation of malaria epidemiology and comparing performance of several diagnostic procedures in Bannu, a highly endemic district of Khyber Pakhtunkhwa, Pakistan. Dried blood spots were collected from patients suspected of malaria visiting a hospital and two private laboratories in district Bannu and processed for species-specific PCR (rRNA). Patients were also screened for malaria through microscopy and RDT. A well-structured questionnaire was used to collect patient information to assess risk factors for malaria. Of 2033 individuals recruited, 21.1% (N = 429) were positive for malaria by at least one method. Overall, positivity detected by PCR was 30.5% (95/311) followed by 17.7% by microscopy (359/2033) and 16.4% by RDT (266/1618). Plasmodium vivax (16.9%, N = 343) was detected as the dominant species followed by Plasmodium falciparum (2.3%, N = 47) and mixed infections (1.2%, N = 39). Microscopy and RDT (Cohen's kappa k = 0.968, p = <0.0001, McNemar test p = 0.069) displayed significant agreement with each other. Satisfactory health, sleeping indoors, presence of health-care facility in vicinity (at an accessible range from home), living in upper middle class and in concrete houses significantly reduced malaria risk; whereas, low literacy level, presence of domestic animals indoors and malaria diagnosis recommended by clinician increased the disease risk. Overall, findings from the study provide reasonable basis for use of RDT as a cost-effective screening tool in field and for clinicians who can proceed with timely treatment of malaria patients. Appropriate management of identified risk factors could contribute to reduction of malaria prevalence in Bannu and its peripheries.
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Affiliation(s)
- Fatima Jahan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Nazma Habib Khan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Sobia Wahid
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Zaki Ullah
- b Department of Pharmacy , University of Peshawar , Peshawar , Pakistan
| | - Aisha Kausar
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Naheed Ali
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
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Kesteman T, Randrianarivelojosia M, Rogier C. The protective effectiveness of control interventions for malaria prevention: a systematic review of the literature. F1000Res 2017; 6:1932. [PMID: 29259767 PMCID: PMC5721947 DOI: 10.12688/f1000research.12952.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 12/22/2022] Open
Abstract
Background: Thanks to a considerable increase in funding, malaria control interventions (MCI) whose efficacy had been demonstrated by controlled trials have been largely scaled up during the last decade. Nevertheless, it was not systematically investigated whether this efficacy had been preserved once deployed on the field. Therefore, we sought the literature to assess the disparities between efficacy and effectiveness and the effort to measure the protective effectiveness (PE) of MCI. Methods: The PubMed database was searched for references with keywords related to malaria, to control interventions for prevention and to study designs that allow for the measure of the PE against parasitemia or against clinical outcomes. Results: Our search retrieved 1423 references, and 162 articles were included in the review. Publications were scarce before the year 2000 but dramatically increased afterwards. Bed nets was the MCI most studied (82.1%). The study design most used was a cross-sectional study (65.4%). Two thirds (67.3%) were conducted at the district level or below, and the majority (56.8%) included only children even if the MCI didn’t target only children. Not all studies demonstrated a significant PE from exposure to MCI: 60.6% of studies evaluating bed nets, 50.0% of those evaluating indoor residual spraying, and 4/8 showed an added PE of using both interventions as compared with one only; this proportion was 62.5% for intermittent preventive treatment of pregnant women, and 20.0% for domestic use of insecticides. Conclusions: This review identified numerous local findings of low, non-significant PE –or even the absence of a protective effect provided by these MCIs. The identification of such failures in the effectiveness of MCIs advocates for the investigation of the causes of the problem found. Ideal evaluations of the PE of MCIs should incorporate both a large representativeness and an evaluation of the PE stratified by subpopulations.
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Affiliation(s)
- Thomas Kesteman
- Fondation Mérieux, Lyon, France.,Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Christophe Rogier
- Malaria Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.,Ecole doctorale Sciences de la vie et de l'environnement, Université d'Antananarivo, Antananarivo, Madagascar.,Institute for Biomedical Research of the French Armed Forces (IRBA), Brétigny-Sur-Orge , France.,Unité de recherche sur les maladies infectieuses et tropicales émergentes - (URMITE), Marseille, France
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8
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Smith JL, Auala J, Haindongo E, Uusiku P, Gosling R, Kleinschmidt I, Mumbengegwi D, Sturrock HJW. Malaria risk in young male travellers but local transmission persists: a case-control study in low transmission Namibia. Malar J 2017; 16:70. [PMID: 28187770 PMCID: PMC5303241 DOI: 10.1186/s12936-017-1719-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/03/2017] [Indexed: 11/24/2022] Open
Abstract
Background A key component of malaria elimination campaigns is the identification and targeting of high risk populations. To characterize high risk populations in north central Namibia, a prospective health facility-based case–control study was conducted from December 2012–July 2014. Cases (n = 107) were all patients presenting to any of the 46 health clinics located in the study districts with a confirmed Plasmodium infection by multi-species rapid diagnostic test (RDT). Population controls (n = 679) for each district were RDT negative individuals residing within a household that was randomly selected from a census listing using a two-stage sampling procedure. Demographic, travel, socio-economic, behavioural, climate and vegetation data were also collected. Spatial patterns of malaria risk were analysed. Multivariate logistic regression was used to identify risk factors for malaria. Results Malaria risk was observed to cluster along the border with Angola, and travel patterns among cases were comparatively restricted to northern Namibia and Angola. Travel to Angola was associated with excessive risk of malaria in males (OR 43.58 95% CI 2.12–896), but there was no corresponding risk associated with travel by females. This is the first study to reveal that gender can modify the effect of travel on risk of malaria. Amongst non-travellers, male gender was also associated with a higher risk of malaria compared with females (OR 1.95 95% CI 1.25–3.04). Other strong risk factors were sleeping away from the household the previous night, lower socioeconomic status, living in an area with moderate vegetation around their house, experiencing moderate rainfall in the month prior to diagnosis and living <15 km from the Angolan border. Conclusions These findings highlight the critical need to target malaria interventions to young male travellers, who have a disproportionate risk of malaria in northern Namibia, to coordinate cross-border regional malaria prevention initiatives and to scale up coverage of prevention measures such as indoor residual spraying and long-lasting insecticide nets in high risk areas if malaria elimination is to be realized. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1719-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer L Smith
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA.
