1
|
Yarhere IE, Nte AR. A Study of Childhood Malaria trends at the University of Port Harcourt Teaching Hospital: 2006 - 2018. Niger Med J 2023; 64:272-280. [PMID: 38898967 PMCID: PMC11185816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background Several efforts have been put in place to reduce the global burden of malaria especially in children and in sub-Saharan Africa. The study aimed to evaluate the impact of malaria control activities on the trend of childhood malarial diseases at a tertiary hospital in South-south Nigeria. Methodology A retrospective review of the case records of all malaria diagnoses including in-patient, out-patient, and emergency room, seen in the Department of paediatrics at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018 was conducted. Results There were 41, 863 malaria cases diagnosed over the 12 years with a decline in yearly diagnosis and admissions, from the year 2006 through 2018. Total malaria admissions were 578, (44.5/ year), giving a severe malaria incidence of 1.26%, and there were 164 malaria death cases, with a yearly average of 12. The causes of death in the children with malarial parasitaemia were severe anaemia in 75 (45.7%), hypoglycaemia in 14 (8.5%), cerebral malaria in 17 (10.4%), and prostration with other co-morbidities, 22 (13.4%). Thirty-six children (22%) were convulsing and died soon after admission, with a compounding diagnosis of aspiration and respiratory failure. Conclusion There is a gradual reduction in childhood malaria disease, admission, and death, though this is slower than anticipated based on efforts and strategies put in place by the Nigerian government and various organizations.
Collapse
Affiliation(s)
- Iroro Enameguolo Yarhere
- Department of Peadiatrics, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria
| | - Alice Romokek Nte
- Department of Peadiatrics, College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria
| |
Collapse
|
2
|
An Overview of Malaria Transmission Mechanisms, Control, and Modeling. Med Sci (Basel) 2022; 11:medsci11010003. [PMID: 36649040 PMCID: PMC9844307 DOI: 10.3390/medsci11010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/11/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
In sub-Saharan Africa, malaria is a leading cause of mortality and morbidity. As a result of the interplay between many factors, the control of this disease can be challenging. However, few studies have demonstrated malaria's complexity, control, and modeling although this perspective could lead to effective policy recommendations. This paper aims to be a didactic material providing the reader with an overview of malaria. More importantly, using a system approach lens, we intend to highlight the debated topics and the multifaceted thematic aspects of malaria transmission mechanisms, while showing the control approaches used as well as the model supporting the dynamics of malaria. As there is a large amount of information on each subject, we have attempted to provide a basic understanding of malaria that needs to be further developed. Nevertheless, this study illustrates the importance of using a multidisciplinary approach to designing next-generation malaria control policies.
Collapse
|
3
|
Bakai TA, Thomas A, Iwaz J, Atcha-Oubou T, Tchadjobo T, Khanafer N, Rabilloud M, Voirin N. Changes in registered malaria cases and deaths in Togo from 2008 to 2017. Int J Infect Dis 2020; 101:298-305. [PMID: 33038554 DOI: 10.1016/j.ijid.2020.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE The WHO Malaria Report 2019 stated that "globally, the burden of malaria was lower than ten years ago, but, in the last few years, there has been an increase in the number of malaria cases around the world". This study reported changes in malaria cases and deaths at the Togo national level (2008-2017) and presented anti-malaria fight results and eradication chances by 2030 in Togo. METHODS Cases and deaths were collected from medical records, monthly reports, and notes of 6000 health workers; then summarized by Region, District, year, and specific subpopulations. Estimates of annual trends of numbers of cases and deaths were obtained through generalized linear models. RESULTS The number of cases increased by four times, whereas the population increased by 1.3 times (2008-2017). Increases affected all regions and subpopulations; the mean annual relative increases in children <5, pregnant women, and other persons ≥5 were 13%, 10%, and 14%, respectively. Death rates decreased in all Regions; the mean annual relative decreases in the subpopulations were 7%, 16%, and 6%, respectively. CONCLUSION Case increases were associated with higher investments and better monitoring and death decreases to better prevention, diagnosis, and treatment. These trends should incite government and partners to maintain or intensify current efforts to meet the elimination goals by 2030.
