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Sanna A, Suárez-Mutis M, Lambert Y, Carvalho L, Cairo H, Cox H, de Bort C, Gomes do Socorro Mendonça M, Forero-Peña DA, Gabaldón-Figueira JC, Grillet ME, Klein F, Lazarus C, Lazrek Y, Louzada J, Malafaia D, Marchesini P, Musset L, Oliveira-Ferreira J, Peterka C, Rousseau C, Roux E, Villegas L, Vreden S, Wiedner-Papin S, Laporta GZ, Hiwat H, Douine M. Cooperation for malaria control and elimination in the Guiana Shield. Lancet Glob Health 2024; 12:e875-e881. [PMID: 38614635 DOI: 10.1016/s2214-109x(24)00047-0] [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: 08/29/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 04/15/2024]
Abstract
The Guiana Shield, a small region of South America, is currently one of the main hotspots of malaria transmission on the continent. This Amazonian area is characterised by remarkable socioeconomic, cultural, health, and political heterogeneity and a high degree of regional and cross-border population mobility, which has contributed to the increase of malaria in the region in the past few years. In this context, regional cooperation to control malaria represents both a challenge and an indispensable initiative. This Viewpoint advocates for the creation of a regional cooperative mechanism for the elimination of malaria in the Guiana Shield. This strategy would help address operational and political obstacles to successful technical cooperation in the region and could contribute to reversing the regional upsurge in malaria incidence through creating a functional international control and elimination partnership.
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Affiliation(s)
- Alice Sanna
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France.
| | - Martha Suárez-Mutis
- Laboratory of Parasitic Diseases, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; International Joint Laboratory Sentinela, Fundação Oswaldo Cruz, University of Brasília, French National Research Institute for Sustainable Development, Rio de Janeiro, Brazil
| | - Yann Lambert
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France
| | | | - Hedley Cairo
- National Malaria Program, Ministry of Health, Paramaribo, Suriname
| | - Horace Cox
- Vector-Borne Diseases Unit, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago
| | - Clara de Bort
- Regional Health Agency, Cayenne, French Guiana, France
| | | | - David A Forero-Peña
- Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela; Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolívar, Venezuela
| | | | - Maria Eugenia Grillet
- Laboratory of Biology of Vectors and Parasites, Institute of Zoology and Tropical Ecology, Faculty of Sciences, Central University of Venezuela, Caracas, Venezuela
| | - François Klein
- Directorate General for Health, Ministry of Health and Prevention, Paris, France
| | - Clément Lazarus
- Directorate General for Health, Ministry of Health and Prevention, Paris, France
| | - Yassamine Lazrek
- Laboratory of Parasitology, Pasteur Institute in French Guiana, Cayenne, French Guiana, France
| | - Jaime Louzada
- Department of Nursing Science, Federal University of Roraima, Boa Vista, Brazil
| | - Dorinaldo Malafaia
- Vigifronteiras Program, Fundação Oswald Cruz, Rio de Janeiro, Brazil; Chamber of Deputies, National Congress, Brasília, Brazil
| | - Paola Marchesini
- Overall Coordination of Surveillance of Zoonoses and Vector-Borne Diseases, Ministry of Health of Brazil, Brasília, Brazil
| | - Lise Musset
- Laboratory of Parasitology, Pasteur Institute in French Guiana, Cayenne, French Guiana, France
| | - Joseli Oliveira-Ferreira
- Laboratory of Immunoparasitology, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Cassio Peterka
- Coordination of Malaria Elimination, Ministry of Health of Brazil, Brasília, Brazil
| | - Cyril Rousseau
- Division of Decentralized Primary Care Centers, Cayenne Hospital, Cayenne, French Guiana, France
| | - Emmanuel Roux
- ESPACE-DEV, French National Research Institute for Sustainable Development, University of Montpellier, University of the French West Indies, University of French Guiana, University of Reunion Island, and University of Perpignan Via Domitia, Montpellier, France; International Joint Laboratory Sentinela, Fundação Oswaldo Cruz, University of Brasília, French National Research Institute for Sustainable Development, Rio de Janeiro, Brazil
| | | | - Stephen Vreden
- Foundation for the Advancement of Scientific Research in Suriname, Paramaribo, Suriname
| | | | | | - Helene Hiwat
- National Malaria Program, Ministry of Health, Paramaribo, Suriname
| | - Maylis Douine
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France
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2
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Walker CR, Hickson RI, Chang E, Ngor P, Sovannaroth S, Simpson JA, Price DJ, McCaw JM, Price RN, Flegg JA, Devine A. A model for malaria treatment evaluation in the presence of multiple species. Epidemics 2023; 44:100687. [PMID: 37348379 PMCID: PMC7614843 DOI: 10.1016/j.epidem.2023.100687] [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: 07/13/2022] [Revised: 03/12/2023] [Accepted: 05/12/2023] [Indexed: 06/24/2023] Open
Abstract
