Effect of Impregnated Mosquito Bed Nets on the Prevalence of Malaria among Pregnant Women in Foumban Subdivision, West Region of Cameroon

Long-lasting insecticidal nets use and the prevalence of Plasmodium falciparum infection among pregnant women attending antenatal care at the Bonassama District Hospital, Littoral Region of Cameroon: a cross-sectional study

BACKGROUND

Malaria during pregnancy continues to be a significant cause of morbidity and mortality for both infants and mothers, particularly in sub-Saharan African (SSA) countries, despite increased efforts to control it. The utilization of long-lasting insecticide-treated nets (LLINs) during pregnancy is a well-established strategy to reduce the prevalence of malaria. Nonetheless, inadequate adherence remains a persistent challenge in certain regions with high malaria endemicity. This research aimed to assess the effectiveness of long-lasting insecticidal nets in preventing asymptomatic malaria infections among pregnant women attending antenatal care at the Bonassama District Hospital in the Littoral Region of Cameroon.

METHODS

A hospital-based cross-sectional study was conducted from March to June 2022. Data on sociodemographic characteristics and LLIN usage were collected through a structured questionnaire, while asymptomatic malaria infections were identified using a PfHRP2/pLDH malaria qualitative rapid diagnostic kit. The relationship between categorical variables was analyzed using the chi-square test and logistic regression at a significance level of 5%.

RESULTS

Out of the 411 pregnant women included in the study, 35.4% were diagnosed with malaria. The LLIN utilization rate was 65.1%. The risk of malaria infection was 2.7 times higher (AOR = 2.75, 95% CI = 1.83-4.14, p < 0.001) among women who did not consistently use LLINs compared to those who did. Pregnant women in their first trimester (AOR = 3.40, 95% CI = 1.24-4.64, p = 0.010) and second trimester (AOR = 1.90, 95%CI = 0.99-3.62, p = 0.055) were more likely to sleep under net when compared to those in the third trimester. Younger women 20-29 years (71.4%), those in the first trimester (69.6%) and those who had the nets before pregnancy (68.9%) were amongst those who frequently used use the nets. Among the reasons reported for not frequently using LLINs were heat (55.2%), suffocation (13.6%) and the smell of nets (8.4%).

CONCLUSION

The use of LLIN was moderately high among the participants in this study, though still below national target. Age group, religion and gestation period were the major factors determining the use of LLINs. Considering the proven effectiveness of LLINs in reducing malaria morbidity and mortality, it is imperative for the National Malaria Control Programme (NMCP) to remain focused in promoting both LLIN ownership and utilization to achieve the national target of 100% and 80%, respectively.

Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey

BACKGROUND

In malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, there is a dearth of literature on the usage of mosquito bed nets by pregnant women in Rwanda. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda.

METHODS

We used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted to determine the factors associated with mosquito bed net use, using SPSS (version 26).

RESULTS

Of the 870 pregnant women, 57.9% (95%CI: 54.6-61.1) used mosquito bed nets. However, 16.7% did not use bed nets among those owning bed nets. On one hand, older age (AOR = 1.59, 95%CI: 1.04-2.44), primary education (AOR = 1.18, 95%CI: 1.07-2.23), being married (AOR = 2.17, 95%CI: 1.43-3.20), being from Kigali region (AOR = 1.97, 95%CI: 1.19-3.91), partner's education (AOR = 1.22, 95%CI: 1.13-3.41), having recently visited a health facility (AOR = 2.07, 95%CI: 1.35-3.18), and being in the third pregnancy trimester (AOR = 2.14, 95%CI: 1.44-3.18) were positively associated with mosquito bed net use. On the other hand, low wealth index (AOR = 0.13, 95%CI: 0.07-0.24), and being from Eastern region (AOR = 0.42, 95% CI: 0.26-0.66) had a negative association.

CONCLUSIONS

About half of the pregnant women in Rwanda used mosquito bed nets and the usage was associated with various socio-demographics. There is a need for appropriate risk communication and continuous sensitisation to improve mosquito net use among pregnant women. Early antenatal care attendance and partner engagement in malaria prevention and mosquito net use, as well as consideration of household dynamics, are also crucial in improving not only mosquito net coverage but also utilization.

Antiplasmodial, Antioxidant, and Cytotoxic Activity of Bridelia micrantha a Cameroonian Medicinal Plant Used for the Treatment of Malaria

Introduction

Resistance to common antimalarial drugs and persistence of the endemicity of malaria constitute a major public health problem in Cameroon. The aim of this study was to evaluate the in vitro antiplasmodial, antioxidant, and cytotoxic activities of aqueous and ethanol extracts of Bridelia micrantha used by Cameroonian traditional healers for the treatment of malaria.

Methods

Aqueous and ethanolic stem bark extracts were prepared according to standard procedures. The SYBR Green method was used for antiplasmodial activity on strains of Plasmodium falciparum sensitive to chloroquine (3D7) and resistant (Dd2). In vitro antioxidant activities of B. micrantha were determined using the scavenging activity of 2,2'-diphenyl-1-picrylhydrazyl, nitric oxide, ferric reducing power, and hydrogen peroxide as well as their cytotoxicity on RAW 264.7 macrophage cells and red blood cells (RBC).