| | - Joyce Auala
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia
| | - Erastus Haindongo
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia
| | - Petrina Uusiku
- National Vector-Borne Disease Control Programme, Ministry of Health and Social Services, Windhoek, Namibia
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA
| | - Immo Kleinschmidt
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Davis Mumbengegwi
- Multidisciplinary Research Center, University of Namibia, Windhoek, Namibia
| | - Hugh J W Sturrock
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA
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Quispe AM, Llanos-Cuentas A, Rodriguez H, Clendenes M, Cabezas C, Leon LM, Chuquiyauri R, Moreno M, Kaslow DC, Grogl M, Herrera S, Magill AJ, Kosek M, Vinetz JM, Lescano AG, Gotuzzo E. Accelerating to Zero: Strategies to Eliminate Malaria in the Peruvian Amazon. Am J Trop Med Hyg 2016; 94:1200-1207. [PMID: 30851016 PMCID: PMC4889734 DOI: 10.4269/ajtmh.15-0369] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AbstractIn February 2014, the Malaria Elimination Working Group, in partnership with the Peruvian Ministry of Health (MoH), hosted its first international conference on malaria elimination in Iquitos, Peru. The 2-day meeting gathered 85 malaria experts, including 18 international panelists, 23 stakeholders from different malaria-endemic regions of Peru, and 11 MoH authorities. The main outcome was consensus that implementing a malaria elimination project in the Amazon region is achievable, but would require: 1) a comprehensive strategic plan, 2) the altering of current programmatic guidelines from control toward elimination by including symptomatic as well as asymptomatic individuals for antimalarial therapy and transmission-blocking interventions, and 3) the prioritization of community-based active case detection with proper rapid diagnostic tests to interrupt transmission. Elimination efforts must involve key stakeholders and experts at every level of government and include integrated research activities to evaluate, implement, and tailor sustainable interventions appropriate to the region.
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Affiliation(s)
- Antonio M. Quispe
- *Address correspondence to Antonio M. Quispe, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205. E-mail:
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Sharma RK, Singh MP, Saha KB, Bharti PK, Jain V, Singh PP, Silawat N, Patel R, Hussain M, Chand SK, Pandey A, Singh N. Socio-economic & household risk factors of malaria in tribal areas of Madhya Pradesh, central India. Indian J Med Res 2016; 141:567-75. [PMID: 26139773 PMCID: PMC4510754 DOI: 10.4103/0971-5916.159515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background & objectives: Malaria is a major public health problem in many States of the country, particularly, in Madhya Pradesh where both Plasmodium vivax and P. falciparum are endemic. Although many studies have been conducted to investigate risk factors for malaria, but only a few have examined household and socio-economic risk factors. The present study was, therefore, undertaken to explore the relationship of different socio-demographic, socio-economic and behavioural risk factors with malaria prevalence in tribal areas of Madhya Pradesh, India. Methods: This study was undertaken in all 62 villages of Bargi Primary Health Centre from May 2005 to June 2008. These villages comprised 7117 households with an average family size of five members. Fortnightly fever surveys were conducted in all villages to assess prevalence of malaria infection in the community. The distinct univariate and multivariate logistic regression models were fitted on the data set. Results: The important socio-demographic risk factors like age of household head, social group, occupation and family size; socio-economic factors like type of walls of house, place of drinking water source, irrigated land, cash crop; and behavioural variables like place of sleeping, use of bed nets, etc. were found significantly associated with malaria in univariate analyses. In multivariate analyses only social groups, family size, type of walls of house, and place of sleeping had strong significant association with prevalence of malaria. Interpretation & conclusions: The study shows that in tribal areas where people are living in poor quality of houses with no proper use of preventive measures, malaria is firmly established. We conclude that community based interventions which bring improvement in standard of living, access to healthcare facilities and health awareness, will have a significant impact on malaria prevention in these areas.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Neeru Singh
- National Institue for Research in Tribal Health (ICMR); National Institute of Malaria Research (Field Station) (ICMR), Jabalpur, Madhya Pradesh, India
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11
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Kesteman T, Randrianarivelojosia M, Raharimanga V, Randrianasolo L, Piola P, Rogier C. Effectiveness of malaria control interventions in Madagascar: a nationwide case-control survey. Malar J 2016; 15:83. [PMID: 26867661 PMCID: PMC4751752 DOI: 10.1186/s12936-016-1132-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Madagascar, as other malaria endemic countries, depends mainly on international funding for the implementation of malaria control interventions (MCI). As these funds no longer increase, policy makers need to know whether these MCI actually provide the expected protection. This study aimed at measuring the effectiveness of MCI deployed in all transmission patterns of Madagascar in 2012–2013 against the occurrence of clinical malaria cases. Methods From September 2012 to August 2013, patients consulting for non-complicated malaria in 31 sentinel health centres (SHC) were asked to answer a short questionnaire about long-lasting insecticidal nets (LLIN) use, indoor residual spraying (IRS) in the household and intermittent preventive treatment of pregnant women (IPTp) intake. Controls were healthy all-ages individuals sampled from a concurrent cross-sectional survey conducted in areas surrounding the SHC. Cases and controls were retained in the database if they were resident of the same communes. The association between Plasmodium infection and exposure to MCI was calculated by multivariate multilevel models, and the protective effectiveness (PE) of an intervention was defined as 1 minus the odds ratio of this association. Results Data about 841 cases (out of 6760 cases observed in SHC) and 8284 controls was collected. The regular use of LLIN provided a significant 51 % PE (95 % CI [16–71]) in multivariate analysis, excluding in one transmission pattern where PE was −11 % (95 % CI [−251 to 65]) in univariate analysis. The PE of IRS was 51 % (95 % CI [31–65]), and the PE of exposure to both regular use of LLIN and IRS was 72 % (95 % CI [28–89]) in multivariate analyses. Vector control interventions avoided yearly over 100,000 clinical cases of malaria in Madagascar. The maternal PE of IPTp was 73 %. Conclusions In Madagascar, LLIN and IRS had good PE against clinical malaria. These results may apply to other countries with similar transmission profiles, but such case–control surveys could be recommended to identify local failures in the effectiveness of MCI. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1132-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thomas Kesteman
- Malaria Research Unit, Institut Pasteur de Madagascar, BP 1274, 101, Avaradoha, Antananarivo, Madagascar. .,Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE) - UMR 6236, 27 boulevard Jean Moulin, 13385, Marseille Cedex 05, France. .,Fondation Mérieux, 17 rue Bourgelat, 69002, Lyon, France.