Collapse
Affiliation(s)
- Tchaa A Bakai
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France; Epidemiology and Modelling in Infectious Diseases (EPIMOD), Dompierre-sur-Veyle, France; Programme National de Lutte contre le Paludisme (PNLP), Lomé, Togo; Service d'Hygiène, Épidémiologie et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.
| | - Anne Thomas
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France; Epidemiology and Modelling in Infectious Diseases (EPIMOD), Dompierre-sur-Veyle, France.
| | - Jean Iwaz
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France.
| | | | | | - Nagham Khanafer
- Service d'Hygiène, Épidémiologie et Prévention, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.
| | - Muriel Rabilloud
- Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France.
| | - Nicolas Voirin
- Epidemiology and Modelling in Infectious Diseases (EPIMOD), Dompierre-sur-Veyle, France.
| |
Collapse
|
4
|
Sanyang Y. Prevalence of under-five years of age mortality by infectious diseases in West African region. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
5
|
Challe DP, Kamugisha ML, Mmbando BP, Francis F, Chiduo MG, Mandara CI, Gesase S, Abdul O, Lemnge MM, Ishengoma DS. Pattern of all-causes and cause-specific mortality in an area with progressively declining malaria burden in Korogwe district, north-eastern Tanzania. Malar J 2018; 17:97. [PMID: 29482553 PMCID: PMC5828081 DOI: 10.1186/s12936-018-2240-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. Verbal autopsy (VA) interviews are alternatively used to determine causes of death in places without or with incomplete hospital records. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania. METHODS The study was conducted from January 2006 to December 2012 in 14 villages under Korogwe HDSS. Vital events such as births, deaths and migrations were routinely updated quarterly. A standard VA questionnaire was administered to parents/close relatives of the deceased to determine cause of death. RESULTS Overall, 1325 deaths of individuals with median age of 46 years were recorded in a population with 170,471.4 person years observed (PY). Crude mortality rate was 7.8 per 1000 PY (95% CI 7.2-8.4) and the highest rate was observed in infants (77.9 per 1000 PY; 95% CI 67.4-90.0). The overall mortality increased between 2006 and 2007, followed by a slight decline up to 2011, with the highest decrease observed in 2012. Causes of deaths were established in 942 (71.1%) deaths and malaria (198 deaths, 21.0%) was the leading cause of death in all age groups except adults (15-59 years). HIV/AIDS (17.6%, n = 365) was the leading cause of death in individuals aged 15-59 years followed by malaria (13.9%) and tuberculosis. Non-communicable diseases (NCDs) including stroke, hypertension, cancer, and cardiac failure caused majority of deaths in elderly (60 years and above) accounting for 37.1% (n = 348) of all deaths, although malaria was the single leading cause of death in this group (16.6%). CONCLUSION The study showed a significant decline of deaths in the Korogwe HDSS site and malaria was the main cause of death in all age groups (except adults, aged 15-59 years) while HIV/AIDS and NCDs were the main causes in adults and elderly, respectively. Further surveillance is required to monitor and document changes in cause-specific mortality as malaria transmission continues to decline in this and other parts of Tanzania.
