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Asmamaw G, Minwagaw T, Samuel M, Ayenew W. Availability and readiness of health facilities providing services for other infectious diseases to treat neglected tropical diseases in Ethiopia: implications for service integration in high burden areas. BMC Health Serv Res 2024; 24:850. [PMID: 39061057 PMCID: PMC11282672 DOI: 10.1186/s12913-024-11257-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The burden of neglected tropical diseases (NTDs), HIV/AIDS, tuberculosis, and malaria pose significant public health challenges in Ethiopia. This study aimed to the explore service availability and readiness for NTD care among Ethiopian health facilities treating tuberculosis (TB), HIV/AIDS, and/or malaria. METHODS This study utilized secondary data from the Ethiopian Service Provision Assessment 2021-22 survey. The availability of services was calculated as the percentage of HIV/AIDS, tuberculosis, or malaria facilities providing NTD services. Facilities were considered highly prepared to manage any type of NTD if they scored at least half (> 50%) of the tracer items listed in each of the three domains (staff training and guidelines, equipment, and essential medicines). Descriptive statistics and logistic regression models were employed to present the study findings and analyze factors influencing facility readiness, respectively. RESULTS Out of 403 health facilities providing NTD care nationally, 179, 183, and 197 also offer TB, HIV/AIDS, and malaria services, respectively. The majority of TB (90.1%), HIV/AIDS (89.6%), and malaria (90.9%) facilities offer soil-transmitted helminth services, followed by trachoma (range 87-90%). The percentages of the aforementioned facilities with at least one trained staff member for any type of NTD were 87.2%, 88.4%, and 82.1%, respectively. The percentage of facilities with guidelines for any type of NTD was relatively low (range 3.7-4.1%). Mebendazole was the most widely available essential medicine, ranging from 69 to 70%. The overall readiness analysis indicated that none of the included facilities (TB = 11.9%; HIV/AIDS = 11.6%; and malaria = 10.6%) were ready to offer NTD care. Specifically, a higher level of readiness was observed only in the domain of medicines across these facilities. Hospitals had better readiness to offer NTD care than did health centers and clinics. Furthermore, a significant associations were observed between facility readiness and factors such as facility type, region, presence of routine management meetings, types of NTD services provided, and fixed costs for services. CONCLUSIONS Ethiopian health facilities treating TB, HIV/AIDS, and malaria had an unsatisfactory overall service availability and a lack of readiness to provide NTD care. Given the existing epidemiological risks and high burden of TB, HIV/AIDS, malaria, and NTDs in Ethiopia, there is an urgent need to consider preparing and implementing a collaborative infectious disease care plan to integrate NTD services in these facilities.
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Affiliation(s)
- Getahun Asmamaw
- Unit of Social and Administrative Pharmacy, Department of Pharmacy, Arba Minch University, Arba Minch, Ethiopia
| | - Tefera Minwagaw
- Department of Pharmacy, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mastewal Samuel
- Department of Pharmacy, Wachemo University, Hassana, Ethiopia
| | - Wondim Ayenew
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia.
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Nag S, Banerjee C, Goyal M, Siddiqui AA, Saha D, Mazumder S, Debsharma S, Pramanik S, Saha SJ, De R, Bandyopadhyay U. Plasmodium falciparum Alba6 exhibits DNase activity and participates in stress response. iScience 2024; 27:109467. [PMID: 38558939 PMCID: PMC10981135 DOI: 10.1016/j.isci.2024.109467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/12/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Alba domain proteins, owing to their functional plasticity, play a significant role in organisms. Here, we report an intrinsic DNase activity of PfAlba6 from Plasmodium falciparum, an etiological agent responsible for human malignant malaria. We identified that tyrosine28 plays a critical role in the Mg2+ driven 5'-3' DNase activity of PfAlba6. PfAlba6 cleaves both dsDNA as well as ssDNA. We also characterized PfAlba6-DNA interaction and observed concentration-dependent oligomerization in the presence of DNA, which is evident from size exclusion chromatography and single molecule AFM-imaging. PfAlba6 mRNA expression level is up-regulated several folds following heat stress and treatment with artemisinin, indicating a possible role in stress response. PfAlba6 has no human orthologs and is expressed in all intra-erythrocytic stages; thus, this protein can potentially be a new anti-malarial drug target.
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Affiliation(s)
- Shiladitya Nag
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Chinmoy Banerjee
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Manish Goyal
- Department of Molecular & Cell Biology, School of Dental Medicine, Boston University Medical Campus, Boston, MA, USA
| | - Asim Azhar Siddiqui
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Debanjan Saha
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Somnath Mazumder
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
- Department of Zoology, Raja Peary Mohan College, 1 Acharya Dhruba Pal Road, Uttarpara, West Bengal 712258, India
| | - Subhashis Debsharma
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Saikat Pramanik
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Shubhra Jyoti Saha
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
| | - Rudranil De
- Amity Institute of Biotechnology, Amity University, Kolkata, Plot No: 36, 37 & 38, Major Arterial Road, Action Area II, Kadampukur Village, Newtown, Kolkata, West Bengal 700135, India
| | - Uday Bandyopadhyay
- Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Road, Jadavpur, Kolkata 700032, West Bengal, India
- Division of Molecular Medicine, Bose Institute, Unified Academic Campus, EN 80, Sector V, Bidhan Nagar, Kolkata, West Bengal 700091, India
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Huda FA, Mathewos K, Mahmood HR, Faruk O, Hirschhorn LR, Binagwaho A. Examining the implementation of facility-based integrated management of childhood illness and insecticide treated nets in Bangladesh: lessons learned through implementation research. BMC Pediatr 2024; 23:653. [PMID: 38413880 PMCID: PMC10900548 DOI: 10.1186/s12887-023-04389-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/26/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Bangladesh significantly reduced under-5 mortality (U5M) between 2000 and 2015, despite its low economic development and projected high mortality rates in children aged under 5 years. A portion of this success was due to implementation of health systems-delivered evidence-based interventions (EBIs) known to reduce U5M. This study aims to understand how Bangladesh was able to achieve this success between 2000 and 2015. Implementation science studies such as this one provide insights on the implementation process that are not sufficiently documented in existing literature. METHODS Between 2017 and 2020, we conducted mixed methods implementation research case studies to examine how six countries including Bangladesh outperformed their regional and economic peers in reducing U5M. Using existing data and reports supplemented by key informant interviews, we studied key implementation strategies and associated implementation outcomes for selected EBIs and contextual factors which facilitated or hindered this work. We used facility-based integrated management of childhood illnesses and insecticide treated nets as examples of two EBIs that were implemented successfully and with wide reach across the country to understand the strategies put in place as well as the facilitating and challenging contextual factors. RESULTS Strategies which contributed to the successful implementation and wide coverage of the selected EBIs included community engagement, data use, and small-scale testing, important to achieving implementation outcomes such as effectiveness, reach and fidelity, although gaps persisted including in quality of care. Key contextual factors including a strong community-based health system, accountable leadership, and female empowerment facilitated implementation of these EBIs. Challenges included human resources for health, dependence on donor funding and poor service quality in the private sector. CONCLUSION As countries work to reduce U5M, they should build strong community health systems, follow global guidance, adapt their implementation using local evidence as well as build sustainability into their programs. Strategies need to leverage facilitating contextual factors while addressing challenging ones.
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Affiliation(s)
| | | | | | - Omar Faruk
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Lisa R Hirschhorn
- University of Global Health Equity, Kigali, Rwanda
- Northwestern University Feinberg School of Medicine, Chicago, USA
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Singh MP, Rajvanshi H, Bharti PK, Anvikar AR, Lal AA. Time series analysis of malaria cases to assess the impact of various interventions over the last three decades and forecasting malaria in India towards the 2030 elimination goals. Malar J 2024; 23:50. [PMID: 38360708 PMCID: PMC10870538 DOI: 10.1186/s12936-024-04872-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Despite the progress made in this decade towards malaria elimination, it remains a significant public health concern in India and many other countries in South Asia and Asia Pacific region. Understanding the historical trends of malaria incidence in relation to various commodity and policy interventions and identifying the factors associated with its occurrence can inform future intervention strategies for malaria elimination goals. METHODS This study analysed historical malaria cases in India from 1990 to 2022 to assess the annual trends and the impact of key anti-malarial interventions on malaria incidence. Factors associated with malaria incidence were identified using univariate and multivariate linear regression analyses. Generalized linear, smoothing, autoregressive integrated moving averages (ARIMA) and Holt's models were used to forecast malaria cases from 2023 to 2030. RESULTS The reported annual malaria cases in India during 1990-2000 were 2.38 million, which dropped to 0.73 million cases annually during 2011-2022. The overall reduction from 1990 (2,018,783) to 2022 (176,522) was 91%. The key interventions of the Enhanced Malaria Control Project (EMCP), Intensified Malaria Control Project (IMCP), use of bivalent rapid diagnostic tests (RDT-Pf/Pv), artemisinin-based combination therapy (ACT), and involvement of the Accredited Social Health Activists (ASHAs) as front-line workers were found to result in the decline of malaria significantly. The ARIMA and Holt's models projected a continued decline in cases with the potential for reaching zero indigenous cases by 2027-2028. Important factors influencing malaria incidence included tribal population density, literacy rate, health infrastructure, and forested and hard-to-reach areas. CONCLUSIONS Studies aimed at assessing the impact of major commodity and policy interventions on the incidence of disease and studies of disease forecasting will inform programmes and policymakers of steps needed during the last mile phase to achieve malaria elimination. It is proposed that these time series and disease forecasting studies should be performed periodically using granular (monthly) and meteorological data to validate predictions of prior studies and suggest any changes needed for elimination efforts at national and sub-national levels.
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Affiliation(s)
- Mrigendra P Singh
- Foundation for Disease Elimination and Control of India, Mumbai, India
| | - Harsh Rajvanshi
- Foundation for Disease Elimination and Control of India, Mumbai, India
- Asia Pacific Leaders' Malaria Alliance, Singapore, Singapore
| | - Praveen K Bharti
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
| | - Anup R Anvikar
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
| | - Altaf A Lal
- Foundation for Disease Elimination and Control of India, Mumbai, India.
- Sun Pharmaceutical Industries Ltd, Mumbai, India.
- Global Health and Pharmaceuticals, Inc, Atlanta, GA, USA.
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Al-Amin HM, Rodriguez I, Phru CS, Khan WA, Haque R, Nahlen BL, Burton TA, Alam MS, Lobo NF. Composition of Anopheles species and bionomic characteristics over the peak malaria transmission season in Bandarban, Bangladesh. Malar J 2023; 22:176. [PMID: 37280591 DOI: 10.1186/s12936-023-04614-2] [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: 01/10/2023] [Accepted: 06/01/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Joint efforts by government and non-government organizations have helped to reduce malaria in Bangladesh and set the country on a clear path to eventual malaria elimination. However, achieving that goal would be challenging without a comprehensive understanding of vector bionomics. METHODS Targeted capturing of Anopheles mosquitoes over a rainy season, utilizing specific sampling methods, including human landing catches (HLCs), CDC-light traps (CDC-LTs), and pyrethrum spray catches (PSCs) were aimed to characterize entomological drivers of transmission in four sites of Bandarban, Bangladesh. RESULTS Molecular characterization of a subset of 4637 mosquitoes has demonstrated the presence of at least 17 species whose capture rates were representative of the rainy season. Species compositions and bionomic traits did not vary between sites with Anopheles maculatus having the highest landing rate by HLCs and Anopheles vagus having the highest capture rate with CDC-LTs. Interestingly, Anopheles species compositions and capture rates varied significantly (p < 0.05) for An. vagus, between HLCs and its often-used proxy-CDC-LTs- suggesting impacts on downstream analysis. CDC-LTs capture rates demonstrated differing compositions with indoor and outdoor biting rates. For example, Anopheles nigerrimus and Anopheles nivipes were more endophagic by HLCs and more exophagic by CDC-LTs. The use of a cow-baited CDC-LT also demonstrated significantly different results when compared to a human-baited CDC-LT considering the high degree of anthropophily in these species. The exception to both zoophily and indoor resting was An. vagus, which demonstrated both anthropophily and high resting rates indoors-pointing to this species being a possible primary vector at this site. CONCLUSION A diverse Anopheles fauna in Bandarban has been confirmed through molecular methods, highlighting the potential impact of sampling techniques. Given the complexity of the local ecosystem, a better understanding of mosquito behaviour and ecology is required to achieve the goal of malaria elimination in Bangladesh.
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Affiliation(s)
- Hasan Mohammad Al-Amin
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
- School of Biological Sciences, University of Queensland, Brisbane, QLD, Australia.
| | - Isabella Rodriguez
- Eck Institute for Global Health (EIGH), University of Notre Dame, Notre Dame, IN, USA
| | - Ching Swe Phru
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Bernard L Nahlen
- Eck Institute for Global Health (EIGH), University of Notre Dame, Notre Dame, IN, USA
| | - Timothy A Burton
- Eck Institute for Global Health (EIGH), University of Notre Dame, Notre Dame, IN, USA
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Neil F Lobo
- Eck Institute for Global Health (EIGH), University of Notre Dame, Notre Dame, IN, USA
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Lalmalsawma P, Balasubramani K, James MM, Pautu L, Prasad KA, Sarma DK, Balabaskaran Nina P. Malaria hotspots and climate change trends in the hyper-endemic malaria settings of Mizoram along the India-Bangladesh borders. Sci Rep 2023; 13:4538. [PMID: 36941291 PMCID: PMC10025798 DOI: 10.1038/s41598-023-31632-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
India has made tremendous progress in reducing malaria mortality and morbidity in the last decade. Mizoram State in North-East India is one of the few malaria-endemic regions where malaria transmission has continued to remain high. As Mizoram shares international borders with Bangladesh and Myanmar, malaria control in this region is critical for malaria elimination efforts in all the three countries. For identifying hotspots for targeted intervention, malaria data from 385 public health sub-centers across Mizoram were analyzed in the Geographic Information System. Almost all the sub-centers reporting high Annual Parasite Index (> 10) are located in Mizoram's districts that border Bangladesh. Getis-Ord Gi* statistic shows most of the sub-centers located along the Bangladesh border in the Lawngtlai and Lunglei districts to be the malaria hotspots. The hotspots also extended into the Mamit and Siaha districts, especially along the borders of Lawngtlai and Lunglei. Analysis of terrain, climatic, and land use/land cover datasets obtained from the Global Modelling and Assimilation Office and satellite images show Mizoram's western part (Lawngtlai, Lunglei, and Mamit districts) to experience similar topographic and climatic conditions as the bordering Rangamati district in the Chittagong division of Bangladesh. Climatic trends in this region from 1981 to 2021, estimated by the Mann-Kendall test and Sen's slope estimates, show an increasing trend in minimum temperature, relative humidity, rainfall, and the associated shift of climatic pattern (temperate to tropical monsoon) could facilitate malaria transmission. The quasi-Poisson regression model estimates a strong association (p < 0.001) between total malaria cases, temperature range, and elevation. The Kruskal-Wallis H test shows a statistically significant association between malaria cases and forest classes (p < 0.001). A regional coordination and strategic plan are required to eliminate malaria from this hyper-endemic malaria region of North-East India.