| | | | - Vaomalala Raharimanga
- Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, 101, Avaradoha, Antananarivo, Madagascar.
| | - Laurence Randrianasolo
- Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, 101, Avaradoha, Antananarivo, Madagascar.
| | - Patrice Piola
- Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, 101, Avaradoha, Antananarivo, Madagascar.
| | - Christophe Rogier
- Malaria Research Unit, Institut Pasteur de Madagascar, BP 1274, 101, Avaradoha, Antananarivo, Madagascar. .,Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE) - UMR 6236, 27 boulevard Jean Moulin, 13385, Marseille Cedex 05, France. .,Institute for Biomedical Research of the French Armed Forces (IRBA), BP 73, 91223, Brétigny-Sur-Orge Cedex, France.
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Khalid B, Ghaffar A. Environmental risk factors and hotspot analysis of dengue distribution in Pakistan. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1721-1746. [PMID: 25869291 DOI: 10.1007/s00484-015-0982-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 03/07/2015] [Accepted: 03/08/2015] [Indexed: 06/04/2023]
Abstract
This study is an attempt to find out the factors responsible for sudden dengue outbreak in different cities of Pakistan during 2011. For this purpose, spatio-temporal distribution of dengue in Islamabad, Rawalpindi, Lahore, and Karachi has been taken into account. According to the available data, the factors responsible for this spread includes climate covariates like rainfall, temperature, and wind speed; social covariates like population, and area of locality, and environmental risk factors like drainage pattern and geo-hydrological conditions. Reported dengue cases from localities and Shuttle Radar Topography Mission (SRTM) 90 m digital elevation model (DEM) of study areas have been processed for hotspots, regression model and stream density in the localities of high dengue incidence. The relationship of daily dengue incidence with climate covariates during the months of July-October of the study year is analyzed. Results show that each dry spell of 2-4 days provides suitable conditions for the development and survival of dengue vectors during the wet months of July and August in the areas of high stream density and population. Very few cases have been reported in July while higher number of cases reported in the months of August, September, until late October. Hotspot analysis highlights the areas of high dengue incidence while regression analysis shows the relationship between the population and the areas of localities with the dengue incidence.
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Affiliation(s)
- Bushra Khalid
- Department of Meteorology, COMSATS Institute of Information Technology (CIIT), Islamabad, Pakistan
- Department of Environmental Sciences, International Islamic University (IIU), Islamabad, Pakistan
| | - Abdul Ghaffar
- Department of Meteorology, COMSATS Institute of Information Technology (CIIT), Islamabad, Pakistan.
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13
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Tusting LS, Ippolito MM, Willey BA, Kleinschmidt I, Dorsey G, Gosling RD, Lindsay SW. The evidence for improving housing to reduce malaria: a systematic review and meta-analysis. Malar J 2015; 14:209. [PMID: 26055986 PMCID: PMC4460721 DOI: 10.1186/s12936-015-0724-1] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The global malaria burden has fallen since 2000, sometimes before large-scale vector control programmes were initiated. While long-lasting insecticide-treated nets and indoor residual spraying are highly effective interventions, this study tests the hypothesis that improved housing can reduce malaria by decreasing house entry by malaria mosquitoes. METHODS A systematic review and meta-analysis was conducted to assess whether modern housing is associated with a lower risk of malaria than traditional housing, across all age groups and malaria-endemic settings. Six electronic databases were searched to identify intervention and observational studies published from 1 January, 1900 to 13 December, 2013, measuring the association between house design and malaria. The primary outcome measures were parasite prevalence and incidence of clinical malaria. Crude and adjusted effects were combined in fixed- and random-effects meta-analyses, with sub-group analyses for: overall house type (traditional versus modern housing); screening; main wall, roof and floor materials; eave type; ceilings and elevation. RESULTS Of 15,526 studies screened, 90 were included in a qualitative synthesis and 53 reported epidemiological outcomes, included in a meta-analysis. Of these, 39 (74%) showed trends towards a lower risk of epidemiological outcomes associated with improved house features. Of studies assessing the relationship between modern housing and malaria infection (n=11) and clinical malaria (n=5), all were observational, with very low to low quality evidence. Residents of modern houses had 47% lower odds of malaria infection compared to traditional houses (adjusted odds ratio (OR) 0°53, 95% confidence intervals (CI) 0°42-0°67, p< 0°001, five studies) and a 45-65% lower odds of clinical malaria (case-control studies: adjusted OR 0°35, 95 % CI 0°20-0°62, p<0°001, one study; cohort studies: adjusted rate ratio 0°55, 95% CI 0°36-0°84, p=0°005, three studies). Evidence of a high risk of bias was found within studies. CONCLUSIONS Despite low quality evidence, the direction and consistency of effects indicate that housing is an important risk factor for malaria. Future research should evaluate the protective effect of specific house features and incremental housing improvements associated with socio-economic development.
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Affiliation(s)
- Lucy S Tusting
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
| | - Matthew M Ippolito
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, 1830 Building Room 450B, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
| | - Barbara A Willey
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Immo Kleinschmidt
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Grant Dorsey
- Department of Medicine, University of California, San Francisco, CA, 94143, USA.
| | - Roly D Gosling
- Global Health Group, University of California, San Francisco, CA, 94105, USA.
| | - Steve W Lindsay
- School of Biological and Biomedical Sciences, Durham University, Durham, DH1 3LE, UK.