Collapse
Affiliation(s)
- Daniel P Challe
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania.
| | - Mathias L Kamugisha
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Bruno P Mmbando
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Mercy G Chiduo
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Samuel Gesase
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Omari Abdul
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Martha M Lemnge
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| | - Deus S Ishengoma
- National Institute for Medical Research, Tanga Centre, P.O Box 5004, Tanga, Tanzania
| |
Collapse
|
6
|
Serology describes a profile of declining malaria transmission in Farafenni, The Gambia. Malar J 2015; 14:416. [PMID: 26492873 PMCID: PMC4618886 DOI: 10.1186/s12936-015-0939-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/09/2015] [Indexed: 11/23/2022] Open
Abstract
Background Malaria morbidity and mortality has declined in recent years in a number of settings. The ability to describe changes in malaria transmission associated with these declines is important in terms of assessing the potential effects of control interventions, and for monitoring and evaluation purposes. Methods Data from five cross-sectional surveys conducted in Farafenni and surrounding villages on the north bank of River Gambia between 1988 and 2011 were compiled. Antibody responses to MSP-119 were measured in samples from all surveys, data were normalized and expressed as seroprevalence and seroconversion rates (SCR) using different mathematical models. Results Results showed declines in serological metrics with seroprevalence in children aged one to 5 years dropping from 19 % (95 % CI 15–23 %) in 1988 to 1 % (0–2 %) in 2011 (p value for trend in proportions < 0.001) and the SCR dropping from 0.069 year−1 (0.059–0.080) to 0.022 year−1 (0.017–0.028; p = 0.004). The serological data were consistent with previously described drops in both parasite prevalence in children aged 1–5 years (62 %, 57–66 %, in 1988 to 2 %, 0–4 %, in 2011; p < 0.001), and all-cause under five mortality rates (37 per 1000 person-years, 34–41, in 1990 to 17, 15–19, in 2006; p = 0.059). Conclusions This analysis shows accurate reconstruction of historical malaria transmission patterns in the Farafenni area using anti-malarial antibody responses. Demonstrating congruence between serological measures, and conventional clinical and parasitological measures suggests broader utility for serology in monitoring and evaluation of malaria transmission. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0939-1) contains supplementary material, which is available to authorized users.
Collapse
|
7
|
Orimadegun A, Ogunbosi B, Orimadegun B. Hypoxemia predicts death from severe falciparum malaria among children under 5 years of age in Nigeria: the need for pulse oximetry in case management. Afr Health Sci 2014; 14:397-407. [PMID: 25320590 DOI: 10.4314/ahs.v14i2.16] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Oxygen saturation is a good marker for disease severity in emergency care. However, studies have not considered its use in identifying individuals infected with Plasmodium falciparum at risk of deaths. OBJECTIVE To investigate the prevalence and predictive value of hypoxaemia for deaths in under-5s with severe falciparum malaria infection. METHODS Oxygen saturation was prospectively measured alongside other indicators of disease severity in 369 under-5s admitted to a tertiary hospital in Nigeria. Participants were children in whom falciparum malaria parasitaemia was confirmed with blood film microscopy in the presence of any of the World Health Organization-defined life-threatening features for malaria. RESULTS Overall mortality rate was 8.1%. Of the 16 indicators of the disease severity assessed, hypoxaemia (OR=7.54; 95% CI=2.80, 20.29), co-morbidity with pneumonia (OR=19.27; 95% CI=2.87, 29.59), metabolic acidosis (OR=6.21; 95% CI=2.21, 17.47) and hypoglycaemia (OR=19.71; 95% CI=2.61, 25.47) were independent predictors of death. Cerebral malaria, male gender, wasting, hypokalaemia, hyponatriaemia, azotaemia and renal impairment were significantly associated with death in univariate analysis but not logistic regression model. CONCLUSIONS Hypoxaemia predicts deaths in Nigerian children with severe malaria, irrespective of other features. Efforts should always be made to measure oxygen saturation as part of the treatments for severe malaria in children.
