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Nebie I, Palacpac NMQ, Bougouma EC, Diarra A, Ouédraogo A, D’Alessio F, Houard S, Tiono AB, Cousens S, Horii T, Sirima SB. Persistence of Anti-SE36 Antibodies Induced by the Malaria Vaccine Candidate BK-SE36/CpG in 5-10-Year-Old Burkinabe Children Naturally Exposed to Malaria. Vaccines (Basel) 2024; 12:166. [PMID: 38400149 PMCID: PMC10892924 DOI: 10.3390/vaccines12020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
Information on the dynamics and decline/persistence of antibody titres is important in vaccine development. A recent vaccine trial in malaria-exposed, healthy African adults and children living in a malaria hyperendemic and seasonal area (Ouagadougou, Burkina Faso) was the first study in which BK-SE36/CpG was administered to different age groups. In 5- to 10-year-old children, the risk of malaria infection was markedly lower in the BK-SE36/CpG arm compared to the control arm. We report here data on antibody titres measured in this age-group after the high malaria transmission season of 2021 (three years after the first vaccine dose was administered). At Year 3, 83% of children had detectable anti-SE36 total IgG antibodies. Geometric mean antibody titres and the proportion of children with detectable anti-SE36 antibodies were markedly higher in the BK-SE36/CpG arm than the control (rabies) arm. The information obtained in this study will guide investigators on future vaccine/booster schedules for this promising blood-stage malaria vaccine candidate.
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Affiliation(s)
- Issa Nebie
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
| | - Nirianne Marie Q. Palacpac
- Department of Malaria Vaccine Development, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan;
| | - Edith Christiane Bougouma
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
| | - Amidou Diarra
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
| | - Alphonse Ouédraogo
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
| | - Flavia D’Alessio
- European Vaccine Initiative, UniversitätsKlinikum Heidelberg, Voßstraße 2, 69115 Heidelberg, Germany; (F.D.); (S.H.)
| | - Sophie Houard
- European Vaccine Initiative, UniversitätsKlinikum Heidelberg, Voßstraße 2, 69115 Heidelberg, Germany; (F.D.); (S.H.)
| | - Alfred B. Tiono
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
| | - Simon Cousens
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Toshihiro Horii
- Department of Malaria Vaccine Development, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan;
| | - Sodiomon B. Sirima
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou 10248, Burkina Faso; (I.N.); (E.C.B.); (A.D.); (A.O.); (A.B.T.)
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Thomas A, Bakai TA, Atcha-Oubou T, Tchadjobo T, Rabilloud M, Voirin N. Exploring malaria prediction models in Togo: a time series forecasting by health district and target group. BMJ Open 2024; 14:e066547. [PMID: 38296296 PMCID: PMC10828885 DOI: 10.1136/bmjopen-2022-066547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/16/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES Integrating malaria prediction models into malaria control strategies can help to anticipate the response to seasonal epidemics. This study aimed to explore the possibility of using routine malaria data and satellite-derived climate data to forecast malaria cases in Togo. METHODS Generalised additive (mixed) models were developed to forecast the monthly number of malaria cases in 40 health districts and three target groups. Routinely collected malaria data from 2013 to 2016 and meteorological and vegetation data with a time lag of 1 or 2 months were used for model training, while the year 2017 was used for model testing. Two methods for selecting lagged meteorological and environmental variables were compared: a first method based on statistical approach ('SA') and a second method based on biological reasoning ('BR'). Both methods were applied to obtain a model per target group and health district and a mixed model per target group and health region with the health district as a random effect. The predictive skills of the four models were compared for each health district and target group. RESULTS The most selected predictors in the models per district for the 'SA' method were the normalised difference vegetation index, minimum temperature and mean temperature. The 'SA' method provided the most accurate models for the training period, except for some health districts in children ≥5 years old and adults and in pregnant women. The most accurate models for the testing period varied by health district and target group, provided either by the 'SA' method or the 'BR' method. Despite the development of models with four different approaches, the number of malaria cases was inaccurately forecasted. CONCLUSIONS These models cannot be used as such in malaria control activities in Togo. The use of finer spatial and temporal scales and non-environmental data could improve malaria prediction.
