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Orish VN, Kyeremateng C, Appiah BP, Addei IB, Ayaba MA, Kwadzokpui PK, Marinkovic A, Prakash S, Okorie C, Izurieta R, Sanyaolu A. Knowledge and perception of asymptomatic malaria in the Volta region of Ghana. Trans R Soc Trop Med Hyg 2024; 118:33-43. [PMID: 37534813 DOI: 10.1093/trstmh/trad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/19/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The control of asymptomatic malaria is considered a key aspect of malaria control. This study aimed to assess the knowledge and perception of asymptomatic malaria among people in Ho municipality of the Volta region. METHODS A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta region of Ghana. Using SPSS version 25 statistical software, frequency distributions and proportions were computed for sociodemographic variables while knowledge and perception about asymptomatic malaria were computed into percentages and categorized into three levels based on Bloom's cut-off for further analysis. Findings with p-values <0.05 were considered statistically significant. RESULTS Among the 200 participants, 197 (98.5%) were aware of malaria. The majority (116 [58.0%]) of the study participants agreed to the possibility of asymptomatic infection, but most (133 [66.5%]) of the community members did not know that asymptomatic individuals can still transmit infections. The majority of the participants (184 [92.0%]) showed interest in getting further education on asymptomatic malaria and a significant majority (180 [90.0%]) expressed a willingness to take treatment after testing positive without showing any symptoms. CONCLUSIONS Asymptomatic malaria control can be achieved through a mass testing and treatment strategy, therefore improving the knowledge and perception about asymptomatic malaria might improve malaria control.
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Affiliation(s)
- Verner N Orish
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Caleb Kyeremateng
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Baffoe P Appiah
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Isaac B Addei
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Moses A Ayaba
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | | | | | | | - Chuku Okorie
- Department of Allied Health Sciences, Union College of Union County, Plainfield Campus, NJ, USA
| | - Ricardo Izurieta
- Department of Global Communicable Diseases, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Adekunle Sanyaolu
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
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Ansah F, Nyame K, Laryea R, Owusu R, Amon D, Boyetey MJB, Ayeke D, Razak N, Kornu VE, Ashitei S, Owusu-Appiah C, Chirawurah JD, Abugri J, Aniweh Y, Opoku N, Sutherland CJ, Binka FN, Kweku M, Awandare GA, Dinko B. The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana. Malar J 2023; 22:271. [PMID: 37710288 PMCID: PMC10500816 DOI: 10.1186/s12936-023-04712-1] [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: 03/14/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. METHODS In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined. RESULTS AND DISCUSSION The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment. CONCLUSION Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques.
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Affiliation(s)
- Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kwamina Nyame
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Rukaya Laryea
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Owusu
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Denick Amon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Mark-Jefferson Buer Boyetey
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Dzidzor Ayeke
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nasibatu Razak
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Victor E Kornu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Sarah Ashitei
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Caleb Owusu-Appiah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Jersley D Chirawurah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - James Abugri
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nicholas Opoku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Fred N Binka
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Bismarck Dinko
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
- Department of Clinical Microbiology, School of Medicine and Dentistry College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana.
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Dassah SD, Nyaah KE, Senoo DKJ, Ziem JB, Aniweh Y, Amenga-Etego L, Awandare GA, Abugri J. Co-infection of Plasmodium falciparum and Schistosoma mansoni is associated with anaemia. Malar J 2023; 22:272. [PMID: 37710279 PMCID: PMC10503114 DOI: 10.1186/s12936-023-04709-w] [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: 07/14/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Malaria and schistosomiasis persist as major public health challenge in sub-Saharan Africa. These infections have independently and also in polyparasitic infection been implicated in anaemia and nutritional deficiencies. This study aimed at assessing asymptomatic malaria, intestinal Schistosoma infections and the risk of anaemia among school children in the Tono irrigation area in the Kassena Nankana East Municipal (KNEM) in the Upper East Region of Northern Ghana. METHODS A cross sectional survey of 326 school children was conducted in the KNEM. Kato Katz technique was used to detect Schistosoma eggs in stool. Finger-prick capillary blood sample was used for the estimation of haemoglobin (Hb) concentration and blood smear for malaria parasite detection by microscopy. RESULTS The average age and Hb concentration were 10.9 years (standard deviation, SD: ± 2.29) and 11.2 g/dl (SD: ± 1.39) respectively with 58.9% (n = 192) being females. The overall prevalence of infection with any of the parasites (single or coinfection) was 49.4% (n = 161, 95% confidence interval, CI [44.0-54.8]). The prevalence of malaria parasite species or Schistosoma mansoni was 32.0% (n = 104) and 25.2% (n = 82), respectively with 7.7% (n = 25) coinfection. The prevalence of anaemia in the cohort was 40.5% (95%CI [35.3-45.9]), of which 44.4% harboured at least one of the parasites. The prevalence of anaemia in malaria parasite spp or S. mansoni mono-infections was 41.8% and 38.6%, respectively and 64.0% in coinfections. There was no statistically significant difference in the odds of being anaemic in mono-infection with malaria (OR = 1.22, 95% CI 0.71-2.11, p = 0.47) or S. mansoni (OR = 1.07, 95% CI 0.58-1.99, p = 0.83) compared to those with no infection. However, the odds of being anaemic and coinfected with malaria parasite species and S. mansoni was 3.03 times higher compared to those with no infection (OR = 3.03, 95% CI 1.26-7.28, p = 0.013). Conclusion The data show a high burden of malaria, S. mansoni infection and anaemia among school children in the irrigation communities. The risk of anaemia was exacerbated by coinfections with malaria parasite(s) and S. mansoni. Targeted integrated interventions are recommended in this focal area of KNEM.