Collapse
Affiliation(s)
- Adebola Orimadegun
- Institute of Child Health College of Medicine, University of Ibadan, Nigeria
| | - Babatunde Ogunbosi
- Department of Paediatrics, College of Medicine, University of Ibadan, Nigeria
| | - Bose Orimadegun
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Nigeria
| |
Collapse
|
8
|
Rumisha SF, Smith TA, Masanja H, Abdulla S, Vounatsou P. Relationship between child survival and malaria transmission: an analysis of the malaria transmission intensity and mortality burden across Africa (MTIMBA) project data in Rufiji demographic surveillance system, Tanzania. Malar J 2014; 13:124. [PMID: 24679119 PMCID: PMC4021084 DOI: 10.1186/1475-2875-13-124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/19/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The precise nature of the relationship between malaria mortality and levels of transmission is unclear. Due to methodological limitations, earlier efforts to assess the linkage have lead to inconclusive results. The malaria transmission intensity and mortality burden across Africa (MTIMBA) project initiated by the INDEPTH Network collected longitudinally entomological data within a number of sites in sub-Saharan Africa to study this relationship. This work linked the MTIMBA entomology database with the routinely collected vital events within the Rufiji Demographic Surveillance System to analyse the transmission-mortality relation in the region. METHODS Bayesian Bernoulli spatio-temporal Cox proportional hazards models with village clustering, adjusted for age and insecticide-treated nets (ITNs), were fitted to assess the relation between mortality and malaria transmission measured by entomology inoculation rate (EIR). EIR was predicted at household locations using transmission models and it was incorporated in the model as a covariate with measure of uncertainty. Effects of covariates estimated by the model are reported as hazard ratios (HR) with 95% Bayesian confidence interval (BCI) and spatial and temporal parameters are presented. RESULTS Separate analysis was carried out for neonates, infants and children 1-4 years of age. No significant relation between all-cause mortality and intensity of malaria transmission was indicated at any age in childhood. However, a strong age effect was shown. Comparing effects of ITN and EIR on mortality at different age categories, a decrease in protective efficacy of ITN was observed (i.e. neonates: HR = 0.65; 95% BCI:0.39-1.05; infants: HR = 0.72; 95% BCI:0.48-1.07; children 1-4 years: HR = 0.88; 95% BCI:0.62-1.23) and reduction on the effect of malaria transmission exposure was detected (i.e. neonates: HR = 1.15; 95% BCI:0.95-1.36; infants: HR = 1.13; 95% BCI:0.98-1.25; children 1-4 years: HR = 1.04; 95% BCI:0.89-1.18). A very strong spatial correlation was also observed. CONCLUSION These results imply that assessing the malaria transmission-mortality relation involves more than the knowledge on the performance of interventions and control measures. This relation depends on the levels of malaria endemicity and transmission intensity, which varies significantly between different settings. Thus, sub-regions analyses are necessary to validate and assess reproducibility of findings.
Collapse
Affiliation(s)
- Susan F Rumisha
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
- National Institute for Medical Research, PO Box 9653, Dar es Salaam, Tanzania
| | - Thomas A Smith
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | | | - Salim Abdulla
- Ifakara Health Institute, PO Box 78373, Dar es Salaam, Tanzania
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| |
Collapse
|
9
|
Ye Y, Kyobutungi C, Ogutu B, Villegas L, Diallo D, Tinto H, Oduro A, Sankoh O. Malaria mortality estimates: need for agreeable approach. Trop Med Int Health 2012. [DOI: 10.1111/tmi.12020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | | | - Halidou Tinto
- Nanoro HDSS; IRSS-DRO/Centre Muraz; Bobo-Dioulasso; Burkina Faso
| | - Abraham Oduro
- Navrongo HDSS; Navrongo Health Research Centre; Navrongo; Ghana
| | | |
Collapse
|
10
|
Tambo E, Adedeji AA, Huang F, Chen JH, Zhou SS, Tang LH. Scaling up impact of malaria control programmes: a tale of events in Sub-Saharan Africa and People's Republic of China. Infect Dis Poverty 2012; 1:7. [PMID: 23849299 PMCID: PMC3710198 DOI: 10.1186/2049-9957-1-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 10/12/2012] [Indexed: 11/10/2022] Open
Abstract