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Affiliation(s)
- Anne Thomas
- Université de Lyon, Lyon, France
- Université Lyon 1, Villeurbanne, France
- Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe Biostatistiques Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France
- Epidemiology and modelling of infectious diseases (EPIMOD), Lent, France
| | - Tchaa Abalo Bakai
- Université de Lyon, Lyon, France
- Université Lyon 1, Villeurbanne, France
- Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe Biostatistiques Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France
- Epidemiology and modelling of infectious diseases (EPIMOD), Lent, France
- Programme National de Lutte contre le Paludisme (PNLP), Lomé, Togo
| | | | | | - Muriel Rabilloud
- Université de Lyon, Lyon, France
- Université Lyon 1, Villeurbanne, France
- Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Équipe Biostatistiques Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France
| | - Nicolas Voirin
- Epidemiology and modelling of infectious diseases (EPIMOD), Lent, France
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Ouédraogo A, Bougouma EC, Palacpac NMQ, Houard S, Nebie I, Sawadogo J, Berges GD, Soulama I, Diarra A, Hien D, Ouedraogo AZ, Konaté AT, Kouanda S, Myoui A, Ezoe S, Ishii KJ, Sato T, D’Alessio F, Leroy O, Tiono AB, Cousens S, Horii T, Sirima SB. Safety and immunogenicity of BK-SE36/CpG malaria vaccine in healthy Burkinabe adults and children: a phase 1b randomised, controlled, double-blinded, age de-escalation trial. Front Immunol 2023; 14:1267372. [PMID: 37908361 PMCID: PMC10613650 DOI: 10.3389/fimmu.2023.1267372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Abstract
Background BK-SE36/CpG is a recombinant blood-stage malaria vaccine candidate based on the N-terminal Plasmodium falciparum serine repeat antigen5 (SE36), adsorbed to aluminium hydroxide gel and reconstituted, prior to administration, with synthetic oligodeoxynucleotides bearing CpG motifs. In healthy Japanese adult males, BK-SE36/CpG was well tolerated. This study assessed its safety and immunogenicity in healthy malaria-exposed African adults and children. Methods A double-blind, randomised, controlled, age de-escalating clinical trial was conducted in an urban area of Ouagadougou, Burkina Faso. Healthy participants (n=135) aged 21-45 years (Cohort 1), 5-10 years (Cohort 2) and 12-24 months (Cohort 3) were randomised to receive three vaccine doses (Day 0, 28 and 112) of BK-SE36/CpG or rabies vaccine by intramuscular injection. Results One hundred thirty-four of 135 (99.2%) subjects received all three scheduled vaccine doses. Vaccinations were well tolerated with no related Grade 3 (severe) adverse events (AEs). Pain/limitation of limb movement, headache in adults and fever in younger children (all mild to moderate in intensity) were the most frequently observed local and systemic AEs. Eighty-three of BK-SE36/CpG (91%) recipients and 37 of control subjects (84%) had Grade 1/2 events within 28 days post vaccination. Events considered by the investigator to be vaccine related were experienced by 38% and 14% of subjects in BK-SE36/CpG and control arms, respectively. Throughout the trial, six Grade 3 events (in 4 subjects), not related to vaccination, were recorded in the BK-SE36/CpG arm: 5 events (in 3 subjects) within 28 days of vaccination. All serious adverse events (SAEs) (n=5) were due to severe malaria (52-226 days post vaccination) and not related to vaccination. In all cohorts, BK-SE36/CpG arm had higher antibody titres after Dose 3 than after Dose 2. Younger cohorts had stronger immune responses (12-24-month-old > 5-10 years-old > 21-45 years-old). Sera predominantly reacted to peptides that lie in intrinsically unstructured regions of SE36. In the control arm, there were no marked fold changes in antibody titres and participants' sera reacted poorly to all peptides spanning SE36. Conclusion BK-SE36/CpG was well-tolerated and immunogenic. These results pave the way for further proof-of-concept studies to demonstrate vaccine efficacy. Clinical trial registration https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1921, PACTR201701001921166.
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Affiliation(s)
| | | | - Nirianne Marie Q. Palacpac
- Department of Malaria Vaccine Development, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Sophie Houard
- European Vaccine Initiative (EVI), Universitäts Klinikum Heidelberg, Heidelberg, Germany
| | - Issa Nebie
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Jean Sawadogo
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | | | - Issiaka Soulama
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Amidou Diarra
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Denise Hien
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | | | - Amadou T. Konaté
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Akira Myoui
- Medical Center for Translational Research, Osaka University Hospital, Suita, Japan
| | - Sachiko Ezoe
- Medical Center for Translational Research, Osaka University Hospital, Suita, Japan
- Department of Space Infection Control, Graduate School of Medicine, Division of Health Sciences, Osaka University, Osaka, Japan
| | - Ken J. Ishii
- Center for Vaccine and Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Japan
- Laboratory of Vaccine Science, Immunology Frontier Research Center, Osaka University, Suita, Japan
- Division of Vaccine Science, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takanobu Sato
- Research and Development Division, Nobelpharma Co., Ltd., Tokyo, Japan
| | - Flavia D’Alessio
- European Vaccine Initiative (EVI), Universitäts Klinikum Heidelberg, Heidelberg, Germany
| | - Odile Leroy
- European Vaccine Initiative (EVI), Universitäts Klinikum Heidelberg, Heidelberg, Germany
| | - Alfred B. Tiono
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Simon Cousens
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Toshihiro Horii
- Department of Malaria Vaccine Development, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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Djaskano MI, Cissoko M, Diar MSI, Israel DK, Clément KH, Ali AM, Dormbaye M, Souleymane IM, Batrane A, Sagara I. Stratification and Adaptation of Malaria Control Interventions in Chad. Trop Med Infect Dis 2023; 8:450. [PMID: 37755911 PMCID: PMC10535759 DOI: 10.3390/tropicalmed8090450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023] Open
Abstract
Malaria remains the leading cause of morbidity and mortality in Chad. The World Health Organization (WHO) has recommended that endemic countries stratify malaria to guide interventions. Thus, the Republic of Chad has initiated a stratification process based on malaria incidence with the aim of defining transmission risk and proposing interventions. We collected routine malaria data from health facilities from 2017-2021, the national survey on malaria indicators, the entomological data of NMCP operational research, the demographic and health surveys, and remote sensing of environmental data. Stratification was based on the adjusted incidence of malaria to guide interventions. The adjusted incidence of malaria was, on average, 374 cases per 1000 people in the country. However, it varied according to health districts. Health districts were stratified into very low malaria incidence (n = 25), low malaria incidence (n = 20), moderate malaria incidence (n = 46) and high malaria incidence (n = 38). Micro-stratification in health districts with very low incidence was carried out to identify districts with incidence <10 cases per 1000 person with a view to a malaria pre-elimination programme. Appropriate malaria control interventions were proposed based on the strata identified. Stratification enables the country to target interventions to accelerate the reduction of the burden caused by malaria with a pre-elimination goal.