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Affiliation(s)
- Pachuau Lalmalsawma
- Integrated Disease Surveillance Programme, Health and Family Welfare Department, Aizawl, Mizoram, India
| | - K Balasubramani
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Meenu Mariya James
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Lalfakzuala Pautu
- Integrated Disease Surveillance Programme, Health and Family Welfare Department, Aizawl, Mizoram, India
- Department of Life Sciences, Pachhunga University College, Mizoram University, Aizawl, Mizoram, India
| | - Kumar Arun Prasad
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Devojit Kumar Sarma
- ICMR- National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India.
| | - Praveen Balabaskaran Nina
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India.
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India.
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Shannon KL, Shields T, Ahmed S, Rahman H, Prue CS, Khyang J, Ram M, Haq MZ, Akter J, Alam MS, Glass GE, Nyunt MM, Sack DA, Sullivan DJ, Khan WA, Curriero FC. Temporal and Spatial Differences between Symptomatic and Asymptomatic Malaria Infections in the Chittagong Hill Districts, Bangladesh. Am J Trop Med Hyg 2022; 107:1210-1217. [PMID: 36122682 PMCID: PMC9768271 DOI: 10.4269/ajtmh.21-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/13/2022] [Indexed: 12/30/2022] Open
Abstract
Mapping asymptomatic malaria infections, which contribute to the transmission reservoir, is important for elimination programs. This analysis compared the spatiotemporal patterns of symptomatic and asymptomatic Plasmodium falciparum malaria infections in a cohort study of ∼25,000 people living in a rural hypoendemic area of about 179 km2 in a small area of the Chittagong Hill Districts of Bangladesh. Asymptomatic infections were identified by active surveillance; symptomatic clinical cases presented for care. Infections were identified by a positive rapid diagnostic test and/or microscopy. Fifty-three subjects with asymptomatic P. falciparum infection were compared with 572 subjects with symptomatic P. falciparum between mid-October 2009 and mid-October 2012 with regard to seasonality, household location, and extent of spatial clustering. We found increased spatial clustering of symptomatic compared with asymptomatic infections, and the areas of high intensity were only sometimes overlapping. Symptomatic cases had a distinct seasonality, unlike asymptomatic infections, which were detected year-round. In a comparison of 42 symptomatic Plasmodium vivax and 777 symptomatic P. falciparum cases from mid-October 2009 through mid-March 2015, we found substantial spatial overlap in areas with high infection rates, but the areas with the greatest concentration of infection differed. Detection of both symptomatic P. falciparum and symptomatic P. vivax infections was greater during the May-to-October high season, although a greater proportion of P. falciparum cases occurred during the high season compared with P. vivax. These findings reinforce that passive malaria surveillance and treatment of symptomatic cases will not eliminate the asymptomatic reservoirs that occur distinctly in time and space.
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Affiliation(s)
- Kerry L. Shannon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland;,Address correspondence to Kerry L. Shannon, MD/DrPH/MPH, Peace Harbor Medical Center, 400 Ninth Street, Florence, OR 97439. E-mail:
| | - Timothy Shields
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sabeena Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Hafizur Rahman
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Chai Shwai Prue
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jacob Khyang
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - M. Zahirul Haq
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jasmin Akter
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Gregory E. Glass
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Myaing M. Nyunt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Institute for Global Health University of Maryland Medical School, Baltimore, Maryland
| | - David A. Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David J. Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Wasif A. Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Frank C. Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Aubourg MA, Al-Amin HM, Sunkara A, Chetan S, Monroe A, Phru CS, Haque R, Khan WA, Hendershot A, Alam MS, Lobo NF. Human behaviour directs household-level exposure to malaria vectors in Bandarban, Bangladesh. Malar J 2022; 21:355. [PMID: 36443751 PMCID: PMC9706855 DOI: 10.1186/s12936-022-04375-4] [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: 04/25/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bangladesh has reduced malaria incidence and mortality by over 75% between 2010 and 2020. Widespread long-lasting insecticidal net (LLIN) distribution and use is one of the measures responsible for this success. Recalcitrant malaria hotspots within the Chittagong Hill Tracts districts suggest important drivers of malaria risk may remain uncharacterized. METHODS Towards understanding how household-level human behaviour impacts exposure to mosquitoes, parallel human landing catches and human behavioural observations were conducted in four households for 6 months (May-October) over the rainy season in the Bandarban District. Analysis quantifies spatiotemporal human behaviour-adjusted exposure to Anopheles with and without LLINs. RESULTS This small-scale operational study demonstrates that human spatial and temporal presence along with LLIN use drives exposure to Anopheles. Though the four households had both outdoor and indoor exposure, especially in the evening (1800-2000 h) and early morning (0400-0500 h), data points to household-based heterogeneity in malaria exposure even with similar LLIN access. CONCLUSION Incorporating human behaviour into exposure estimates can be used to understand the efficacy and limitations of local vector control strategies and identify gaps in protection, as well as where present intervention strategies may be optimized.
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Affiliation(s)
- Matthew A Aubourg
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Hasan Mohammad Al-Amin
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.,QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Anoop Sunkara
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Sanjna Chetan
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Ching Swe Phru
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wasif A Khan
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Allison Hendershot
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Mohammad Shafiul Alam
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Neil F Lobo
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
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Pradhan S, Hore S, Maji SK, Manna S, Maity A, Kundu PK, Maity K, Roy S, Mitra S, Dam P, Mondal R, Ghorai S, Jawed JJ, Dutta S, Das S, Mandal S, Mandal S, Kati A, Sinha S, Maity AB, Dolai TK, Mandal AK, İnce İA. Study of epidemiological behaviour of malaria and its control in the Purulia district of West Bengal, India (2016-2020). Sci Rep 2022; 12:630. [PMID: 35022476 PMCID: PMC8755807 DOI: 10.1038/s41598-021-04399-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Purulia is a malaria-prone district in West Bengal, India, with approximately half of the blocks defined as malaria endemic. We analyzed the malaria case in each block of the Purulia district from January 1, 2016, to December 31, 2020. As per the API, 20 blocks of Purulia were assigned to four different categories (0-3) and mapped using ArcGIS software. An exponential decay model was fitted to forecast the trend of malaria cases for each block of Purulia (2021-2025). There was a sharp decrease in total malaria cases and API from 2016 to 2020 due to the mass distribution of LLINs. The majority of cases (72.63%) were found in ≥ 15-year age group. Males were more prone to malaria (60.09%). Malaria was highly prevalent among Scheduled Tribes (48.44%). Six blocks were reported in Category 3 (high risk) and none in Category 0 (no risk) in 2016, while no blocks were determined to be in Category 3, and three blocks were in Category 0 in 2020. The exponential decay model prediction is oriented towards gaining malaria-free status in thirteen blocks of Purulia by 2025. This study will incite the government to uphold and strengthen the current efforts to meet the malaria elimination goals.
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Affiliation(s)
- Sayantan Pradhan
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
- Hematology Department, Nil Ratan Sircar Medical College & Hospital, Kolkata, 700014, India
| | - Samrat Hore
- Department of Statistics, Tripura University, Agartala, Tripura, 799022, India
| | - Suman Kumar Maji
- District Public Health Centre, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, 723101, India
| | - Simi Manna
- Department of Bio-Medical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, 721102, India
| | - Abhijit Maity
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Pratip Kumar Kundu
- Calcutta School of Tropical Medicine, College Square, Kolkata, West Bengal, 700073, India
| | - Krishna Maity
- Department of Statistics, VisvaBharati University, Bolpur, West Bengal, 731204, India
| | - Stabak Roy
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Saptarshi Mitra
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Paulami Dam
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Rittick Mondal
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Suvankar Ghorai
- Department of Microbiology, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Junaid Jibran Jawed
- School of Biotechnology, Presidency University - 2nd Campus, Kolkata, West Bengal, 700156, India
| | - Subhadeep Dutta
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Sandip Das
- Department of Botany, School of Sciences, Durgapur Regional Centre, Netaji Subhas Open University, West Burdwan, Kolkata, West Bengal, 713214, India
| | - Sukhendu Mandal
- Laboratory of Molecular Bacteriology, Department of Microbiology, University of Calcutta, Kolkata, 700019, India
| | - Sanjib Mandal
- Department of Economics, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Ahmet Kati
- Department of Biotechnology, Institution of Health Sciences, University of Health Sciences, Uskudar, Istanbul, 34668, Turkey
| | - Sangram Sinha
- Department of Botany, Vivekananda Mahavidyalaya, Haripal, Hoogly, West Bengal, 712405, India
| | - Amit Bikram Maity
- Department of Otorhinolaryngology, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, 723101, India
| | - Tuphan Kanti Dolai
- Hematology Department, Nil Ratan Sircar Medical College & Hospital, Kolkata, 700014, India.
| | - Amit Kumar Mandal
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India.
- Centre for Nanotechnology Sciences, Raiganj University, North Dinajpur, West Bengal, 733134, India.
| | - İkbal Agah İnce
- Department of Medical Microbiology, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Ataşehir, Istanbul, 34752, Turkey.
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10
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Wilairatana P, Chanmol W, Rattaprasert P, Masangkay FR, Milanez GDJ, Kotepui KU, Kotepui M. Prevalence and characteristics of malaria co-infection among individuals with visceral leishmaniasis in Africa and Asia: a systematic review and meta-analysis. Parasit Vectors 2021; 14:545. [PMID: 34688312 PMCID: PMC8542298 DOI: 10.1186/s13071-021-05045-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Malaria and visceral leishmaniasis (VL) co-infection can occur due to the overlapping geographical distributions of these diseases; however, only limited data of this co-infection have been reported and reviewed. This study aimed to explore the pooled prevalence and characteristics of this co-infection using a systematic review approach. Methods The PubMed, Web of Science and Scopus databases were searched for relevant studies. The quality of these studies was assessed in accordance with strengthening the reporting of observational studies in epidemiology (STROBE) guidelines. The numbers of individuals co-infected with Plasmodium and VL and the total numbers of individuals with VL were used to estimate the pooled prevalence using random-effects models. Differences in age, sex and the presence of anemia and malnutrition on admission were compared between co-infected individuals and individuals with VL using a random-effects model; the results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity among the included studies was assessed and quantified using Cochrane Q and I2 statistics. Results Of the 3075 studies identified, 12 met the eligibility criteria and were included in this systematic review. The pooled prevalence of Plasmodium infection among the 6453 individuals with VL was 13%, with substantial heterogeneity of the data (95% CI 7–18%, I2 97.9%). Subgroup analysis demonstrated that the highest prevalence of co-infection occurred in African countries, whereas the lowest prevalence occurred in Asian countries. Patients aged < 5 years had higher odds of having co-infection than having VL (co-infection, n = 202; VL, n = 410) (OR 1.66, 95% CI 1.37–2.01, I2 0%; P < 0.0001), whereas patients aged 20–29 years had lower odds of having co-infection than having VL (co-infection, n = 170; VL, n = 699) (OR 0.75, 95% CI 0.60–0.93, I2 18%; P = 0.01). Male patients had equivalent odds of having co-infection and having VL (co-infection, n = 525; VL, n = 2232) (OR 0.92, 95% CI 0.078–1.08, I2 0%; P = 0.29). Patients with co-infection had lower odds of having anemia at admission than those with VL (co-infection, n = 902; VL, n = 2939) (OR 0.64, 95% CI 0.44–0.93, I2 0%; P = 0.02). No difference in malnutrition at admission was found in the meta-analysis. Conclusions The prevalence of malaria co-infection among individuals with VL was heterogeneous and ranged from 7 to 18%, depending on geographical area. Age and anemia at admission were associated with co-infection status. Further longitudinal studies are needed to determine if co-infection with malaria has an impact on the severity of VL. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05045-1.
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Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Wetpisit Chanmol
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand
| | - Pongruj Rattaprasert
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Frederick Ramirez Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, 10100, Manila, Philippines
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, 10100, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, 80160, Thailand.
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Brooks WA, Zaman K, Goswami D, Prosperi C, Endtz HP, Hossain L, Rahman M, Ahmed D, Rahman MZ, Banu S, Shikder AU, Jahan Y, Nahar K, Chisti MJ, Yunus M, Khan MA, Matin FB, Mazumder R, Shahriar Bin Elahi M, Saifullah M, Alam M, Bin Shahid ASMS, Haque F, Sultana S, Higdon MM, Haddix M, Feikin DR, Murdoch DR, Hammitt LL, O’Brien KL, Deloria Knoll M. The Etiology of Childhood Pneumonia in Bangladesh: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study. Pediatr Infect Dis J 2021; 40:S79-S90. [PMID: 34448747 PMCID: PMC8448409 DOI: 10.1097/inf.0000000000002648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pneumonia remains the leading infectious cause of death among children <5 years, but its cause in most children is unknown. We estimated etiology for each child in 2 Bangladesh sites that represent rural and urban South Asian settings with moderate child mortality. METHODS As part of the Pneumonia Etiology Research for Child Health study, we enrolled children 1-59 months of age with World Health Organization-defined severe and very severe pneumonia, plus age-frequency-matched controls, in Matlab and Dhaka, Bangladesh. We applied microbiologic methods to nasopharyngeal/oropharyngeal swabs, blood, induced sputum, gastric and lung aspirates. Etiology was estimated using Bayesian methods that integrated case and control data and accounted for imperfect sensitivity and specificity of the measurements. RESULTS We enrolled 525 cases and 772 controls over 24 months. Of the cases, 9.1% had very severe pneumonia and 42.0% (N = 219) had infiltrates on chest radiograph. Three cases (1.5%) had positive blood cultures (2 Salmonella typhi, 1 Escherichia coli and Klebsiella pneumoniae). All 4 lung aspirates were negative. The etiology among chest radiograph-positive cases was predominantly viral [77.7%, 95% credible interval (CrI): 65.3-88.6], primarily respiratory syncytial virus (31.2%, 95% CrI: 24.7-39.3). Influenza virus had very low estimated etiology (0.6%, 95% CrI: 0.0-2.3). Mycobacterium tuberculosis (3.6%, 95% CrI: 0.5-11.0), Enterobacteriaceae (3.0%, 95% CrI: 0.5-10.0) and Streptococcus pneumoniae (1.8%, 95% CrI: 0.0-5.9) were the only nonviral pathogens in the top 10 etiologies. CONCLUSIONS Childhood severe and very severe pneumonia in young children in Bangladesh is predominantly viral, notably respiratory syncytial virus.