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Affiliation(s)
- Sylvester Donne Dassah
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University for Technology and Applied Sciences, Navrongo, Ghana.
| | - Kingsley Enock Nyaah
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University for Technology and Applied Sciences, Navrongo, Ghana
| | | | - Juventus B Ziem
- School of Medicine, C. K. Tedam University for Technology and Applied Sciences, Navrongo, Ghana
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Lucas Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - James Abugri
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University for Technology and Applied Sciences, Navrongo, Ghana.
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Aninagyei E, Boakye AA, Tettey CO, Ntiri KA, Ofori SO, Tetteh CD, Aphour TT, Rufai T. Utilization of 18s ribosomal RNA LAMP for detecting Plasmodium falciparum in microscopy and rapid diagnostic test negative patients. PLoS One 2022; 17:e0275052. [PMID: 36201568 PMCID: PMC9536604 DOI: 10.1371/journal.pone.0275052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022] Open
Abstract
In this study, Plasmodium falciparum was detected in patients that were declared negative for malaria microscopy and rapid diagnostic test kit (mRDT), using Plasmodium 18s rRNA loop-mediated isothermal amplification (LAMP) technique. The main aim of this study was to assess the usefulness of LAMP assay for detecting pre-clinical malaria, when microscopy and mRDT were less sensitive. DNA was obtained from 100 μL of whole blood using the boil and spin method. Subsequently, the Plasmodium 18s rRNA LAMP assay was performed to amplify the specific Plasmodium 18s rRNA gene. Microscopy and mRDT negative samples [697/2223 (31.2%)] were used for this study. Compared to frequencies obtained for the other demographic variables, most of the patients were < 6 years (37.7%), females (59.0%), peri-urban dwellers (39.0%) and patients that sought outpatient department services (39.3%). Overall, the prevalence of Plasmodium 18s rRNA was 17.5%. when stratified by study variables, Plasmodium 18s rRNA LAMP positivity was higher in patients over 30 years [58/122 (54.2%)], males [69/122 (56.5%)], rural dwellers [69/122 (56.5%)] and patients that sought OPD services [68/122 (55.7%)]. The risk of being infected with Plasmodium when routine tests were negative was higher in 15-30-year group (OR = 3.03, 95% CI: 1.6-5.8, p = 0.0007), patients > 30 years (OR = 15.2, 95% CI: 8.3-27.7, p<0.001), males (OR = 2.1, 95% CI: 1.4-3.2, p = 0.0002) and rural dwellers (OR = 2.2, 95% CI:1.4-3.6, p = 0.0009). However, risk was lower in post-natal children (OR = 0.3, 95% CI: 0.18-0.51, p<0.001). Majority (81.5%) of the infected patients presented with headache, herpes labialis, diarrhea and vomiting. We demonstrated the lack of sensitivities of microscopy and mRDT for one-time diagnosis of malaria. Therefore, it is essential to utilize a sensitive technique such as Plasmodium 18s rRNA LAMP to increase the detection rate of Plasmodium infection.