Plasmodium falciparum and P. vivax are the two most common causes of malaria. While the majority of deaths and severe morbidity are due to P. falciparum, P. vivax poses a greater challenge to eliminating malaria outside of Africa due to its ability to form latent liver stage parasites (hypnozoites), which can cause relapsing episodes within an individual patient. In areas where P. falciparum and P. vivax are co-endemic, individuals can carry parasites of both species simultaneously. These mixed infections complicate dynamics in several ways: treatment of mixed infections will simultaneously affect both species, P. falciparum can mask the detection of P. vivax, and it has been hypothesised that clearing P. falciparum may trigger a relapse of dormant P. vivax. When mixed infections are treated for only blood-stage parasites, patients are at risk of relapse infections due to P. vivax hypnozoites. We present a stochastic mathematical model that captures interactions between P. falciparum and P. vivax, and incorporates both standard schizonticidal treatment (which targets blood-stage parasites) and radical cure treatment (which additionally targets liver-stage parasites). We apply this model via a hypothetical simulation study to assess the implications of different treatment coverages of radical cure for mixed and P. vivax infections and a "unified radical cure" treatment strategy where P. falciparum, P. vivax, and mixed infections all receive radical cure after screening glucose-6-phosphate dehydrogenase (G6PD) normal. In addition, we investigated the impact of mass drug administration (MDA) of blood-stage treatment. We find that a unified radical cure strategy leads to a substantially lower incidence of malaria cases and deaths overall. MDA with schizonticidal treatment was found to decrease P. falciparum with little effect on P. vivax. We perform a univariate sensitivity analysis to highlight important model parameters.
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Affiliation(s)
- C R Walker
- School of Mathematics and Statistics, University of Melbourne, Australia.
| | - R I Hickson
- School of Mathematics and Statistics, University of Melbourne, Australia; Australian Institute of Tropical Health and Medicine, and College of Public Health, Medical & Veterinary Sciences, James Cook University, Australia; Health and Biosecurity, CSIRO, Australia
| | - E Chang
- School of Mathematics and Statistics, University of Melbourne, Australia
| | - P Ngor
- Cambodian National Center for Parasitology, Entomology and Malaria Control, Cambodia; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - S Sovannaroth
- Cambodian National Center for Parasitology, Entomology and Malaria Control, Cambodia
| | - J A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - D J Price
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia; Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Australia
| | - J M McCaw
- School of Mathematics and Statistics, University of Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - R N Price
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Thailand; Division of Global and Tropical Health, Menzies School of Health Research and Charles Darwin University, Australia; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, UK
| | - J A Flegg
- School of Mathematics and Statistics, University of Melbourne, Australia
| | - A Devine
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia; Division of Global and Tropical Health, Menzies School of Health Research and Charles Darwin University, Australia
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Fambirai T, Chimbari MJ, Ndarukwa P. Global Cross-Border Malaria Control Collaborative Initiatives: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12216. [PMID: 36231519 PMCID: PMC9566216 DOI: 10.3390/ijerph191912216] [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: 04/12/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 06/16/2023]
Abstract
Malaria remains a global disease of public health concern. Malaria control collaborative initiatives are widely being adopted to reduce malaria burden by various countries. This review sought to describe current and past cross-border malaria control initiatives focusing on key activities, outcomes and challenges. An exhaustive search was conducted in Web of Science, PubMed, Google Scholar and EBSCOhost using the following key words: cross-border malaria control, cross-border malaria elimination, bi-national malaria control and multinational malaria control, in combination with Boolean operators "AND" and "OR". Eleven studies satisfied the inclusion criteria for this review. The majority of collaborative initiatives have been formed within regional developmental and continental bodies with support from political leadership. The studies revealed that joint vector control, cases management, epidemiological data sharing along border regions as well as resource sharing and capacity building are some of the key collaborative initiatives being implemented globally. Collaborative initiatives have led to significant reduction in malaria burden and mortality. The majority of collaborative initiatives are underfunded and rely on donor support. We concluded that cross-border malaria collaborative initiatives have the capacity to reduce malaria burden and mortality along border regions; however, inadequate internal funding and over-reliance on donor funding remain the biggest threats to the survival of collaborative initiatives.