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Affiliation(s)
- W. Abdullah Brooks
- From the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Doli Goswami
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Hubert P. Endtz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Department of Clinical Microbiology & Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Fondation Mérieux, Lyon, France
| | - Lokman Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Dilruba Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Arif Uddin Shikder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Yasmin Jahan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kamrun Nahar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Mohammed Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | | | - Razib Mazumder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Muhammad Saifullah
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Muntasir Alam
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Fahim Haque
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabiha Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Melissa M. Higdon
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Meredith Haddix
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel R. Feikin
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David R. Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
- Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Laura L. Hammitt
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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12
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Conteh L, Shuford K, Agboraw E, Kont M, Kolaczinski J, Patouillard E. Costs and Cost-Effectiveness of Malaria Control Interventions: A Systematic Literature Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1213-1222. [PMID: 34372987 PMCID: PMC8324482 DOI: 10.1016/j.jval.2021.01.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To systematically review the literature on the unit cost and cost-effectiveness of malaria control. METHODS Ten databases and gray literature sources were searched to identify evidence relevant to the period 2005 to 2018. Studies with primary financial or economic cost data from malaria endemic countries that took a provider, provider and household, or societal perspective were included. RESULTS We identified 103 costing studies. The majority of studies focused on individual rather than combined interventions, notably insecticide-treated bed nets and treatment, and commonly took a provider perspective. A third of all studies took place in 3 countries. The median provider economic cost of protecting 1 person per year ranged from $1.18 to $5.70 with vector control and from $0.53 to $5.97 with chemoprevention. The median provider economic cost per case diagnosed with rapid diagnostic tests was $6.06 and per case treated $9.31 or $89.93 depending on clinical severity. Other interventions did not share enough similarities to be summarized. Cost drivers were rarely reported. Cost-effectiveness of malaria control was reiterated, but care in methodological and reporting standards is required to enhance data transferability. CONCLUSIONS Important information that can support resource allocation was reviewed. Given the variability in methods and reporting, global efforts to follow existing standards are required for the evidence to be most useful outside their study context, supplemented by guidance on options for transferring existing data across settings.
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Affiliation(s)
- Lesong Conteh
- Department of Health Policy, London School of Economics and Political Science, London, England, UK; School of Public Health, Imperial College London, St Mary's Campus, Paddington, England, UK
| | - Kathryn Shuford
- Department of Health Policy, London School of Economics and Political Science, London, England, UK
| | - Efundem Agboraw
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, England, UK
| | - Mara Kont
- Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, England, UK
| | - Jan Kolaczinski
- Department of the Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Edith Patouillard
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland.
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13
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Wilairatana P, Mala W, Rattaprasert P, Kotepui KU, Kotepui M. Prevalence of Malaria and Leptospirosis Co-Infection among Febrile Patients: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2021; 6:tropicalmed6030122. [PMID: 34287366 PMCID: PMC8293407 DOI: 10.3390/tropicalmed6030122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 06/29/2021] [Indexed: 12/28/2022] Open
Abstract
Malaria and leptospirosis are important cosmopolitan infections that have emerged with overlapping geographic distribution, especially in tropical and subtropical regions. Therefore, co-infection with malaria and leptospirosis may occur in overlapping areas. The present study aimed to quantify the prevalence of malaria and leptospirosis co-infection among febrile patients. The association between malaria and leptospirosis infections was also investigated. Relevant studies that had reported malaria and leptospirosis co-infection were identified from PubMed, Scopus, and Web of Science. The risk of bias of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The pooled prevalence of malaria and leptospirosis co-infections among febrile patients and the pooled prevalence of leptospirosis infection among malaria patients were estimated using random effect models. The association between malaria and leptospirosis infection among febrile patients was estimated using random effect models. The outcomes of each study were shown in a forest plot in point estimate and 95% confidence interval (CI). Heterogeneity among the included studies was assessed using Cochran’s Q and quantified using I-squared statistics. For leptospirosis, subgroup analyses of countries, diagnostic tests, and participants’ age groups were performed to specify prevalence in each subgroup. Publication bias was assessed by funnel-plot visualization. Of the 2370 articles identified from the databases, 15 studies met the eligibility criteria and were included for qualitative and quantitative syntheses. Most of the included studies were conducted in India (5/15, 33.3%), Thailand (3/15, 20%), and Cambodia (2/15, 13.3%). Most of the enrolled cases were febrile patients (5838 cases) and malaria-positive patients (421 cases). The meta-analysis showed that the pooled prevalence of malaria and leptospirosis co-infection (86 cases) among febrile patients was 1% (95% CI: 1–2%, I2: 83.3%), while the pooled prevalence of leptospirosis infection (186 cases) among malaria patients was 13% (95% CI: 9–18%, I2: 90.3%). The meta-analysis showed that malaria and leptospirosis co-infections occurred by chance (p: 0.434, OR: 1.4, 95% CI: 0.6–3.28, I2: 85.2%). The prevalence of malaria in leptospirosis co-infection among febrile patients in the included studies was low. Co-infection was likely to occur by chance. However, as clinical symptoms of leptospirosis patients were non-specific and not distinguishable from symptoms of malaria patients, clinicians caring for febrile patients in an area where those two diseases are endemic should maintain a high index of suspicion for both diseases and whether mono-infections or co-infections are likely. Recognition of this co-infection may play an important role in reducing disease severity and treatment duration.
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Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
| | - Pongruj Rattaprasert
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand; (W.M.); (K.U.K.)
- Correspondence: ; Tel.: +66-954392469
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14
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Insights into the first seven-months of COVID-19 pandemic in Bangladesh: lessons learned from a high-risk country. Heliyon 2021; 7:e07385. [PMID: 34189333 PMCID: PMC8226055 DOI: 10.1016/j.heliyon.2021.e07385] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/22/2020] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
South Asian countries have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures. This review aims to describe the epidemiological features and shortcomings in public health preparedness to tackle COVID-19 as well as derive lessons from these events in the context of Bangladesh. We have shown that an increase in human mobility was evident throughout the lockdown period. Over 20,000 frontline health workers were affected, and more than 2100 unofficial deaths possibly linked with COVID-19 diagnosis were reported. Males were disproportionately affected in terms of infection (71%) and death (77%) than females. Over 50% of infected cases were reported among young adults (20-40-year age group). After seven months into the pandemic, a downward trend in laboratory test positive percentage was seen, although the number of new deaths per day remained largely unchanged. We believe our findings, observations and recommendations will remain as a valuable resource to facilitate better public health practice and policy for managing current and future infectious disease like COVID-19 in resource-poor developing countries.
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Engel N, Ghergu C, Matin MA, Kibria MG, Thriemer K, Price RN, Ding XC, Howes RE, Ley B, Incardona S, Alam MS. Implementing radical cure diagnostics for malaria: user perspectives on G6PD testing in Bangladesh. Malar J 2021; 20:217. [PMID: 33980257 PMCID: PMC8114691 DOI: 10.1186/s12936-021-03743-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/20/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The radical cure of Plasmodium vivax requires treatment with an 8-aminoquinoline drug, such as primaquine and tafenoquine, to eradicate liver hypnozoite stages, which can reactivate to cause relapsing infections. Safe treatment regimens require prior screening of patients for glucose-6-phosphate dehydrogenase (G6PD) deficiency to avoid potential life-threatening drug induced haemolysis. Testing is rarely available in malaria endemic countries, but will be needed to support routine use of radical cure. This study investigates end-user perspectives in Bangladesh on the introduction of a quantitative G6PD test (SD Biosensor STANDARD™ G6PD analyser) to support malaria elimination. METHODS The perspectives of users on the SD Biosensor test were analysed using semi-structured interviews and focus group discussions with health care providers and malaria programme officers in Bangladesh. Key emerging themes regarding the feasibility of introducing this test into routine practice, including perceived barriers, were analysed. RESULTS In total 63 participants were interviewed. Participants emphasized the life-saving potential of the biosensor, but raised concerns including the impact of limited staff time, high workload and some technical aspects of the device. Participants highlighted that there are both too few and too many P. vivax patients to implement G6PD testing owing to challenges of funding, workload and complex testing infrastructure. Implementing the biosensor would require flexibility and improvisation to deal with remote sites, overcoming a low index of suspicion and mutual interplay of declining patient numbers and reluctance to test. This approach would generate new forms of evidence to justify introduction in policy and carefully consider questions of deployment given declining patient numbers. CONCLUSIONS The results of the study show that, in an elimination context, the importance of malaria needs to be maintained for both policy makers and the affected communities, in this case by ensuring P. vivax, PQ treatment, and G6PD deficiency remain visible. Availability of new technologies, such as the biosensor, will fuel ongoing debates about priorities for allocating resources that must be adapted to a constantly evolving target. Technical and logistical concerns regarding the biosensor should be addressed by future product designs, adequate training, strengthened supply chains, and careful planning of communication, advocacy and staff interactions at all health system levels.
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Affiliation(s)
- Nora Engel
- Department of Health, Ethics & Society, Research School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, Netherlands.
| | - Cristian Ghergu
- Department of Health, Ethics & Society, Research School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Mohammad Abdul Matin
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Golam Kibria
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Ric N Price
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Xavier C Ding
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Rosalind E Howes
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Sandra Incardona
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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16
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Johora FT, Elahi R, Nima MK, Hossain MS, Rashid H, Kibria MG, Mohon AN, Khan WA, Haque R, Alam MS. Persistence of Markers of Chloroquine Resistance in Plasmodium falciparum in Bangladesh. Am J Trop Med Hyg 2021; 104:276-282. [PMID: 33146120 DOI: 10.4269/ajtmh.20-0415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The control of malaria, in terms of drug resistance, remains a significant global challenge, with Bangladesh, a malaria-endemic country, being no exception. The aim of this study was to explore antimalarial resistance in Bangladesh by molecular analysis of Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance transporter 1 (pfmdr1) genetic markers of P. falciparum. Samples were obtained from uncomplicated malaria patients between 2009 and 2014 from six malaria-endemic districts. Based on parasite transmission intensity, the endemic districts were divided into high-transmission (Chittagong Hill Tracts [CHT]) and low-transmission (non-CHT) regions. Falciparum malaria-positive isolates were genotyped for K76T of the pfcrt gene, and N86Y and Y184F of the pfmdr1 gene: in total, 262 P. falciparum clinical isolates were analyzed. In CHT areas, the prevalence of polymorphisms was 70.6% for 76T, 14.4% for 86Y, and 7.8% for 184F. In non-CHT areas, 76T and 86Y mutations were found in 78.0% and 19.5% of the samples, respectively, whereas no 184F mutations were observed. We compared our data with previous similar molecular observations, which shows a significant decrease in pfcrt 76T mutation prevalence. No pfmdr1 amplification was observed in any of the samples suggesting an unaltered susceptibility to amino alcohol drugs such as mefloquine and lumefantrine. This study provides an updated assessment of the current status of pfcrt and pfmdr1 gene mutations in Bangladesh, and suggests there is persistent high prevalence of markers of resistance to aminoquinoline drugs.
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Affiliation(s)
- Fatema Tuj Johora
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rubayet Elahi
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,2Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Maisha Khair Nima
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,3Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana
| | - Mohammad Sharif Hossain
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Humaira Rashid
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Golam Kibria
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abu Naser Mohon
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,4Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Alberta, Canada
| | - Wasif A Khan
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashidul Haque
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Shafiul Alam
- 1Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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17
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Emeto TI, Adegboye OA, Rumi RA, Khan MUI, Adegboye M, Khan WA, Rahman M, Streatfield PK, Rahman KM. Disparities in Risks of Malaria Associated with Climatic Variability among Women, Children and Elderly in the Chittagong Hill Tracts of Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9469. [PMID: 33348771 PMCID: PMC7766360 DOI: 10.3390/ijerph17249469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/04/2022]
Abstract
Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1-7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8-7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7-27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9-25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar settings.
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Affiliation(s)
- Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Reza A. Rumi
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Mahboob-Ul I. Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | | | - Wasif A. Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka 1212, Bangladesh;
| | - Peter K. Streatfield
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Kazi M. Rahman
- North Coast Public Health Unit, New South Wales Health, Lismore, NSW 2480, Australia;
- The University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia
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18
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Wide range of G6PD activities found among ethnic groups of the Chittagong Hill Tracts, Bangladesh. PLoS Negl Trop Dis 2020; 14:e0008697. [PMID: 32925910 PMCID: PMC7514097 DOI: 10.1371/journal.pntd.0008697] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/24/2020] [Accepted: 08/11/2020] [Indexed: 01/13/2023] Open
Abstract
The proportion of Plasmodium vivax malaria among all malarias is increasing worldwide. Treatment with 8-aminoquinolines remain the only radical cure. However, 8-aminoquinolines can cause severe hemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. The population of the multi-ethnic Chittagong Hill Tracts (CHT) carry the highest malaria burden within Bangladesh. As in many countries the national treatment guidelines recommend 8-aminoquinoline based radical cure without routine G6PD deficiency (G6PDd) testing to guide treatment. Aim of this study was to determine the need for routine testing within a multi-ethnic population by assessing the prevalence of G6PDd among the local population. Participants from 11 ethnicities were randomly selected and malaria status was assessed by microscopy, rapid diagnostic test (RDT) and polymerase chain reaction (PCR). G6PD status was determined by spectrophotometry and G6PD genotyping. The adjusted male median (AMM) was defined as 100% G6PD activity, participants were categorized as G6PD deficient (<30% activity), G6PD intermediate (30% to 70% activity) or G6PD normal (>70% activity). Median G6PD activities between ethnicities were compared and the association between G6PD activity and malaria status was assessed. 1002 participants were enrolled and tested for malaria. G6PD activity was measured by spectrophotometry in 999 participants and host G6PD genotyping undertaken in 323 participants. Seven participants (0.7%) had peripheral parasitaemia detected by microscopy or RDT and 42 by PCR (4.2%). Among 106 participants (32.8%) with confirmed genotype, 99 (93.4%) had the Mahidol variant. The AMM was 7.03U/gHb with 90 (9.0%) G6PD deficient participants and 133 (13.3%) with intermediate G6PD activity. Median G6PD activity differed significantly between ethnicities (p<0.001), proportions of G6PD deficient individuals ranged from 2% to 26% but did not differ between participants with and without malaria. The high G6PDd prevalence and significant variation between ethnicities suggest routine G6PDd testing to guide 8-aminoquinoline based radical in the CHT and comparable settings.
