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McArdle RP, Phru CS, Hossain MS, Alam MS, Haldar K. Bangladesh should engage the private sector for malaria elimination by 2030. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 31:100487. [PMID: 39399862 PMCID: PMC11465204 DOI: 10.1016/j.lansea.2024.100487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 09/15/2024] [Accepted: 09/15/2024] [Indexed: 10/15/2024]
Abstract
Bangladesh reduced malaria incidence by 93% from 2008 to 2020 through the action of governmental and non-governmental organizations. The Bangladesh context is unique to South Asia because its successful public sector malaria control programs have historically not engaged corporate partners (as undertaken in Sri Lanka and proposed in India). However, ∼18 million people continue to live at risk of infection in Bangladesh and for-profit private healthcare providers, catalytic for malaria elimination in many countries, are expected to benefit the national program. We distilled (from a large and complex literature) nine distinct strategies important in other developing settings and weighed them in the context of Bangladesh's flourishing private health care sector, driven by patient demand, self-interest and aspirations for public good, as well as heterogeneity in providers and malaria-prevalence. We propose a new model dependent on five strategies and its immediate deployment considerations in high endemic areas, to empower Bangladesh's phased agenda of eliminating indigenous malaria transmission by 2030.
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Affiliation(s)
- Ryan Patrick McArdle
- Boler-Parseghian Center, Department of Biological Sciences, University of Notre Dame, USA
| | - Ching Swe Phru
- Infectious Diseases Division, International Center for Diarrheal Disease Research, Bangladesh
| | - Mohammad Sharif Hossain
- Infectious Diseases Division, International Center for Diarrheal Disease Research, Bangladesh
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Center for Diarrheal Disease Research, Bangladesh
| | - Kasturi Haldar
- Boler-Parseghian Center, Department of Biological Sciences, University of Notre Dame, USA
- Eck Institute for Global Health, University of Notre Dame, USA
- Pulte Institute for Global Development, University of Notre Dame, USA
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Hoek Spaans R, Mkumbwa A, Nasoni P, Jones CM, Stanton MC. Impact of four years of annually repeated indoor residual spraying (IRS) with Actellic 300CS on routinely reported malaria cases in an agricultural setting in Malawi. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002264. [PMID: 38656965 PMCID: PMC11042720 DOI: 10.1371/journal.pgph.0002264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Indoor residual spraying (IRS) is one of the main vector control tools used in malaria prevention. This study evaluates IRS in the context of a privately run campaign conducted across a low-lying, irrigated, sugarcane estate from Illovo Sugar, in the Chikwawa district of Malawi. The effect of Actellic 300CS annual spraying over four years (2015-2018) was assessed using a negative binomial mixed effects model, in an area where pyrethroid resistance has previously been identified. With an unadjusted incidence rate ratio (IRR) of 0.38 (95% CI: 0.32-0.45) and an adjusted IRR of 0.50 (95% CI: 0.42-0.59), IRS has significantly contributed to a reduction in case incidence rates at Illovo, as compared to control clinics and time points outside of the six month protective period. This study shows how the consistency of a privately run IRS campaign can improve the health of employees. More research is needed on the duration of protection and optimal timing of IRS programmes.
