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Effects of Age, Gender and Soil-Transmitted Helminth Infection on Prevalence of Plasmodium Infection among Population Living in Bata District, Equatorial Guinea. Trop Med Infect Dis 2023; 8:tropicalmed8030149. [PMID: 36977150 PMCID: PMC10059851 DOI: 10.3390/tropicalmed8030149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction: Malaria and soil-transmitted helminth (STH) co-infection is an important parasitic infection affecting populations in co-endemic countries including Equatorial Guinea. To date, the health impact of STH and malaria co-infection is inconclusive. The current study aimed to report the malaria and STH infection epidemiology in the continental region of Equatorial Guinea. Methods: We performed a cross-sectional study between October 2020 and January 2021 in the Bata district of Equatorial Guinea. Participants aged 1–9 years, 10–17 years and above 18 were recruited. Fresh venous blood was collected for malaria testing via mRDTs and light microscopy. Stool specimens were collected, and the Kato–Katz technique was used to detect the presence of Ascaris lumbricoides, Trichuris trichiura, hookworm spp. and intestinal Schistosoma eggs. Results: A total of 402 participants were included in this study. An amount of 44.3% of them lived in urban areas, and only 51.9% of them reported having bed nets. Malaria infections were detected in 34.8% of the participants, while 50% of malaria infections were reported in children aged 10–17 years. Females had a lower prevalence of malaria (28.8%) compared with males (41.7%). Children of 1–9 years carried more gametocytes compared with other age groups. An amount of 49.3% of the participants infected with T. trichiura had malaria parasites compared with those infected with A. lumbricoides (39.6%) or both (46.8%). Conclusions: The overlapping problem of STH and malaria is neglected in Bata. The current study forces the government and other stakeholders involved in the fight against malaria and STH to consider a combined control program strategy for both parasitic infections in Equatorial Guinea.
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Zerdo Z, Bastiaens H, Anthierens S, Massebo F, Masne M, Biresaw G, Shewangizaw M, Tunje A, Chisha Y, Yohannes T, Van Geertruyden JP. Prevalence and associated risk factors of asymptomatic malaria and anaemia among school-aged children in Dara Mallo and Uba Debretsehay districts: results from baseline cluster randomized trial. Malar J 2021; 20:400. [PMID: 34645464 PMCID: PMC8513194 DOI: 10.1186/s12936-021-03937-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/30/2021] [Indexed: 12/31/2022] Open
Abstract
Background Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases. Methods This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable. Results The overall prevalence of malaria was 1.62% (95% CI 1.15–2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR = 0.38; 95% CI 0.15–0.95) and residence house located at an altitude range above 1100 masl (AOR = 0.40; 95% CI 0.17–0.94). The prevalence of anaemia was 22.00% (95% CI 20.3–23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR = 0.64; 95% CI 0.41–0.99). Conclusions The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia.
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Affiliation(s)
- Zerihun Zerdo
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia. .,Global Health Institute, Antwerp University, Antwerp, Belgium.
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Antwerp University, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, Antwerp University, Antwerp, Belgium
| | - Fekadu Massebo
- Department of Biology, College of Natural Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Matewos Masne
- Department of Biology, College of Natural Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gelila Biresaw
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangizaw
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abayneh Tunje
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yilma Chisha
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tsegaye Yohannes
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Nderu D, Kimani F, Karanja E, Thiong'o K, Akinyi M, Too E, Chege W, Nambati E, Wangai LN, Meyer CG, Velavan TP. Genetic diversity and population structure of Plasmodium falciparum in Kenyan-Ugandan border areas. Trop Med Int Health 2019; 24:647-656. [PMID: 30816614 DOI: 10.1111/tmi.13223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Kenya has, in the last decade, made tremendous progress in the fight against malaria. Nevertheless, continued surveillance of the genetic diversity and population structure of Plasmodium falciparum is required to refine malaria control and to adapt and improve elimination strategies. Twelve neutral microsatellite loci were genotyped in 201 P. falciparum isolates obtained from the Kenyan-Ugandan border (Busia) and from two inland malaria-endemic sites situated in western (Nyando) and coastal (Msambweni) Kenya. Analyses were done to assess the genetic diversity (allelic richness and expected heterozygosity, [He ]), multilocus linkage disequilibrium ( I S A ) and population structure. A similarly high degree of genetic diversity was observed among the three parasite populations surveyed (mean He = 0.76; P > 0.05). Except in Msambweni, random association of microsatellite loci was observed, indicating high parasite out-breeding. Low to moderate genetic structure (FST = 0.022-0.076; P < 0.0001) was observed with only 5% variance in allele frequencies observed among the populations. This study shows that the genetic diversity of P. falciparum populations at the Kenyan-Ugandan border is comparable to the parasite populations from inland Kenya. In addition, high genetic diversity, panmixia and weak population structure in this study highlight the fitness of Kenyan P. falciparum populations to successfully withstand malaria control interventions.
