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Khainza AT, Soita D, Okia D, Okello F, Matovu JKB, Lubaale Y, Byamukama E, Okibure A, Alunyo JP, Nantale R, Wanume B, Ogutu D, Mukunya D, Olupot-Olupot P. Community Involvement in Onchocerciasis Post-elimination Surveillance in Bududa District, Eastern Uganda: A cross-sectional study. PLoS Negl Trop Dis 2024; 18:e0012270. [PMID: 39012847 PMCID: PMC11251607 DOI: 10.1371/journal.pntd.0012270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/04/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Globally, there are an estimated 20.9 million cases of onchocerciasis, with Africa bearing the greatest burden. The World Health Organization (WHO) has targeted the disease for elimination by 2030. As of August 2023, there were 15 foci in 37/48 (76%) districts and one city in Uganda that had reached the elimination phase. However, there is a paucity of data on community involvement in post-elimination surveillance (PES) activities. The communities in the post-elimination phase are expected to maintain surveillance, provide health education, refer cases for treatment, and participate in surveillance. However, it is not clear whether this is being done. In this study, we assessed the feasibility of community involvement in post-elimination surveillance activities in Bududa District, Eastern Uganda, to draw key generalisable lessons for similar settings. METHODS This was a cross-sectional study employing rigorous mixed methods of data collection. We used a semi-structured questionnaire to collect quantitative data on randomly sampled study participants in two sub-countries in the district. Community involvement in post-elimination surveillance (PES) was our dependent variable, measured using Yes or No questions, and our independent variables were measured on different scales. Computations of proportions and associations were done using Stata 15 software. Conversely, qualitative data were collected via focus group discussions (FGDs) for community participants and key informant interviews (KIIs) for local leaders. For the qualitative component, we had 2 FGDs, each consisting of 8 gender-balanced participants per group and 8 KIIs. Qualitative data analyses were done using a robust thematic framework approach, ensuring the reliability and validity of our findings. RESULTS A total of 422 participants with a mean age of 51.4 years (SD = 15.8) participated in the study. Community involvement in post-elimination surveillance was low (14%). Factors associated with involvements were district support [Adjusted odd ratio AOR 14, 95 CI = (2.5, 81.7)], seeing black flies in the environment in a week preceding the survey [AOR 8, 95% CI = (1.5, 42.5)], in one month [AOR 3.8, 95% CI = (1.1, 13.2)], and being a community volunteer in the Ivermectin treatment program [AOR 4.3, 95% CI = (1.03, 17.9)]. Lack of funding, poor motivation, poor program sustainability planning, and a lack of drugs at health facilities were key challenges affecting community involvement in post-elimination surveillance. CONCLUSION Community involvement in onchocerciasis post-elimination surveillance activities in Bududa District in Eastern Uganda was low but could be improved by increased district support, funding, community motivation and sensitisation.