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Affiliation(s)
- Mahamat Idriss Djaskano
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Mady Cissoko
- Malaria Research and Training Center, FMOS-FAPH, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali;
- SESSTIM, UM1252, ISSPAM, INSERM, IRD, Aix Marseille University, 13005 Marseille, France
| | - Mahamat Saleh Issakha Diar
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Demba Kodindo Israel
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Kerah Hinzoumbé Clément
- United Nations Development Program (UNDP), Support Project for Malaria Control in Chad (PA-LAT), N’Djamena BP 906, Chad; (K.H.C.); (A.M.A.)
| | - Aicha Mohamed Ali
- United Nations Development Program (UNDP), Support Project for Malaria Control in Chad (PA-LAT), N’Djamena BP 906, Chad; (K.H.C.); (A.M.A.)
| | - Makido Dormbaye
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Issa Mahamat Souleymane
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Adam Batrane
- National Malaria Control Program (NMCP Chad), N’Djamena 1953, Chad; (M.I.D.); (M.S.I.D.); (D.K.I.); (M.D.); (I.M.S.); (A.B.)
| | - Issaka Sagara
- Malaria Research and Training Center, FMOS-FAPH, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali;
- SESSTIM, UM1252, ISSPAM, INSERM, IRD, Aix Marseille University, 13005 Marseille, France
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Bationo C, Cissoko M, Katilé A, Sylla B, Ouédraogo A, Ouedraogo JB, Tougri G, Kompaoré SCB, Moiroux N, Gaudart J. Malaria in Burkina Faso: A comprehensive analysis of spatiotemporal distribution of incidence and environmental drivers, and implications for control strategies. PLoS One 2023; 18:e0290233. [PMID: 37703223 PMCID: PMC10499254 DOI: 10.1371/journal.pone.0290233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/05/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The number of malaria cases worldwide has increased, with over 241 million cases and 69,000 more deaths in 2020 compared to 2019. Burkina Faso recorded over 11 million malaria cases in 2020, resulting in nearly 4,000 deaths. The overall incidence of malaria in Burkina Faso has been steadily increasing since 2016. This study investigates the spatiotemporal pattern and environmental and meteorological determinants of malaria incidence in Burkina Faso. METHODS We described the temporal dynamics of malaria cases by detecting the transmission periods and the evolution trend from 2013 to 2018. We detected hotspots using spatial scan statistics. We assessed different environmental zones through a hierarchical clustering and analyzed the environmental and climatic data to identify their association with malaria incidence at the national and at the district's levels through generalized additive models. We also assessed the time lag between malaria peaks onset and the rainfall at the district level. The environmental and climatic data were synthetized into indicators. RESULTS The study found that malaria incidence had a seasonal pattern, with high transmission occurring during the rainy seasons. We also found an increasing trend in the incidence. The highest-risk districts for malaria incidence were identified, with a significant expansion of high-risk areas from less than half of the districts in 2013-2014 to nearly 90% of the districts in 2017-2018. We identified three classes of health districts based on environmental and climatic data, with the northern, south-western, and western districts forming separate clusters. Additionally, we found that the time lag between malaria peaks onset and the rainfall at the district level varied from 7 weeks to 17 weeks with a median at 10 weeks. Environmental and climatic factors have been found to be associated with the number of cases both at global and districts levels. CONCLUSION The study provides important insights into the environmental and spatiotemporal patterns of malaria in Burkina Faso by assessing the spatio temporal dynamics of Malaria cases but also linking those dynamics to the environmental and climatic factors. The findings highlight the importance of targeted control strategies to reduce the burden of malaria in high-risk areas as we found that Malaria epidemiology is complex and linked to many factors that make some regions more at risk than others.
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Affiliation(s)
- Cédric Bationo
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, UMR1252, Marseille, France
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France
| | - Mady Cissoko
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, UMR1252, Marseille, France
- Malaria Research and Training Center—Ogobara, Doumbo (MRTC-OD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako Mali, Bamako, Mali
| | - Abdoulaye Katilé
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, UMR1252, Marseille, France
- Malaria Research and Training Center—Ogobara, Doumbo (MRTC-OD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako Mali, Bamako, Mali
| | - Bry Sylla
- Direction des Systèmes d’Information en Santé, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Ambroise Ouédraogo
- Programme National de Lutte contre le Paludisme, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Jean Baptiste Ouedraogo
- Programme National de Lutte contre le Paludisme, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Gauthier Tougri
- Programme National de Lutte contre le Paludisme, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Sidzabda C. B. Kompaoré
- Programme National de Lutte contre le Paludisme, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Nicolas Moiroux
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Jean Gaudart
- Malaria Research and Training Center—Ogobara, Doumbo (MRTC-OD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako Mali, Bamako, Mali
- Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM, UMR1252, APHM, Hop Timone, BioSTIC, Biostatistic & ICT, Marseille, France
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Katale RN, Gemechu DB. Spatio-temporal analysis of malaria incidence and its risk factors in North Namibia. Malar J 2023; 22:149. [PMID: 37149600 PMCID: PMC10163860 DOI: 10.1186/s12936-023-04577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 04/25/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Millions of dollars have been spent in fighting malaria in Namibia. However, malaria remains a major public health concern in Namibia, mostly in Kavango West and East, Ohangwena and Zambezi region. The primary goal of this study was to fit a spatio-temporal model that profiles spatial variation in malaria risk areas and investigate possible associations between disease risk and environmental factors at the constituency level in highly risk northern regions of Namibia. METHODS Malaria data, climatic data, and population data were merged and Global spatial autocorrelation statistics (Moran's I) was used to detect the spatial autocorrelation of malaria cases while malaria occurrence clusters were identified using local Moran statistics. A hierarchical Bayesian CAR model (Besag, York and Mollie's model "BYM") known to be the best model for modelling the spatial and temporal effects was then fitted to examine climatic factors that might explain spatial/temporal variation of malaria infection in Namibia. RESULTS Average rainfall received on an annual basis and maximum temperature were found to have a significant spatial and temporal variation on malaria infection. Every mm increase in annual rainfall in a specific constituency in each year increases annual mean malaria cases by 0.6%, same to average maximum temperature. The posterior means of the time main effect (year t) showed a visible slightly increase in global trend from 2018 to 2020. CONCLUSION The study discovered that the spatial temporal model with both random and fixed effects best fit the model, which demonstrated a strong spatial and temporal heterogeneity distribution of malaria cases (spatial pattern) with high risk in most of the Kavango West and East outskirt constituencies, posterior relative risk (RR: 1.57 to 1.78).