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Affiliation(s)
- Remy Hoek Spaans
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | - Christopher M. Jones
- Illovo Sugar Malawi, Nchalo, Malawi
- Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
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Millat-Martínez P, Baro B, Kasian B, Lorry L, Sanz S, Wali C, Raulo S, Elizah A, Koleala T, Kaius-Ome M, Karl S, Mitjà O, Laman M, Pomat W, Bassat Q. A cross-sectional study to ascertain malaria prevalence among asymptomatic travellers arriving on the Lihir Group of Islands, Papua New Guinea: implications for elimination efforts. Malar J 2023; 22:364. [PMID: 38031175 PMCID: PMC10688477 DOI: 10.1186/s12936-023-04804-y] [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: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND The Lihir Islands of Papua New Guinea host a mining operation that has resulted in a mine-impacted zone (MIZ) with reduced malaria transmission and a substantial influx of mine employees, informal cross-country traders, returning locals, and visitors. Prevalence of malaria parasites was assessed in travellers arriving on the Lihir Group of Islands to evaluate the risk of parasite importation. METHODS In 2018, a cross-sectional study at the airport and main wharf was conducted, targeting asymptomatic travellers who had been away from Lihir for at least 12 days. Microscopy, rapid diagnostic tests (RDTs), and quantitative PCR (qPCR) were used to determine Plasmodium parasite prevalence, employing logistic regression models to identify factors associated with qPCR positivity. RESULTS 398 travellers arriving by plane and 402 arriving by boat were included. Both cohorts were significantly different. Mean age among travellers arriving by plane was 40.1 years (SD ± 10.1), 93% were male and 96% were employed at the mine. In contrast, among travellers arriving by boat, the mean age was 31.7 years (SD ± 14.0), 68% were male and 36% were employed at the mine. The prevalence of malaria infection among travellers arriving by plane was 1% by RDT and microscopy, and increased to 5% by qPCR. In contrast, those arriving by boat showed a prevalence of 8% by RDT and microscopy, and 17% by qPCR. Risk factors for infection were arriving by boat (OR 4.2; 95%CI 2.45,7.21), arriving from nearby provinces with high malaria incidence (OR 5.02; 95%CI 1.80, 14.01), and having been away from Lihir for 91 days or more (OR 4.15; 95%CI 2.58, 6.66). Being mine worker staying at the mine accommodation was related with less infection risk (OR 0.24; 95% CI 0.14, 0.43); while Lihirian residents returning from a trip, VFRs, or people with trading unrelated to mining had higher risks (p = 0.0066). CONCLUSIONS Travellers arriving by boat faced increased risk of malaria infection than those arriving by plane. This subpopulation poses an import risk to the MIZ and the rest of Lihir Islands. Screening of high-risk groups at wharfs, and collaboration with nearby Islands, could sustain reduced transmission and facilitate malaria elimination strategies.
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Affiliation(s)
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | - Bernadine Kasian
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Lina Lorry
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Sergi Sanz
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Chilaka Wali
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Sylvia Raulo
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Arthur Elizah
- Lihir Malaria Elimination Programme, Lihir Island, Papua New Guinea
| | - Tamarah Koleala
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Maria Kaius-Ome
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Stephan Karl
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Oriol Mitjà
- Fight Infectious Diseases Foundation, Hospital Germans Trias I Pujol, Badalona, Spain
- School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Vic, Catalonia, Spain
- Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea
| | - Moses Laman
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - William Pomat
- Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Rahi M, Sharma A. India could harness public-private partnerships to achieve malaria elimination. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 5:100059. [PMID: 37383669 PMCID: PMC10305908 DOI: 10.1016/j.lansea.2022.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Public-private partnerships (PPP) have been beneficial in different sectors like infrastructure development and service sector across the world, including in India. Such partnerships in the healthcare sector have also been successful in providing access to affordable medical attention to all sections of society. These partnerships between public and private entities have proven to be beneficial in controlling malaria in high burden districts of India and taking these areas to the brink of elimination, thus setting examples to follow. The two successful ones are the Comprehensive Case Management Project (CCMP) in Odisha which is now adopted by the state, and the Malaria Elimination Demonstration Project (MEDP) which has nearly eliminated malaria from the highly endemic district of Mandla in Madhya Pradesh. Here we propose that non-government and semi-government actors may be given vital roles in the malaria elimination efforts till 2030 and beyond. These partners will add value to the national programme and may have the potential to develop and test different models of malaria elimination in real-life settings that the government programme can absorb sustainably.
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Affiliation(s)
- Manju Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Amit Sharma
- Academy of Scientific and Innovative Research, Ghaziabad, India
- ICMR-National Institute of Malaria Research, New Delhi, India
- Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
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Okumu F, Gyapong M, Casamitjana N, Castro MC, Itoe MA, Okonofua F, Tanner M. What Africa can do to accelerate and sustain progress against malaria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000262. [PMID: 36962314 PMCID: PMC10021840 DOI: 10.1371/journal.pgph.0000262] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
After a longstanding global presence, malaria is now largely non-existent or suppressed in most parts of the world. Today, cases and deaths are primarily concentrated in sub-Saharan Africa. According to many experts, this persistence on the African continent reflects factors such as resistance to insecticides and drugs as well as insufficient access to essential commodities such as insecticide-treated nets and effective drugs. Crucially, however, this narrative ignores many central weaknesses in the fight against malaria and instead reinforces a narrow, commodity-driven vision of disease control. This paper therefore describes the core challenges hindering malaria programs in Africa and highlights key opportunities to rethink current strategies for sustainable control and elimination. The epidemiology of malaria in Africa presents far greater challenges than elsewhere and requires context-specific initiatives tailored to national and sub-national targets. To sustain progress, African countries must systematically address key weaknesses in its health systems, improve the quality and use of data for surveillance-responses, improve both technical and leadership competencies for malaria control, and gradually reduce overreliance on commodities while expanding multisectoral initiatives such as improved housing and environmental sanitation. They must also leverage increased funding from both domestic and international sources, and support pivotal research and development efforts locally. Effective vaccines and drugs, or other potentially transformative technologies such as genedrive modified mosquitoes, could further accelerate malaria control by complementing current tools. However, our underlying strategies remain insufficient and must be expanded to include more holistic and context-specific approaches critical to achieve and sustain effective malaria control.