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Affiliation(s)
- Annet Tabitha Khainza
- Department of Community and Public Health, Busitema University, Mbale, Uganda
- The Carter Center, Kampala, Uganda
| | - David Soita
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - David Okia
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Francis Okello
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Joseph KB Matovu
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Yovani Lubaale
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | | | - Ambrose Okibure
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | | | - Ritah Nantale
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Benon Wanume
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | | | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda
| | - Peter Olupot-Olupot
- Department of Community and Public Health, Busitema University, Mbale, Uganda
- Department of Research, Mbale Clinical Research Institute, Mbale, Uganda
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Gu J, Cao Y, Chai L, Xu E, Liu K, Chong Z, Zhang Y, Zou D, Xu Y, Wang J, Müller O, Cao J, Zhu G, Lu G. Delayed care-seeking in international migrant workers with imported malaria in China. J Travel Med 2024; 31:taae021. [PMID: 38335249 DOI: 10.1093/jtm/taae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/12/2023] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Imported malaria cases continue to pose major challenges in China as well as in other countries that have achieved elimination. Early diagnosis and treatment of each imported malaria case is the key to successfully maintaining malaria elimination success. This study aimed to build an easy-to-use predictive nomogram to predict and intervene against delayed care-seeking among international migrant workers with imported malaria. METHODS A prediction model was built based on cases with imported malaria from 2012 to 2019, in Jiangsu Province, China. Routine surveillance information (e.g. sex, age, symptoms, origin country and length of stay abroad), data on the place of initial care-seeking and the gross domestic product (GDP) of the destination city were extracted. Multivariate logistic regression was performed to identify independent predictors and a nomogram was established to predict the risk of delayed care-seeking. The discrimination and calibration of the nomogram was performed using area under the curve and calibration plots. In addition, four machine learning models were used to make a comparison. RESULTS Of 2255 patients with imported malaria, 636 (28.2%) sought care within 24 h after symptom onset, and 577 (25.6%) sought care 3 days after symptom onset. Development of symptoms before entry into China, initial care-seeking from superior healthcare facilities and a higher GDP level of the destination city were significantly associated with delayed care-seeking among migrant workers with imported malaria. Based on these independent risk factors, an easy-to-use and intuitive nomogram was established. The calibration curves of the nomogram showed good consistency. CONCLUSIONS The tool provides public health practitioners with a method for the early detection of delayed care-seeking risk among international migrant workers with imported malaria, which may be of significance in improving post-travel healthcare for labour migrants, reducing the risk of severe malaria, preventing malaria reintroduction and sustaining achievements in malaria elimination.
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Affiliation(s)
- Jiyue Gu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Liying Chai
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Enyu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Kaixuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Zeyin Chong
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Dandan Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
| | - Yuhui Xu
- Center for Disease Control and Prevention, Yangzhou, Jiangsu Province, 225007, China
| | - Jian Wang
- Yangzhou Schistosomiasis and Parasitic Disease Control Office, Yangzhou, Jiangsu Province, 225007, China
| | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, 69117, Germany
| | - Jun Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, 214064, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, 211166, China
| | - Guangyu Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, 225009, China
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Hasyim H, Marini H, Misnaniarti M, Flora R, Liberty IA, Elagali A, Hartoni H, Maharani FE. Evaluation of the malaria elimination programme in Muara Enim Regency: a qualitative study from Indonesia. Malar J 2024; 23:43. [PMID: 38347633 PMCID: PMC10860310 DOI: 10.1186/s12936-024-04857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Malaria remains an enduring public health concern in Indonesia, exacerbated by its equatorial climate that fosters the proliferation of Anopheles mosquitoes. This study seeks to assess the performance of the malaria elimination programme comprehensively. METHODS Between May and August 2022, a qualitative study was conducted in Muara Enim Regency, South Sumatra Province, involving 22 healthcare professionals from diverse backgrounds. These informants were strategically chosen for their pivotal roles in providing profound insights into various facets of the malaria elimination programme. This encompasses inputs such as human resources, budgetary allocation, and infrastructural support; processes like case identification and management, capacity enhancement, epidemiological surveillance, prevention measures, outbreak control, and enhanced communication and educational initiatives; and, notably, the programme's outcomes. Data were collected through 3-h Focus Group Discussions (FGDs) divided into two groups, each with 12 participants: healthcare professionals and programme managers. Additionally, in-depth interviews (IDIs) were conducted with ten informants. Employing the Input-Process-Output (IPO) model, this study meticulously analysed the healthcare system dynamics and the interventions' efficacy. RESULTS The study unveiled many challenges during the input phase, including the absence of entomologists and a shortage of diagnostic tools. Despite these obstacles, it documented remarkable accomplishments in the output domain, marked by significant advancements in the distribution of mosquito nets and the successful implementation of the Early Warning System (EWS). Despite the adversities, the programme has made substantial strides towards malaria elimination. CONCLUSIONS Urgent action is imperative to bolster the effectiveness of the malaria elimination programme. Key measures encompass augmenting the entomologist workforce, optimizing resource allocation, and ensuring stringent adherence to regional regulations. Addressing these concerns will enhance programme efficacy, yielding enduring public health benefits. This research substantially contributes to Indonesia's ongoing malaria elimination endeavours, furnishing actionable insights for programme enhancement. Consequently, this research holds significant importance for the malaria elimination drive.