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Affiliation(s)
- Tichaona Fambirai
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Moses John Chimbari
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban 4001, South Africa
- Pro Vice Chancellor’s Office, Main Campus, Great Zimbabwe University, Morning Side Drive, Masvingo P.O. Box 1235, Zimbabwe
| | - Pisirai Ndarukwa
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban 4001, South Africa
- Department of Health Sciences, Faculty of Sciences and Engineering, Main Campus, Bindura University of Science Education, Chimurenga Road off Trojan Road, Bindura P.O. Box 720, Zimbabwe
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Cintyamena U, Murhandarwati EEH, Elyazar I, Probandari A, Ahmad RA. Identifying forms of interventions towards cross border malaria in the Asia-Pacific region: a scoping review protocol. BMJ Open 2022; 12:e056265. [PMID: 35168980 PMCID: PMC8852765 DOI: 10.1136/bmjopen-2021-056265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION An ambitious epidemiology strategy has been set by the WHO, targeting malaria elimination for at least 35 countries in 2030. Challenges in preventing malaria cross borders require greater attention to achieve the elimination target. This scoping review aims to identify successful forms of interventions to control malaria transmission across national borders in the Asia-Pacific region. METHODS AND ANALYSIS This scoping review will search four electronic databases (PubMed, ScienceDirect, EBSCOhost and ProQuest) limiting the time of publication to the last 10 years. Two independent reviewers will screen all titles and abstracts during the second stage. Study characteristics will be recorded; qualitative data will be extracted and evaluated, while quantitative data will be extracted and summarised. Overall, we will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. ETHICS AND DISSEMINATION This scoping review has received ethical approval from the Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada. The results will be disseminated through peer-reviewed publications, conference presentations and policy briefs.
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Affiliation(s)
- Utsamani Cintyamena
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - E Elsa Herdiana Murhandarwati
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Iqbal Elyazar
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute for Molecular Biology, Jakarta Pusat, DKI Jakarta, Indonesia
| | - Ari Probandari
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Riris Andono Ahmad
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Zheng J, Shi B, Xia S, Yang G, Zhou XN. Spatial patterns of <em>Plasmodium vivax</em> transmission explored by multivariate auto-regressive state-space modelling - A case study in Baoshan Prefecture in southern China. GEOSPATIAL HEALTH 2021; 16. [PMID: 33733649 DOI: 10.4081/gh.2021.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/21/2020] [Indexed: 06/12/2023]
Abstract
The transition from the control phase to elimination of malaria in China through the national malaria elimination programme has focussed attention on the need for improvement of the surveillance- response systems. It is now understood that routine passive surveillance is inadequate in the parasite elimination phase that requires supplementation by active surveillance in foci where cluster cases have occurred. This study aims to explore the spatial clusters and temporal trends of malaria cases by the multivariate auto-regressive state-space model (MARSS) along the border to Myanmar in southern China. Data for indigenous cases spanning the period from 2007 to 2010 were extracted from the China's Infectious Diseases Information Reporting Management System (IDIRMS). The best MARSS model indicated that malaria transmission in the study area during 36 months could be grouped into three clusters. The estimation of malaria transmission patterns showed a downward trend across all clusters. The proposed methodology used in this study offers a simple and rapid, yet effective way to categorize patterns of foci which provide assistance for active monitoring of malaria in the elimination phase.
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Affiliation(s)
- Jinxin Zheng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai.
| | - Benyun Shi
- School of Computer Science and Technology, Nanjing Tech University, Nanjing, Jiangsu.
| | - Shang Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai.
| | - Guojing Yang
- Hainan Medical University, Laboratory of Tropical Environment and Health, Haikou, Hainan, China; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute; University of Basel, Basel.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, China; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai.