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19
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Shah S, Abbas G, Riaz N, Anees Ur Rehman, Hanif M, Rasool MF. Burden of communicable diseases and cost of illness: Asia pacific region. Expert Rev Pharmacoecon Outcomes Res 2020; 20:343-354. [PMID: 32530725 DOI: 10.1080/14737167.2020.1782196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Communicable diseases such as AIDS/HIV, dengue fever, and malaria have a great burden and subsequent economic loss in the Asian region. The purpose of this article is to review the widespread burden of communicable diseases and related health-care burden for the patient in Asia and the Pacific. AREAS COVERED In Central Asia, the number of new AIDS cases increased by 29%. It is more endemic in the poor population with variations in the cost of illness. Dengue is prevalent in more than 100 countries, including the Asia-Pacific region. In Southeast Asia, the annual economic burden of dengue fever was between $ 610 and $ 1,384 million, with a per capita cost of $ 1.06 to $ 2.41. Globally, 2.9 billion people are at risk of developing malaria, 90% of whom are residents of the Asia and Pacific region. The annual per capita cost of malaria control ranged from $ 0.11 to $ 39.06 and for elimination from $ 0.18 to $ 27. EXPERT OPINION The cost of AIDS, dengue, and malaria varies from country to country due to different health-care systems. The literature review has shown that the cost of dengue disease and malaria is poorly documented.
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Affiliation(s)
- Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Ghulam Abbas
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Nabeel Riaz
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Anees Ur Rehman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Penang , Gelugor, Malaysia
| | - Muhammad Hanif
- Faculty of Pharmacy, Bahauddin Zakariya University , Multan, Pakistan
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20
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Sarker AR, Sultana M. Cost-effective analysis of childhood malaria vaccination in endemic hotspots of Bangladesh. PLoS One 2020; 15:e0233902. [PMID: 32470101 PMCID: PMC7259743 DOI: 10.1371/journal.pone.0233902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/14/2020] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Bangladesh has a history of endemic malaria transmission, with 17.5 million people at risk. The objective of this study was to assess the cost-effectiveness of universal childhood malaria vaccination in Chittagong Hill Tracts (CHT) of Bangladesh with newly developed RTS,S/AS01 malaria vaccines. METHODS A decision model was been developed using Microsoft® Excel to examine the potential impact of future vaccination in Bangladesh. We estimated the economic and health burden due to malaria and the cost-effectiveness of malaria vaccination from the health system and societal perspective. The primary outcomes include the incremental cost per Disability-Adjusted Life Year (DALY) averted, incremental cost per case averted, and the incremental cost per death averted. RESULTS Introducing childhood malaria vaccination in CHT in Bangladesh for a single birth cohort could prevent approximately 500 malaria cases and at least 30 deaths from malaria during the first year of vaccination. The cost per DALY averted of introducing the malaria vaccine compared to status quo is US$ 2,629 and US$ 2,583 from the health system and societal perspective, respectively. CONCLUSIONS Introduction of malaria vaccination in CHT region is estimated to be a cost-effective preventive intervention and would offer substantial future benefits particularly for young children vaccinated today. Policies should, thus, consider the operational advantages of targeting these populations, particularly in the CHT area, with the vaccine along with other malaria control initiatives.
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Affiliation(s)
- Abdur Razzaque Sarker
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Dhaka, Bangladesh
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Marufa Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- School of Health and Social Development, Deakin University, Burwood, Melbourne, Australia
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21
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Lu A, Cote O, Dimitrova SD, Cooley G, Alamgir A, Uzzaman MS, Flora MS, Widiati Y, Akhtar MS, Vandenent M, Ehlman DC, Bennett SD, Feldstein LR, Rogier E. Screening for malaria antigen and anti-malarial IgG antibody in forcibly-displaced Myanmar nationals: Cox's Bazar district, Bangladesh, 2018. Malar J 2020; 19:130. [PMID: 32228699 PMCID: PMC7106647 DOI: 10.1186/s12936-020-03199-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/23/2020] [Indexed: 11/21/2022] Open
Abstract
Background Several refugee settlements in Bangladesh have provided housing and medical care for the forcibly-displaced Myanmar nationals (FDMN, also known as Rohingya) population. The identification of malaria infection status in the refugee settlements is useful in treating infected persons and in developing malaria prevention recommendations. Assays for Plasmodium antigens and human IgG against Plasmodium parasites can be used as indicators to determine malaria infection status and exposure. Methods Dried blood spot (DBS) samples (N = 1239) from a household survey performed April–May 2018 in three settlements in Cox’s Bazar district, Bangladesh were utilized for a sample population of children from ages 1–14 years of age. The samples were tested using a bead-based multiplex antigen assay for presence of the pan-Plasmodium antigen aldolase as well as Plasmodium falciparum histidine rich protein 2 (HRP2). A bead-based multiplex assay was also used to measure human IgG antibody response to P. falciparum, Plasmodium malariae, and Plasmodium vivax merozoite surface protein 1 antigen (MSP1) isoforms, and P. falciparum antigens LSA1, CSP, and GLURP-R0. Results There were no detectable Plasmodium antigens in any samples, suggesting no active malaria parasite infections in the tested children. IgG seroprevalence was highest to P. vivax (3.1%), but this was not significantly different from the percentages of children antibody responses to P. falciparum (2.1%) and P. malariae (1.8%). The likelihood of an anti-Plasmodium IgG response increased with age for all three malaria species. Evidence of exposure to any malaria species was highest for children residing 8–10 months in the settlements, and was lower for children arriving before and after this period of time. Conclusions Absence of Plasmodium antigen in this population provides evidence that children in these three Bangladeshi refugee settlements did not have malaria at time of sampling. Higher rates of anti-malarial IgG carriage from children who were leaving Myanmar during the malaria high-transmission season indicate these migrant populations were likely at increased risk of malaria exposure during their transit.
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Affiliation(s)
- Austin Lu
- Georgia State University, Atlanta, GA, 30302, USA
| | - Olivia Cote
- Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Silvia D Dimitrova
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Synergy America, Inc., Duluth, GA, 30097, USA
| | - Gretchen Cooley
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - A Alamgir
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | - M Salim Uzzaman
- Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | | | - Yulia Widiati
- United Nations Children's Fund, Motel Road, Cox's Bazar, 4700, Bangladesh
| | | | - Maya Vandenent
- United Nations Children's Fund, 1 Minto Road, Dhaka, 1000, Bangladesh
| | - Daniel C Ehlman
- Global Immunization Division, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Sarah D Bennett
- Global Immunization Division, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Leora R Feldstein
- Global Immunization Division, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
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22
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Mihreteab S, Lubinda J, Zhao B, Rodriguez-Morales AJ, Karamehic-Muratovic A, Goitom A, Shad MY, Haque U. Retrospective data analyses of social and environmental determinants of malaria control for elimination prospects in Eritrea. Parasit Vectors 2020; 13:126. [PMID: 32164770 PMCID: PMC7068948 DOI: 10.1186/s13071-020-3974-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background The present study focuses on both long- and short-term malaria transmission in Eritrea and investigates the risk factors. Annual aggregates of information on malaria cases, deaths, diagnostics and control interventions from 2001 to 2008 and monthly reported data from 2009 to 2017 were obtained from the National Malaria Control Programme. We used a generalized linear regression model to examine the associations among total malaria cases, death, insecticide-treated net coverage, indoor residual spraying and climatic parameters. Results Reduction in malaria mortality is demonstrated by the milestone margins of over 97% by the end of 2017. Malaria incidence likewise declined during the period (from 33 to 5 per 1000 population), representing a reduction of about 86% (R2 = 0.3) slightly less than the decline in mortality. The distribution of insecticide treated nets generally declined between 2001 and 2014 (R2 = 0.16) before increasing from 2015 to 2017, while the number of people protected by indoor residual spraying slightly increased (R2 = 0.27). Higher rainfall was significantly associated with an increased number of malaria cases. The covariates rainfall and temperature are a better pair than IRS and LLIN to predict incidences. On the other hand, IRS and LLIN is a more significant pair to predict mortality cases. Conclusions While Eritrea has made significant progress towards malaria elimination, this progress should be maintained and further improved. Distribution, coverage and utilization of malaria control and elimination tools should be optimized and sustained to safeguard the gains made. Additionally, consistent annual performance evaluation of malaria indicators would ensure a continuous learning process from gains/threats of epidemics and resurgence in regions already earmarked for elimination.
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Affiliation(s)
- Selam Mihreteab
- National Malaria Control Programme, Ministry of Health, Asmara, Eritrea.
| | - Jailos Lubinda
- School of Geography and Environmental Sciences, Ulster University, Coleraine, UK
| | - Bingxin Zhao
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Medical School, Faculty of Health Sciences, UniFranz, Cochabamba, Bolivia.,Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | | | - Aman Goitom
- National Malaria Control Programme, Ministry of Health, Asmara, Eritrea
| | | | - Ubydul Haque
- Department of Geography, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
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23
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Sinha I, Sayeed AA, Uddin D, Wesolowski A, Zaman SI, Faiz MA, Ghose A, Rahman MR, Islam A, Karim MJ, Saha A, Rezwan MK, Shamsuzzaman AKM, Jhora ST, Aktaruzzaman MM, Chang HH, Miotto O, Kwiatkowski D, Dondorp AM, Day NPJ, Hossain MA, Buckee C, Maude RJ. Mapping the travel patterns of people with malaria in Bangladesh. BMC Med 2020; 18:45. [PMID: 32127002 PMCID: PMC7055101 DOI: 10.1186/s12916-020-1512-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Spread of malaria and antimalarial resistance through human movement present major threats to current goals to eliminate the disease. Bordering the Greater Mekong Subregion, southeast Bangladesh is a potentially important route of spread to India and beyond, but information on travel patterns in this area are lacking. METHODS Using a standardised short survey tool, 2090 patients with malaria were interviewed at 57 study sites in 2015-2016 about their demographics and travel patterns in the preceding 2 months. RESULTS Most travel was in the south of the study region between Cox's Bazar district (coastal region) to forested areas in Bandarban (31% by days and 45% by nights), forming a source-sink route. Less than 1% of travel reported was between the north and south forested areas of the study area. Farmers (21%) and students (19%) were the top two occupations recorded, with 67 and 47% reporting travel to the forest respectively. Males aged 25-49 years accounted for 43% of cases visiting forests but only 24% of the study population. Children did not travel. Women, forest dwellers and farmers did not travel beyond union boundaries. Military personnel travelled the furthest especially to remote forested areas. CONCLUSIONS The approach demonstrated here provides a framework for identifying key traveller groups and their origins and destinations of travel in combination with knowledge of local epidemiology to inform malaria control and elimination efforts. Working with the NMEP, the findings were used to derive a set of policy recommendations to guide targeting of interventions for elimination.
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Affiliation(s)
- Ipsita Sinha
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | | | - Didar Uddin
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Amy Wesolowski
- John Hopkins Bloomberg School of Public Health, Baltimore, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Sazid Ibna Zaman
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- BRAC (Building Resources Across Communities), BRAC Centre, Mohakhali, Dhaka, Bangladesh
| | - M Abul Faiz
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Dev Care Foundation, Dhaka, Bangladesh
| | - Aniruddha Ghose
- Chittagong Medical College and Hospital, Chittagong, Bangladesh
| | | | - Akramul Islam
- BRAC (Building Resources Across Communities), BRAC Centre, Mohakhali, Dhaka, Bangladesh
| | - Mohammad Jahirul Karim
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
- Filariasis Elimination, STH Control, Dhaka, Bangladesh
| | - Anjan Saha
- National Malaria Elimination Programme, Dhaka, Bangladesh
| | - M Kamar Rezwan
- Vector-Borne Disease Control, World Health Organization, Dhaka, Bangladesh
| | | | - Sanya Tahmina Jhora
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | - M M Aktaruzzaman
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
- National Malaria Elimination Programme, Dhaka, Bangladesh
| | - Hsiao-Han Chang
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Olivo Miotto
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Big Data Institute, University of Oxford, Oxford, UK
| | - Dominic Kwiatkowski
- Big Data Institute, University of Oxford, Oxford, UK
- Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - M Amir Hossain
- Chittagong Medical College and Hospital, Chittagong, Bangladesh
| | - Caroline Buckee
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Richard J Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
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Systematic review and meta-analysis of the cost and cost-effectiveness of distributing insecticide-treated nets for the prevention of malaria. Acta Trop 2020; 202:105229. [PMID: 31669182 DOI: 10.1016/j.actatropica.2019.105229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022]
Abstract
Insecticide-treated nets are one of two core vector control interventions recommended by the World Health Organization for deployment in malaria-endemic regions around the world, especially sub-Saharan Africa. Although there are many factors that influence the type of distribution strategy chosen, among the most important considerations for the type of distribution strategy chosen is cost, both in terms of total expenditure required and in terms of relative cost-effectiveness. This research attempted to inform these decisions by conducting a systematic review and meta-analysis of the literature on the cost and cost-effectiveness of ITN distribution. The analysis compared the relative cost and cost-effectiveness of distribution strategies. Findings suggest that mass campaigns have lower average distribution costs per net compared with continuous/health facility distribution or sale/vouchers, although the relationship between distribution channel and cost were not statistically significant in the multivariate regression models. Continuous/health facility distribution channels were found to be more cost-effective than mass campaigns for averting DALYs, death, and cases of malaria. Those who design and budget for malaria programs should base decisions about distribution channels more on operational and epidemiological considerations than on cost per net, as the costs per net between distribution channels are not statistically different.