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Affiliation(s)
- Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia.
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine at Goethe University, 60629, Frankfurt am Main, Germany.
| | - Heni Marini
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia
- Regional Technical Implementation Unit, Health Training Center (Bapelkes), Palembang, 30961, Indonesia
| | | | - Rostika Flora
- Faculty of Public Health, Universitas Sriwijaya, Indralaya, 30662, Indonesia
| | - Iche Andriyani Liberty
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, 30126, Indonesia
| | - Ahmed Elagali
- School of Biological Sciences, The University of Western Australia, Perth, 6907, Australia
- Minderoo Foundation, Perth, 6907, Australia
| | - Hartoni Hartoni
- Biology Department, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Indralaya, 30662, Indonesia
| | - Fadhilah Eka Maharani
- Biology Department, Faculty of Mathematics and Natural Sciences, Universitas Sriwijaya, Indralaya, 30662, Indonesia
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An Q, Li Y, Sun Z, Gao X, Wang H. Seasonal prediction of the distribution of three major malaria vectors in China: Based on an ecological niche model. PLoS Negl Trop Dis 2024; 18:e0011884. [PMID: 38236812 PMCID: PMC10796015 DOI: 10.1371/journal.pntd.0011884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
Against the backdrop of a global malaria epidemic that remains severe, China has eradicated indigenous malaria but still has to be alert to the risk of external importation. Understanding the distribution of vectors can provide an adequate and reliable basis for the development and implementation of vector control strategies. However, with the decline of malaria prevalence in recent years, the capacity of vector monitoring and identification has been greatly weakened. Here we have used new sampling records, climatic data, and topographic data to establish ecological niche models of the three main malaria vectors in China. The model results accurately identified the current habitat suitability areas for the three species of Anopheles and revealed that in addition to precipitation and temperature as important variables affecting the distribution of Anopheles mosquitoes, topographic variables also influenced the distribution of Anopheles mosquitoes. Anopheles sinensis is the most widespread malaria vector in China, with a wide region from the northeast (Heilongjiang Province) to the southwest (Yunnan Province) suitable for its survival. Suitable habitat areas for Anopheles lesteri are concentrated in the central, eastern, and southern regions of China. The suitable habitat areas of Anopheles minimus are the smallest and are only distributed in the border provinces of southern China. On this basis, we further assessed the seasonal variation in habitat suitability areas for these three major malaria vectors in China. The results of this study provide new and more detailed evidence for vector monitoring. In this new era of imported malaria prevention in China, regular reassessment of the risk of vector transmission is recommended.