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6
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Noviyanti R, Miotto O, Barry A, Marfurt J, Siegel S, Thuy-Nhien N, Quang HH, Anggraeni ND, Laihad F, Liu Y, Sumiwi ME, Trimarsanto H, Coutrier F, Fadila N, Ghanchi N, Johora FT, Puspitasari AM, Tavul L, Trianty L, Utami RAS, Wang D, Wangchuck K, Price RN, Auburn S. Implementing parasite genotyping into national surveillance frameworks: feedback from control programmes and researchers in the Asia-Pacific region. Malar J 2020; 19:271. [PMID: 32718342 PMCID: PMC7385952 DOI: 10.1186/s12936-020-03330-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/09/2020] [Indexed: 01/13/2023] Open
Abstract
The Asia-Pacific region faces formidable challenges in achieving malaria elimination by the proposed target in 2030. Molecular surveillance of Plasmodium parasites can provide important information on malaria transmission and adaptation, which can inform national malaria control programmes (NMCPs) in decision-making processes. In November 2019 a parasite genotyping workshop was held in Jakarta, Indonesia, to review molecular approaches for parasite surveillance and explore ways in which these tools can be integrated into public health systems and inform policy. The meeting was attended by 70 participants from 8 malaria-endemic countries and partners of the Asia Pacific Malaria Elimination Network. The participants acknowledged the utility of multiple use cases for parasite genotyping including: quantifying the prevalence of drug resistant parasites, predicting risks of treatment failure, identifying major routes and reservoirs of infection, monitoring imported malaria and its contribution to local transmission, characterizing the origins and dynamics of malaria outbreaks, and estimating the frequency of Plasmodium vivax relapses. However, the priority of each use case varies with different endemic settings. Although a one-size-fits-all approach to molecular surveillance is unlikely to be applicable across the Asia-Pacific region, consensus on the spectrum of added-value activities will help support data sharing across national boundaries. Knowledge exchange is needed to establish local expertise in different laboratory-based methodologies and bioinformatics processes. Collaborative research involving local and international teams will help maximize the impact of analytical outputs on the operational needs of NMCPs. Research is also needed to explore the cost-effectiveness of genetic epidemiology for different use cases to help to leverage funding for wide-scale implementation. Engagement between NMCPs and local researchers will be critical throughout this process.
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Affiliation(s)
| | - Olivo Miotto
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Wellcome Sanger Institute, Hinxton, Cambridge, UK
- Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Alyssa Barry
- School of Medicine, Deakin University, Geelong, VIC, Australia
- Burnet Institute, Melbourne, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Jutta Marfurt
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia
| | - Sasha Siegel
- Wellcome Sanger Institute, Hinxton, Cambridge, UK
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia
| | - Nguyen Thuy-Nhien
- Centre for Tropical Medicine, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Huynh Hong Quang
- Institute of Malariology, Parasitology and Entomology, Quy Nhon, Vietnam
| | | | | | - Yaobao Liu
- 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, China
| | | | | | - Farah Coutrier
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Nadia Fadila
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Najia Ghanchi
- Pathology, Aga Khan University Hospital, Karachi, Pakistan
| | - Fatema Tuj Johora
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka, Bangladesh
| | | | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Leily Trianty
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | | | - Duoquan Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Kesang Wangchuck
- Royal Center for Disease Control, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Ric N Price
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sarah Auburn
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Aide P, Candrinho B, Galatas B, Munguambe K, Guinovart C, Luis F, Mayor A, Paaijmans K, Fernández-Montoya L, Cirera L, Bassat Q, Mocumbi S, Menéndez C, Nhalungo D, Nhacolo A, Rabinovich R, Macete E, Alonso P, Saúte F. Setting the scene and generating evidence for malaria elimination in Southern Mozambique. Malar J 2019; 18:190. [PMID: 31170984 PMCID: PMC6554892 DOI: 10.1186/s12936-019-2832-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/04/2019] [Indexed: 03/31/2024] Open
Abstract
Mozambique has historically been one of the countries with the highest malaria burden in the world. Starting in the 1960s, malaria control efforts were intensified in the southern region of the country, especially in Maputo city and Maputo province, to aid regional initiatives aimed to eliminate malaria in South Africa and eSwatini. Despite significant reductions in malaria prevalence, elimination was never achieved. Following the World Health Organization's renewed vision of a malaria-free-world, and considering the achievements from the past, the Mozambican National Malaria Control Programme (NMCP) embarked on the development and implementation of a strategic plan to accelerate from malaria control to malaria elimination in southern Mozambique. An initial partnership, supported by the Bill and Melinda Gates Foundation and the La Caixa Foundation, led to the creation of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) and the Malaria Technical and Advisory Committee (MTAC) to promote national ownership and partner coordination to work towards the goal of malaria elimination in local and cross-border initiatives. Surveillance systems to generate epidemiological and entomological intelligence to inform the malaria control strategies were strengthened, and an impact and feasibility assessment of various interventions aimed to interrupt malaria transmission were conducted in Magude district (Maputo Province) through the "Magude Project". The primary aim of this project was to generate evidence to inform malaria elimination strategies for southern Mozambique. The goal of malaria elimination in areas of low transmission intensity is now included in the national malaria strategic plan for 2017-22 and the NMCP and its partners have started to work towards this goal while evidence continues to be generated to move the national elimination agenda forward.