Results

The aqueous and ethanol extracts of Bridelia micrantha showed antiplasmodial activity on the 3D7 strain with IC₅₀ of 31.65 ± 0.79 μg/ml and 19.41 ± 2.93 μg/ml, respectively, as well as 37.64 ± 0.77 μg/ml and 36.22 ± 1.04 μg/ml for the Dd2 strain, respectively. The aqueous and ethanol extracts showed free radical scavenging properties. The IC₅₀ aqueous and ethanol extract was approximately 0.0001737 μg/ml, 42.92 μg/ml, 1197 μg/ml, 63.78 μg/ml and 4.617 μg/ml, 429.9 μg/ml, 511 μg/ml, and 69.32 μg/ml for DPPH, NO, H2O2, and FRAP, respectively, which were compared to ascorbic acid (8.610e - 005 μg/ml, 2901 μg/ml, 3237 μg/ml, and 18.57 μg/ml). The aqueous and ethanol extracts of B. micrantha were found to be nontoxic with CC₅₀ values of 950 ± 6.6 μg/ml and 308.3 ± 45.4 μg/ml, respectively. Haemolysis test showed that the two extracts were not toxic.

Conclusion

These results suggest that B. micrantha can serve as an antimalarial agent. However, further studies are needed to validate the use of B. micrantha as an antimalarial.

High prevalence of asymptomatic Plasmodium falciparum malaria in Makenene, a locality in the forest-savannah transition zone, Centre Region of Cameroon

Malaria transmission and prevalence is still not well documented across Cameroon particularly in medium-sized cities or localities representing high transit zone. Different risk factors could be associated with persistence malaria transmission such as population movement from high to low transmission settings. A cross-sectional community-based study was carried out to determine malaria prevalence and risk factors in Makenene, a small city in a forest-savannah which is a crossroads between different parts of the country where travellers usually stop-over day and night to rest. Using malaria diagnostic test (mRDTs from SD-BIOLINE) and microscopy (thin and thick blood smears), 406 participants from 237 households were tested for malaria infection. The prevalence of malaria was high irrespective of the detection method: mRDT (41.87%) or microscopy (38.42%). At household level, 46.41% of households had at least one case of malaria with an average of 1.41 infected individuals per household. Parasite density was also high with the majority of infected individuals (64.74%) bearing more than 500 parasites/μl. Only Plasmodium falciparum was found. The chances of being infected with malaria parasites was almost the same for all participants irrespective of the sleeping behavior, bednet usage, house type and environmental factors. The study supports high malaria transmission in the locality and the need for additional studies on vectors bionomics and transmission patterns.

Impact of long lasting insecticidal nets on asymptomatic malaria during pregnancy, in a rural and urban setting in Cameroon

According to the world malaria report more malaria cases were reported in 2020 than in 2019, due to disruptions in the distribution of insecticide treated nets, caused by the COVID-19 pandemic. Consequently a projected 34.32% (11.6 million out of 33.8 million) pregnancies were exposed to malaria in the WHO African Region in 2020. This study was therefore designed to assess the impact of long lasting insecticidal nets (LLINs) on asymptomatic malaria in the pregnant women attending the Foumbot District Hospital (rural setting) and the Bamenda Regional Hospital (urban setting). This was a hospital based cross-sectional study done within three months from February to April 2021. A structured questionnaire and the CareStart™ Pf Malaria HRP2 qualitative rapid diagnostic test were used for data collection. Data were analysed using descriptive statistics, and Chi-square test. The relative risk, attributable risk, odds ratio, and likelihood ratio of malaria occurrence in exposed patients were determined by Chi-square (and Fisher's exact) test. The prevalence of asymptomatic malaria was 10.14% (63/621), with a higher prevalence among the pregnant women in the rural setting (12.21%; 37/303), than the urban setting (8.18%; 26/318). As indicated by the attributable risk, 21% of malaria incidence was attributed to absence of LLINs distribution in neighborhoods of the rural setting meanwhile 10% of malaria incidence is attributed to absence of LLINs distribution in neighborhoods of the urban setting. Regular screening for asymptomatic malaria in pregnancy and consistent free distribution of LLINs are recommended in endemic areas, especially in the rural settings.

Evaluation of malaria preventive measures among adult patients attending the Bamendjou and Foumbot district hospitals of the West Region of Cameroon

BACKGROUND

Although a significant decrease in entomological and epidemiological indicators was reported in Cameroon since the introduction of insecticide-treated bed nets, malaria prevalence remains high also in some parts of the West Region of Cameroon. This study was designed to evaluate malaria preventive measures among patients attending the Bamendjou and Foumbot District hospitals of the West Region of Cameroon.

METHODS

This was a cross-sectional study carried out within a period of 3 months, from January to March 2020. Data was obtained using a structured questionnaire and laboratory analysis. The CareStart™ Pf Malaria HRP2 qualitative rapid diagnostic test was used for malaria diagnosis. The questionnaire was designed to collect information on respondent's socio-demographic characteristics, and the use of malaria preventive measures. Data were analysed using descriptive statistics, regression analysis, and Chi-square (and Fisher's exact) test.

RESULTS

A total of 170 study participants were recruited in Foumbot and 197 in Bamendjou. Malaria was significantly (P < 0.0001) more prevalent in Foumbot (47.06%) than in Bamendjou (19.8%). In Foumbot, non-use of insect repellent spray (P = 0.0214), insect repellent body cream (P = 0.0009), mosquito spray (P = 0.0001) and not draining stagnant water (P = 0.0004) predisposed to higher risk of malaria. In Bamendjou, non-use of insect repellent spray (P = 0.0012), long-lasting insecticidal bed nets (P = 0.0001), window and door nets (P = 0.0286), predisposed to a higher risk of malaria.

CONCLUSIONS

Malaria prevalence was high among the study participants especially in Foumbot. An adequate follow-up to ensure effective execution of the recently launched third phase of LLINs distribution campaign in Cameroon is recommended. Additionally, integrated vector management is required to ensure effective control of malaria transmission in Foumbot and Bamendjou.