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Affiliation(s)
- David Nderu
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,School of Health Sciences, Kirinyaga University, Kerugoya, Kenya
| | - Francis Kimani
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Evaline Karanja
- Department of Biochemistry and Biotechnology, School of Biological and Life Sciences, Technical University of Kenya, Nairobi, Kenya
| | - Kelvin Thiong'o
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Maureen Akinyi
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edwin Too
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - William Chege
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Eva Nambati
- Center for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Laura N Wangai
- School of Health Sciences, Kirinyaga University, Kerugoya, Kenya
| | - Christian G Meyer
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Centre for Medical Research, Hanoi, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Vietnamese-German Centre for Medical Research, Hanoi, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam.,Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
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Kapesa A, Kweka EJ, Atieli H, Afrane YA, Kamugisha E, Lee MC, Zhou G, Githeko AK, Yan G. The current malaria morbidity and mortality in different transmission settings in Western Kenya. PLoS One 2018; 13:e0202031. [PMID: 30092043 PMCID: PMC6084967 DOI: 10.1371/journal.pone.0202031] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/26/2018] [Indexed: 01/17/2023] Open
Abstract
Background Passive surveillance of malaria in health facilities remains vital for implementation of control and elimination programs. It is therefore essential understanding current age profile of clinical malaria morbidity, mortality and presentations in areas with variant infection susceptibility. This study aimed at understanding the current malaria morbidity and mortality in Western Kenya. Methods Surveillance of clinical and asymptomatic parasitological positivity rates of all malaria suspected patients and school children were respectively determined from June 2015 to August 2016. From 2014 to 2016, register books in hospitals were referred and the confirmed malaria cases in conjunction with total number of monthly outpatient visits (OPD) counted. All registered malaria admissions were counted together with other causes of admissions. Moreover, outcome of malaria admissions in terms of discharge or death was recorded using inpatient charts within the same time frame. Prospective surveillance of severe malaria collected information on clinical features of the disease. Giemsa stained blood slides confirmed existence of malaria parasitemia. Chi-square and analysis of variance tests were used, respectively, to compute proportions and means; then a comparison was made between different age groups, periods, and study areas. Results During the survey of asymptomatic infections among school children, overall blood slide positivity ranged from 6.4% at the epidemic prone site to 38.3% at the hyperendemic site. During the clinical malaria survey, school age children (5–14) presented with overall the highest (45%) blood slide positivity rate among those suspected to have the infection at the epidemic prone study site. The survey of all malaria confirmed and registered cases at OPD found 17% to 27% of all consultations among <5 children and 9.9% to 20.7% of all OPD visits among the ≥5 patients were due to malaria. Moreover, survey of all registered causes of admission in hospitals found 47% of admissions were due to malaria. The disease was a major cause of admission in epidemic prone setting where 63.4% of the <5 children and 62.8% of the ≥5 patients were admitted due to malaria (p>0.05) and 40% of all malaria admissions were school age children. Malaria related death rate was highest among <5 years at the hyperendemic site, that is 60.9 death per 1000 malaria <5 admissions. Conversely, the epidemic prone setting experienced highest malaria related death among ≥15 years (18.6 death per 1000 admissions) than the < 15 years (5.7 death per 1000 admissions of the <15 years) (p< 0.001). Surveillance of severe form of the disease found that hyperpyrexia, hyperparastemia, prostration and convulsions as common presentations of severe disease. Conclusion Malaria is still the major cause of hospital consultations in Western Kenya with an alarming number of severe forms of the disease among the school aged children at the epidemic prone setting. Mortalities were higher among <5 children years in high infection transmission setting and among ≥15 years in low and moderate transmission settings. Surveillance of asymptomatic and symptomatic malaria along with evaluation of current interventions in different age groups should be implemented in Kenya.