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Affiliation(s)
- Qi An
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
- Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
| | - Yuepeng Li
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
- Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
| | - Zhuo Sun
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
- Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
| | - Xiang Gao
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
- Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
| | - Hongbin Wang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
- Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People’s Republic of China
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Wang X, Xu W, Luo F, Lin K, Zhang T, Yao L, Zhang X, Zhang J, Auburn S, Wang D, Ruan W. Increasing incidence of Plasmodium ovale and persistent reporting of Plasmodium vivax in imported malaria cases: an analysis of 9-year surveillance data in four areas of China. Front Public Health 2023; 11:1203095. [PMID: 37448654 PMCID: PMC10338171 DOI: 10.3389/fpubh.2023.1203095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 07/15/2023] Open
Abstract
Background This study aimed at exploring the epidemiological pattern of imported malaria in China before malaria elimination in 2021, to provide evidence-based data for preventing malaria re-establishment in China. Methods Nine-year surveillance data on imported malaria in four provincial-level administrative divisions (PLADs) (Anhui, Chongqing, Guangxi, and Zhejiang) between 2011 and 2019 were thoroughly collected and analyzed. Results A quite stable trend in imported malaria cases between 2011 and 2019 was observed. In total, 6,064 imported patients were included. Plasmodium falciparum was the most frequently reported species (4,575, 75.6%). Cases of malaria were most frequently imported from Western Africa (54.4%). We identified an increasing trend in P. ovale and a persistence of P. vivax infections among the cases of malaria imported from Western Africa. Most patients (97.5%) were 20-50 years old. Among imported malaria infections, the main purposes for traveling abroad were labor export (4,914/6,064, 81.0%) and business trips (649, 10.7%). Most patients (2,008/6,064, 33.1%) first visited county-level medical institutions when they sought medical help in China. More patients were diagnosed within 3 days after visiting Centers for Disease Control and Prevention (CDCs) or entry-exit quarantine facilities (EQFs) (1,147/1609, 71.3%) than after visiting medical institutions (2,182/3993, 54.6%). Conclusion Imported malaria still poses a threat to the malaria-free status of China. County-level institutions are the primary targets in China to improve the sensitivity of the surveillance system and prevent the re-establishment of malaria. Health education should focus on exported labors, especially to Western and Central Africa. Increasing trend in P. ovale and persistence of P. vivax infections indicated their underestimations in Western Africa. Efficient diagnostic tools and sensitive monitoring systems are required to identify Plasmodium species in Africa.
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Affiliation(s)
- Xiaoxiao Wang
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
| | - Wenjie Xu
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
| | - Fei Luo
- Department of Endemic and Parasitic Diseases, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Kangming Lin
- Department of Infectious Diseases, Guangxi Center of Disease Control and Prevention, Nanning, China
| | - Tao Zhang
- Department of Infectious Diseases, Anhui Center of Disease Control and Prevention, Hefei, China
| | - Linong Yao
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
| | - Xuan Zhang
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
| | - Jiaqi Zhang
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
| | - Sarah Auburn
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Duoquan Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Ruan
- Department of Infectious Diseases, Zhejiang Center of Disease Control and Prevention, Hangzhou, China
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Lu G, Zhang D, Chen J, Cao Y, Chai L, Liu K, Chong Z, Zhang Y, Lu Y, Heuschen AK, Müller O, Zhu G, Cao J. Predicting the risk of malaria re-introduction in countries certified malaria-free: a systematic review. Malar J 2023; 22:175. [PMID: 37280626 DOI: 10.1186/s12936-023-04604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/22/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Predicting the risk of malaria in countries certified malaria-free is crucial for the prevention of re-introduction. This review aimed to identify and describe existing prediction models for malaria re-introduction risk in eliminated settings. METHODS A systematic literature search following the PRISMA guidelines was carried out. Studies that developed or validated a malaria risk prediction model in eliminated settings were included. At least two authors independently extracted data using a pre-defined checklist developed by experts in the field. The risk of bias was assessed using both the prediction model risk of bias assessment tool (PROBAST) and the adapted Newcastle-Ottawa Scale (aNOS). RESULTS A total 10,075 references were screened and 10 articles describing 11 malaria re-introduction risk prediction models in 6 countries certified malaria free. Three-fifths of the included prediction models were developed for the European region. Identified parameters predicting malaria re-introduction risk included environmental and meteorological, vectorial, population migration, and surveillance and response related factors. Substantial heterogeneity in predictors was observed among the models. All studies were rated at a high risk of bias by PROBAST, mostly because of a lack of internal and external validation of the models. Some studies were rated at a low risk of bias by the aNOS scale. CONCLUSIONS Malaria re-introduction risk remains substantial in many countries that have eliminated malaria. Multiple factors were identified which could predict malaria risk in eliminated settings. Although the population movement is well acknowledged as a risk factor associated with the malaria re-introduction risk in eliminated settings, it is not frequently incorporated in the risk prediction models. This review indicated that the proposed models were generally poorly validated. Therefore, future emphasis should be first placed on the validation of existing models.
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Affiliation(s)
- Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225007, China.