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Affiliation(s)
- Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
- * E-mail:
| | - Adjoa Agyemang Boakye
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Clement Okraku Tettey
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Kofi Adjei Ntiri
- Ghana Health Service, Greater Accra Region, Mayera-Faase Health Centre, Mayera-Faase, Ghana
| | | | - Comfort Dede Tetteh
- Ghana Health Service, Municipal Health Directorate, Ga West Municipal, Amasaman, Ghana
| | - Thelma Teley Aphour
- Ghana Health Service, Greater Accra Region, Ablekuma North Health Directorate, Accra, Ghana
| | - Tanko Rufai
- Ghana Health Service, Eastern Region, New Juaben South Municipal Health Directorate, Koforidua, Ghana
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Akindeh NM, Ngum LN, Niba PTN, Ali IM, Ayem OLO, Chedjou JPK, Fomboh CT, Ekollo AHM, Mbu’u CM, Mbacham WF. Assessing Asymptomatic Malaria Carriage of Plasmodium falciparum and Non- falciparum Species in Children Resident in Nkolbisson, Yaoundé, Cameroon. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8110960. [PMID: 34828673 PMCID: PMC8623063 DOI: 10.3390/children8110960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
Malaria is still a threat to public health as it remains the first endemic disease in the world. It is a pervasive parasitic disease in tropical and subtropical regions where asymptomatic malaria infection among humans serves as a significant reservoir for transmission. A rapid and correct diagnosis is considered to be an important strategy in the control of the disease especially in children, who are the most vulnerable group. This study assessed the prevalence of asymptomatic malaria in children at the Nkolbisson health area in Yaoundé, Cameroon. A cross-sectional study design and a convenience sampling plan were used. A total of 127 participants were recruited after informed and signed consent from parents and/or guardians. Blood samples were collected by finger-pricking and venipuncture from children aged 6 months to 10 years and then screened for asymptomatic parasitemia by a rapid diagnostic test (RDT), light microscopy (LM) staining with Giemsa and 18S rRNA polymerase chain reaction (PCR) for speciation. The data were analyzed using SPSS version 20 software. The study identified 85 children who were positive from the PCR, 95 positive from the RDT and 71 from the LM, revealing a malaria prevalence of 66.9%, 74.8% and 55.9%, respectively. The prevalence was not observed to be dependent on the sex and age group of the participants. Plasmodium falciparum was the predominant species followed by Plasmodium malariae and then Plasmodium ovale. The RDT and LM had the same sensitivity (90.6%) with a slight difference in their specificity (RDT: 57.1%; LM: 54.8%). The RDT also demonstrated higher positive and negative predictive values compared with those of the LM.
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Affiliation(s)
- Nji Mbuh Akindeh
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
- Correspondence: (N.M.A.); (W.F.M.); Tel.: +237-675354405 (N.M.A.); +237-677579180 (W.F.M.)
| | - Lesley Ngum Ngum
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Medicine and Biomedical Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
- Institute of Medicine and Medicinal Plants Studies, Dschang 00237, Cameroon
| | - Peter Thelma Ngwa Niba
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
| | - Innocent Mbulli Ali
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang 00237, Cameroon
| | - Ornella Laetitia Oben Ayem
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
| | - Jean Paul Kengne Chedjou
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Buea, Buea P.O. Box 63, Cameroon
| | - Calvino Tah Fomboh
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
| | - Aristid Herve Mbange Ekollo
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Institut Universitaire de Technologie, University of Ngoundere, Ngoundere BP 61207, Cameroon
| | - Cyrille Mbanwi Mbu’u
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Microbiology, Faculty of Science, University of Yaoundé I, Yaoundé P.O. Box 3851, Cameroon
| | - Wilfred Fon Mbacham
- Biotechnology Center, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon; (L.N.N.); (P.T.N.N.); (I.M.A.); (O.L.O.A.); (J.P.K.C.); (C.T.F.); (A.H.M.E.); (C.M.M.)
- Department of Biochemistry, Faculty of Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
- Department of Biochemistry, Faculty of Medicine and Biomedical Science, University of Yaoundé I, Messa, Yaoundé P.O. Box 3851, Cameroon
- Correspondence: (N.M.A.); (W.F.M.); Tel.: +237-675354405 (N.M.A.); +237-677579180 (W.F.M.)