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Affiliation(s)
| | - Margaret Gyapong
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Núria Casamitjana
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic–University of Barcelona, Barcelona, Spain
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Maurice A. Itoe
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Friday Okonofua
- Department of Obstetrics and Gynaecology, School of Medicine, University of Benin, Benin City, Nigeria
| | - Marcel Tanner
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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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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Tadesse Boltena M, El-Khatib Z, Kebede AS, Asamoah BO, Yaw ASC, Kamara K, Constant Assogba P, Tadesse Boltena A, Adane HT, Hailemeskel E, Biru M. Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5444. [PMID: 35564842 PMCID: PMC9101176 DOI: 10.3390/ijerph19095444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/22/2022]
Abstract
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute's critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The I2 statistics and Egger's test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were Hookworm (48%), Ascaris lumbricoides (37%), and Trichuris trichiura (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
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Affiliation(s)
- Minyahil Tadesse Boltena
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, 17176 Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, QC J9X 5E4, Canada
| | | | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, 22184 Lund, Sweden; (B.O.A.); (A.T.B.)
| | - Appiah Seth Christopher Yaw
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi 101, Ghana;
| | - Kassim Kamara
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Phénix Constant Assogba
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey-Calavi 526, Benin;
| | - Andualem Tadesse Boltena
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, 22184 Lund, Sweden; (B.O.A.); (A.T.B.)
| | - Hawult Taye Adane
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
| | - Elifaged Hailemeskel
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Mulatu Biru
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
- Child and Family Health, Department of Health Sciences, Lund University, 22184 Lund, Sweden
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Zembere K, Chirombo J, Nasoni P, McDermott DP, Tchongwe-Divala L, Hawkes FM, Jones CM. The human-baited host decoy trap (HDT) is an efficient sampling device for exophagic Anopheles arabiensis within irrigated lands in southern Malawi. Sci Rep 2022; 12:3428. [PMID: 35236911 PMCID: PMC8891353 DOI: 10.1038/s41598-022-07422-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: 08/24/2021] [Accepted: 02/10/2022] [Indexed: 11/15/2022] Open
Abstract
Irrigation schemes provide an ideal habitat for Anopheles mosquitoes particularly during the dry season. Reliable estimates of outdoor host-seeking behaviour are needed to assess the impact of vector control options and this is particularly the case for Anopheles arabiensis which displays a wide range of behaviours that circumvent traditional indoor-insecticide based control. In this study we compared the sampling efficiency of the host decoy trap (HDT) with the human landing catch (HLC) and Suna trap in a repeated Latin square design in two villages (Lengwe and Mwanza) on an irrigated sugar estate in southern Malawi. Over the course of 18 trapping nights, we caught 379 female Anopheles, the majority of which were identified as An. arabiensis. Across both villages, there was no detectable difference in Anopheles catch between the HDT compared with the HLC (RR = 0.85, P = 0.508). The overall sensitivity of the HLC was greater than the Suna trap regardless of mosquito density (Lengwe, α = 2.75, 95% credible interval: 2.03-3.73; Mwanza, α = 3.38, 95% credible interval: 1.50-9.30) whereas the sensitivity of the HDT was only greater than the Suna trap when mosquito numbers were high (Lengwe, α = 2.63, 95% credible interval: 2.00-3.85).We conclude that the HDT is an effective sampling device for outdoor host seeking An. arabiensis in southern Malawi. The presence of An. arabiensis in irrigated lands during the dry season poses a challenge for ongoing indoor vector control efforts.
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Affiliation(s)
- Kennedy Zembere
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - James Chirombo
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | | | - Daniel P McDermott
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Frances M Hawkes
- Natural Resources Institute, Central Avenue, University of Greenwich, Chatham Maritime, Kent, ME4 4TB, UK
| | - Christopher M Jones
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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