This review aims at providing synthetic information with scientific evidence on the trends in the malaria events from 1960 to 2011, with the hope that it will help policy makers to take informed decisions on public health issues and intervention designs on malaria control towards elimination in both Sub-Sahara Africa and in the People's Republic of China by highlighting the achievements, progress and challenges in research on moving malaria from epidemic status towards elimination. Our findings showed that since 1960, malaria control programmes in most countries have been disjointed and not harmonized. Interestingly, during the last decade, the causal factors of the unprecedented and substantial decline in malaria morbidity and mortality rates in most vulnerable groups in these endemic areas are multifaceted, including not only the spread of malaria and its related effects but also political and financial willingness, commitment and funding by governments and international donors. The benefits of scaling up the impact of malaria coverage interventions, improvement of health system approaches and sustained commitment of stakeholders are highlighted, although considerable efforts are still necessary in Sub-Sahara Africa. Furthermore, novel integrated control strategies aiming at moving malaria from epidemic status to control towards elimination, require solid research priorities both for sustainability of the most efficient existing tools and intervention coverage, and in gaining more insights in the understanding of the epidemiology, pathogenesis, vector dynamics, and socioeconomic aspects of the disease. In conclusion, political commitment and financial investment of stakeholders in sustaining the scaling up impact of malaria control interventions, networking between African and Chinese scientists, and their Western partners are urgently needed in upholding the recent gains, and in translating lessons learnt from the Chinese malaria control achievements and successes into practical interventions in malaria endemic countries in Africa and elsewhere.
Collapse
Affiliation(s)
- Ernest Tambo
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre on Malaria, Schisostomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Rd, Shanghai, 200025, People’s Republic of China
- School of Medicine & Pharmacy, Houdegbe North American University PK10, Route de Porto-Novo, 06 BP 2080, Cotonou, République du Bénin
| | - Ahmed Adebowale Adedeji
- Department of Pharmacology and Toxicology, Kampala International University Western Campus, P.O.Box 71, Ishaka, Bushenyi, Uganda
| | - Fang Huang
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre on Malaria, Schisostomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Rd, Shanghai, 200025, People’s Republic of China
| | - Jun-Hu Chen
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre on Malaria, Schisostomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Rd, Shanghai, 200025, People’s Republic of China
| | - Shui-Sen Zhou
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre on Malaria, Schisostomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Rd, Shanghai, 200025, People’s Republic of China
| | - Ling-Hua Tang
- National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre on Malaria, Schisostomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, 207 Rui Jin Er Rd, Shanghai, 200025, People’s Republic of China
| |
Collapse
|
11
|
Wang GG, Chen G, Feng H, Liu J, Jiang YJ, Shang H, Cao YM. Plasmodium chabaudi AS: distinct CD4(+)CD25(+)Foxp3(+) regulatory T cell responses during infection in DBA/2 and BALB/c mice. Parasitol Int 2012; 62:24-31. [PMID: 22971347 DOI: 10.1016/j.parint.2012.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 08/11/2012] [Accepted: 08/19/2012] [Indexed: 11/26/2022]
Abstract
Malaria infections display variation patterns of clinical course and outcome. Although CD4(+)CD25(+)Foxp3(+) regulatory T (Treg) cells play an essential role in immune homeostasis, the immune regulatory roles involved in malaria infection remains to be elucidated. Herein, we compared the disparity in Treg cells response during the course of blood stage Plasmodium chabaudi chabaudi AS (P. c chabaudi AS) infection in DBA/2 and BALB/c mice. BALB/c mice initiated a Th1/Th2 profile respond to P. c chabaudi AS infection, but DBA/2 mice failed to control P. c chabaudi AS infection and almost of them died post-peak parasitemia. At the peak parasitemia, we found that higher proportion of Treg cells with elevated Foxp3 expression in DBA/2 than in BALB/c mice. We used anti-CD25 mAb to deplete Treg cells and found that the survival time and rate were prolonged in DBA/2 mice treated with anti-CD25 mAb. Treatment with anti-CD25 mAb in vivo led to enhanced pro-inflammation responses and Foxp3 expression decline on Treg cells. In contrast, after DBA/2 was treatment with anti-IL-10R mAb, IL-10R blockade in vivo caused excessive pro-inflammation responses and Foxp3 expression loss on CD4(+)CD25(+) T cells. Earlier death was found in all of DBA/2 mice with anti-IL-10R mAb. It suggested that IL-2 and IL-10 signal involved in maintaining Foxp3 expression on Treg cells. In all, the moderate suppressive activity of Treg cells may facilitate resistance to P. c chabaudi AS infection.