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Affiliation(s)
- Pedro Aide
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique.
- National Institute of Health, Ministry of Health, Maputo, Mozambique.
| | - Baltazar Candrinho
- National Malaria Control Programme, Ministry of Health, Maputo, Mozambique
| | - Beatriz Galatas
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- Universidade de Eduardo Mondlane, Maputo, Mozambique
| | | | - Fabião Luis
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Alfredo Mayor
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Krijn Paaijmans
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- School of Life Sciences, Center for Evolution and Medicine, Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, USA
| | | | - Laia Cirera
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Sonia Mocumbi
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Clara Menéndez
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Delino Nhalungo
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Ariel Nhacolo
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Regina Rabinovich
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eusébio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- National Directorate of Health, Ministry of Health, Maputo, Mozambique
| | - Pedro Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
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8
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Chitnis N, Schapira A, Schindler C, Penny MA, Smith TA. Mathematical analysis to prioritise strategies for malaria elimination. J Theor Biol 2018; 455:118-130. [PMID: 30006002 PMCID: PMC6117457 DOI: 10.1016/j.jtbi.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 06/21/2018] [Accepted: 07/09/2018] [Indexed: 11/27/2022]
Abstract
Malaria and some other tropical diseases are currently targeted for elimination and eventually eradication. Since resources are limited, prioritisation of countries or areas for elimination is often necessary. However, this prioritisation is frequently conducted in an ad hoc manner. Lower transmission areas are usually targeted for elimination first, but for some areas this necessitates long and potentially expensive surveillance programs while transmission is eliminated from neighbouring higher transmission areas. We use a mathematical model to compare the implications of prioritisation choices in reducing overall burden and costs. We show that when the duration of the elimination program is independent of the transmission potential, burden is always reduced most by targeting high transmission areas first, but to reduce costs the optimal ordering depends on the actual transmission levels. In general, when overall transmission potential is low and the surveillance cost per secondary case compared to the cost per imported case is low, targeting the higher transmission area for elimination first is favoured.
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Affiliation(s)
- Nakul Chitnis
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland.
| | - Allan Schapira
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Thomas A Smith
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
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9
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Baird JK. Asia-Pacific malaria is singular, pervasive, diverse and invisible. Int J Parasitol 2016; 47:371-377. [PMID: 27836630 PMCID: PMC5482320 DOI: 10.1016/j.ijpara.2016.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/29/2016] [Accepted: 06/01/2016] [Indexed: 12/27/2022]
Abstract
Malaria in the Asia-Pacific region has been targeted for elimination by the year 2030. This article asks the question, "by what means?" in the context of proven technical strategies and tools against key challenges imposed by the distinct character of the Asia-Pacific malaria problem. The misperception of malaria in the Asia-Pacific region as a less serious but otherwise essentially similar problem to African malaria lulls us into rote application of the same tools and strategies. Those now mitigating the harm done by malaria in Africa will not suffice to eliminate malaria in the Asia-Pacific region - these tasks and the problems are fundamentally distinct. This article describes the singular characteristics of Asia-Pacific malaria and the bearing of those upon the technical strategy of malaria elimination. Most of the tools needed for that endeavour do not yet exist and spirited calls for elimination within the next 14years may discourage the patience and investments needed to conceive, optimise and validate them.