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Mensah BA, Myers-Hansen JL, Obeng Amoako E, Opoku M, Abuaku BK, Ghansah A. Prevalence and risk factors associated with asymptomatic malaria among school children: repeated cross-sectional surveys of school children in two ecological zones in Ghana. BMC Public Health 2021; 21:1697. [PMID: 34535112 PMCID: PMC8447720 DOI: 10.1186/s12889-021-11714-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 08/29/2021] [Indexed: 11/27/2022] Open
Abstract
Background Asymptomatic Plasmodium infections significantly drive malaria transmission and impact control and elimination strategies, but are largely uncharacterized. We investigated the prevalence and risk factors of asymptomatic malaria infections to inform malaria control strategies in Ghana. Method Five cross-sectional surveys were conducted at the end of the peak transmission season (August–September) on 4892 school children aged between 6 and 14 years in two distinct ecological settings in Ghana between 2013 and 2017. The study sites were Begoro (forest ecology) and Cape Coast (coastal ecology). The children were screened for malaria parasites by microscopic examination of Giemsa-stained thin and thick blood films. Hemoglobin levels were measured using the Hemocue HB analyzer. In addition, height was measured and the height-for-age z-scores estimated from the reference population defined by WHO to determine children who were stunted. Proportions of categorical and means of continuous variables were compared using Chi-square test and Student’s t-test respectively, and multivariable logistic regression was done to assess risk factors associated with asymptomatic infections. Results The overall prevalence of asymptomatic malaria in the school children was higher in Begoro compared to Cape Coast (27% (95% CI: 17, 24%) vs. 24% (95% CI: 17, 24%), p value = 0.04). The study recorded three species of Plasmodium (Plasmodia falciparum, malariae, and ovale) in both sites. Plasmodium falciparum was the predominant species, accounting for about 85% of infections in both study sites. The asymptomatic school children were more likely to be anaemic (OR = 2.01, p value< 0.001) and stunted in growth (OR = 1.46, p value< 0.001). Males carried more asymptomatic infection than females (OR = 1.18, p value = 0.015). School children aged 12–14 years had more asymptomatic infections than those aged 6–8 years (OR = 1.28, p value = 0.005). Conclusion There is a considerable burden of asymptomatic malaria in the two regions of Ghana, which is associated with males, older children, anaemia, and stunted growth in children, and may have implications for malaria control and elimination strategies in Ghana.
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Affiliation(s)
- B A Mensah
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - J L Myers-Hansen
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - E Obeng Amoako
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - M Opoku
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - B K Abuaku
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A Ghansah
- Department of Epidemiology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana. .,Department of Parasitology, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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Brown CA, Pappoe-Ashong PJ, Duah N, Ghansah A, Asmah H, Afari E, Koram KA. High frequency of the Duffy-negative genotype and absence of Plasmodium vivax infections in Ghana. Malar J 2021; 20:99. [PMID: 33596926 PMCID: PMC7888148 DOI: 10.1186/s12936-021-03618-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/02/2021] [Indexed: 01/01/2023] Open
Abstract
Background Recent studies from different malaria-endemic regions including western Africa have now shown that Plasmodium vivax can infect red blood cells (RBCs) and cause clinical disease in Duffy-negative people, though the Duffy-negative phenotype was thought to confer complete refractoriness against blood invasion with P. vivax. The actual prevalence of P. vivax in local populations in Ghana is unknown and little information is available about the distribution of Duffy genotypes. The aim of this study was to assess the prevalence of P. vivax in both asymptomatic and symptomatic outpatients and the distribution of Duffy genotypes in Ghana. Methods DNA was extracted from dried blood spots (DBS) collected from 952 subjects (845 malaria patients and 107 asymptomatic persons) from nine locations in Ghana. Plasmodium species identification was carried out by nested polymerase chain reaction (PCR) amplification of the small-subunit (SSU) rRNA genes. For P. vivax detection, a second PCR of the central region of the Pvcsp gene was carried out. Duffy blood group genotyping was performed by allele-specific PCR to detect the presence of the FYES allele. Results No cases of P. vivax were detected in any of the samples by both PCR methods used. Majority of infections (542, 94.8%) in the malaria patient samples were due to P. falciparum with only 1 infection (0.0017%) due to Plasmodium malariae, and 2 infections (0.0034%) due to Plasmodium ovale. No case of mixed infection was identified. Of the samples tested for the FYES allele from all the sites, 90.5% (862/952) had the FYES allele. All positive samples were genotyped as FY*B-33/FY*B-33 (Duffy-negative homozygous) and therefore classified as Fy(a−b−). Conclusions No cases of P. vivax were detected by both PCRs and majority of the subjects tested carried the FYES allele. The lack of P. vivax infections observed can be attributed to the high frequency of the FYES allele that silences erythroid expression of the Duffy. These results provide insights on the host susceptibility for P. vivax infections that had not been investigated in Ghana before.