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Affiliation(s)
- Remember Ndahalashili Katale
- Department of Mathematics, Statistics, and Actuarial Science, Faculty of Health, Natural Resources and Applied Sciences, School of Natural and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia
| | - Dibaba Bayisa Gemechu
- Department of Mathematics, Statistics, and Actuarial Science, Faculty of Health, Natural Resources and Applied Sciences, School of Natural and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia.
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Bisanzio D, Lalji S, Abbas FB, Ali MH, Hassan W, Mkali HR, Al-Mafazy AW, Joseph JJ, Nyinondi S, Kitojo C, Serbantez N, Reaves E, Eckert E, Ngondi JM, Reithinger R. Spatiotemporal dynamics of malaria in Zanzibar, 2015-2020. BMJ Glob Health 2023; 8:bmjgh-2022-009566. [PMID: 36639160 PMCID: PMC9843203 DOI: 10.1136/bmjgh-2022-009566] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Despite high coverage of malaria interventions, malaria elimination in Zanzibar remains elusive, with the annual number of cases increasing gradually over the last 3 years. OBJECTIVE The aims of the study were to (1) assess the spatiotemporal dynamics of malaria in Zanzibar between 2015 and 2020 and (2) identify malaria hotspots that would allow Zanzibar to develop an epidemiological stratification for more effective and granular intervention targeting. METHODS In this study, we analysed data routinely collected by Zanzibar's Malaria Case Notification (MCN) system. The system collects sociodemographic and epidemiological data from all malaria cases. Cases are passively detected at health facilities (ie, primary index cases) and through case follow-up and reactive case detection (ie, secondary cases). Analyses were performed to identify the spatial heterogeneity of case reporting at shehia (ward) level during transmission seasons. RESULTS From 1 January 2015 to 30 April 2020, the MCN system reported 22 686 index cases. Number of cases reported showed a declining trends from 2015 to 2016, followed by an increase from 2017 to 2020. More than 40% of cases had a travel history outside Zanzibar in the month prior to testing positive for malaria. The proportion of followed up index cases was approximately 70% for all years. Out of 387 shehias, 79 (20.4%) were identified as malaria hotspots in any given year; these hotspots reported 52% of all index cases during the study period. Of the 79 hotspot shehias, 12 were hotspots in more than 4 years, that is, considered temporally stable, reporting 14.5% of all index cases. CONCLUSIONS Our findings confirm that the scale-up of malaria interventions has greatly reduced malaria transmission in Zanzibar since 2006. Analyses identified hotspots, some of which were stable across multiple years. Malaria efforts should progress from a universal intervention coverage approach to an approach that is more tailored to a select number of hotspot shehias.