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Affiliation(s)
- J Kevin Baird
- Eijkman Oxford Clinical Research Unit, Jakarta, Indonesia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
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10
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Towards malaria elimination in the MOSASWA (Mozambique, South Africa and Swaziland) region. Malar J 2016; 15:419. [PMID: 27538990 PMCID: PMC4991067 DOI: 10.1186/s12936-016-1470-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/02/2016] [Indexed: 11/25/2022] Open
Abstract
The substantial impact of cross-border collaborative control efforts on the burden of malaria in southern Africa has previously been demonstrated through the successes of the Lubombo Spatial Development Initiative. Increases in malaria cases recorded in the three partner countries (Mozambique, South Africa, Swaziland) since termination of that programme in 2011 have provided impetus for the resuscitation of cooperation in the form of the MOSASWA malaria initiative. MOSASWA, launched in 2015, seeks to renew regional efforts to accelerate progress towards malaria elimination goals already established in the region. National malaria programmes, together with developmental partners, academic institutions and the private sector seek to harmonize policy, strengthen capacity, share expertise, expand access to elimination interventions particularly amongst migrant and border population groups, mobilize resources and advocate for long-term funding to ultimately achieve and sustain malaria elimination in the MOSASWA region.
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11
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Liu H, Xu JW, Yang HL, Li M, Sun CD, Yin YJ, Zheng ZL, Zhang GY, Yu AS, Yang YH, Li CH, Ai S. Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar Border from June to December 2014. Infect Dis Poverty 2016; 5:32. [PMID: 27109419 PMCID: PMC4843199 DOI: 10.1186/s40249-016-0127-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 04/05/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND From 2007 to 2013, intensive control measures reduced malaria burden by 90 % along the China-Myanmar border. However, despite these measures a P. falciparum malaria outbreak was reported in the Shan Special Region II of Myanmar in June of 2014. METHODS Epidemiological, parasitological and entomological investigations were performed. Dihydroartemisinin piperaquine (DAPQ) was immediately administered to treat parasite positive individuals. Long lasting insecticidal nets (LLIN), indoor residual spraying (IRS) with insecticides and behavior change communication (BCC) were also provided for outbreak control. An embedded efficacy study was conducted evaluating DP. Molecular genotyping via polymerase chain reaction (PCR) was performed on the Kelch gene on chromosome 13. RESULTS All infections were identified as Plasmodium falciparum by RDT and microscopy. Two fatalities resulted from the outbreak. The attack rate was 72.8 % (67/92) and the incidence density rate was 14.2 per 100 person-weeks. The positive rate of rapid diagnostic test (RDT) was 72.2 % (65/90) and microscopically-determine parasite rate 42.2 % (38/90). Adjusted odds ratio (OR) of multivariate logistic regression analysis for aged <15 years, 15-45 years, inappropriate treatment from a private healer and lack of bed nets were 13.51 (95 % confidence interval, 2.21-105.89), 7.75 (1.48-44.97), 3.78 (1.30-46.18) and 3.21(1.21-15.19) respectively. In the six surrounding communities of the outbreak site, positive RDT rate was 1.2 % (4/328) and microscopically-determine parasite rate 0.6 % (2/328). Two light traps collected a total of 110 anopheline mosquitoes including local vectors, An. minimus, An. sinensis and An. maculates. After intensive control, the detection of malaria attacks, parasites and antigen were reduced to zero between July 1 and December 1, 2014. The cure rate of P. falciparum patients at day 42 was 94.3 % (95 % CI, 80.8-99.3 %). The PCR did not detect K13-propeller mutations. CONCLUSION Imported P. falciparum caused the outbreak. Age, seeking inappropriate treatment and lack of bed nets were risk factors for infection during the outbreak. P. falciparum was sensitive to treatment with DAPQ. The integrated measures controlled the outbreak and prevented the spread of P. falciparum effectively. The results of this study indicate that malaria control on the China-Myanmar border, especially among special populations, needs further collaboration between China, Myanmar and international societies.