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Khalid B, Ghaffar A. Dengue transmission based on urban environmental gradients in different cities of Pakistan. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:267-283. [PMID: 24817491 DOI: 10.1007/s00484-014-0840-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/16/2014] [Indexed: 06/03/2023]
Abstract
This study focuses on the dengue transmission in different regions of Pakistan. For this purpose, the data of dengue cases for 2009-2012 from four different cities (Rawalpindi, Islamabad, Lahore, and Karachi) of the country is collected, evaluated, and compiled. To identify the reasons and regions of higher risk of Dengue transmission, land use classification, analysis of climate covariates and drainage patterns was done. Analysis involves processing of SPOT 5 10 m, Landsat TM 30 m data sets, and SRTM 90 m digital elevation models by using remote sensing and GIS techniques. The results are based on the change in urbanization and population density, analysis of temperature, rainfall, and wind speed; calculation of drainage patterns including stream features, flow accumulation, and drainage density of the study areas. Results suggest that the low elevation areas with calm winds and minimum temperatures higher than the normal, rapid increase in unplanned urbanization, low flow accumulation, and higher drainage density areas favor the dengue transmission.
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Affiliation(s)
- Bushra Khalid
- Department of Meteorology, COMSATS Institute of Information Technology Islamabad, Islamabad, ICT, Pakistan
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15
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Kateera F, Mens PF, Hakizimana E, Ingabire CM, Muragijemariya L, Karinda P, Grobusch MP, Mutesa L, van Vugt M. Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda. Malar J 2015; 14:16. [PMID: 25604040 PMCID: PMC4308829 DOI: 10.1186/s12936-014-0534-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/27/2014] [Indexed: 01/05/2023] Open
Abstract
Background Based on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be characterized. Measurement of malaria parasitaemia rates and evaluation of associated risk factors among asymptomatic household members in a rural community in Rwanda were conducted. Methods A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda. Screening for malaria parasite carriage and collection of demographic, socio-economic, house structural features, and prior fever management data, were performed. Logistic regression models with adjustment for within- and between-households clustering were used to assess malaria parasitaemia risk determinants. Results Overall, malaria parasitaemia was found in 652 (5%) individuals, with 518 (13%) of households having at least one parasitaemic member. High malaria parasite carriage risk was associated with being male, child or adolescent (age group 4–15), reported history of fever and living in a household with multiple occupants. A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials. Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands. Conclusion Overall, Ruhuha Sector can be classified as hypo-endemic, albeit with a particular ‘cell of villages’ posing a higher risk for malaria parasitaemia than others. Efforts to further reduce transmission and eventually eliminate malaria locally should focus on investments in programmes that improve house structure features (that limit indoor malaria transmission), making insecticide-treated bed nets and indoor residual spraying implementation more effective.
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Affiliation(s)
- Fredrick Kateera
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, Amsterdam, 1100 DE, The Netherlands.
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Mosha JF, Sturrock HJW, Brown JM, Hashim R, Kibiki G, Chandramohan D, Gosling RD. The independent effect of living in malaria hotspots on future malaria infection: an observational study from Misungwi, Tanzania. Malar J 2014; 13:445. [PMID: 25413016 PMCID: PMC4255924 DOI: 10.1186/1475-2875-13-445] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As malaria transmission declines, continued improvements of prevention and control interventions will increasingly rely on accurate knowledge of risk factors and an ability to define high-risk areas and populations at risk for focal targeting of interventions. This paper explores the independent association between living in a hotspot and prospective risk of malaria infection. METHODS Malaria infection status defined by nPCR and AMA-1 status in year 1 were used to define geographic hotspots using two geospatial statistical methods (SaTScan and Kernel density smoothing). Other malaria risk factors for malaria infection were explored by fitting a multivariable model. RESULTS This study demonstrated that residing in infection hotspot of malaria transmission is an independent predictor of malaria infection in the future. CONCLUSION It is likely that targeting such hotspots with better coverage and improved malaria control strategies will result in more cost-efficient uses of resources to move towards malaria elimination.
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Affiliation(s)
- Jacklin F Mosha
- National Institute for Medical Research (NIMR), Mwanza Medical Research Centre, Mwanza, Tanzania.
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Okebe J, Mwesigwa J, Kama EL, Ceesay SJ, Njie F, Correa S, Bojang K. A comparative case control study of the determinants of clinical malaria in The Gambia. Malar J 2014; 13:306. [PMID: 25106080 PMCID: PMC4248480 DOI: 10.1186/1475-2875-13-306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 08/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The massive deployment of life saving malaria interventions has not only resulted in a decline in disease burden but a change in the risk of infection and disease. The study reassesses the importance of known risk factors and reviews demographic and socio-economic determinants of malaria risk in the population. METHODS This was a case-control study involving 150 children with test-confirmed malaria infection recruited from the outpatient clinics of three health facilities (cases) in the Greater Banjul area, The Gambia. One hundred and fifty controls, negative for malaria were matched on age, residence. Information was collected from respondents on the use of long lasting insecticidal nets, occupation, housing structure, knowledge of malaria and socio-demographic factors. RESULTS The mean age of study participants was 6.8 (SD 3.3) years with 147 (49%) being males. Significant determinants of malaria risk were parent's occupation: mother as trader (OR 0.18, 95% CI 0.04 - 0.73, p = 0.017), father as trader (OR 0.02, 95% CI 0.002- 0.193, p = 0.001), civil servants (OR 0.04, 95% CI 0.008- 0.257, p =0.001) or handyman (OR 0.03, 95% CI 0.005- 0.182, p < 0.001). Children sleeping in rooms with windowpanes had a 76% reduction in their odds of malaria (OR 0.24, 95%CI 0.07- 0.82, p = 0.022. CONCLUSION Household socio-economic status plays an important role in management of illnesses. The ability of mothers to engage in an occupation increases household resources to access healthcare and on time. The balance between the type of mother's occupation and her time available to supervise the child is an interesting emerging issue that needs further investigation.
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Affiliation(s)
- Joseph Okebe
- Medical Research Council Unit, Fajara, The Gambia.