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
| | - Dongying Zhang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Juan Chen
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yuanyuan Cao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Liying Chai
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225007, China
| | - Kaixuan Liu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225007, China
| | - Zeying Chong
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225007, China
| | - Yuying Zhang
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225007, China
| | - Yan Lu
- Nanjing Health and Customs Quarantine Office, Nanjing, China
| | | | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
| | - Guoding Zhu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China.
| | - Jun Cao
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China.
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Santos-Luna R, Román-Pérez S, Reyes-Cabrera G, Sánchez-Arcos MDR, Correa-Morales F, Pérez-Solano MA. Web Geographic Information System: A Support Tool for the Study, Evaluation, and Monitoring of Foci of Malaria Transmission in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3282. [PMID: 36833980 PMCID: PMC9961844 DOI: 10.3390/ijerph20043282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Malaria is currently an endemic disease in Mexico. The country joined the WHO's E-25 initiative for the elimination of Plasmodium vivax to achieve elimination and certification within the established period. Having a Web-based information system was, therefore, deemed necessary to assist in the detection, investigation, and elimination of transmission in the foci, as well as for the timely treatment of malaria-positive cases. The "Information System for the Elimination of Malaria in Mexico" was designed, developed, and implemented with a geographic vision, which includes a Web tool to georeference homes and aquatic systems, a dashboard and an indicator evaluation card for monitoring activities, notification of probable cases, and vector control among other indicators. The implementation of the system was gradual in the seven states that are currently in the malaria elimination phase; subsequently, the system was implemented in non-transmission states. In 2020, the system implementation stage began; first, the basic data of more than 96,000 homes throughout the country were georeferenced, and then the primary data capture tools of 17 formats, 32 reports, and 2 geographic viewers were enabled for information queries. A total of 56 active foci have been identified in 406 localities as well as 71 residual foci in 320 localities. Recently, the Foci Manager was developed, which is a specific tool for the study, evaluation, and monitoring of active foci through a GIS, a dashboard, and a systematized evaluation certificate. Georeferencing tools decreased the cost of spatial data collection.
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Affiliation(s)
- René Santos-Luna
- Subdirectorate of Medical Geography and Geomatics, National Institute of Public Health, Cuernavaca 62550, Mexico
| | - Susana Román-Pérez
- Subdirectorate of Medical Geography and Geomatics, National Institute of Public Health, Cuernavaca 62550, Mexico
| | - Gerardo Reyes-Cabrera
- Subdirectorate of Vectors, National Center for Preventive Programs and Disease Control, Mexico City 06100, Mexico
| | | | - Fabián Correa-Morales
- Subdirectorate of Vectors, National Center for Preventive Programs and Disease Control, Mexico City 06100, Mexico
| | - Marco Antonio Pérez-Solano
- Subdirectorate of Medical Geography and Geomatics, National Institute of Public Health, Cuernavaca 62550, Mexico
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Liu Y, Zhang T, Chen SB, Cui YB, Wang SQ, Zhang HW, Shen HM, Chen JH. Retrospective analysis of Plasmodium vivax genomes from a pre-elimination China inland population in the 2010s. Front Microbiol 2023; 14:1071689. [PMID: 36846776 PMCID: PMC9948256 DOI: 10.3389/fmicb.2023.1071689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/04/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction In malaria-free countries, imported cases are challenging because interconnections with neighboring countries with higher transmission rates increase the risk of parasite reintroduction. Establishing a genetic database for rapidly identifying malaria importation or reintroduction is crucial in addressing these challenges. This study aimed to examine genomic epidemiology during the pre-elimination stage by retrospectively reporting whole-genome sequence variation of 10 Plasmodium vivax isolates from inland China. Methods The samples were collected during the last few inland outbreaks from 2011 to 2012 when China implemented a malaria control plan. After next-generation sequencing, we completed a genetic analysis of the population, explored the geographic specificity of the samples, and examined clustering of selection pressures. We also scanned genes for signals of positive selection. Results China's inland populations were highly structured compared to the surrounding area, with a single potential ancestor. Additionally, we identified genes under selection and evaluated the selection pressure on drug-resistance genes. In the inland population, positive selection was detected in some critical gene families, including sera, msp3, and vir. Meanwhile, we identified selection signatures in drug resistance, such as ugt, krs1, and crt, and noticed that the ratio of wild-type dhps and dhfr-ts increased after China banned sulfadoxine-pyrimethamine (SP) for decades. Discussion Our data provides an opportunity to investigate the molecular epidemiology of pre-elimination inland malaria populations, which exhibited lower selection pressure on invasion and immune evasion genes than neighbouring areas, but increased drug resistance in low transmission settings. Our results revealed that the inland population was severely fragmented with low relatedness among infections, despite a higher incidence of multiclonal infections, suggesting that superinfection or co-transmission events are rare in low-endemic circumstances. We identified selective signatures of resistance and found that the proportion of susceptible isolates fluctuated in response to the prohibition of specific drugs. This finding is consistent with the alterations in medication strategies during the malaria elimination campaign in inland China. Such findings could provide a genetic basis for future population studies, assessing changes in other pre-elimination countries.