Collapse
Affiliation(s)
- Ge-Ge Wang
- Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China
| | | | | | | | | | | | | |
Collapse
|
12
|
Dicko A, Konare M, Traore D, Testa J, Salamon R, Doumbo O, Rogier C. The implementation of malaria intermittent preventive trialtreatment with sulphadoxine-pyrimethamine in infants reduced all-cause mortality in the district of Kolokani, Mali: results from a cluster randomized control. Malar J 2012; 11:73. [PMID: 22423611 PMCID: PMC3359262 DOI: 10.1186/1475-2875-11-73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 03/16/2012] [Indexed: 11/10/2022] Open
Abstract
Background Malaria intermittent preventive treatment of malaria in infant with sulphadoxine-pyrimethamine (IPTi-SP) reduced the incidence of malaria and anaemia by 30% and 20% respectively. The strategy is now a recommended policy for malaria control. However, there was no published study on the impact of the strategy on mortality. The present study assessed the impact of the implementation of IPTi-SP in health services in Mali on all-cause mortality. Methods The 22 health sub-districts of the district of Kolokani were randomized at a 1:1 ratio to either receive IPTi-SP or to serve as a control. The IPTi-SP was implemented for two years starting December 2006. Information on births and deaths through 31 March, 2009 was collected on all children who reached four months of age on 1 December, 2006, likely to be exposed to the intervention in 75 localities randomly selected in each zone. Results A total of 5,882 children (2,869 from the intervention zone and 3,013 from the nonintervention zone) who reached four months of age between 1 December, 2006 and 1 December, 2008 were surveyed between the age of four months to the age of 18 months from 1 December, 2006 to 31 March, 2009. In the cohort of four to 18 months of age, the mortality rate per 1,000 children was 2.53 in the intervention zone compared to 3.46 in the nonintervention zone, gender and season adjusted mortality rate ratio (MRR) = 0.73 (95% CI 0.55-0.97, p = 0.029). In the cohort of the four to 12 months of age, mortality rates per 1,000 children were 2.22 in the intervention zone and 3.13 in the non-intervention zone, MRR = 0.71 (95% CI 0.49-1.02, p = 0.064) adjusted for gender and season. Conclusion The implementation of the IPTi-SP resulted in a substantial reduction in all-cause mortality in children. The results of this study support the adoption and the implementation of IPTi-SP as malaria control strategy. Trial Registration ClinicalTrials.govNCT00766662
Collapse
Affiliation(s)
- Alassane Dicko
- Malaria Research and Training Center, Faculty of Medicine Pharmacy and Dentistry, University of Bamako, PO Box 1805, Bamako, Mali.