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25
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Chanda E, Arshad M, Khaloua A, Zhang W, Namboze J, Uusiku P, Angula AH, Gausi K, Tiruneh D, Islam QM, Kolivras K, Haque U. An investigation of the Plasmodium falciparum malaria epidemic in Kavango and Zambezi regions of Namibia in 2016. Trans R Soc Trop Med Hyg 2019; 112:546-554. [PMID: 30252108 DOI: 10.1093/trstmh/try097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/10/2018] [Indexed: 01/26/2023] Open
Abstract
Background Namibia is one of the countries among the eight that are targeting malaria elimination in southern Africa. However, the country has encountered malaria epidemics in recent years. The objective of this study was to investigate malaria epidemics and to contribute to strengthening malaria surveillance and control in an effort to move Namibia toward eliminating malaria. Method Malaria epidemiology data for 2014-2015 were collected from the weekly surveillance system. All consenting household members within a 100-m radius of index households were screened in 2016 using a Carestart malaria HRP2/pLDH combined rapid diagnostic test after epidemics. All houses within this radius were sprayed in 2016 with the pyrethroid deltamethrin and K-Othrine WG 250. Anopheles mosquito-positive breeding sites were identified and treated with the organophosphate larvicide temephos. Insecticide susceptibility and bioassay tests were conducted. Results During the epidemic response period in 2016, 56 parasitologically confirmed Plasmodium falciparum malaria cases in the Zambezi region were detected from active screening. The majority of those cases (83%) were asymptomatic infections. In the Kavango region, the malaria epidemic persisted, with 228 P. falciparum malaria cases recorded, but only 97 were investigated. In Namibia, malaria vector susceptibility was detected to 4% dichlorodiphenyltrichloroethane. Indoor residual spraying was conducted in 377 (90%) of the targeted households along with community awareness through health education of 1499 people and distribution of more than 2000 information, education and communication materials. The P. falciparum malaria cases in the Zambezi decreased from 122 in week 9 to 97 after week 15. Conclusions Malaria epidemics along with the persistence of asymptomatic reservoir infections pose a serious challenge in Namibia's elimination effort. The country needs to ensure sustainable interventions to target asymptomatic reservoir infections and prevent epidemics in order to successfully achieve its goal of eliminating malaria.
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Affiliation(s)
- Emmanuel Chanda
- World Health Organization, Regional Office for Africa, Cite du Djoue, Brazzaville, Republic of the Congo
| | - Mohd Arshad
- Department of Statistics and Operations Research, Aligarh Muslim University, Aligarh, India
| | - Asmaa Khaloua
- Department of Computer Science and Engineering, 1155 Union Circle #311366 Denton, Texas, USA
| | - Wenyi Zhang
- Institute of Disease Control and Prevention of PLA, NO. 20 Dong-Da-Jie Street, Fengtai District, Beijing, PR China
| | - Josephine Namboze
- World Health Organization, Country Office, Geza Banda-Adi Yacob St 178, Asmara 291-1, Eritrea
| | - Pentrina Uusiku
- Ministry of Health and Social Services, National Vector-borne Diseases Control Programme, Florence Nightingale Street, Windhoek, Namibia
| | - Andreas H Angula
- Ministry of Health and Social Services, National Vector-borne Diseases Control Programme, Florence Nightingale Street, Windhoek, Namibia
| | - Khoti Gausi
- World Health Organization, East and Southern Africa Inter-country Support Team, Causeway Harare, Zimbabwe
| | - Desta Tiruneh
- World Health Organization, Country Office, Windhoek, Namibia
| | - Quazi M Islam
- World Health Organization, Country Office, Windhoek, Namibia
| | - Korine Kolivras
- Department of Geography, Virginia Tech, 220 Stanger St, 115 Major Williams Hall, Blacksburg, VA, USA
| | - Ubydul Haque
- Department of Geography, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
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Hannah H, Brezak A, Hu A, Chiwanda S, Simckes M, Revere D, Shambira G, Tshimanga M, Mberikunashe J, Juru T, Gombe N, Kasprzyk D, Montaño D, Baseman J. Field-based evaluation of malaria outbreak detection and response in Mudzi and Goromonzi districts, Zimbabwe - 2017. Glob Public Health 2019; 14:1898-1910. [PMID: 31303135 DOI: 10.1080/17441692.2019.1642367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
National-level evaluations may fail to identify capacity improvements for detecting and responding to outbreaks which begin and are first detected at the local level. In response to this issue, we conducted a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe. We visited eleven clinics in Mudzi and Goromonzi districts. Twenty-one interviews were conducted with key informants from the provincial (n = 2), district (n = 7), and clinic (n = 12) levels. Interviews focused on surveillance system activities, preparedness, data quality, timeliness, stability, and usefulness. Main themes were captured utilising standard qualitative data analysis techniques. While the surveillance system detects malaria outbreaks at all levels, we identified several gaps. Clinics experience barriers to timely and reliable reporting of outbreaks to the district level and staff cross-training. Stability of resources, including transportation (33% of informants, n = 7) and staff capacity (48% of informants, n = 10), presented barriers. Strengthening these surveillance barriers may improve staff readiness to detect malaria outbreaks, resulting in timelier outbreak response and a reduction in malaria outbreaks, cases, and deaths. By focusing at the local level, our assessment approach provides a framework for identifying and addressing gaps that may be overlooked when utilising tools that evaluate surveillance capacity at the national level.
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Affiliation(s)
- Haylea Hannah
- Department of Epidemiology, School of Public Health, University of Washington , Seattle , WA , United States of America
| | - Audrey Brezak
- Department of Epidemiology, School of Public Health, University of Washington , Seattle , WA , United States of America
| | - Audrey Hu
- Department of Epidemiology, School of Public Health, University of Washington , Seattle , WA , United States of America
| | - Simbarashe Chiwanda
- Department of Community Medicine, Field Epidemiology Training Program, University of Zimbabwe , Harare , Zimbabwe
| | - Maayan Simckes
- Department of Epidemiology, School of Public Health, University of Washington , Seattle , WA , United States of America
| | - Debra Revere
- Department of Health Services, School of Public Health, University of Washington , Seattle , United States of America
| | - Gerald Shambira
- Department of Community Medicine, Field Epidemiology Training Program, University of Zimbabwe , Harare , Zimbabwe
| | - Mufuta Tshimanga
- Department of Community Medicine, Field Epidemiology Training Program, University of Zimbabwe , Harare , Zimbabwe
| | - Joseph Mberikunashe
- Ministry of Health and Child Care, National Malaria Control Program , Harare , Zimbabwe
| | - Tsitsi Juru
- Department of Community Medicine, Field Epidemiology Training Program, University of Zimbabwe , Harare , Zimbabwe
| | - Notion Gombe
- Department of Community Medicine, Field Epidemiology Training Program, University of Zimbabwe , Harare , Zimbabwe
| | - Danuta Kasprzyk
- Departments of Family and Child Nursing and Global Health, University of Washington , Seattle , WA , United States of America
| | - Daniel Montaño
- Departments of Family and Child Nursing and Global Health, University of Washington , Seattle , WA , United States of America
| | - Janet Baseman
- Department of Epidemiology, School of Public Health, University of Washington , Seattle , WA , United States of America.,Department of Health Services, School of Public Health, University of Washington , Seattle , United States of America
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Mahumud RA, Alam K, Renzaho AMN, Sarker AR, Sultana M, Sheikh N, Rawal LB, Gow J. Changes in inequality of childhood morbidity in Bangladesh 1993-2014: A decomposition analysis. PLoS One 2019; 14:e0218515. [PMID: 31216352 PMCID: PMC6583970 DOI: 10.1371/journal.pone.0218515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 06/04/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. MATERIALS AND METHODS A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993-2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. RESULTS The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. CONCLUSIONS High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economically disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.
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Affiliation(s)
- Rashidul Alam Mahumud
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Khorshed Alam
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Andre M. N. Renzaho
- School of Social Science and Psychology, Western Sydney University, Sydney Australia
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Management Science, University of Strathclyde Business School, Glasgow, United Kingdom
| | - Marufa Sultana
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- School of Health & Social Development, Deakin University, Melbourne, Australia
| | - Nurnabi Sheikh
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Lal B. Rawal
- School of Social Science and Psychology, Western Sydney University, Sydney Australia
| | - Jeff Gow
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
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28
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Chang HH, Wesolowski A, Sinha I, Jacob CG, Mahmud A, Uddin D, Zaman SI, Hossain MA, Faiz MA, Ghose A, Sayeed AA, Rahman MR, Islam A, Karim MJ, Rezwan MK, Shamsuzzaman AKM, Jhora ST, Aktaruzzaman MM, Drury E, Gonçalves S, Kekre M, Dhorda M, Vongpromek R, Miotto O, Engø-Monsen K, Kwiatkowski D, Maude RJ, Buckee C. Mapping imported malaria in Bangladesh using parasite genetic and human mobility data. eLife 2019; 8:43481. [PMID: 30938289 PMCID: PMC6478433 DOI: 10.7554/elife.43481] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/14/2019] [Indexed: 01/25/2023] Open
Abstract
For countries aiming for malaria elimination, travel of infected individuals between endemic areas undermines local interventions. Quantifying parasite importation has therefore become a priority for national control programs. We analyzed epidemiological surveillance data, travel surveys, parasite genetic data, and anonymized mobile phone data to measure the spatial spread of malaria parasites in southeast Bangladesh. We developed a genetic mixing index to estimate the likelihood of samples being local or imported from parasite genetic data and inferred the direction and intensity of parasite flow between locations using an epidemiological model integrating the travel survey and mobile phone calling data. Our approach indicates that, contrary to dogma, frequent mixing occurs in low transmission regions in the southwest, and elimination will require interventions in addition to reducing imported infections from forested regions. Unlike risk maps generated from clinical case counts alone, therefore, our approach distinguishes areas of frequent importation as well as high transmission.
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Affiliation(s)
- Hsiao-Han Chang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States.,The Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Ipsita Sinha
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Ayesha Mahmud
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States.,The Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Didar Uddin
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sazid Ibna Zaman
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Md Amir Hossain
- Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
| | - M Abul Faiz
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Dev Care Foundation, Dhaka, Bangladesh
| | | | | | | | | | | | - M Kamar Rezwan
- Vector-Borne Disease Control, World Health Organization, Dhaka, Bangladesh
| | | | - Sanya Tahmina Jhora
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | | | - Eleanor Drury
- Wellcome Sanger Institute, Cambridge, United Kingdom
| | | | - Mihir Kekre
- Wellcome Sanger Institute, Cambridge, United Kingdom
| | - Mehul Dhorda
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Worldwide Antimalarial Resistance Network, Asia Regional Centre, Bangkok, Thailand
| | - Ranitha Vongpromek
- Worldwide Antimalarial Resistance Network, Asia Regional Centre, Bangkok, Thailand
| | - Olivo Miotto
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Wellcome Sanger Institute, Cambridge, United Kingdom.,Big Data Institute, Oxford University, Oxford, United Kingdom
| | | | - Dominic Kwiatkowski
- Wellcome Sanger Institute, Cambridge, United Kingdom.,Big Data Institute, Oxford University, Oxford, United Kingdom
| | - Richard J Maude
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States.,The Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, United States.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Caroline Buckee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States.,The Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, United States
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29
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Khanam F, Hossain MB, Chowdhury TR, Rahman MS, Kabir M, Naher S, Islam MA, Rahman M. Exploring the gap between coverage, access, and utilization of long-lasting insecticide-treated nets (LLINs) among the households of malaria endemic districts in Bangladesh. Malar J 2018; 17:455. [PMID: 30522487 PMCID: PMC6282300 DOI: 10.1186/s12936-018-2610-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is still a major public health concern in Bangladesh in spite of mass distribution of long-lasting insecticide-treated nets (LLINs) as a key preventive strategy. There might be a considerable gap between coverage and actual use of nets by the population in endemic areas. This study intended to assess the gap between coverage, access to and use of LLINs among the households in malaria-endemic settings in Bangladesh. METHODS This cross-sectional study collected data from 2640 households of 13 endemic districts of Bangladesh through three-stage cluster random sampling. The gap between coverage, access and use of LLINs were calculated using the procedure established by the Roll Back Malaria Monitoring and Evaluation Reference Group. To support the quantitative findings, qualitative data were also collected through in-depth interview, focus group discussion and key informant interview and analysed accordingly. RESULTS Of 2640 total households, 77.4% (n = 2044) possessed at least two LLINs, 56.8% (n = 1499) had insufficient access, and 18.8% (n = 495) had excess LLINs. Members of 77.9% (n = 2056) households had used LLINs the previous night and 6.0% (n = 68) did not use LLINs despite having sufficient access. LLIN use was lower in non-hill track areas, in Bengali community, in richer households and households with more than four members. Moreover, qualitative findings revealed that the major reasons behind not using LLINs were insufficient access, sleeping outside the home, migration, perceived low efficacy of LLINs, or fear of physical side effects. CONCLUSION Closing the access gap by providing enough nets through solid investment and well-designed behavioural change interventions are crucial for achieving and sustaining universal coverage.
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Affiliation(s)
- Fouzia Khanam
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Belal Hossain
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Tridib Roy Chowdhury
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Sajedur Rahman
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Moktadir Kabir
- Tuberculosis and Malaria Control Programme, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Shamsun Naher
- Tuberculosis and Malaria Control Programme, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Akramul Islam
- Tuberculosis and Malaria Control Programme, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Mahfuzar Rahman
- Research and Evaluation Division, BRAC, BRAC Centre, 75 Mohakhali, Dhaka, 1212, Bangladesh.
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30
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Noé A, Zaman SI, Rahman M, Saha AK, Aktaruzzaman MM, Maude RJ. Mapping the stability of malaria hotspots in Bangladesh from 2013 to 2016. Malar J 2018; 17:259. [PMID: 29996835 PMCID: PMC6042289 DOI: 10.1186/s12936-018-2405-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria claims hundreds of thousands of lives each year, most of them children. A "malaria-free world" is the World Health Organization's vision, but elimination from the southeast Asian Region is hampered by factors including anti-malarial resistance and systematic underreporting. Malaria is a significant public health problem in Bangladesh and while there have been recent gains in control, there is large spatial and temporal heterogeneity in the disease burden. This study aims to determine the pattern and stability of malaria hotspots in Bangladesh with the end goal of informing intervention planning for elimination. RESULTS Malaria in Bangladesh exhibited highly seasonal, hypoendemic transmission in geographic hotspots, which remained conserved over time. The southeast areas of the Chittagong Hill Tracts were identified as malaria hotspots for all 4 years examined. Similarly, areas in Sunamganj and Netrakona districts in the Northeast were hotspots for 2013-2016. Highly stable hotspots from 1 year predicted the following year's hotspot locations in the southeast of Bangladesh. Hotspots did not appear to act as sources of spread with no evidence of consistent patterns of contiguous spread or recession of hotspots as high or low transmission seasons progressed. CONCLUSIONS Areas were identified with temporal and spatial clustering of high malaria incidence in Bangladesh. Further studies are required to understand the vector, sociodemographic and disease dynamics within these hotspots. Given the low caseloads occurring in the low transmission seasons, and the conserved nature of malaria hotspots, directing resources towards these areas may be an efficient way to achieve malaria elimination in Bangladesh.