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Galagan SR, Prue CS, Khyang J, Khan WA, Ahmed S, Ram M, Alam MS, Haq MZ, Akter J, Streatfield PK, Glass G, Norris DE, Nyunt MM, Shields T, Sullivan DJ, Sack DA. The practice of jhum cultivation and its relationship to Plasmodium falciparum infection in the Chittagong Hill Districts of Bangladesh. Am J Trop Med Hyg 2014; 91:374-83. [PMID: 24821843 DOI: 10.4269/ajtmh.13-0592] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Malaria is endemic in the Chittagong Hill Districts of southeastern Bangladesh. Previous epidemiological analyses identified the agricultural practice of jhum cultivation as a potential risk factor for malaria infection. We conducted qualitative interviews with jhum cultivators and surveillance workers to describe jhum cultivation and used demographic and malaria surveillance in two study unions from May of 2010 to August of 2012 to better understand the relationship between jhum cultivation and malaria infection. Qualitative interviews revealed that jhum cultivation is conducted on remote, steep hillsides by ethnic tribal groups. Quantitative analyses found that adult jhum cultivators and individuals who live in the same residence had significantly higher incidence rates of symptomatic Plasmodium falciparum infection compared with non-cultivators. These results confirm that jhum cultivation is an independent risk factor for malaria infection and underscore the need for malaria testing and treatment services to reach remote populations in the Chittagong Hill Districts.
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Affiliation(s)
- Sean R Galagan
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Chai Shwai Prue
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jacob Khyang
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Wasif Ali Khan
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sabeena Ahmed
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Malathi Ram
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Shafiul Alam
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M Zahirul Haq
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jasmin Akter
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Peter Kim Streatfield
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Gregory Glass
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Douglas E Norris
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Myaing Myaing Nyunt
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Timothy Shields
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - David J Sullivan
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - David A Sack
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Population, Urbanization and Climate Change, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Rosas-Aguirre A, Llanos-Cuentas A, Speybroeck N, Cook J, Contreras-Mancilla J, Soto V, Gamboa D, Pozo E, Ponce OJ, Pereira MO, Soares IS, Theisen M, D'Alessandro U, Erhart A. Assessing malaria transmission in a low endemicity area of north-western Peru. Malar J 2013; 12:339. [PMID: 24053144 PMCID: PMC3849384 DOI: 10.1186/1475-2875-12-339] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 09/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Where malaria endemicity is low, control programmes need increasingly sensitive tools for monitoring malaria transmission intensity (MTI) and to better define health priorities. A cross-sectional survey was conducted in a low endemicity area of the Peruvian north-western coast to assess the MTI using both molecular and serological tools. METHODS Epidemiological, parasitological and serological data were collected from 2,667 individuals in three settlements of Bellavista district, in May 2010. Parasite infection was detected using microscopy and polymerase chain reaction (PCR). Antibodies to Plasmodium vivax merozoite surface protein-119 (PvMSP1₁₉) and to Plasmodium falciparum glutamate-rich protein (PfGLURP) were detected by ELISA. Risk factors for exposure to malaria (seropositivity) were assessed by multivariate survey logistic regression models. Age-specific antibody prevalence of both P. falciparum and P. vivax were analysed using a previously published catalytic conversion model based on maximum likelihood for generating seroconversion rates (SCR). RESULTS The overall parasite prevalence by microscopy and PCR were extremely low: 0.3 and 0.9%, respectively for P. vivax, and 0 and 0.04%, respectively for P. falciparum, while seroprevalence was much higher, 13.6% for P. vivax and 9.8% for P. falciparum. Settlement, age and occupation as moto-taxi driver during previous year were significantly associated with P. falciparum exposure, while age and distance to the water drain were associated with P. vivax exposure. Likelihood ratio tests supported age seroprevalence curves with two SCR for both P. vivax and P. falciparum indicating significant changes in the MTI over time. The SCR for PfGLURP was 19-fold lower after 2002 as compared to before (λ1 = 0.022 versus λ2 = 0.431), and the SCR for PvMSP1₁₉ was four-fold higher after 2006 as compared to before (λ1 = 0.024 versus λ2 = 0.006). CONCLUSION Combining molecular and serological tools considerably enhanced the capacity of detecting current and past exposure to malaria infections and related risks factors in this very low endemicity area. This allowed for an improved characterization of the current human reservoir of infections, largely hidden and heterogeneous, as well as providing insights into recent changes in species specific MTIs. This approach will be of key importance for evaluating and monitoring future malaria elimination strategies.
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Affiliation(s)
- Angel Rosas-Aguirre
- Instituto de Medicina Tropical, Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Chuquiyauri R, Paredes M, Peñataro P, Torres S, Marin S, Tenorio A, Brouwer KC, Abeles S, Llanos-Cuentas A, Gilman RH, Kosek M, Vinetz JM. Socio-demographics and the development of malaria elimination strategies in the low transmission setting. Acta Trop 2012; 121:292-302. [PMID: 22100446 PMCID: PMC3294046 DOI: 10.1016/j.actatropica.2011.11.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/31/2011] [Accepted: 11/04/2011] [Indexed: 10/15/2022]
Abstract
This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis.
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Affiliation(s)
- Raul Chuquiyauri
- Department of Medicine, Division of Infectious Diseases, University of California San Diego, La Jolla, United States.
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Naidoo S, London L, Burdorf A, Naidoo RN, Kromhout H. Occupational activities associated with a reported history of malaria among women working in small-scale agriculture in South Africa. Am J Trop Med Hyg 2011; 85:805-10. [PMID: 22049030 DOI: 10.4269/ajtmh.2011.11-0092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Malaria-endemic agricultural communities are at risk for this disease because of crop and agricultural activities. A cross-sectional survey among women in small-scale agriculture on irrigated and dryland areas in Makhatini Flats, KwaZulu-Natal South Africa explored associations with self-reported history of malaria, including demographics, crop production, and specific agricultural activities. Ninety-eight (15.2%) of 644 women reported malaria while working in agriculture. More women working in drylands than women working in irrigation scheme reported disease (18.4% versus 10.9%; P < 0.05). Working self or family-owned farms (prevalence ratio [PR] = 2.6, 95% confidence interval [CI] = 1.3-5.2), spraying pesticides (PR = 2.3; 95% CI = 1.4-3.8), cultivating sugar cane (PR = 1.6, 95% CI = 1.1-2.3), and cultivating cotton and mangoes (PR = 1.7, 95% CI = 1.1-2.6) were positively associated with a history of malaria while working in agriculture. This study suggests that certain agricultural activities and types of crop production may increase the risk for malaria among women working in small-scale agriculture.