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Affiliation(s)
- Charles A Brown
- School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Ghana.
| | - Prince J Pappoe-Ashong
- School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Nancy Duah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Anita Ghansah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Harry Asmah
- School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Edwin Afari
- School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
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Okyere B, Owusu-Ofori A, Ansong D, Buxton R, Benson S, Osei-Akoto A, Owiredu EW, Adjei C, Xorse Amuzu E, Marfo Boaheng J, Dickerson T. Point prevalence of asymptomatic Plasmodium infection and the comparison of microscopy, rapid diagnostic test and nested PCR for the diagnosis of asymptomatic malaria among children under 5 years in Ghana. PLoS One 2020; 15:e0232874. [PMID: 32716936 PMCID: PMC7384639 DOI: 10.1371/journal.pone.0232874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/23/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Plasmodium infection among children is a serious public health problem. Asymptomatic malaria infection among humans serves as a significant reservoir for transmitting Plasmodium to uninfected Anopheles mosquitoes, fueling malaria endemicity and asymptomatic malaria may progress to clinical malaria. Therefore, prompt and accurate diagnosis of malaria infection is crucial for the management and control of malaria, especially in endemic areas. This study assessed the point prevalence of asymptomatic malaria infection and evaluated the performance of malaria Rapid Diagnostic Tests (RDT), light microscopy and nested PCR (nPCR) for the diagnosis of asymptomatic malaria infection in a paediatric population in the Atwima Nwabiagya North district, Ghana. METHODS This cross-sectional study enrolled 500 asymptomatic children aged ≤ 5 years. After consent was obtained from a parent, blood samples were collected from each participant to assess for Plasmodium infection based on histidine rich protein-2 (pfHRP-2)-based malaria RDT, light microscopy and nPCR. RESULTS The point prevalence of asymptomatic malaria by microscopy, RDT, and nPCR were 116/500 (23.2%), 156/500 (31.2%), and 184/500 (36.8%), respectively. Using nPCR as the reference, RDT presented with a perfect sensitivity (100.0%), specificity (100.0%), accuracy (100.0%), and reliability (100.0%) in detecting asymptomatic P. falciparum infection. Likewise, microscopy presented with an excellent specificity and high accuracy in detecting both P. falciparum (100.0%; 85.6%) and P. malariae (100.0%; 100.0%). However, the sensitivity (56.4%) and reliability (56.4%) of microscopy was low for both P. falciparum. CONCLUSION The findings of this study indicate a high point prevalence of asymptomatic Plasmodium infection among children in Atwima Nwabiagya North district, Ghana. In the absence of the more sensitive PCR, pfHRP-2-based malaria RDT provides substantial diagnostic sensitivity, specificity, accuracy and reliability and is superior to microscopy.
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Affiliation(s)
- Bismark Okyere
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Owusu-Ofori
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Ansong
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rebecca Buxton
- Medical Laboratory Science Division, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Scott Benson
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Alex Osei-Akoto
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Collins Adjei
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Evans Xorse Amuzu
- Research and Development Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Ty Dickerson
- Division of Pediatric Inpatient Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- * E-mail:
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Prevalence of Asymptomatic Malaria among Children in the Tamale Metropolis: How Does the PfHRP2 CareStart™ RDT Perform against Microscopy? J Trop Med 2019; 2019:6457628. [PMID: 31933652 PMCID: PMC6942882 DOI: 10.1155/2019/6457628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022] Open
Abstract
Background Asymptomatic carriage of the malaria parasites, likewise its misdiagnosis, especially false negatives, due to the use of substandard rapid diagnosis tests (RDTs) has been shown to hinder the progress of the fight against malaria. Method The study assessed the prevalence of asymptomatic malaria as well as the performance of Plasmodium falciparum-specific protein and histidine-rich protein 2 (PfHRP2) CareStart™ RDT against standard microscopy in the detection of malaria infection among 345 children (1–15 yrs) from two (2) basic schools in Tamale Metropolis. Results From the microscopy (considered as gold standard), prevalence of malaria among the asymptomatic children was found to be 2.6%, with sensitivity and specificity of CareStart™ RDT in detecting P. falciparum infections found to be 55.6% and 93.8%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of CareStart™ RDT were found to be 19.23% and 98.45%, respectively. There was an evidence showing a significant relation between CareStart™ RDT and microscopy in determining malaria infection (χ2 = 30.579, p < 0.001). Conclusion Prevalence of asymptomatic malaria among children was found to be 2.6%. The study reported low sensitivity and PPV for PfHRP2 CareStart™ RDT in an asymptomatic population at instances of low parasitaemia.