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Affiliation(s)
- Andrés Noé
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Sazid Ibna Zaman
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Mosiqure Rahman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Anjan Kumar Saha
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - M M Aktaruzzaman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Richard James Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA.
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Hasan MI, Hossain SJ, Braat S, Dibley MJ, Fisher J, Grantham-McGregor S, Tofail F, Simpson JA, Arifeen SE, Hamadani J, Biggs BA, Pasricha SR. Benefits and risks of Iron interventions in children (BRISC): protocol for a three-arm parallel-group randomised controlled field trial in Bangladesh. BMJ Open 2017; 7:e018325. [PMID: 29146650 PMCID: PMC5695407 DOI: 10.1136/bmjopen-2017-018325] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Anaemia is a major global health problem affecting about 43% of preschool children globally and 60% of 6-24-month-old children in rural Bangladesh, half of which is attributed to iron deficiency (ID). Although WHO recommends universal supplementation with iron or home fortification with iron-containing multiple micronutrient powders (MMPs) to children under 2 years, evidence for benefits of these interventions on childhood development (a key rationale for these interventions) and harms (especially infection) remains limited. This study aims to evaluate the impact of iron or MMPs supplementation compared with placebo on (a) children's development, (b) growth, (c) morbidity from infections and (d) haematological and iron indices. METHODS AND ANALYSIS This study is a three-arm, blinded, double-dummy, parallel-group, placebo-controlled superiority trial using stratified individual block randomisation. The trial will randomise 3300 children aged 8-9 months equally to arm 1: iron syrup (12.5 mg elemental iron), placebo MMPs; arm 2: MMPs (including 12.5 mg elemental iron), placebo syrup; and arm 3: placebo syrup, placebo MNPs. Children will receive interventions for 3 months based on WHO recommendations and then be followed up for 9 months post intervention. The primary outcome is cognitive composite score measured by Bayley III. Secondary outcomes include motor and language composite score by Bayley III, behaviour rating using selected items from Wolke's rating scales and BSID-II behaviour ratings, temperament, growth, haemoglobin, anaemia and iron status, and infectious morbidity. Outcomes will be measured at baseline, at the end of 3-month intervention and after 9 months postintervention follow-up. ETHICS AND DISSEMINATION The trial has been approved by the Ethical Review Committee of icddr,b (Dhaka, Bangladesh) and the Melbourne Health Human Research Ethics Committee (Melbourne, Australia). Results of the study will be disseminated through scientific publications, presentations at international meetings and policy briefs to key stakeholders. TRIAL REGISTRATION NUMBER ACTRN12617000660381;Pre-results. WHO UNIVERSAL TRIAL NUMBER U1111-1196-1125.
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Affiliation(s)
- Mohammed Imrul Hasan
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sheikh Jamal Hossain
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health and Melbourne Clinical and Translational Sciences (MCATS), University of Melbourne, Melbourne, Australia
| | | | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Fahmida Tofail
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health and Melbourne Clinical and Translational Sciences (MCATS), University of Melbourne, Melbourne, Australia
| | - Shams Ei Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jena Hamadani
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Sant-Rayn Pasricha
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, Australia
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32
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Alam MZ, Niaz Arifin SM, Al-Amin HM, Alam MS, Rahman MS. A spatial agent-based model of Anopheles vagus for malaria epidemiology: examining the impact of vector control interventions. Malar J 2017; 16:432. [PMID: 29078771 PMCID: PMC5658966 DOI: 10.1186/s12936-017-2075-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 10/19/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Malaria, being a mosquito-borne infectious disease, is still one of the most devastating global health issues. The malaria vector Anopheles vagus is widely distributed in Asia and a dominant vector in Bandarban, Bangladesh. However, despite its wide distribution, no agent based model (ABM) of An. vagus has yet been developed. Additionally, its response to combined vector control interventions has not been examined. METHODS A spatial ABM, denoted as ABM[Formula: see text], was designed and implemented based on the biological attributes of An. vagus by modifying an established, existing ABM of Anopheles gambiae. Environmental factors such as temperature and rainfall were incorporated into ABM[Formula: see text] using daily weather profiles. Real-life field data of Bandarban were used to generate landscapes which were used in the simulations. ABM[Formula: see text] was verified and validated using several standard techniques and against real-life field data. Using artificial landscapes, the individual and combined efficacies of existing vector control interventions are modeled, applied, and examined. RESULTS Simulated female abundance curves generated by ABM[Formula: see text] closely follow the patterns observed in the field. Due to the use of daily temperature and rainfall data, ABM[Formula: see text] was able to generate seasonal patterns for a particular area. When two interventions were applied with parameters set to mid-ranges, ITNs/LLINs with IRS produced better results compared to the other cases. Moreover, any intervention combined with ITNs/LLINs yielded better results. Not surprisingly, three interventions applied in combination generate best results compared to any two interventions applied in combination. CONCLUSIONS Output of ABM[Formula: see text] showed high sensitivity to real-life field data of the environmental factors and the landscape of a particular area. Hence, it is recommended to use the model for a given area in connection to its local field data. For applying combined interventions, three interventions altogether are highly recommended whenever possible. It is also suggested that ITNs/LLINs with IRS can be applied when three interventions are not available.
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Affiliation(s)
- Md. Zahangir Alam
- Department of Computer Science & Engineering (CSE), Bangladesh University of Engineering & Technology (BUET), ECE Building, West Palasi, Dhaka, 1205 Bangladesh
| | - S. M. Niaz Arifin
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, Indiana 46556 USA
| | - Hasan Mohammad Al-Amin
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212 Bangladesh
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212 Bangladesh
| | - M. Sohel Rahman
- Department of Computer Science & Engineering (CSE), Bangladesh University of Engineering & Technology (BUET), ECE Building, West Palasi, Dhaka, 1205 Bangladesh
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Alam MS, Ley B, Nima MK, Johora FT, Hossain ME, Thriemer K, Auburn S, Marfurt J, Price RN, Khan WA. Molecular analysis demonstrates high prevalence of chloroquine resistance but no evidence of artemisinin resistance in Plasmodium falciparum in the Chittagong Hill Tracts of Bangladesh. Malar J 2017; 16:335. [PMID: 28806961 PMCID: PMC5557264 DOI: 10.1186/s12936-017-1995-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/10/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Artemisinin resistance is present in the Greater Mekong region and poses a significant threat for current anti-malarial treatment guidelines in Bangladesh. The aim of this molecular study was to assess the current status of drug resistance in the Chittagong Hill Tracts of Bangladesh near the Myanmar border. METHODS Samples were obtained from patients enrolled into a Clinical Trial (NCT02389374) conducted in Alikadam, Bandarban between August 2014 and January 2015. Plasmodium falciparum infections were confirmed by PCR and all P. falciparum positive isolates genotyped for the pfcrt K76T and pfmdr1 N86Y markers. The propeller region of the kelch 13 (k13) gene was sequenced from isolates from patients with delayed parasite clearance. RESULTS In total, 130 P. falciparum isolates were available for analysis. The pfcrt mutation K76T, associated with chloroquine resistance was found in 81.5% (106/130) of cases and the pfmdr1 mutation N86Y in 13.9% (18/130) cases. No single nucleotide polymorphisms were observed in the k13 propeller region. CONCLUSION This study provides molecular evidence for the ongoing presence of chloroquine resistant P. falciparum in Bangladesh, but no evidence of mutations in the k13 propeller domain associated with artemisinin resistance. Monitoring for artemisinin susceptibility in Bangladesh is needed to ensure early detection and containment emerging anti-malarial resistance.
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Affiliation(s)
- Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka, 1212 Bangladesh
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Maisha Khair Nima
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka, 1212 Bangladesh
| | - Fatema Tuj Johora
- Department of Zoology, University of Dhaka, Ramna, Dhaka, 1000 Bangladesh
| | - Mohammad Enayet Hossain
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka, 1212 Bangladesh
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Sarah Auburn
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Jutta Marfurt
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Wasif A. Khan
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka, 1212 Bangladesh
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Lai S, Li Z, Wardrop NA, Sun J, Head MG, Huang Z, Zhou S, Yu J, Zhang Z, Zhou SS, Xia Z, Wang R, Zheng B, Ruan Y, Zhang L, Zhou XN, Tatem AJ, Yu H. Malaria in China, 2011-2015: an observational study. Bull World Health Organ 2017; 95:564-573. [PMID: 28804168 PMCID: PMC5537755 DOI: 10.2471/blt.17.191668] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/03/2017] [Accepted: 05/09/2017] [Indexed: 12/16/2022] Open
Abstract
Objective To ascertain the trends and burden of malaria in China and the costs of interventions for 2011–2015. Methods We analysed the spatiotemporal and demographic features of locally transmitted and imported malaria cases using disaggregated surveillance data on malaria from 2011 to 2015, covering the range of dominant malaria vectors in China. The total and mean costs for malaria elimination were calculated by funding sources, interventions and population at risk. Findings A total of 17 745 malaria cases, including 123 deaths (0.7%), were reported in mainland China, with 15 840 (89%) being imported cases, mainly from Africa and south-east Asia. Almost all counties of China (2855/2858) had achieved their elimination goals by 2015, and locally transmitted cases dropped from 1469 cases in 2011 to 43 cases in 2015, mainly occurring in the regions bordering Myanmar where Anopheles minimus and An. dirus are the dominant vector species. A total of United States dollars (US$) 134.6 million was spent in efforts to eliminate malaria during 2011–2015, with US$ 57.2 million (43%) from the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$ 77.3 million (57%) from the Chinese central government. The mean annual investment (US$ 27 million) per person at risk (574 million) was US$ 0.05 (standard deviation: 0.03). Conclusion The locally transmitted malaria burden in China has decreased. The key challenge is to address the remaining local transmission, as well as to reduce imported cases from Africa and south-east Asia. Continued efforts and appropriate levels of investment are needed in the 2016–2020 period to achieve elimination.
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Affiliation(s)
- Shengjie Lai
- School of Public Health, Fudan University, Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Zhongjie Li
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nicola A Wardrop
- Department of Geography and Environment, University of Southampton, Southampton, England
| | - Junling Sun
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Michael G Head
- Faculty of Medicine and Global Health Research Institute, University of Southampton, Southampton, England
| | - Zhuojie Huang
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng Zhou
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianxing Yu
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences
| | - Zike Zhang
- The First Affiliated Hospital College of Medicine, Zhejiang University, Hangzhou, China
| | - Shui-Sen Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Zhigui Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Rubo Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Bin Zheng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Yao Ruan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Andrew J Tatem
- Department of Geography and Environment, University of Southampton, Southampton, England
| | - Hongjie Yu
- School of Public Health, Fudan University, Dongan Road, Xuhui District, Shanghai, 200032, China
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Shretta R, Avanceña ALV, Hatefi A. The economics of malaria control and elimination: a systematic review. Malar J 2016; 15:593. [PMID: 27955665 PMCID: PMC5154116 DOI: 10.1186/s12936-016-1635-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Declining donor funding and competing health priorities threaten the sustainability of malaria programmes. Elucidating the cost and benefits of continued investments in malaria could encourage sustained political and financial commitments. The evidence, although available, remains disparate. This paper reviews the existing literature on the economic and financial cost and return of malaria control, elimination and eradication. METHODS A review of articles that were published on or before September 2014 on the cost and benefits of malaria control and elimination was performed. Studies were classified based on their scope and were analysed according to two major categories: cost of malaria control and elimination to a health system, and cost-benefit studies. Only studies involving more than two control or elimination interventions were included. Outcomes of interest were total programmatic cost, cost per capita, and benefit-cost ratios (BCRs). All costs were converted to 2013 US$ for standardization. RESULTS Of the 6425 articles identified, 54 studies were included in this review. Twenty-two were focused on elimination or eradication while 32 focused on intensive control. Forty-eight per cent of studies included in this review were published on or after 2000. Overall, the annual per capita cost of malaria control to a health system ranged from $0.11 to $39.06 (median: $2.21) while that for malaria elimination ranged from $0.18 to $27 (median: $3.00). BCRs of investing in malaria control and elimination ranged from 2.4 to over 145. CONCLUSION Overall, investments needed for malaria control and elimination varied greatly amongst the various countries and contexts. In most cases, the cost of elimination was greater than the cost of control. At the same time, the benefits of investing in malaria greatly outweighed the costs. While the cost of elimination in most cases was greater than the cost of control, the benefits greatly outweighed the cost. Information from this review provides guidance to national malaria programmes on the cost and benefits of malaria elimination in the absence of data. Importantly, the review highlights the need for more robust economic analyses using standard inputs and methods to strengthen the evidence needed for sustained financing for malaria elimination.
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Affiliation(s)
- Rima Shretta
- The Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA 94158 USA
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- University of Basel, Petersplatz 1, 4001 Basel, Switzerland
| | - Anton L. V. Avanceña
- The Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA 94158 USA
| | - Arian Hatefi
- The Global Health Group, University of California, San Francisco, 550 16th St, 3rd Floor, Box 1224, San Francisco, CA 94158 USA
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA USA
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Alam MS, Kabir MM, Hossain MS, Naher S, Ferdous NEN, Khan WA, Mondal D, Karim J, Shamsuzzaman AKM, Ahmed BN, Islam A, Haque R. Reduction in malaria prevalence and increase in malaria awareness in endemic districts of Bangladesh. Malar J 2016; 15:552. [PMID: 27836016 PMCID: PMC5105313 DOI: 10.1186/s12936-016-1603-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is endemic in 13 districts of Bangladesh. A baseline malaria prevalence survey across the endemic districts of Bangladesh was conducted in 2007, when the prevalence was reported around 39.7 per 1000 population. After two rounds of Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)-funded intervention by the National Malaria Control Programme (NMCP) and a BRAC-led NGO consortium, a follow-up survey was conducted across the malaria-endemic districts of Bangladesh to measure the change in prevalence rate and in people's knowledge of malaria. METHODS The survey was carried out from August to November 2013 in 70 upazilas (sub-districts) of 13 malaria-endemic districts of Bangladesh, following the same multi-stage cluster sampling design and the same number of households enrolled during the baseline prevalence survey in 2007, to collect 9750 randomly selected blood samples. For on-the-spot diagnosis of malaria, a rapid diagnostic test was used. The household head or eldest person available was interviewed using a pre-coded structured questionnaire to collect data on the knowledge and awareness of malaria in the household. RESULTS Based on a weighted calculation, the overall malaria prevalence was found to be 1.41 per 1000 population. The proportion of Plasmodium falciparum mono-infection was 77.78% while both Plasmodium vivax mono-infection and mixed infection of the two species were found to be 11.11%. Bandarban had the highest prevalence (6.67 per 1000 population). Knowledge of malaria signs, symptoms and mode of transmission were higher in the follow-up survey (97.26%) than the baseline survey. Use of bed nets for prevention of malaria was found to be high (90.15%) at respondent level. People's knowledge of selected parameters increased significantly during the follow-up survey compared to the baseline survey conducted in 2007. CONCLUSIONS A reduced prevalence rate of malaria and increased level of knowledge were observed in the present malaria prevalence survey in Bangladesh.