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Affiliation(s)
- Saloshni Naidoo
- Department of Occupational and Environmental Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Congella, Durban, South Africa
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Al-Mekhlafi AM, Al-Mekhlafi HM, Mahdy MAK, Azazy AA, Fong MY. Human malaria in the highlands of Yemen. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 105:187-95. [PMID: 21801497 PMCID: PMC4090792 DOI: 10.1179/136485911x12987676649421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 02/08/2011] [Accepted: 02/10/2011] [Indexed: 12/28/2022]
Abstract
Between June 2008 and March 2009, a cross-sectional study of human malaria was carried out in four governorates of Yemen, two (Taiz and Hodiedah) representing the country's highlands and the others (Dhamar and Raymah) the country's coastal plains/foothills. The main aims were to determine the prevalences of Plasmodium infection among 455 febrile patients presenting for care at participating health facilities and to investigate the potential risk factors for such infection. Malarial infection was detected in 78 (17·1%) of the investigated patients and was more likely to be detected among the febrile patients from the highlands than among those presenting in the coastal plains/foothills (22·6% v.13·9%; χ(2)=10·102; P=0·018). Binary logistic-regression models identified low household income [odds ratio (OR)=13·52; 95% confidence interval (CI)=2·62-69·67; P=0·002], living in a household with access to a water pump (OR=4·18; CI=1·60-10·96; P=0·004) and living in a household near a stream (OR=4·43; CI=1·35-14·56; P=0·014) as significant risk factors for malarial infection in the highlands. Low household income was the only significant risk factor identified for such infection in the coastal plains and foothills (OR = 8·20; CI=1·80-37·45; P=0·007). It is unclear why febrile patients in the highlands of Yemen are much more likely to be found to have malarial infection than their counterparts from the coastal plains and foothills. Although it is possible that malarial transmission is relatively intense in the highlands, it seems more likely that, compared with those who live at lower altitudes, those who live in the highlands are less immune to malaria, and therefore more likely to develop febrile illness following malarial infection. Whatever the cause of the symptomatic malarial infection commonly found in the highlands of Yemen, it is a matter of serious concern that should be addressed in the national strategy to control malaria.
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Yamamoto SS, Souares A, Sié A, Sauerborn R. Does recent contact with a health care provider make a difference in malaria knowledge? J Trop Pediatr 2010; 56:414-20. [PMID: 20211856 DOI: 10.1093/tropej/fmq016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Knowledge and practices with respect to malaria are aspects that need to be considered as part of effective malaria programs. We assessed and compared malaria practices and knowledge among those who had recently visited a health care provider and those who had not. A matched, population-based case-control study was conducted among 338 women between 15 and 45 years of age and caretakers of children ≤ 9 years of age in Nouna, Burkina Faso. Little difference was found in the reported responses between the cases and controls, which indicates that recent visits to health care providers may not have an effect on malaria risk or knowledge. Differences were noted in malaria practices, which could suggest that health care providers are consulted only after home treatments fail. Therefore, programs and policies targeted to health care providers aimed at improving the dissemination of information may be of some benefit.
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Affiliation(s)
- S S Yamamoto
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
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Household risk factors for clinical malaria in a semi-urban area of Burkina Faso: a case–control study. Trans R Soc Trop Med Hyg 2010; 104:61-5. [DOI: 10.1016/j.trstmh.2009.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 07/03/2009] [Accepted: 07/03/2009] [Indexed: 11/20/2022] Open
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Yamamoto SS, Louis VR, Sié A, Sauerborn R. The effects of zooprophylaxis and other mosquito control measures against malaria in Nouna, Burkina Faso. Malar J 2009; 8:283. [PMID: 20003189 PMCID: PMC2799429 DOI: 10.1186/1475-2875-8-283] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 12/09/2009] [Indexed: 11/10/2022] Open
Abstract
Background In the absence of large scale, organized vector control programmes, individual protective measures against mosquitoes are essential for reducing the transmission of diseases like malaria. Knowledge of the types and effectiveness of mosquito control methods used by households can aid in the development and promotion of preventive measures. Methods A matched, population-based case control study was carried out in the semi-urban region of Nouna, Burkina Faso. Surveys and mosquito captures were conducted for each participating household. Data were analysed using conditional logistic regression and Pearson's product-moment correlations. Results In Nouna, Burkina Faso, the main types of reported mosquito control measures used included sleeping under bed nets (insecticide-treated and untreated) and burning mosquito coils. Most of the study households kept animals within the compound or house at night. Insecticide house sprays, donkeys, rabbits and pigs were significantly associated with a reduced risk of malaria only in univariate analyses. Conclusion Given the conflicting results of the effects of zooprophylaxis from previous studies, other community-based preventive measures, such as bed nets, coils and insecticide house-spraying, may be of more benefit.
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Affiliation(s)
- Shelby S Yamamoto
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
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Zamora Perea E, Balta León R, Palomino Salcedo M, Brogdon WG, Devine GJ. Adaptation and evaluation of the bottle assay for monitoring insecticide resistance in disease vector mosquitoes in the Peruvian Amazon. Malar J 2009; 8:208. [PMID: 19728871 PMCID: PMC2742550 DOI: 10.1186/1475-2875-8-208] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 09/03/2009] [Indexed: 11/25/2022] Open
Abstract
Background The purpose of this study was to establish whether the "bottle assay", a tool for monitoring insecticide resistance in mosquitoes, can complement and augment the capabilities of the established WHO assay, particularly in resource-poor, logistically challenging environments. Methods Laboratory reared Aedes aegypti and field collected Anopheles darlingi and Anopheles albimanus were used to assess the suitability of locally sourced solvents and formulated insecticides for use with the bottle assay. Using these adapted protocols, the ability of the bottle assay and the WHO assay to discriminate between deltamethrin-resistant Anopheles albimanus populations was compared. The diagnostic dose of deltamethrin that would identify resistance in currently susceptible populations of An. darlingi and Ae. aegypti was defined. The robustness of the bottle assay during a surveillance exercise in the Amazon was assessed. Results The bottle assay (using technical or formulated material) and the WHO assay were equally able to differentiate deltamethrin-resistant and susceptible An. albimanus populations. A diagnostic dose of 10 μg a.i./bottle was identified as the most sensitive discriminating dose for characterizing resistance in An. darlingi and Ae. aegypti. Treated bottles, prepared using locally sourced solvents and insecticide formulations, can be stored for > 14 days and used three times. Bottles can be stored and transported under local conditions and field-assays can be completed in a single evening. Conclusion The flexible and portable nature of the bottle assay and the ready availability of its components make it a potentially robust and useful tool for monitoring insecticide resistance and efficacy in remote areas that require minimal cost tools.