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10
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Knowledge, attitudes and practices regarding malaria in people living with HIV in rural and urban Ghana. Acta Trop 2018; 181:16-20. [PMID: 29391127 DOI: 10.1016/j.actatropica.2018.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/18/2018] [Accepted: 01/23/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND One of the malaria vulnerable groups is people living with HIV. This study investigated knowledge, attitude and practices (KAP) towards malaria in people living with HIV attending anti-retroviral therapy (ART) clinics in rural and urban Ghana. METHODS In this descriptive cross-sectional study patients attending the ART clinics in Atibie (rural area) and Accra (urban area) were interviewed on their knowledge, attitude and practices regarding malaria. Finger-prick capillary blood was tested for Plasmodium spp. with rapid diagnostic tests. Multivariate regression analysis was used to determine the influence of KAP on malaria prevalence. RESULTS Parasitemia was generally more frequent among HIV positive individuals in the rural area (29/116; 25%) in the rural area than in the urban area (35/350; 10%). Inaccurate knowledge of cause of malaria and prevention methods were associated with increased odds of malaria parasitemia; [OR = 1.51 (CI: 1.29-5.12); p < .05] and [OR = 2.59 (CI: 2.53-4.75); p < .05], respectively. There were disparities in socio-economic factors. For instance, low level of education was higher in the rural area (45/116; 38.8%) compared to the urban area (121/350; 34.6%). CONCLUSIONS Malaria control efforts may yield further results when the knowledge and socio-economic gap between rural and urban areas is closed.
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Gbalégba CGN, Ba H, Silué KD, Ba O, Tia E, Chouaibou M, Tian-Bi NTY, Yapi GY, Koné B, Utzinger J, Koudou BG. Distribution of Plasmodium spp. infection in asymptomatic carriers in perennial and low seasonal malaria transmission settings in West Africa. Infect Dis Poverty 2018; 7:39. [PMID: 29690913 PMCID: PMC5926534 DOI: 10.1186/s40249-018-0412-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
Abstract
Background Since 2000, substantial progress has been made in reducing malaria worldwide. However, some countries in West Africa remain a hotspot for malaria with all age groups at risk. Asymptomatic carriers of Plasmodium spp. are important sources of infections for malaria vectors and thus contribute to the anchoring of the disease in favourable eco-epidemiological settings. The objective of this study was to assess the asymptomatic malaria case rates in Korhogo and Kaedi, two urban areas in northern Côte d’Ivoire and southern Mauritania, respectively. Methods Cross-sectional surveys were carried out during the rainy season in 2014 and the dry season in 2015 in both settings. During each season, 728 households were randomly selected and a household-based questionnaire was implemented to collect demographic and epidemiological data, including of malaria preventive methods used in communities. Finger-prick blood samples were obtained for biological examination using microscopy and rapid diagnostic tests (RDTs). Results Overall, 2672 households and 15 858 consenting participants were surveyed. Plasmodium spp. infection was confirmed in 12.4% (n = 832) and 0.3% (n = 22) of the assessed individuals in Korhogo and Kaedi, respectively. In Korhogo, the prevalence of asymptomatic malaria was 10.5% (95% CI: 9.7–11.2) as determined by microscopy and 9.3% (95% CI: 8.6–10.0%) when assessed by RDT. In Kaedi, asymptomatic malaria prevalence was 0.2% (95% CI: 0.1–0.4%) according to microscopy, while all RDTs performed were negative (n = 8372). In Korhogo, asymptomatic malaria infection was significantly associated with age and season, with higher risk within the 5–14 years-old, and during the rainy season. In Kaedi, the risk of asymptomatic malaria infection was associated with season only (higher during the dry season; crude OR (cOR): 6.37, 95% CI: 1.87–21.63). P. falciparum was the predominant species identified in both study sites representing 99.2% (n = 825) in Korhogo and 59.1% (n = 13) in Kaedi. Gametocytes were observed only in Korhogo and only during the rainy season at 1.3% (95% CI: 0.7–2.4%). Conclusions Our findings show a low prevalence of clinical malaria episodes with a significant proportion of asymptomatic carriers in both urban areas. National policies for malaria infections are focused on treatment of symptomatic cases. Malaria control strategies should be designed for monitoring and managing malaria infections in asymptomatic carriers. Additional measures, including indoor residual spraying, effective use of long-lasting insecticidal nets is strongly needed to reduce the number of Plasmodium spp. infections in Korhogo and Kaedi. Electronic supplementary material The online version of this article (10.1186/s40249-018-0412-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Constant G N Gbalégba
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 B.P. 801, Abidjan, 02, Côte d'Ivoire. .,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.