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Affiliation(s)
| | | | | | | | | | - Wasif Ali Khan
- icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Dinesh Mondal
- icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | | | | | | | | | - Rashidul Haque
- icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
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Irish SR, Al-Amin HM, Alam MS, Harbach RE. A review of the mosquito species (Diptera: Culicidae) of Bangladesh. Parasit Vectors 2016; 9:559. [PMID: 27770829 PMCID: PMC5075421 DOI: 10.1186/s13071-016-1848-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background Diseases caused by mosquito-borne pathogens remain an important source of morbidity and mortality in Bangladesh. To better control the vectors that transmit the agents of disease, and hence the diseases they cause, and to appreciate the diversity of the family Culicidae, it is important to have an up-to-date list of the species present in the country. Original records were collected from a literature review to compile a list of the species recorded in Bangladesh. Results Records for 123 species were collected, although some species had only a single record. This is an increase of ten species over the most recent complete list, compiled nearly 30 years ago. Collection records of three additional species are included here: Anopheles pseudowillmori, Armigeres malayi and Mimomyia luzonensis. Conclusions While this work constitutes the most complete list of mosquito species collected in Bangladesh, further work is needed to refine this list and understand the distributions of those species within the country. Improved morphological and molecular methods of identification will allow the refinement of this list in years to come.
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Affiliation(s)
- Seth R Irish
- Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Hasan Mohammad Al-Amin
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Ralph E Harbach
- Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, UK
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Wangdi K, Gatton ML, Kelly GC, Banwell C, Dev V, Clements ACA. Malaria elimination in India and regional implications. THE LANCET. INFECTIOUS DISEASES 2016; 16:e214-e224. [PMID: 27527748 DOI: 10.1016/s1473-3099(16)30123-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/30/2016] [Accepted: 05/05/2016] [Indexed: 12/16/2022]
Abstract
The malaria situation in India is complex as a result of diverse socio-environmental conditions. India contributes a substantial burden of malaria outside sub-Saharan Africa, with the third highest Plasmodium vivax prevalence in the world. Successful malaria control in India is likely to enhance malaria elimination efforts in the region. Despite modest gains, there are many challenges for malaria elimination in India, including: varied patterns of malaria transmission in different parts of the country demanding area-specific control measures; intense malaria transmission fuelled by favourable climatic and environment factors; varying degrees of insecticide resistance of vectors; antimalarial drug resistance; a weak surveillance system; and poor national coordination of state programmes. Prevention and protection against malaria are low as a result of a weak health-care system, as well as financial and socioeconomic constraints. Additionally, the open borders of India provide a potential route of entry for artesunate-resistant parasites from southeast Asia. This situation calls for urgent dialogue around tackling malaria across borders-between India's states and neighbouring countries-through sharing of information and coordinated control and preventive measures, if we are to achieve the aim of malaria elimination in the region.
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Affiliation(s)
- Kinley Wangdi
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia; Phuentsholing General Hospital, Phuentsholing, Bhutan.
| | - Michelle L Gatton
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Gerard C Kelly
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
| | - Cathy Banwell
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
| | - Vas Dev
- National Institute of Malaria Research (ICMR), Guwahati, Assam, India
| | - Archie C A Clements
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, ACT, Australia
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39
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Banu SS, Ahmed BN, Shamsuzzaman AKM, Lee R. Evaluation of recombinant K39 antigen and various promastigote antigens in sero-diagnosis of visceral leishmaniasis in Bangladesh. Parasite Epidemiol Control 2016; 1:219-228. [PMID: 29988192 PMCID: PMC5991841 DOI: 10.1016/j.parepi.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/20/2016] [Accepted: 07/20/2016] [Indexed: 01/30/2023] Open
Abstract
Background Definitive diagnosis of visceral leishmaniasis (VL) by demonstrating parasites in tissue smears or by culture involves invasive procedures, technical expertise and adequate laboratory facilities. Endemic countries rely mainly on serological tests to diagnose VL. Currently, the immunochromatographic test incorporating the recombinant K39 antigen (rK39 ICT) is the reference test for rapid diagnosis of VL in the Indian subcontinent. The performance of serological tests using rK39 and other promastigote antigens can vary due to differences in antigen expression, the various hosts and environmental factors. To achieve elimination of VL, diagnostic accuracy will be necessary for active case detection especially in those who carry asymptomatic infections. We evaluated the performance of rK39 ICT, enzyme linked immunosorbent assay using mixed Leishmania promastigotes from different Leishmania species (p-ELISA) and indirect fluorescent antibody test (IFAT) utilizing whole promastigotes from the Leishmania donovani complex for sero-diagnosis of VL in Bangladesh. Methods The sensitivity of each serological test was evaluated on 155 patients who were diagnosed to have VL by microscopy and/or by culture methods. Test specificities were calculated on 706 healthy blood donors, 91 diagnostic sera from patients with a febrile illness and sera from patients positive for malaria (n = 91) and Chagas disease (n = 91). All statistical calculations were at 95% confidence intervals. Results The sensitivities of rK39 ICT, p-ELISA and IFAT were 100%, 86.5% and 92.3%, respectively. All three serological methods had a pooled sensitivity of 82.6%. The specificities of rK39 ICT, p-ELISA and IFAT from combined control groups were 100%, 93.1% and 99.9%, respectively. The respective positive and negative predictive values of the tests were both 100% for rK39 ICT, 66.3% and 97.8% for p-ELISA and 99.3% and 98.8% for IFAT. The p-ELISA showed cross reactivity with 36.3% of sera positive for malaria and 28.6% of sera positive for Chagas disease while rK39 ICT and IFAT showed no cross reactivity. Conclusion This study confirms the efficiency of rK39 ICT for rapid diagnosis of VL. The p-ELISA using mixed promastigote antigens did not perform well as a serological test for VL in Bangladesh. Due to high sensitivity and specificity of whole promastigote antigen of L. donovani complex utilized in IFAT, this test can be considered in combination with rK39 ICT to confirm VL diagnosis when clinical diagnosis cannot distinguish between other diseases.
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Affiliation(s)
- Sultana Shahana Banu
- Parasitology Department, Centre for Infectious Diseases and Microbiology (CIDM), ICPMR, Westmead Hospital, Westmead, NSW, Australia.,Discipline of Medicine, Sydney Medical School, University of Sydney, NSW, Australia.,Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MOHFW), Dhaka, Bangladesh
| | - Be-Nazir Ahmed
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MOHFW), Dhaka, Bangladesh
| | | | - Rogan Lee
- Parasitology Department, Centre for Infectious Diseases and Microbiology (CIDM), ICPMR, Westmead Hospital, Westmead, NSW, Australia.,Discipline of Medicine, Sydney Medical School, University of Sydney, NSW, Australia
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Shannon KL, Khan WA, Sack DA, Alam MS, Ahmed S, Prue CS, Khyang J, Ram M, Haq MZ, Akter J, Glass GE, Shields TM, Galagan SR, Nyunt MM, Sullivan DJ. Subclinical Plasmodium falciparum infections act as year-round reservoir for malaria in the hypoendemic Chittagong Hill districts of Bangladesh. Int J Infect Dis 2016; 49:161-9. [PMID: 27350586 DOI: 10.1016/j.ijid.2016.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES An analysis of the risk factors and seasonal and spatial distribution of individuals with subclinical malaria in hypoendemic Bangladesh was performed. METHODS From 2009 to 2012, active malaria surveillance without regard to symptoms was conducted on a random sample (n=3971) and pregnant women (n=589) during a cohort malaria study in a population of 24000. RESULTS The overall subclinical Plasmodium falciparum malaria point prevalence was 1.0% (n=35), but was 3.2% (n=18) for pregnant women. The estimated incidence was 39.9 per 1000 person-years for the overall population. Unlike symptomatic malaria, with a marked seasonal pattern, subclinical infections did not show a seasonal increase during the rainy season. Sixty-nine percent of those with subclinical P. falciparum infections reported symptoms commonly associated with malaria compared to 18% without infection. Males, pregnant women, jhum cultivators, and those living closer to forests and at higher elevations had a higher prevalence of subclinical infection. CONCLUSIONS Hypoendemic subclinical malaria infections were associated with a number of household and demographic factors, similar to symptomatic cases. Unlike clinical symptomatic malaria, which is highly seasonal, these actively detected infections were present year-round, made up the vast majority of infections at any given time, and likely acted as reservoirs for continued transmission.
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Affiliation(s)
- Kerry L Shannon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - David A Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - M Shafiul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabeena Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Chai Shwai Prue
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jacob Khyang
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - M Zahirul Haq
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jasmin Akter
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Gregory E Glass
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA; Department of Geography, University of Florida, Gainesville, Florida, USA
| | - Timothy M Shields
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA
| | - Sean R Galagan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Myaing M Nyunt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David J Sullivan
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA.
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Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies. Nat Commun 2016; 7:11553. [PMID: 27189525 PMCID: PMC4873939 DOI: 10.1038/ncomms11553] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 04/07/2016] [Indexed: 02/07/2023] Open
Abstract
Antimalarial chemotherapy, globally reliant on artemisinin-based combination therapies (ACTs), is threatened by the spread of drug resistance in Plasmodium falciparum parasites. Here we use zinc-finger nucleases to genetically modify the multidrug resistance-1 transporter PfMDR1 at amino acids 86 and 184, and demonstrate that the widely prevalent N86Y mutation augments resistance to the ACT partner drug amodiaquine and the former first-line agent chloroquine. In contrast, N86Y increases parasite susceptibility to the partner drugs lumefantrine and mefloquine, and the active artemisinin metabolite dihydroartemisinin. The PfMDR1 N86 plus Y184F isoform moderately reduces piperaquine potency in strains expressing an Asian/African variant of the chloroquine resistance transporter PfCRT. Mutations in both digestive vacuole-resident transporters are thought to differentially regulate ACT drug interactions with host haem, a product of parasite-mediated haemoglobin degradation. Global mapping of these mutations illustrates where the different ACTs could be selectively deployed to optimize treatment based on regional differences in PfMDR1 haplotypes. Antimalarial chemotherapy relies on combination therapies (ACTs) consisting of an artemisinin derivative and a partner drug. Here, the authors study the effects of globally prevalent mutations in a multidrug resistance transporter (PfMDR1) on the parasite's susceptibility to ACT drugs.
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42
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Alam MS, Elahi R, Mohon AN, Al-Amin HM, Kibria MG, Khan WA, Khanum H, Haque R. Plasmodium falciparum Genetic Diversity in Bangladesh Does Not Suggest a Hypoendemic Population Structure. Am J Trop Med Hyg 2016; 94:1245-50. [PMID: 27139455 DOI: 10.4269/ajtmh.15-0446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 03/28/2016] [Indexed: 11/07/2022] Open
Abstract
Despite the recommendation for the use of merozoite surface protein 1 (msp1), merozoite surface protein 2 (msp2), and glutamate-rich protein (glurp) genes as markers in drug efficacy studies by World Health Organization and their limited use in Bangladesh, the circulating Plasmodium falciparum population genetic structure has not yet been assessed in Bangladesh. This study presents a comprehensive report on the circulating P. falciparum population structure based on msp1, msp2, and glurp polymorphic gene markers in Bangladesh. Among the 130 pretreatment (day 0) P. falciparum samples from seven malaria-endemic districts, 14 distinct genotypes were observed for msp1, 20 for msp2, and 13 for glurp Polyclonal infection was reported in 94.6% (N = 123) of the samples. Multiplicity of infection (MOI) for msp1 was the highest (1.5) among the MOIs of the markers. The heterozygosity for msp1, msp2, and glurp was 0.89, 0.93, and 0.83, respectively. Data according to different malaria-endemic areas are also presented and discussed. Bangladesh is considered as a malaria-hypoendemic country. However, the prevalence of polyclonal infection and the genetic diversity of P. falciparum do not represent hypoendemicity.
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Affiliation(s)
- Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Rubayet Elahi
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Abu Naser Mohon
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Hasan Mohammad Al-Amin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Mohammad Golam Kibria
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Hamida Khanum
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Department of Biochemistry, Virginia Tech, Blacksburg, Virginia; Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, Canada; Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka, Bangladesh
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Seasonal dynamics and microgeographical spatial heterogeneity of malaria along the China-Myanmar border. Acta Trop 2016; 157:12-19. [PMID: 26812008 DOI: 10.1016/j.actatropica.2016.01.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/29/2015] [Accepted: 01/21/2016] [Indexed: 02/04/2023]
Abstract
Malaria transmission is heterogeneous in the Greater Mekong Subregion with most of the cases occurring along international borders. Knowledge of transmission hotspots is essential for targeted malaria control and elimination in this region. This study aimed to determine the dynamics of malaria transmission and possible existence of transmission hotspots on a microgeographical scale along the China-Myanmar border. Microscopically confirmed clinical malaria cases were recorded in five border villages through a recently established surveillance system between January 2011 and December 2014. A total of 424 clinical cases with confirmed spatial and temporal information were analyzed, of which 330 (77.8%) were Plasmodium vivax and 88 (20.8%) were Plasmodium falciparum, respectively. The P. vivax and P. falciparum case ratio increased dramatically from 2.2 in 2011 to 4.7 in 2014, demonstrating that P. vivax malaria has become the predominant parasite species. Clinical infections showed a strong bimodal seasonality. There were significant differences in monthly average incidence rates among the study villages with rates in a village in China being 3-8 folds lower than those in nearby villages in Myanmar. Spatial analysis revealed the presence of clinical malaria hotspots in four villages. This information on malaria seasonal dynamics and transmission hotspots should be harnessed for planning targeted control.