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Al-Taiar A, Assabri A, Al-Habori M, Azazy A, Algabri A, Alganadi M, Whitty CJ, Jaffar S. Socioeconomic and environmental factors important for acquiring non-severe malaria in children in Yemen: a case–control study. Trans R Soc Trop Med Hyg 2009; 103:72-8. [DOI: 10.1016/j.trstmh.2008.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Revised: 09/14/2008] [Accepted: 09/14/2008] [Indexed: 11/25/2022] Open
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Kreuels B, Kobbe R, Adjei S, Kreuzberg C, von Reden C, Bäter K, Klug S, Busch W, Adjei O, May J. Spatial Variation of Malaria Incidence in Young Children from a Geographically Homogeneous Area with High Endemicity. J Infect Dis 2008; 197:85-93. [DOI: 10.1086/524066] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Biran A, Smith L, Lines J, Ensink J, Cameron M. Smoke and malaria: are interventions to reduce exposure to indoor air pollution likely to increase exposure to mosquitoes? Trans R Soc Trop Med Hyg 2007; 101:1065-71. [PMID: 17888474 DOI: 10.1016/j.trstmh.2007.07.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Revised: 07/31/2007] [Accepted: 07/31/2007] [Indexed: 10/22/2022] Open
Abstract
Indoor air pollution from the domestic use of biomass fuels by poor households in developing countries is known to be harmful to health, and efforts are being made to address this problem by changes in fuel type, stove technology, house design and fuel-use practices. However, anecdotal evidence suggests that smoke may play an important role by providing protection from biting insects and that efforts to reduce smoke may increase exposure, particularly to mosquitoes and malaria. This paper reviews the literature relating to the repellent effect of smoke on mosquitoes and finds that there is currently no evidence that smoke from domestic fuel use provides effective protection from mosquitoes and malaria. Given the limited number and quality of studies, this finding cannot be interpreted as conclusive. The literature relating to house ventilation and mosquito entry was also reviewed, and an association between eaves spaces and increased indoor mosquito density was noted. Additionally, literature on the effect of soot on the efficacy of insecticide-treated bed nets was considered, but no direct impact was shown. Efforts to reduce indoor air pollution remain desirable even in areas of malaria transmission.
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Affiliation(s)
- Adam Biran
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
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Tobón C. A, Giraldo S. C, Pineros J. JG, Arboleda N. M, Blair T. S, Carmona-Fonseca J. Epidemiologia de la malaria falciparum complicada: estudio de casos y controles en Tumaco y Turbo, Colombia, 2003. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2006. [DOI: 10.1590/s1415-790x2006000300003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: Identificar aspectos del hospedero, del parásito y del ambiente asociados con ocurrencia de malaria por Plasmodium falciparum complicada. MÉTODOS: Estudio de casos y controles en pacientes de Tumaco y Turbo (Colombia) aplicando los criterios de complicación de la Organización Mundial de la Salud. RESULTADOS: Entre noviembre 2002 y julio 2003 se captaron 64 casos (malaria complicada) y 135 controles (malaria no complicada). Las complicaciones fueron: hiperparasitemia (40%), falla hepática (36%), síndrome dificultad respiratoria aguda (7%), falla renal (4%), trombocitopenia grave (3%), anemia grave (2%), malaria cerebral (2%) e hipoglicemia grave (1%). Se encontraron como factores de riesgo para malaria falciparum complicada: a) Los antecedentes de malaria falciparum durante el último año fueron menores en los casos (OR= 7.0 (1.2-43.6) P=0.019); b) Mayor uso previo de antimaláricos en los casos (OR=2.2 (1.1-4.4) P=0.031) y c) mayor uso de cloroquina en los casos (OR=7.4 (1.1-7.8) P=0.017). Se hallaron los alelos MAD-20 y K1 del gen msp1 y FC-27 e IC-1 del gen msp2, cuya distribución de frecuencias fue similar entre casos y controles, aunque el alelo K1 mostró una variación importante entre grupos (casos: 9.4%, controles: 3.5%). La frecuencia de "signos de peligro" fue significativamente mayor en los casos (OR= 3.3, (1.5-7.4) P=0.001). Los criterios de complicación malárica de la Organización Mundial de la Salud se comparan con otros y se discuten algunas implicaciones. CONCLUSIÓN: Se identificaron como factores de riesgo para malaria falciparum complicada, la ausencia de antecedentes de malaria falciparum en el último año y el uso de antimaláricos antes de llegar al hospital.
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Foley DH, Torres EP, Mueller I, Bryan JH, Bell D. Host-dependent Anopheles flavirostris larval distribution reinforces the risk of malaria near water. Trans R Soc Trop Med Hyg 2004; 97:283-7. [PMID: 15228242 DOI: 10.1016/s0035-9203(03)90143-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Malaria control strategies are more likely to be successful if groups at high risk can be accurately predicted. Given that mosquitoes have an obligate aquatic phase we were interested in determining how vector larval abundance relates to the spatial distribution of human malaria infection. We examined the relationship between malaria parasite prevalence and distance from vector larval habitat, and vector larval abundance and distance from human habitation, in separate studies in rural, low-endemic areas of the Philippines. Parasite prevalence among symptomatic patients was significantly higher among those living in proximity (< or = 50 m) to potential larval habitats of the major vector, Anopheles flavirostris (adjusted odds ratio [AOR] = 2.64, P = 0.02 and AOR = 3.43, P = 0.04). A larval survey of A. flavirostris revealed a higher density of early and late instars near human habitation (adjusted P < 0.05). The results suggest that larvae are associated with human habitation, thereby reinforcing malaria risk in people living close to larval habitats. This has implications for understanding the interaction between vectors, hosts, and parasites, and the potential for success of localized malaria control measures.
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Affiliation(s)
- D H Foley
- Department of Zoology and Entomology, University of Queensland, 4072 Brisbane, Australia.