| | | | | | | | | | | | | |
Collapse
|
13
|
Rankin JC, Lorenz E, Neuhann F, Yé M, Sié A, Becher H, Ramroth H. Exploring the role narrative free-text plays in discrepancies between physician coding and the InterVA regarding determination of malaria as cause of death, in a malaria holo-endemic region. Malar J 2012; 11:51. [PMID: 22353802 PMCID: PMC3359180 DOI: 10.1186/1475-2875-11-51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 02/21/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In countries where tracking mortality and clinical cause of death are not routinely undertaken, gathering verbal autopsies (VA) is the principal method of estimating cause of death. The most common method for determining probable cause of death from the VA interview is Physician-Certified Verbal Autopsy (PCVA). A recent alternative method to interpret Verbal Autopsy (InterVA) is a computer model using a Bayesian approach to derive posterior probabilities for causes of death, given an a priori distribution at population level and a set of interview-based indicators. The model uses the same input information as PCVA, with the exception of narrative text information, which physicians can consult but which were not inputted into the model. Comparing the results of physician coding with the model, large differences could be due to difficulties in diagnosing malaria, especially in holo-endemic regions. Thus, the aim of the study was to explore whether physicians' access to electronically unavailable narrative text helps to explain the large discrepancy in malaria cause-specific mortality fractions (CSMFs) in physician coding versus the model. METHODS Free-texts of electronically available records (N = 5,649) were summarised and incorporated into the InterVA version 3 (InterVA-3) for three sub-groups: (i) a 10%-representative subsample (N = 493) (ii) records diagnosed as malaria by physicians and not by the model (N = 1035), and (iii) records diagnosed by the model as malaria, but not by physicians (N = 332). CSMF results before and after free-text incorporation were compared. RESULTS There were changes of between 5.5-10.2% between models before and after free-text incorporation. No impact on malaria CSMFs was seen in the representative sub-sample, but the proportion of malaria as cause of death increased in the physician sub-sample (2.7%) and saw a large decrease in the InterVA subsample (9.9%). Information on 13/106 indicators appeared at least once in the free-texts that had not been matched to any item in the structured, electronically available portion of the Nouna questionnaire. DISCUSSION Free-texts are helpful in gathering information not adequately captured in VA questionnaires, though access to free-text does not explain differences in physician and model determination of malaria as cause of death.
Collapse
Affiliation(s)
- Johanna C Rankin
- Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany
| | - Eva Lorenz
- Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany
| | - Florian Neuhann
- Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany
| | - Maurice Yé
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Heiko Becher
- Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany
| | - Heribert Ramroth
- Institute of Public Health, University Hospital of Heidelberg, Heidelberg, Germany
| |
Collapse
|
14
|
Diallo AH, Meda N, Ouédraogo WT, Cousens S, Tylleskar T. A prospective study on neonatal mortality and its predictors in a rural area in Burkina Faso: can MDG-4 be met by 2015? J Perinatol 2011; 31:656-63. [PMID: 21372798 PMCID: PMC3183235 DOI: 10.1038/jp.2011.6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To measure the neonatal mortality rate (NMR) and investigate its predictors in a rural area of Burkina Faso. STUDY DESIGN A cohort of infants born in 24 villages in Banfora region was followed until the children were 6 months old. We estimated the risk of neonatal death and used logistic regression to identify its predictors. RESULT Among 864 live births followed to day 28, there were 40 neonatal deaths, a NMR of 46.3 per 1000 live births (95% confidence intervals (CI): 22 to 70). Multivariable regression identified twin birth (OR=11.5, 95% CI: 4.5 to 29.8), having a nulliparous mother (odds ratio (OR)=4.3, 95% CI: 1.5 to 12.1), and birth into a polygynous household (OR=2.1, 95% CI: 1.0 to 4.7) as main predictors of neonatal death. CONCLUSION The burden of neonatal mortality in rural Burkina Faso is very high and the observed NMRs in a predominantly rural country suggest that it is unlikely Burkina will meet fourth Millennium Development Goal (MDG-4) by 2015.
Collapse
Affiliation(s)
- A H Diallo
- Centre MURAZ Research Institute, Ministry of Health/Burkina Faso, Bobo-Dioulasso, Burkina Faso.