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Affiliation(s)
- Anthony Kapesa
- Climate and Health Laboratory, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- * E-mail: (AK); (GY)
| | - Eliningaya J. Kweka
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Division of Livestock and Human Health Disease Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania
| | - Harrysone Atieli
- Climate and Health Laboratory, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Yaw A. Afrane
- Climate and Health Laboratory, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Erasmus Kamugisha
- Department of Biochemistry and Molecular Biology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Ming-Chieh Lee
- Program in Public Health, University of California, Irvine, CA, United States of America
| | - Guofa Zhou
- Program in Public Health, University of California, Irvine, CA, United States of America
| | - Andrew K. Githeko
- Climate and Health Laboratory, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Guiyun Yan
- Program in Public Health, University of California, Irvine, CA, United States of America
- * E-mail: (AK); (GY)
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Kapesa A, Kweka EJ, Zhou G, Atieli HE, Kamugisha E, Mazigo HD, Ngallaba SE, Githeko AK, Yan G. Utility of passive malaria surveillance in hospitals as a surrogate to community infection transmission dynamics in western Kenya. ACTA ACUST UNITED AC 2018; 76:39. [PMID: 30065835 PMCID: PMC6060476 DOI: 10.1186/s13690-018-0288-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/15/2018] [Indexed: 11/23/2022]
Abstract
Background Malaria continued to be the major public health concern in sub-Sahara Africa, thus for better planning of control activities, periodic surveillance of both clinical and asymptomatic cases remains important. However, the usability of routinely collected malaria data in Kenyan hospitals as a predictor of the asymptomatic malaria infection in the community amidst rapid infection resurgence or reduction in different areas of disease endemicities remains widely unstudied. This study was therefore aimed to evaluate the utility of passive surveillance of malaria in health facilities as a proxy of infection transmission of the surrounding community in different transmission intensities. Methods Prospective multiple cross-sectional surveys were done in three villages in western Kenya. Monthly asymptomatic malaria positivity among school children, number of outpatient (OPD) confirmed malaria cases and abundancy of indoor resting malaria vectors were surveyed from June 2015 to August 2016. Community surveys on antimalarial drug use among adults and children were also done. Detection of malaria parasitaemia was done using thick and thin Giemsa stained blood slide microscopy for both clinical and school participants. A questionnaire was used to collect information on self-use of antimalarial drugs from randomly selected households. Results The overall OPD blood slide positivity from all study sites was 26.6% (95%CI 26.2–27.0) and highest being among the 5–14 years (41.2% (95% CI 40.1–42.3). Asymptomatic malaria positivity among the school children were 6.4% (95%CI 5.3–7.5) and 38.3% (95%CI 36.1–40.5) in low and high transmission settings respectively. A strong correlation between overall monthly OPD positivity and the school age children positivity was evident at Marani (low transmission) (rho = 0.78, p = 0.001) and at Iguhu (Moderate transmission) (rho = 0.61, p = 0.02). The high transmission setting (Kombewa) showed no significant correlation (rho = − 0.039, p = 0.89). Conclusion Hospital malaria data from low and moderate malaria transmission predicted the infection transmission dynamics of the surrounding community. In endemic sites, hospital based passive surveillance didn’t predict the asymptomatic infection dynamics in the respective community. Electronic supplementary material The online version of this article (10.1186/s13690-018-0288-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony Kapesa
- 1Climate and health laboratory, Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578, Kisumu, Kenya.,2Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania
| | - Eliningaya J Kweka
- 3Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania.,5Division of Livestock and Human Health Disease Vector Control, Tropical Pesticides Research Institute, P.O. Box 3024, Arusha, Tanzania
| | - Guofa Zhou
- 6Program in Public Health, University of California, Irvine, CA 92697 USA
| | - Harrysone Etemesi Atieli
- 1Climate and health laboratory, Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578, Kisumu, Kenya
| | - Erasmus Kamugisha
- 4Department of Biochemistry and molecular Biology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Humphrey D Mazigo
- 3Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania
| | - Sospatro E Ngallaba
- 2Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences, P.O Box 1464, Mwanza, Tanzania
| | - Andrew K Githeko
- 1Climate and health laboratory, Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578, Kisumu, Kenya
| | - Guiyun Yan
- 6Program in Public Health, University of California, Irvine, CA 92697 USA
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