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Moore DA, Grant AD, Armstrong M, Stümpfle R, Behrens RH. Risk factors for malaria in UK travellers. Trans R Soc Trop Med Hyg 2004; 98:55-63. [PMID: 14702838 DOI: 10.1016/s0035-9203(03)00007-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
After observing an apparent increase in severe falciparum malaria among travellers returning from The Gambia to the United Kingdom (UK) in the last quarter of 2000, we conducted a case-control study to investigate risk factors for malaria. The study participants had visited The Gambia between 1 September and 31 December 2000, travelling with the largest UK tour operator serving this destination. The main outcome measures were risk factors associated with malaria. Forty-six cases and 557 controls were studied. Eighty-seven percent of all participants reported antimalarial use (41% chloroquine/proguanil, 31% mefloquine). On univariate analysis the strongest risk factors for disease were: early calendar period of visit, longer duration of stay, non-use of antimalarial prophylaxis, non-use of mefloquine, lack of room air-conditioning, less use of insect repellent, prior visit to another malarial area and accommodation in 'hotel X'. After adjustment in multivariate analysis, use of mefloquine remained strongly protective (odds ratios, OR 0.13 [95% confidence intervals, 95% CI 0.04-0.40]), and the strongest independent risk factors for malaria were early calendar period (OR 5.19 [2.35-11.45] for 1 September to 9 November 2000 versus 10 November to 31 December 2000), prior visit to another malarial area (OR 3.27 [1.41-7.56]), main accommodation in 'hotel X' (OR 3.24 [1.51-6.97]) and duration of stay (OR 2.05 per extra week [1.42-2.95]). Neither any use, nor > 90% adherence to chloroquine/proguanil were protective (adjusted OR for any use 0.57 [0.27-1.21], P = 0.14). We concluded mefloquine use was strongly protective against malaria (87% protective efficacy), whereas chloroquine/proguanil, which is no longer recommended but remains widely used, was less than half as effective (43% protective efficacy). Waning efficacy of chloroquine/proguanil may have contributed to the observed increase in malaria among travellers to The Gambia in 2000. Local factors may also influence the risk of malaria. Malaria could be prevented among travellers to West Africa if current national guidelines on antimalarial prophylaxis were better implemented.
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Affiliation(s)
- David A Moore
- Hospital for Tropical Diseases, Mortimer Market, London School of Hygiene and Tropical Medicine, Imperial College London, London W12 0NN, UK
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Van Der Hoek W, Konradsen F, Amerasinghe PH, Perera D, Piyaratne MK, Amerasinghe FP. Towards a risk map of malaria for Sri Lanka: the importance of house location relative to vector breeding sites. Int J Epidemiol 2003; 32:280-5. [PMID: 12714550 DOI: 10.1093/ije/dyg055] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In Sri Lanka, the major malaria vector Anopheles culicifacies breeds in pools formed in streams and river beds and it is likely that people living close to such breeding sites are at higher risk of malaria than people living further away. This study was done to quantify the importance of house location relative to vector breeding sites for the occurrence of malaria in order to assess the usefulness of this parameter in future malaria risk maps. Such risk maps could be important tools for planning efficient malaria control measures. METHODS In a group of seven villages in north central Sri Lanka, malaria cases were compared with community controls for distance from house to breeding sites and a number of other variables, including type of housing construction and use of anti-mosquito measures. The presence of An. culicifacies in bedrooms was determined by indoor insecticide spray collections. RESULTS People living within 750 m of the local stream, which was the established vector-breeding site, were at much higher risk for malaria than people living further away (odds ratio adjusted for confounding by other variables 5.93, 95% CI: 3.50-8.91). Houses close to the stream also had more adult An. culicifacies in the bedrooms. Poor housing construction was an independent risk factor for malaria. CONCLUSIONS Risk maps of malaria in Sri Lanka can be based on the location of houses relative to streams and rivers that are potential breeding sites for the malaria vector An. culicifacies. A distance of 750 m is suggested as the cut-off point in defining low- and high-risk villages.
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Affiliation(s)
- Wim Van Der Hoek
- International Water Management Institute (IWMI), PO Box 2075, Colombo, Sri Lanka.
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Abstract
Sometimes, valuable lessons from history are forgotten, remain unknown, or worse, are ignored. This article reminds us of the pioneering work of Angelo Celli at the end of the 19th century, who demonstrated that people could be protected from malaria by screening their homes against mosquitoes. Since then, public health scientists have continued to show that simple changes in house design have the potential for protecting people against this life-threatening disease. Yet today, this type of intervention remains virtually ignored. The literature reviewed here demonstrates the enormous potential of these methods to reduce malaria, in the hope that it will stimulate scientific debate and further research.
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Affiliation(s)
- Steve W Lindsay
- School of Biological and Biomedical Sciences, University of Durham, Science Laboratories, South Road, Durham, UK.
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Guthmann JP, Llanos-Cuentas A, Palacios A, Hall AJ. Environmental factors as determinants of malaria risk. A descriptive study on the northern coast of Peru. Trop Med Int Health 2002; 7:518-25. [PMID: 12031074 DOI: 10.1046/j.1365-3156.2002.00883.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We conducted a series of studies on the northern Pacific coast of Peru to determine environmental risk factors for malaria. We report in this paper the results of both a descriptive study of incidence and a prevalence survey of malaria. Both studies showed that the area was at low risk for malaria. The malaria incidence rate was 40/1000 p.a. during the study period, and the prevalence of infection was 0.9% (95% CI: 0.4-1.7) before and 1.4% (95% CI: 0.8-2.2) after the high incidence period. However, the risk of malaria varied according to season, village and even house within a single village. Incidence rates increased from February (2.6/1000 p.a.) to May (12.9/1000 p.a.) and decreased during the second part of the year. Most of the cases were clustered in four villages that constituted only 21% of the total population of the area. Houses where multiple cases were recorded were often located near a source of water. Our observations suggested that environmental factors, and particularly the presence of water for irrigation around villages and houses, played a major role in determining the risk of malaria. These observations were extended through an entomological study and a case-control study, to be published elsewhere.
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Affiliation(s)
- J P Guthmann
- Infectious and Tropical Disease Department, Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, England.
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