| | - N Meda
- Centre MURAZ Research Institute, Ministry of Health/Burkina Faso, Bobo-Dioulasso, Burkina Faso
| | - W T Ouédraogo
- Centre MURAZ Research Institute, Ministry of Health/Burkina Faso, Bobo-Dioulasso, Burkina Faso
| | - S Cousens
- London School of Hygiene and Tropical Medicine, Infectious Diseases Epidemiology Unit (IDEU), London, United Kingdom
| | - T Tylleskar
- Centre for International Health (CIH), University of Bergen, Arstadveien 21, Bergen, Norway
| | | |
Collapse
|
15
|
Sié A, Louis VR, Gbangou A, Müller O, Niamba L, Stieglbauer G, Yé M, Kouyaté B, Sauerborn R, Becher H. The Health and Demographic Surveillance System (HDSS) in Nouna, Burkina Faso, 1993-2007. Glob Health Action 2010; 3. [PMID: 20847837 PMCID: PMC2940452 DOI: 10.3402/gha.v3i0.5284] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 08/19/2010] [Accepted: 08/20/2010] [Indexed: 11/16/2022] Open
Abstract
The Nouna Health and Demographic Surveillance System (HDSS) is located in rural Burkina Faso and has existed since 1992. Currently, it has about 78,000 inhabitants. It is a member of the International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), a global network of members who conducts longitudinal health and demographic evaluation of populations in low- and middle-income countries. The health facilities consist of one hospital and 13 basic health centres (locally known as CSPS). The Nouna HDSS has been used as a sampling frame for numerous studies in the fields of clinical research, epidemiology, health economics, and health systems research. In this paper we review some of the main findings, and we describe the effects that almost 20 years of health research activities have shown in the population in general and in terms of the perception, economic implications, and other indicators. Longitudinal data analyses show that childhood, as well as overall mortality, has significantly decreased over the observation period 1993–2007. The under-five mortality rate dropped from about 40 per 1,000 person-years in the mid-1990s to below 30 per 1,000 in 2007. Further efforts are needed to meet goal four of the Millennium Development Goals, which is to reduce the under-five mortality rate by two-thirds between 1990 and 2015.
Collapse
Affiliation(s)
- Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Africa's 9th malaria day celebration in 2009 and its bearing on most vulnerable groups. ASIAN PAC J TROP MED 2010. [DOI: 10.1016/s1995-7645(10)60072-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
17
|
Finney OC, Riley EM, Walther M. Regulatory T cells in malaria – friend or foe? Trends Immunol 2010; 31:63-70. [DOI: 10.1016/j.it.2009.12.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 12/06/2009] [Accepted: 12/08/2009] [Indexed: 10/20/2022]
|
18
|
Age patterns of severe paediatric malaria and their relationship to Plasmodium falciparum transmission intensity. Malar J 2009; 8:4. [PMID: 19128453 PMCID: PMC2630996 DOI: 10.1186/1475-2875-8-4] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 01/07/2009] [Indexed: 11/18/2022] Open
Abstract
Background The understanding of the epidemiology of severe malaria in African children remains incomplete across the spectrum of Plasmodium falciparum transmission intensities through which communities might expect to transition, as intervention coverage expands. Methods Paediatric admission data were assembled from 13 hospitals serving 17 communities between 1990 and 2007. Estimates of Plasmodium falciparum transmission intensity in these communities were assembled to be spatially and temporally congruent to the clinical admission data. The analysis focused on the relationships between community derived parasite prevalence and the age and clinical presentation of paediatric malaria in children aged 0–9 years admitted to hospital. Results As transmission intensity declined a greater proportion of malaria admissions were in older children. There was a strong linear relationship between increasing transmission intensity and the proportion of paediatric malaria admissions that were infants (R2 = 0.73, p < 0.001). Cerebral malaria was reported among 4% and severe malaria anaemia among 17% of all malaria admissions. At higher transmission intensity cerebral malaria was a less common presentation compared to lower transmission sites. There was no obvious relationship between the proportions of children with severe malaria anaemia and transmission intensity. Conclusion As the intensity of malaria transmission declines in Africa through the scaling up of insecticide-treated nets and other vector control measures a focus of disease prevention among very young children becomes less appropriate. The understanding of the relationship between parasite exposure and patterns of disease risk should be used to adapt malaria control strategies in different epidemiological settings.
Collapse
|