| | - Hampâté Ba
- Laboratoire de Parasitologie - Mycologie, Institut National de Recherches en Santé Publique , B.P. 695, Nouakchott, Mauritania
| | - Kigbafori D Silué
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 B.P. 582, Abidjan, 22, Côte d'Ivoire
| | - Ousmane Ba
- Laboratoire de Parasitologie - Mycologie, Institut National de Recherches en Santé Publique , B.P. 695, Nouakchott, Mauritania
| | - Emmanuel Tia
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, 27 B.P. 529, Abidjan, 27, Côte d'Ivoire
| | - Mouhamadou Chouaibou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire
| | - Nathan T Y Tian-Bi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 B.P. 582, Abidjan, 22, Côte d'Ivoire
| | - Grégoire Y Yapi
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, 27 B.P. 529, Abidjan, 27, Côte d'Ivoire
| | - Brama Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Université Péléforo Gon Coulibaly, B.P. 1328, Korhogo, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute , P.O. Box, CH- 4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Benjamin G Koudou
- Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 B.P. 801, Abidjan, 02, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire , 01 B.P. 1303, Abidjan, 01, Côte d'Ivoire.,Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool, L3 5QA, UK
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12
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Owusu EDA, Cofie NSA, Nai EA, Klipstein-Grobusch K, Brown CA, Mens PF, Grobusch MP. Malaria, sickle cell disease, HIV, and co-trimoxazole prophylaxis: An observational study. Int J Infect Dis 2018; 69:29-34. [PMID: 29408573 DOI: 10.1016/j.ijid.2018.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/27/2018] [Accepted: 01/29/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES This observational study recorded the malaria and sickle cell disease (SCD) profile of people living with HIV/AIDS (PLHA) and determined whether prophylactic co-trimoxazole (CTX) and the haemoglobin S (Hb S) allele influenced malaria episodes. METHODS Sickling status, malaria episodes, and HIV type, as well as other data, were extracted retrospectively from the clinical records of 1001 patients attending the antiretroviral therapy clinic at Ridge Regional Hospital in Accra, Ghana between 2010 and 2015. Finger-prick capillary blood of returning patients (n=501) was tested for the haemoglobin (Hb) level and malaria, after information on malaria prevention methods was obtained through the administration of a questionnaire. RESULTS The use of insecticide-treated mosquito nets was low (22.8%). CTX prophylaxis showed no significant influence on the overall number of malaria episodes from 2010 to 2015; however, it did show a statistically significant relationship (p=0.026) with the time elapsed since the last malaria episode. Even though 19% of participants possessed Hb S, it had no influence on malaria episodes. CONCLUSIONS Hb S did not influence malaria in PLHA. Further studies in Hb SS and Hb SC are needed, as there are suggestions of increased frequency and severity of malaria. The impact of CTX prophylaxis on this cohort will be insightful.
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Affiliation(s)
- Ewurama D A Owusu
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
| | - Nana S A Cofie
- Department of Pharmacy, Ridge Regional Hospital, Accra, Ghana.
| | - Edna A Nai
- The ART Clinic, Ridge Regional Hospital, Accra, Ghana.
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - Charles A Brown
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
| | - Petra F Mens
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; KIT Biomedical Research, Department of Parasitology, Amsterdam, the Netherlands.