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Affiliation(s)
- Hui Liu
- />Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000 China
| | - Jian-Wei Xu
- />Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000 China
| | - Heng-Lin Yang
- />Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000 China
| | - Mei Li
- />National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025 China
| | - Cheng-De Sun
- />Wa State Department of Health, Pangsang, Shan Special Region II Myanmar
| | - Yi-Jie Yin
- />Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000 China
| | - Zhi-Liang Zheng
- />Wa State Office of Health Poverty Action, Pangsang, Shan Special Region II Myanmar
| | - Guang-Yun Zhang
- />Wa State Office of Health Poverty Action, Pangsang, Shan Special Region II Myanmar
| | - Ai-Shui Yu
- />Menglian Center for Disease Control and Prevention, Menglian, 665800 China
| | - Yong-Hui Yang
- />Menglian Center for Disease Control and Prevention, Menglian, 665800 China
| | - Chun-Hui Li
- />Menglian Center for Disease Control and Prevention, Menglian, 665800 China
| | - Shui Ai
- />Wa State Center for Disease Control and Prevention, Pangsang, Shan Special Region II Myanmar
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12
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Xu JW, Liu H, Zhang Y, Guo XR, Wang JZ. Risk factors for border malaria in a malaria elimination setting: a retrospective case-control study in Yunnan, China. Am J Trop Med Hyg 2015; 92:546-51. [PMID: 25601994 DOI: 10.4269/ajtmh.14-0321] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A retrospective case-control study was conducted to identify risk factors for border malaria in a malaria elimination setting of Yunnan Province, China. The study comprised 214 cases and 428 controls. The controls were individually matched to the cases on the basis of residence, age, and gender. In addition, statistical associations are based on matched analyses. The frequencies of imported, male, adult, and vivax malaria cases were respectively 201 (93.9%), 194 (90.7%), 210 (98.1%), and 176 (82.2%). Overnight stay in Myanmar within the prior month was independently associated with malaria infection (odds ratio [OR] 159.5, 95% confidence interval [CI] 75.1-338.9). In particular, stays in lowland and foothill (OR 5.5, 95% CI 2.5-11.8) or mid-hill (OR 42.8, 95% CI 5.1-319.8) areas, or near streamlets (OR 15.3, 95% CI 4.3-55.2) or paddy field or pools (OR10.1, 95% CI 4.4-55.8) were found to be independently associated with malaria. Neither forest exposure nor use of vector control measures was associated with malaria. In conclusion, travel to lowland and foothill or mid-hill hyperendemic areas, especially along the waterside in Myanmar, was found to be the highest risk factor for malaria. In considering the limitations of the study, further investigations are needed to identify the major determinants of malaria risk and develop new strategies for malaria elimination on China-Myanmar border.
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Affiliation(s)
- Jian-Wei Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China
| | - Hui Liu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China
| | - Yu Zhang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China
| | - Xiang-Rui Guo
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China
| | - Jia-Zhi Wang
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-Borne Diseases Control and Research, Puer 665000, China; The Fourth Hospital of Baotou Municipality, Inner Mongolia, Baotou, China; Yingjiang County Center for Disease Control and Prevention, Yingjiang China; Tengchong County Center for Disease Control and Prevention, Tengchong, China
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13
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Xu JW, Liao YM, Liu H, Nie RH, Havumaki J. Use of bed nets and factors that influence bed net use among Jinuo Ethnic Minority in southern China. PLoS One 2014; 9:e103780. [PMID: 25080267 PMCID: PMC4117543 DOI: 10.1371/journal.pone.0103780] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 07/05/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insecticide-treated nets (ITNs) are an integral part of vector control recommendations for malaria elimination in China. This study investigated the extent to which bed nets were used and which factors influence bed net use among Jinuo Ethnic Minority in China-Myanmar-Laos border areas. METHODS AND FINDINGS This study combined a quantitative household questionnaire survey and qualitative semi-structured in-depth interviews (SDI). Questionnaires were administered to 352 heads of households. SDIs were given to 20 key informants. The bed net to person ratio was 1∶2.1 (i.e., nearly one net for every two people), however only 169 (48.0%) households owned at least one net and 623 (47.2%) residents slept under bed nets the prior night. The percentages of residents who regularly slept under nets (RSUN) and slept under nets the prior night (SUNPN) were similar (48.0% vs. 47.2%, P>0.05), however the percentage correct use of nets (CUN) was significantly lower (34.5%, P<0.0001). The annual cash income per person (ACIP) was an independent factor that influenced bed net use (P<0.0001), where families with an ACIP of CNY10000 or more were much more likely to use nets. House type was strongly associated with bed net use (OR: 4.71, 95% CI: 2.81, 7.91; P<0.0001), where those with traditional wood walls and terracotta roofs were significantly more likely to use nets, and the head of household's knowledge was an independent factor (OR: 5.04, 95% CI: 2.72, 9.35; P<0.0001), where those who knew bed nets prevent malaria were significantly more likely to use nets too. CONCLUSIONS High bed net availability does not necessarily mean higher coverage or bed net use. Household income, house type and knowledge of the ability of bed nets to prevent malaria are all independent factors that influence bed net use among Jinuo Ethnic Minority.