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Affiliation(s)
- Ying Liu
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- National Health Commission of the People’s Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China
- World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Tao Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Shen-Bo Chen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- National Health Commission of the People’s Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China
- World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Yan-Bing Cui
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- National Health Commission of the People’s Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China
- World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Shu-Qi Wang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Hong-Wei Zhang
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Hai-Mo Shen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- National Health Commission of the People’s Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China
- World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Jun-Hu Chen
- National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- National Health Commission of the People’s Republic of China (NHC) Key Laboratory of Parasite and Vector Biology, Shanghai, China
- World Health Organization (WHO) Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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9
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Xu JW, Deng DW, Wei C, Zhou XW, Li JX. Risk factors associated with malaria infection along China–Myanmar border: a case–control study. Malar J 2022; 21:288. [PMID: 36210453 PMCID: PMC9548336 DOI: 10.1186/s12936-022-04312-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background The World Health Organization (WHO) has certificated China malaria free, but imported malaria is a continuous challenge in preventing reintroduction of malaria in the border area of China. Understanding risk factors of malaria along China–Myanmar border is benefit for preventing reintroduction of malaria in China and achieving the WHO’s malaria elimination goal in the Greater Mekong Subregion (GMS). Methods This is a case–control study with one malaria case matched to two controls, in which cases were microscopy-confirmed malaria patients and controls were feverish people with microscopy-excluded malaria. A matched logistic regression analysis (LRA) was used to identify risk factors associated with malaria infection. Results From May 2016 through October 2017, the study recruited 223 malaria cases (152 in China and 71 in Myanmar) and 446 controls (304 in China and 142 in Myanmar). All the 152 cases recruited in China were imported malaria. Independent factors associated with malaria infection were overnight out of home in one month prior to attendance of health facilities (adjusted odd ratio [AOR] 13.37, 95% confidence interval [CI]: 6.32–28.28, P < 0.0001), staying overnight in rural lowland and foothill (AOR 2.73, 95% CI: 1.45–5.14, P = 0.0019), staying overnight at altitude < 500 m (AOR 5.66, 95% CI: 3.01–10.71, P < 0.0001) and streamlets ≤ 100 m (AOR9.98, 95% CI: 4.96–20.09, P < 0.0001) in the border areas of Myanmar; and people lacking of knowledge of malaria transmission (AOR 2.17, 95% CI: 1.42–3.32, P = 0.0004). Conclusions Malaria transmission is highly focalized in lowland and foothill in the border areas of Myanmar. The risk factors associated with malaria infection are overnight staying out of home, at low altitude areas, proximity to streamlets and lack of knowledge of malaria transmission. To prevent reintroduction of malaria transmission in China and achieve the WHO goal of malaria elimination in the GMS, cross-border collaboration is continuously necessary, and health education is sorely needed for people in China to maintain their malaria knowledge and vigilance, and in Myanmar to improve their ability of personal protection. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04312-5.