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Affiliation(s)
- Donal Bisanzio
- RTI International, Washington, District of Columbia, USA
| | - Shabbir Lalji
- RTI International, Dar es Salaam, United Republic of Tanzania
| | - Faiza B Abbas
- Zanzibar Malaria Elimination Programme, Ministry of Health, Stone Town, Zanzibar, United Republic of Tanzania
| | - Mohamed H Ali
- Zanzibar Malaria Elimination Programme, Ministry of Health, Stone Town, Zanzibar, United Republic of Tanzania
| | - Wahida Hassan
- Zanzibar Malaria Elimination Programme, Ministry of Health, Stone Town, Zanzibar, United Republic of Tanzania
| | | | | | - Joseph J Joseph
- RTI International, Dar es Salaam, United Republic of Tanzania
| | - Ssanyu Nyinondi
- RTI International, Dar es Salaam, United Republic of Tanzania
| | - Chonge Kitojo
- U.S. President’s Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, United Republic of Tanzania
| | - Naomi Serbantez
- U.S. President’s Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, United Republic of Tanzania
| | - Erik Reaves
- U.S. President’s Malaria Initiative, U.S. Centers for Disease Control, Dar es Salaam, United Republic of Tanzania
| | - Erin Eckert
- RTI International, Washington, District of Columbia, USA
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8
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Katile A, Sagara I, Cissoko M, Bationo CS, Dolo M, Thera I, Traore S, Kone M, Dembele P, Bocoum D, Sidibe I, Simaga I, Sissoko MS, Landier J, Gaudart J. Spatio-Temporal Variability of Malaria Incidence in the Health District of Kati, Mali, 2015-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14361. [PMID: 36361240 PMCID: PMC9656757 DOI: 10.3390/ijerph192114361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Despite the implementation of control strategies at the national scale, the malaria burden remains high in Mali, with more than 2.8 million cases reported in 2019. In this context, a new approach is needed, which accounts for the spatio-temporal variability of malaria transmission at the local scale. This study aimed to describe the spatio-temporal variability of malaria incidence and the associated meteorological and environmental factors in the health district of Kati, Mali. METHODS Daily malaria cases were collected from the consultation records of the 35 health areas of Kati's health district, for the period 2015-2019. Data on rainfall, relative humidity, temperature, wind speed, the normalized difference vegetation index, air pressure, and land use-land cover were extracted from open-access remote sensing sources, while data on the Niger River's height and flow were obtained from the National Department of Hydraulics. To reduce the dimension and account for collinearity, strongly correlated meteorological and environmental variables were combined into synthetic indicators (SI), using a principal component analysis. A generalized additive model was built to determine the lag and the relationship between the main SIs and malaria incidence. The transmission periods were determined using a change-point analysis. High-risk clusters (hotspots) were detected using the SatScan method and were ranked according to risk level, using a classification and regression tree analysis. RESULTS The peak of the malaria incidence generally occurred in October. Peak incidence decreased from 60 cases per 1000 person-weeks in 2015, to 27 cases per 1000 person-weeks in 2019. The relationship between the first SI (river flow and height, relative humidity, and rainfall) and malaria incidence was positive and almost linear. A non-linear relationship was found between the second SI (air pressure and temperature) and malaria incidence. Two transmission periods were determined per year: a low transmission period from January to July-corresponding to a persisting transmission during the dry season-and a high transmission period from July to December. The spatial distribution of malaria hotspots varied according to the transmission period. DISCUSSION Our study confirmed the important variability of malaria incidence and found malaria transmission to be associated with several meteorological and environmental factors in the Kati district. The persistence of malaria during the dry season and the spatio-temporal variability of malaria hotspots reinforce the need for innovative and targeted strategies.
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Affiliation(s)
- Abdoulaye Katile
- INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Issaka Sagara
- INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Mady Cissoko
- INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Cedric Stephane Bationo
- INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
| | - Mathias Dolo
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Ismaila Thera
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Siriman Traore
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Mamady Kone
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Pascal Dembele
- Programme National de Lutte Contre le Paludisme, Bamako BP 233, Mali
| | - Djoouro Bocoum
- Direction Nationale de L’Hydraulique, Bamako BP 66, Mali
| | | | - Ismael Simaga
- Centre de Santé de Référence du District Sanitaire de Kati, Région de Koulikoro, Kati BP 594, Mali
| | - Mahamadou Soumana Sissoko
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
| | - Jordi Landier
- INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
| | - Jean Gaudart
- Malaria Research and Training Center (MRTC), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 423, Mali
- APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Hop Timone, BioSTIC, Biostatistic & ICT, Faculty of Medicine, Aix Marseille University, 13005 Marseille, France
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9
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Sangaré I, Ouattara CA, Soma DD, Soma D, Assogba BS, Namountougou M, Tougri G, Savadogo LB. Spatial-temporal pattern of malaria in Burkina Faso from 2013 to 2020. Parasite Epidemiol Control 2022; 18:e00261. [PMID: 35859938 PMCID: PMC9289732 DOI: 10.1016/j.parepi.2022.e00261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 06/04/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the implementation of different strategies to fight against malaria in Burkina Faso since 2005, it remains today the leading cause of hospitalization and death. Adapting interventions to the spatial and temporal distribution of malaria could help to reduce this burden. This study aims to determine the structure and stability of malaria hotspots in Burkina Faso, with the objective of adapting interventions at small geographical scales. Data on malaria cases from 2013 to 2020 were acquired at municipalities level. Municipality-wise malaria endemicity levels were mapped through geographical information system (GIS) tools. Spatial statistical analysis using Kulldoff sweeps were carried out to identify malaria hotspots. Then we mapped the monthly malaria risk. Malaria is endemic in all the municipalities of Burkina Faso. However, two stable main spatial clusters (South-Western and Eastern part of the country) are emerging with seasonal reinforcement. Interventions targeting the identified clusters could significantly reduce the incidence of malaria in Burkina Faso. This also prompts for further studies to identify the local determinants of this high transmission for the future success of malaria control.
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10
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Thomas A, Bakai TA, Atcha-Oubou T, Tchadjobo T, Bossard N, Rabilloud M, Voirin N. Seasonality of confirmed malaria cases from 2008 to 2017 in Togo: a time series analysis by health district and target group. BMC Infect Dis 2021; 21:1189. [PMID: 34836505 PMCID: PMC8620157 DOI: 10.1186/s12879-021-06893-z] [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: 08/05/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to assess the seasonality of confirmed malaria cases in Togo and to provide new indicators of malaria seasonality to the National Malaria Control Programme (NMCP). Methods Aggregated data of confirmed malaria cases were collected monthly from 2008 to 2017 by the Togo’s NMCP and stratified by health district and according to three target groups: children < 5 years old, children ≥ 5 years old and adults, and pregnant women. Time series analysis was carried out for each target group and health district. Seasonal decomposition was used to assess the seasonality of confirmed malaria cases. Maximum and minimum seasonal indices, their corresponding months, and the ratio of maximum/minimum seasonal indices reflecting the importance of malaria transmission, were provided by health district and target group. Results From 2008 to 2017, 7,951,757 malaria cases were reported in Togo. Children < 5 years old, children ≥ 5 years old and adults, and pregnant women represented 37.1%, 57.7% and 5.2% of the confirmed malaria cases, respectively. The maximum seasonal indices were observed during or shortly after a rainy season and the minimum seasonal indices during the dry season between January and April in particular. In children < 5 years old, the ratio of maximum/minimum seasonal indices was higher in the north, suggesting a higher seasonal malaria transmission, than in the south of Togo. This is also observed in the other two groups but to a lesser extent. Conclusions This study contributes to a better understanding of malaria seasonality in Togo. The indicators of malaria seasonality could allow for more accurate forecasting in malaria interventions and supply planning throughout the year. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06893-z.