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Affiliation(s)
- Jian-wei Xu
- Yunnan Institute of Parasitic Diseases, Puer, China
| | - Yuan-mei Liao
- Health School of Ganzhou, Jiangxi Province, Ganzhou, China
| | - Hui Liu
- Yunnan Institute of Parasitic Diseases, Puer, China
| | - Ren-hua Nie
- Yunnan Institute of Parasitic Diseases, Puer, China
| | - Joshua Havumaki
- Foundation for Innovative New Diagnostics, Cointrin/Geneva, Switzerland
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14
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Smith Gueye C, Newby G, Hwang J, Phillips AA, Whittaker M, MacArthur JR, Gosling RD, Feachem RGA. The challenge of artemisinin resistance can only be met by eliminating Plasmodium falciparum malaria across the Greater Mekong subregion. Malar J 2014; 13:286. [PMID: 25064614 PMCID: PMC4124510 DOI: 10.1186/1475-2875-13-286] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/16/2014] [Indexed: 12/01/2022] Open
Abstract
Artemisinin-based combinations are currently the most effective anti-malarials and, in addition to vector control, have led to significant declines in malaria morbidity and mortality. However, foci of artemisinin drug resistance have been identified in the Greater Mekong subregion (GMS) of the Asia Pacific, threatening the major gains made in malaria control and potentially creating a parasite pool that is more difficult to treat and eliminate. Efforts are underway to halt the spread of artemisinin resistance, including coordination of activities and funding, and identification of areas of suspected artemisinin resistance, now using a newly identified molecular marker. However, targeting resources to the containment of resistant parasites is likely inefficient and monitoring impact is challenging. A more sustainable solution is the rapid elimination of all Plasmodium falciparum parasites from the GMS. This strategy is more efficient for several reasons. First, a subregional strategy is in line with current commitment to elimination and will build upon the existing national political support for elimination as well as enhancing collaboration among countries. Second, the challenge of human mobility in the GMS is subregional in scope and requires a harmonized elimination strategy. Third, countries will need to improve and intensify malaria operations to reach elimination, and this will be a singular goal across the subregion. Rallying around the goal of P. falciparum elimination will not only utilize existing regional bodies to catalyze political and funding support, but will also leverage the funding already in place to achieve this subregional goal.
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Affiliation(s)
- Cara Smith Gueye
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, USA.
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15
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Abstract
In a linked Perspective, Roly Gosling and Michelle Hsiang discuss the importance of non-falciparum malaria species to regional and global health. Please see later in the article for the Editors' Summary
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Affiliation(s)
- Roly D. Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, California, United States of America
| | - Michelle S. Hsiang
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, San Francisco, California, United States of America
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, San Francisco, California, United States of America
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16
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Cotter C, Sturrock HJW, Hsiang MS, Liu J, Phillips AA, Hwang J, Gueye CS, Fullman N, Gosling RD, Feachem RGA. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet 2013; 382:900-11. [PMID: 23594387 PMCID: PMC10583787 DOI: 10.1016/s0140-6736(13)60310-4] [Citation(s) in RCA: 449] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Malaria-eliminating countries achieved remarkable success in reducing their malaria burdens between 2000 and 2010. As a result, the epidemiology of malaria in these settings has become more complex. Malaria is increasingly imported, caused by Plasmodium vivax in settings outside sub-Saharan Africa, and clustered in small geographical areas or clustered demographically into subpopulations, which are often predominantly adult men, with shared social, behavioural, and geographical risk characteristics. The shift in the populations most at risk of malaria raises important questions for malaria-eliminating countries, since traditional control interventions are likely to be less effective. Approaches to elimination need to be aligned with these changes through the development and adoption of novel strategies and methods. Knowledge of the changing epidemiological trends of malaria in the eliminating countries will ensure improved targeting of interventions to continue to shrink the malaria map.
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Affiliation(s)
- Chris Cotter
- The Global Health Group, University of California, San Francisco, CA 94105, USA.
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