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Ansah EK, Moucheraud C, Arogundade L, Rangel GW. Rethinking integrated service delivery for malaria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000462. [PMID: 36962405 PMCID: PMC10021790 DOI: 10.1371/journal.pgph.0000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Despite worldwide efforts and much progress toward malaria control, declines in malaria morbidity and mortality have hit a plateau. While many nations achieved significant malaria suppression or even elimination, success has been uneven, and other nations have made little headway-or even lost ground in this battle. These alarming trends threaten to derail the attainment of global targets for malaria control. Among the challenges impeding success in malaria reduction, many strategies center malaria as a set of technical problems in commodity development and delivery. Yet, this narrow perspective overlooks the importance of strong health systems and robust healthcare delivery. This paper argues that strategies that move the needle on health services and behaviors offer a significant opportunity to achieve malaria control through a comprehensive approach that integrates malaria with broader health services efforts. Indeed, malaria may serve as the thread that weaves integrated service delivery into a path forward for universal health coverage. Using key themes identified by the "Rethinking Malaria in the Context of COVID-19" effort through engagement with key stakeholders, we provide recommendations for pursuing integrated service delivery that can advance malaria control via strengthening health systems, increasing visibility and use of high-quality data at all levels, centering issues of equity, promoting research and innovation for new tools, expanding knowledge on effective implementation strategies for interventions, making the case for investing in malaria among stakeholders, and engaging impacted communities and nations.
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Affiliation(s)
- Evelyn K. Ansah
- Centre for Malaria Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Corrina Moucheraud
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA Center for Health Policy Research, University of California Los Angeles, Los Angeles, California, United States of America
| | - Linda Arogundade
- Harvard Kennedy School, Cambridge, Massachusetts, United States of America
| | - Gabriel W. Rangel
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, Pennsylvania, United States of America
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11
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Liu H, Zhou Y, Deng Y, Lin Z, Zhang C, Chen Q, Wei C, Duan K, Tian P, Zhou H, Xu J. Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study. Infect Dis Poverty 2022; 11:51. [PMID: 35538510 PMCID: PMC9088148 DOI: 10.1186/s40249-022-00972-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Border malaria is one of the most intractable problems hindering malaria elimination worldwide. Movement of both the human population and anopheline mosquitoes infected with Plasmodium spp. can cause cross-border malaria transmission. The Yunnan border area was still hyperendemic for malaria in the early part of this century. The objective of this case study was to analyze the strategies, interventions and impacts of malaria control and elimination in the Yunnan border area. MAIN TEXT A total of 10,349 malaria cases and 17.1 per 10,000 person-years of annual parasite incidence (API) were reported in the border area in 2003. Based on natural village-based stratification, integrated interventions, including mass drug administration for radical cures and preventive treatment, clinically presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out from 2003 to 2013. The overall API was reduced to 0.6 per 10,000 person-years by 2013, while effective cross-border collaboration interventions dramatically reduced the malaria burden in the neighbouring border areas of Myanmar. From 2014 forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, a rapid response to possible malaria cases and effective border collaboration with neighbouring areas, successfully eliminated malaria and prevented reintroduction of malaria transmission in the Yunnan border area. CONCLUSIONS In Yunnan malaria burden has successfully reduced by dynamically accurate stratification and comprehensive interventions; and then the region achieved elimination and prevented reintroduction of malaria transmission through intensive surveillance, rapid response and border collaboration. Other border areas should perform their own intervention trials to develop their own effective strategy.