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Affiliation(s)
- Anne Thomas
- Université de Lyon, Lyon, France. .,Université Lyon 1, Villeurbanne, France. .,Service de Biostatistique et 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 of Infectious Diseases (EPIMOD), Lent, France.
| | - Tchaa A Bakai
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique et 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 of Infectious Diseases (EPIMOD), Lent, France.,Programme National de Lutte contre le Paludisme (PNLP), Lomé, Togo
| | | | | | - Nadine Bossard
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique et Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS, UMR 5558, Villeurbanne, France
| | - Muriel Rabilloud
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique et 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 of Infectious Diseases (EPIMOD), Lent, France
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11
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Starck T, Bulstra CA, Tinto H, Rouamba T, Sie A, Jaenisch T, Bärnighausen T. The effect of malaria on haemoglobin concentrations: a nationally representative household fixed-effects study of 17,599 children under 5 years of age in Burkina Faso. Malar J 2021; 20:416. [PMID: 34688294 PMCID: PMC8542337 DOI: 10.1186/s12936-021-03948-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background Although the association between malaria and anaemia is widely studied in patient cohorts, the population-representative causal effects of malaria on anaemia remain unknown. This study estimated the malaria-induced decrease in haemoglobin levels among young children in malaria-endemic Burkina Faso. Methods The study was based on pooled individual-level nationally representative health survey data (2010–2011, 2014, 2017–2018) from 17 599 children under 5 years of age. This data was used to estimate the effects of malaria on haemoglobin concentration, controlling for household fixed-effects, age, and sex in a series of regression analyses. The fixed-effects controlled for observed and unobserved confounding on the household level and allowed to determine the impact of malaria infection status on haemoglobin levels and anaemia prevalence. Furthermore, the diagnostic results from microscopy and rapid diagnostic tests were leveraged to provide a quasi-longitudinal perspective of acute and prolonged effects after malaria infection. Results The prevalence of both malaria (survey prevalence ranging from 17.4% to 65.2%) and anaemia (survey prevalence ranging from 74% to 88.2%) was very high in the included surveys. Malaria was estimated to significantly reduce haemoglobin levels, with an overall effect of − 7.5 g/dL (95% CI − 8.5, − 6.5). Acute malaria resulted in a − 7.7 g/dL (95% CI − 8.8, − 6.6) decrease in haemoglobin levels. Recent malaria without current parasitaemia decreased haemoglobin concentration by − 7.1 g/dL (95% CI − 8.3, − 5.9). The in-sample predicted prevalence of severe anaemia was 9.4% among malaria positives, but only 2.2% among children without malaria. Conclusion Malaria infection has a strong detrimental effect on haemoglobin levels among young children in Burkina Faso. This effect seems to carry over even after acute infection, indicating prolonged haemoglobin reductions even after successful parasite-elimination. The quasi-experimental fixed-effect approach adds a population level perspective to existing clinical evidence. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03948-z.
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Affiliation(s)
- Tim Starck
- Heidelberg Institute of Global Health, Heidelberg University Medical Cente, Heidelberg, Germany.
| | - Caroline A Bulstra
- Heidelberg Institute of Global Health, Heidelberg University Medical Cente, Heidelberg, Germany.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | - Ali Sie
- National Institute of Public Health (INSP), Nouna Health Research Centre (CRSN), Nouna, Burkina Faso
| | - Thomas Jaenisch
- Heidelberg Institute of Global Health, Heidelberg University Medical Cente, Heidelberg, Germany.,Center for Global Health, Colorado School of Public Health, Aurora, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Medical Cente, Heidelberg, Germany.,Harvard Center for Population and Development Studies, Boston, USA.,Africa Health Research Institute (AHRI), Durban, KwaZulu-Natal, South Africa
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12
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Bationo CS, Gaudart J, Dieng S, Cissoko M, Taconet P, Ouedraogo B, Somé A, Zongo I, Soma DD, Tougri G, Dabiré RK, Koffi A, Pennetier C, Moiroux N. Spatio-temporal analysis and prediction of malaria cases using remote sensing meteorological data in Diébougou health district, Burkina Faso, 2016-2017. Sci Rep 2021; 11:20027. [PMID: 34625589 PMCID: PMC8501026 DOI: 10.1038/s41598-021-99457-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Malaria control and prevention programs are more efficient and cost-effective when they target hotspots or select the best periods of year to implement interventions. This study aimed to identify the spatial distribution of malaria hotspots at the village level in Diébougou health district, Burkina Faso, and to model the temporal dynamics of malaria cases as a function of meteorological conditions and of the distance between villages and health centres (HCs). Case data for 27 villages were collected in 13 HCs. Meteorological data were obtained through remote sensing. Two synthetic meteorological indicators (SMIs) were created to summarize meteorological variables. Spatial hotspots were detected using the Kulldorf scanning method. A General Additive Model was used to determine the time lag between cases and SMIs and to evaluate the effect of SMIs and distance to HC on the temporal evolution of malaria cases. The multivariate model was fitted with data from the epidemic year to predict the number of cases in the following outbreak. Overall, the incidence rate in the area was 429.13 cases per 1000 person-year with important spatial and temporal heterogeneities. Four spatial hotspots, involving 7 of the 27 villages, were detected, for an incidence rate of 854.02 cases per 1000 person-year. The hotspot with the highest risk (relative risk = 4.06) consisted of a single village, with an incidence rate of 1750.75 cases per 1000 person-years. The multivariate analysis found greater variability in incidence between HCs than between villages linked to the same HC. The time lag that generated the better predictions of cases was 9 weeks for SMI1 (positively correlated with precipitation variables) and 16 weeks for SMI2 (positively correlated with temperature variables. The prediction followed the overall pattern of the time series of reported cases and predicted the onset of the following outbreak with a precision of less than 3 weeks. This analysis of malaria cases in Diébougou health district, Burkina Faso, provides a powerful prospective method for identifying and predicting high-risk areas and high-transmission periods that could be targeted in future malaria control and prevention campaigns.