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Centre de Recherches Médicales de Lambaréné (CERMEL), Hôpital Albert Schweitzer, Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
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13
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Tiedje KE, Oduro AR, Agongo G, Anyorigiya T, Azongo D, Awine T, Ghansah A, Pascual M, Koram KA, Day KP. Seasonal Variation in the Epidemiology of Asymptomatic Plasmodium falciparum Infections across Two Catchment Areas in Bongo District, Ghana. Am J Trop Med Hyg 2017; 97:199-212. [PMID: 28719306 DOI: 10.4269/ajtmh.16-0959] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Understanding the epidemiology of asymptomatic Plasmodium falciparum infections is critical for countries to move toward malaria elimination. Using different methods for parasite detection, we evaluated how seasonality, spatial location, and other factors affect the age-specific epidemiology of asymptomatic malaria in Bongo District, Ghana. Asymptomatic prevalence by microscopy decreased significantly from 42.5% at the end of the wet to 27.5% at the end of the dry season (P < 0.001). Using the 18S rRNA polymerase chain reactions (PCRs), all microscopy-negative samples were screened and prevalence of submicroscopic infections also decreased significantly from the wet (55.4%) to the dry (20.7%) season (P < 0.001). Combining detection methods, 74.4% and 42.5% of the population in the wet and dry seasons, respectively, had evidence of a P. falciparum infection. Interestingly in those > 20 years of age, we found evidence of infection in 64.3% of the population in the wet and 27.0% in the dry season. Using both microscopy and PCR, the asymptomatic P. falciparum reservoir peaks at the end of the wet season and infections in all age groups constitute the reservoir of malaria infection. At the end of the wet season, spatial heterogeneity in the prevalence and density of P. falciparum infections was observed between the two catchment areas surveyed in Bongo District. These results indicate that if elimination is to succeed, interventions will need to target not just P. falciparum infections in children but also in adults, and be implemented toward the end of the dry season in this area of West Africa.
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Affiliation(s)
- Kathryn E Tiedje
- Department of Microbiology, New York University, New York, New York.,School of BioSciences, Bio21 Institute/University of Melbourne, Melbourne, Australia
| | | | | | | | | | | | - Anita Ghansah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Mercedes Pascual
- Santa Fe Institute, Sante Fe, New Mexico.,Department of Ecology and Evolution, University of Chicago, Chicago, Illinois
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Karen P Day
- Department of Microbiology, New York University, New York, New York.,School of BioSciences, Bio21 Institute/University of Melbourne, Melbourne, Australia
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Owusu EDA, Brown CA, Grobusch MP, Mens P. Prevalence of Plasmodium falciparum and non-P. falciparum infections in a highland district in Ghana, and the influence of HIV and sickle cell disease. Malar J 2017; 16:167. [PMID: 28438159 PMCID: PMC5404324 DOI: 10.1186/s12936-017-1823-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 04/18/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In the past two decades, there has been a reported decline in malaria in Ghana and the rest of the world; yet it remains the number one cause of mortality and morbidity. Human immuno-deficiency virus (HIV) and sickle cell disease (SCD) share a common geographical space with malaria in sub-Saharan Africa and an interaction between these three conditions has been suggested. This study determined the Plasmodium falciparum and non-P. falciparum status of symptomatic and non-symptomatic residents of Mpraeso in the highlands of Kwahu-South district of Ghana based on evidence of current national decline. The influence of HIV and SCD on malaria was also determined. METHODS Participants were 354 symptomatic patients visiting the Kwahu Government Hospital and 360 asymptomatic residents of the district capital. This cross-sectional study was conducted during the minor rainy season (October-December 2014). Rapid diagnostic tests (RDT), blood film microscopy and real-time polymerase chain reaction assessment of blood were done. Participants who tested positive with RDT were treated with artemisinin-based combination therapy; and assessment of venous blood was repeated 7 days after treatment. HIV screening and haemoglobin genotyping was done. Univariate and multivariate regression analysis was used to determine the influence of SCD and HIV. RESULTS Plasmodium falciparum was prevalent at 124/142 (87.3%). Plasmodium malariae was the only non-falciparum species detected at 18/142 (12.7%). HIV and SCD did not significantly increase odds of malaria infection. However, the use of ITN and recent anti-malarial intake significantly decreased the odds of being malaria infected by 0.45-fold and 0.46-fold respectively. CONCLUSION Plasmodium falciparum and P. malariae infection are the prevailing species in the study area; albeit varying from the national average. HIV and SCD were not associated with the risk of having malaria.
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Affiliation(s)
- Ewurama D A Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-bu, Accra, Ghana. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Charles A Brown
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-bu, Accra, Ghana
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné (CERMEL), Hôpital Albert Schweitzer, Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Petra Mens
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,Department of Medical Microbiology, Clinical Parasitology, Division of Laboratory Specialisms, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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15
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Assessing Climate Driven Malaria Variability in Ghana Using a Regional Scale Dynamical Model. CLIMATE 2017. [DOI: 10.3390/cli5010020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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