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Affiliation(s)
- Hui Liu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Yaowu Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Yan Deng
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Zurui Lin
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Canglin Zhang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Qiyan Chen
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Chun Wei
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Kaixia Duan
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Peng Tian
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
| | - Hongning Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China.
| | - Jianwei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Yunnan Institute of Parasitic Diseases Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Puer, 665000, China
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12
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Oyegoke OO, Maharaj L, Akoniyon OP, Kwoji I, Roux AT, Adewumi TS, Maharaj R, Oyebola BT, Adeleke MA, Okpeku M. Malaria diagnostic methods with the elimination goal in view. Parasitol Res 2022; 121:1867-1885. [PMID: 35460369 PMCID: PMC9033523 DOI: 10.1007/s00436-022-07512-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/01/2022] [Indexed: 01/08/2023]
Abstract
Malaria control measures have been in use for years but have not completely curbed the spread of infection. Ultimately, global elimination is the goal. A major playmaker in the various approaches to reaching the goal is the issue of proper diagnosis. Various diagnostic techniques were adopted in different regions and geographical locations over the decades, and these have invariably produced diverse outcomes. In this review, we looked at the various approaches used in malaria diagnostics with a focus on methods favorably used during pre-elimination and elimination phases as well as in endemic regions. Microscopy, rapid diagnostic testing (RDT), loop-mediated isothermal amplification (LAMP), and polymerase chain reaction (PCR) are common methods applied depending on prevailing factors, each with its strengths and limitations. As the drive toward the elimination goal intensifies, the search for ideal, simple, fast, and reliable point-of-care diagnostic tools is needed more than ever before to be used in conjunction with a functional surveillance system supported by the ideal vaccine.
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Affiliation(s)
- Olukunle O Oyegoke
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Leah Maharaj
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Oluwasegun P Akoniyon
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Illiya Kwoji
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Alexandra T Roux
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Taiye S Adewumi
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Rajendra Maharaj
- Office of Malaria Research, Medical Research Council, Durban, South Africa
| | | | - Matthew A Adeleke
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa
| | - Moses Okpeku
- Discipline of Genetics School of Life Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa.
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13
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Wang T, Fan ZW, Ji Y, Chen JJ, Zhao GP, Zhang WH, Zhang HY, Jiang BG, Xu Q, Lv CL, Zhang XA, Li H, Yang Y, Fang LQ, Liu W. Mapping the Distributions of Mosquitoes and Mosquito-Borne Arboviruses in China. Viruses 2022; 14:v14040691. [PMID: 35458421 PMCID: PMC9031751 DOI: 10.3390/v14040691] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 12/20/2022] Open
Abstract
The geographic expansion of mosquitos is associated with a rising frequency of outbreaks of mosquito-borne diseases (MBD) worldwide. We collected occurrence locations and times of mosquito species, mosquito-borne arboviruses, and MBDs in the mainland of China in 1954−2020. We mapped the spatial distributions of mosquitoes and arboviruses at the county level, and we used machine learning algorithms to assess contributions of ecoclimatic, socioenvironmental, and biological factors to the spatial distributions of 26 predominant mosquito species and two MBDs associated with high disease burden. Altogether, 339 mosquito species and 35 arboviruses were mapped at the county level. Culex tritaeniorhynchus is found to harbor the highest variety of arboviruses (19 species), followed by Anopheles sinensis (11) and Culex pipiens quinquefasciatus (9). Temperature seasonality, annual precipitation, and mammalian richness were the three most important contributors to the spatial distributions of most of the 26 predominant mosquito species. The model-predicted suitable habitats are 60–664% larger in size than what have been observed, indicating the possibility of severe under-detection. The spatial distribution of major mosquito species in China is likely to be under-estimated by current field observations. More active surveillance is needed to investigate the mosquito species in specific areas where investigation is missing but model-predicted probability is high.
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Affiliation(s)
- Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Zheng-Wei Fan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Yang Ji
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Guo-Ping Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Wen-Hui Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Yang Yang
- College of Public Health and Health Professions and Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China; (T.W.); (Z.-W.F.); (Y.J.); (J.-J.C.); (G.-P.Z.); (W.-H.Z.); (H.-Y.Z.); (B.-G.J.); (Q.X.); (C.-L.L.); (X.-A.Z.)
- Correspondence: (H.L.); (Y.Y.); (L.-Q.F.); (W.L.)
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