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Affiliation(s)
- Cédric S Bationo
- INSERM, IRD, SESSTIM, UMR1252, Institute of Public Health Sciences, ISSPAM, Aix Marseille Univ, 13005, Marseille, France
- CNRS, IRD, MIVEGEC, Univ. Montpellier, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Jean Gaudart
- INSERM, IRD, SESSTIM, UMR1252, Institute of Public Health Sciences, ISSPAM, APHM, Hop Timone, BioSTIC, Biostatistic & ICT, Aix Marseille Univ, 13005, Marseille, France.
- Malaria Research and Training Center-Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, 1805, Mali.
| | - Sokhna Dieng
- INSERM, IRD, SESSTIM, UMR1252, Institute of Public Health Sciences, ISSPAM, Aix Marseille Univ, 13005, Marseille, France
| | - Mady Cissoko
- INSERM, IRD, SESSTIM, UMR1252, Institute of Public Health Sciences, ISSPAM, Aix Marseille Univ, 13005, Marseille, France
- Malaria Research and Training Center-Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, 1805, Mali
| | - Paul Taconet
- CNRS, IRD, MIVEGEC, Univ. Montpellier, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Boukary Ouedraogo
- Direction des Systèmes d'information en Santé, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Anthony Somé
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Issaka Zongo
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Dieudonné D Soma
- CNRS, IRD, MIVEGEC, Univ. Montpellier, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Gauthier Tougri
- Programme National de Lutte Contre le Paludisme, Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Roch K Dabiré
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
| | - Alphonsine Koffi
- Institut Pierre Richet (IPR), Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire
| | - Cédric Pennetier
- CNRS, IRD, MIVEGEC, Univ. Montpellier, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
- Institut Pierre Richet (IPR), Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire
| | - Nicolas Moiroux
- CNRS, IRD, MIVEGEC, Univ. Montpellier, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo Dioulasso, Burkina Faso
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13
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Van Gordon MM, McCarthy KA, Proctor JL, Hagedorn BL. Evaluating COVID-19 reporting data in the context of testing strategies across 31 low- and middle-income countries. Int J Infect Dis 2021; 110:341-352. [PMID: 34303843 PMCID: PMC8299143 DOI: 10.1016/j.ijid.2021.07.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The case count for coronavirus disease 2019 (COVID-19) is the predominant measure used to track epidemiological dynamics and inform policy decision-making. Case counts, however, are influenced by testing rates and strategies, which have varied over time and space. A method to interpret COVID-19 case counts consistently in the context of other surveillance data is needed, especially for data-limited settings in low- and middle-income countries (LMICs). METHODS Statistical analyses were used to detect changes in COVID-19 surveillance data. The pruned exact linear time change detection method was applied for COVID-19 case counts, number of tests, and test positivity rate over time. With this information, change points were categorized as likely driven by epidemiological dynamics or non-epidemiological influences, such as noise. FINDINGS Higher rates of epidemiological change detection are more associated with open testing policies than with higher testing rates. This study quantified alignment of non-pharmaceutical interventions with epidemiological changes. LMICs have the testing capacity to measure prevalence with precision if they use randomized testing. Rwanda stands out as a country with an efficient COVID-19 surveillance system. Subnational data reveal heterogeneity in epidemiological dynamics and surveillance. INTERPRETATION Relying solely on case counts to interpret pandemic dynamics has important limitations. Normalizing counts by testing rate mitigates some of these limitations, and an open testing policy is key to efficient surveillance. The study findings can be leveraged by public health officials to strengthen COVID-19 surveillance and support programmatic decision-making.