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Ley B, Alam MS, Thriemer K, Hossain MS, Kibria MG, Auburn S, Poirot E, Price RN, Khan WA. G6PD Deficiency and Antimalarial Efficacy for Uncomplicated Malaria in Bangladesh: A Prospective Observational Study. PLoS One 2016; 11:e0154015. [PMID: 27128675 PMCID: PMC4851315 DOI: 10.1371/journal.pone.0154015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/07/2016] [Indexed: 12/19/2022] Open
Abstract
Background The Bangladeshi national treatment guidelines for uncomplicated malaria follow WHO recommendations but without G6PD testing prior to primaquine administration. A prospective observational study was conducted to assess the efficacy of the current antimalarial policy. Methods Patients with uncomplicated malaria, confirmed by microscopy, attending a health care facility in the Chittagong Hill Tracts, Bangladesh, were treated with artemether-lumefantrine (days 0–2) plus single dose primaquine (0.75mg/kg on day2) for P. falciparum infections, or with chloroquine (days 0–2) plus 14 days primaquine (3.5mg/kg total over 14 days) for P. vivax infections. Hb was measured on days 0, 2 and 9 in all patients and also on days 16 and 30 in patients with P. vivax infection. Participants were followed for 30 days. The study was registered with the clinical trials website (NCT02389374). Results Between September 2014 and February 2015 a total of 181 patients were enrolled (64% P. falciparum, 30% P. vivax and 6% mixed infections). Median parasite clearance times were 22.0 (Interquartile Range, IQR: 15.2–27.3) hours for P. falciparum, 20.0 (IQR: 9.5–22.7) hours for P. vivax and 16.6 (IQR: 10.0–46.0) hours for mixed infections. All participants were afebrile within 48 hours, two patients with P. falciparum infection remained parasitemic at 48 hours. No patient had recurrent parasitaemia within 30 days. Adjusted male median G6PD activity was 7.82U/gHb. One male participant (1/174) had severe G6PD deficiency (<10% activity), five participants (5/174) had mild G6PD deficiency (10–60% activity). The Hb nadir occurred on day 2 prior to primaquine treatment in P. falciparum and P. vivax infected patients; mean fractional fall in Hb was -8.8% (95%CI -6.7% to -11.0%) and -7.4% (95%CI: -4.5 to -10.4%) respectively. Conclusion The current antimalarial policy remains effective. The prevalence of G6PD deficiency was low. Main contribution to haemolysis in G6PD normal individuals was attributable to acute malaria rather than primaquine administration. Trial Registration ClinicalTrials.gov NCT02389374
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Affiliation(s)
- Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | | | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | | | | | - Sarah Auburn
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Eugenie Poirot
- Global Health Group, University of California San Francisco, San Francisco, California, United States of America
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Wasif Ali Khan
- International Centre for Diarrheal Diseases and Research, Dhaka, Bangladesh
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Chihanga S, Haque U, Chanda E, Mosweunyane T, Moakofhi K, Jibril HB, Motlaleng M, Zhang W, Glass GE. Malaria elimination in Botswana, 2012-2014: achievements and challenges. Parasit Vectors 2016; 9:99. [PMID: 26911433 PMCID: PMC4765051 DOI: 10.1186/s13071-016-1382-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/16/2016] [Indexed: 12/25/2022] Open
Abstract
Background Botswana significantly reduced its malaria burden between 2000 and 2012. Incidence dropped from 0.99 to 0.01 % and deaths attributed to malaria declined from 12 to 3. The country initiated elimination strategies in October 2012. We examine the progress and challenges during implementation and identify future needs for a successful program in Botswana. Methods A national, rapid notification and response strategy was developed. Cases detected through the routine passive surveillance system at health facilities were intended to initiate screening of contacts around a positive case during follow up. Positive cases were reported to district health management teams to activate district rapid response teams (DRRT). The health facility and the DRRT were to investigate the cases, and screen household members within 100 m of case households within 48 h of notification using rapid diagnostic tests (RDT) and microscopy. Positive malaria cases detected in health facilities were used for spatial analysis. Results There were 1808 malaria cases recorded in Botswana during 26 months from October, 2012 to December, 2014. Males were more frequently infected (59 %) than females. Most cases (60 %) were reported from Okavango district which experienced an outbreak in 2013 and 2014. Among the factors creating challenges for malaria eradication, only 1148 cases (63.5 %) were captured by the required standardized notification forms. In total, 1080 notified cases were diagnosed by RDT. Of the positive malaria cases, only 227 (12.6 %) were monitored at the household level. One hundred (8.7 %) cases were associated with national or transnational movement of patients. Local movements of infected individuals within Botswana accounted for 31 cases while 69 (6.01 %) cases were imported from other countries. Screening individuals in and around index households identified 37 additional, asymptomatic infections. Oscillating, sporadic and new malaria hot-spots were detected in Botswana during the study period. Conclusion Botswana’s experience shows some of the practical challenges of elimination efforts. Among them are the substantial movements of human infections within and among countries, and the persistence of asymptomatic reservoir infections. Programmatically, challenges include improving the speed of communicating and improving the thoroughness when responding to newly identified cases. The country needs further sustainable interventions to target infections if it is to successfully achieve its elimination goal.
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Affiliation(s)
- Simon Chihanga
- National Malaria Programme, Ministry of Health, Gaborone, Botswana.
| | - Ubydul Haque
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA. .,Department of Geography, University of Florida, Gainesville, Florida, USA.
| | - Emmanuel Chanda
- Vector Control Specialist/Consultant, 11 Granite Street, Plot 33421/917 Kamwa South, Lusaka, Zambia.
| | | | | | | | - Mpho Motlaleng
- National Malaria Programme, Ministry of Health, Gaborone, Botswana.
| | - Wenyi Zhang
- Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, People's Republic of China.
| | - Gregory E Glass
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA. .,Department of Geography, University of Florida, Gainesville, Florida, USA.
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Assessment of Burden of Malaria in Gwanda District, Zimbabwe, Using the Disability Adjusted Life Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:244. [PMID: 26907320 PMCID: PMC4772264 DOI: 10.3390/ijerph13020244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/04/2016] [Accepted: 02/14/2016] [Indexed: 11/17/2022]
Abstract
Malaria is one of the highest contributors to morbidity and mortality in Zimbabwe. However, there is paucity of knowledge regarding disability adjusted life years (DALYs) as a measure of burden of malaria in affected communities. The DALYs metric was used to assess the burden of malaria in Gwanda District with the aim of contributing to a better understanding of the impact of disease on affected communities. Data was collected from health facility malaria registers and the District Health Information System (DHIS) to estimate DALYs at household and district levels respectively. The household DALYs included 130 malaria cases from 2013 to 2015 while the DALYs for the district included 719 confirmed malaria cases from 2011 to 2015. Households lost a total of 153.89 DALYs with the majority of the disease burden (65.55%) occurring in the most economically productive age group (15-45 years) with a mean loss of 1.18 DALYs per malaria case. At district level, 251.09 DALYs were lost due to malaria and the calculated average district DALY rate for 2011-2015 was 36.29 DALYs/100,000 persons per year. It is important to estimate malaria burden to assist policy makers in making informed decisions when channelling resources for control and prevention of the disease.
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Analyzing Protein Clusters on the Plasma Membrane: Application of Spatial Statistical Analysis Methods on Super-Resolution Microscopy Images. FOCUS ON BIO-IMAGE INFORMATICS 2016; 219:95-122. [DOI: 10.1007/978-3-319-28549-8_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kibria MG, Elahi R, Mohon AN, Khan WA, Haque R, Alam MS. Genetic diversity of Plasmodium vivax in clinical isolates from Bangladesh. Malar J 2015; 14:267. [PMID: 26159168 PMCID: PMC4498513 DOI: 10.1186/s12936-015-0790-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022] Open
Abstract
Background Plasmodium vivax is the second most prevalent human malaria parasite in Bangladesh; however, there are no data of its genetic diversity. Several molecular markers are available where Pvcsp, Pvmsp 1 and Pvmsp 3α are most commonly used for P. vivax genotyping studies. The aim of the study was to investigate the population structure of P. vivax in Bangladesh. Methods A total of 102 P. vivax-positive blood samples were collected from different malaria-endemic areas in Bangladesh and subsequently analysed for those three genotyping markers. Nested PCR was performed for diagnosis and genotyping analysis followed by PCR–RFLP to detect genetic diversity using Pvcsp, Pvmsp 1 and Pvmsp 3α markers. Results Analysis of Pvcsp showed that the VK210 repeat type was highly prevalent (64.7%, 66/102) compared to VK247 (35.3%, 36/102), although the prevalence of VK247 was higher than other Southeast Asian countries. Analysis of these three genes revealed a diverse, circulating population of P. vivax where a total of ten, 56 and 35 distinct genotypes were detected for Pvcsp, Pvmsp 1 and Pvmsp 3α, respectively. Conclusion This genotyping observation of P. vivax is the first report from Bangladesh and will provide valuable information for establishing the genotyping methods and circulating genetic variants of these three markers available in Bangladesh.
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Affiliation(s)
- Mohammad Golam Kibria
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
| | - Rubayet Elahi
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh. .,Department of Biochemistry, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Abu Naser Mohon
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh. .,Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N1N4, Canada.
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
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Kamuliwo M, Kirk KE, Chanda E, Elbadry MA, Lubinda J, Weppelmann TA, Mukonka VM, Zhang W, Mushinge G, Mwanza-Ingwe M, Haque U. Spatial patterns and determinants of malaria infection during pregnancy in Zambia. Trans R Soc Trop Med Hyg 2015; 109:514-21. [PMID: 26160256 DOI: 10.1093/trstmh/trv049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/18/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Malaria in pregnancy (MiP) is a major concern in Zambia. Here we aim to determine the burden and risk factors of MiP. METHODS Monthly reported district-level malaria cases among pregnant women (count data) from January 2009 to December 2014 were obtained from the Zambian District Health Information System. Negative binomial regression model was used to investigate the associations between vector control tools, coverage of health care facilities, transportation networks and population density. Data on MiP treatment were obtained from the 2012 Zambian Malaria Indicator Survey. Yearly clusters of MiP were investigated using spatial statistics in ArcGIS v 10.1. RESULTS The results indicated that MiP decreased in Zambia between 2010 and 2013. MiP was observed throughout the year, but showed a strong seasonal pattern. Persistent hotspots of MiP were reported in the southeast and northeast regions of Zambia, with districts that had better access to rail road and presence of water bodies associated with decreased prevalence of MiP. Better indoor residual spraying and long-lasting insecticide-treated nets coverage was demonstrated to be protective against MiP. CONCLUSIONS Mapping the distribution of MiP to track the future requirements for scaling up essential disease-prevention efforts in stable hotspots can help the Zambian National Malaria Control Center to further develop strategies to reduce malaria prevalence in this vulnerable sub-population.
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Affiliation(s)
- Mulakwa Kamuliwo
- Ministry of Health, National Malaria Control Centre, Lusaka, Zambia
| | | | - Emmanuel Chanda
- Vector Control Specialist/Consultant, 11 Granite Street, Plot 33421/917 Kamwa South, Lusaka, Zambia
| | - Maha A Elbadry
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Thomas A Weppelmann
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Victor M Mukonka
- Department of Public Health, Copperbelt University, School of Medicine, Ndola, Zambia
| | - Wenyi Zhang
- Institute of Disease Control and Prevention, Center for Disease Control, Beijing, People's Republic of China
| | | | | | - Ubydul Haque
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA Department of Geography, University of Florida, Gainesville, FL, USA
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Al-Amin HM, Elahi R, Mohon AN, Kafi MAH, Chakma S, Lord JS, Khan WA, Haque R, Norris DE, Alam MS. Role of underappreciated vectors in malaria transmission in an endemic region of Bangladesh-India border. Parasit Vectors 2015; 8:195. [PMID: 25889228 PMCID: PMC4416289 DOI: 10.1186/s13071-015-0803-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/17/2015] [Indexed: 11/19/2022] Open
Abstract
Background Despite the efforts of the National Malaria Control Programme, malaria remains as an important public health problem in Bangladesh, particularly in the south-eastern region bordering India. Successful malaria control strategies rely on a detailed understanding of the underlying causes of malaria transmission. Here, an entomological survey was conducted in a malaria endemic area of Bangladesh bordering India to investigate the Anopheles mosquito community and assess their Plasmodium infection status. Methods Monthly entomological collections were undertaken from October 2010 to September 2011 in five villages in the Matiranga sub-district, Khagrachari district in Bangladesh, bordering the Indian State of Tripura. CDC miniature light traps were placed inside houses to collect adult Anopheles mosquitoes. Following morphological and molecular identification of the female Anopheles mosquitoes collected, they were screened for circumsporozoite proteins (CSP) of Plasmodium falciparum (Pf), Plasmodium vivax-210 (Pv-210) and Plasmodium vivax-247 (Pv-247), by ELISA to determine natural infection rates. Variation in Anopheles species composition, relative abundance and Plasmodium infection rates were analysed between sampled villages. Results A total of 2,027 female Anopheles were collected, belonging to 20 species. Anopheles nivipes was the most abundant species in our test villages during the peak malaria transmission season, and was observed sympatrically with An. philippinensis in the studied area. However, in the dry off-peak season, An. jeyporiensis was the most abundant species. Shannon’s diversity index was highest in October (2.12) and evenness was highest in May (0.91). The CSP ELISA positive rate overall was 0.44%. Anopheles karwari (n = 2), An. barbirostris s.l. (n = 1) and An. vagus (n = 1) were recorded positive for Pf. Anopheles kochi (n = 1) was positive for Pv-210 while An. umbrosus (n = 1), An. nivipes (n = 1) and An. kochi (n = 1) were positive for Pv-247. A mixed infection of Pf and Pv-247 was detected in An. barbirostris s.l.. Conclusion High diversity of Anopheles species was observed in areas close to the international border where species that were underestimated for malaria transmission significantly outnumbered principal vector species and these may play a significantly heightened role in malaria transmission. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-0803-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hasan Mohammad Al-Amin
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Rubayet Elahi
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. .,Department of Biochemistry, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Abu Naser Mohon
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh. .,Department of Microbiology and Infectious Disease, Cumming School of Medicine, University of Calgary, Alberta, T2N1N4, Canada.
| | - Mohammad Abdullah Heel Kafi
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Sumit Chakma
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Jennifer S Lord
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Douglas E Norris
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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