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Affiliation(s)
- Mollie M Van Gordon
- Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, WA, USA.
| | - Kevin A McCarthy
- Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Joshua L Proctor
- Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Brittany L Hagedorn
- Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, WA, USA
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14
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Odhiambo JN, Kalinda C, Macharia PM, Snow RW, Sartorius B. Spatial and spatio-temporal methods for mapping malaria risk: a systematic review. BMJ Glob Health 2021; 5:bmjgh-2020-002919. [PMID: 33023880 PMCID: PMC7537142 DOI: 10.1136/bmjgh-2020-002919] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background Approaches in malaria risk mapping continue to advance in scope with the advent of geostatistical techniques spanning both the spatial and temporal domains. A substantive review of the merits of the methods and covariates used to map malaria risk has not been undertaken. Therefore, this review aimed to systematically retrieve, summarise methods and examine covariates that have been used for mapping malaria risk in sub-Saharan Africa (SSA). Methods A systematic search of malaria risk mapping studies was conducted using PubMed, EBSCOhost, Web of Science and Scopus databases. The search was restricted to refereed studies published in English from January 1968 to April 2020. To ensure completeness, a manual search through the reference lists of selected studies was also undertaken. Two independent reviewers completed each of the review phases namely: identification of relevant studies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data extraction and methodological quality assessment using a validated scoring criterion. Results One hundred and seven studies met the inclusion criteria. The median quality score across studies was 12/16 (range: 7–16). Approximately half (44%) of the studies employed variable selection techniques prior to mapping with rainfall and temperature selected in over 50% of the studies. Malaria incidence (47%) and prevalence (35%) were the most commonly mapped outcomes, with Bayesian geostatistical models often (31%) the preferred approach to risk mapping. Additionally, 29% of the studies employed various spatial clustering methods to explore the geographical variation of malaria patterns, with Kulldorf scan statistic being the most common. Model validation was specified in 53 (50%) studies, with partitioning data into training and validation sets being the common approach. Conclusions Our review highlights the methodological diversity prominent in malaria risk mapping across SSA. To ensure reproducibility and quality science, best practices and transparent approaches should be adopted when selecting the statistical framework and covariates for malaria risk mapping. Findings underscore the need to periodically assess methods and covariates used in malaria risk mapping; to accommodate changes in data availability, data quality and innovation in statistical methodology.
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Affiliation(s)
| | - Chester Kalinda
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.,Faculty of Agriculture and Natural Resources, University of Namibia, Windhoek, Namibia
| | - Peter M Macharia
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Robert W Snow
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Benn Sartorius
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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15
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Kamau A, Mtanje G, Mataza C, Bejon P, Snow RW. Spatial-temporal clustering of malaria using routinely collected health facility data on the Kenyan Coast. Malar J 2021; 20:227. [PMID: 34016100 PMCID: PMC8138976 DOI: 10.1186/s12936-021-03758-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The over-distributed pattern of malaria transmission has led to attempts to define malaria "hotspots" that could be targeted for purposes of malaria control in Africa. However, few studies have investigated the use of routine health facility data in the more stable, endemic areas of Africa as a low-cost strategy to identify hotspots. Here the objective was to explore the spatial and temporal dynamics of fever positive rapid diagnostic test (RDT) malaria cases routinely collected along the Kenyan Coast. METHODS Data on fever positive RDT cases between March 2018 and February 2019 were obtained from patients presenting to six out-patients health-facilities in a rural area of Kilifi County on the Kenyan Coast. To quantify spatial clustering, homestead level geocoded addresses were used as well as aggregated homesteads level data at enumeration zone. Data were sub-divided into quarterly intervals. Kulldorff's spatial scan statistics using Bernoulli probability model was used to detect hotspots of fever positive RDTs across all ages, where cases were febrile individuals with a positive test and controls were individuals with a negative test. RESULTS Across 12 months of surveillance, there were nine significant clusters that were identified using the spatial scan statistics among RDT positive fevers. These clusters included 52% of all fever positive RDT cases detected in 29% of the geocoded homesteads in the study area. When the resolution of the data was aggregated at enumeration zone (village) level the hotspots identified were located in the same areas. Only two of the nine hotspots were temporally stable accounting for 2.7% of the homesteads and included 10.8% of all fever positive RDT cases detected. CONCLUSION Taking together the temporal instability of spatial hotspots and the relatively modest fraction of the malaria cases that they account for; it would seem inadvisable to re-design the sub-county control strategies around targeting hotspots.
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Affiliation(s)
- Alice Kamau
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
| | - Grace Mtanje
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Christine Mataza
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Ministry of Health, Kilifi County Government, Kilifi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Robert W Snow
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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16
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Tassembedo M, Coulibaly S, Ouedraogo B. Factors associated with the use of insecticide-treated nets: analysis of the 2018 Burkina Faso Malaria Indicator Survey. Malar J 2021; 20:220. [PMID: 34001104 PMCID: PMC8130301 DOI: 10.1186/s12936-021-03756-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background Sleeping under an ITN reduces contact with mosquitoes through the combination of a physical barrier and an insecticidal effect, which reduces the incidence of malaria. The 2016–2020 Burkina Faso National Malaria Strategic Plan aims to have at least 90% of the population, 100% of children under age 5, and 100% of pregnant women sleep under an ITN. Methods The analysis examines individual, household, and community-level factors associated with ITN usage. According to the 2017–18 Burkina Faso MIS, 58% of individuals in households that own at least one ITN reported that they slept under an ITN on the night before the survey. Results The use of ITNs was significantly associated with individual, household, and community-level variables that included age, gender, age of household head, number of sleeping rooms, wealth, malaria prevalence, residence, and region. Conclusions The results highlight areas of intervention at the individual, household, and community levels that can increase ITN use.
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Affiliation(s)
- Mahamadi Tassembedo
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso. .,Direction du Suivi, de l'évaluation et de la Capitalisation, Ministère de la santé, Ouagadougou, Burkina Faso.
| | - Soumaila Coulibaly
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso.,Centre National de Recherche et de Formation sur le Paludisme (CNRFP)/Institut National de Santé Publique (INSP), Ministère de la santé, Ouagadougou, Burkina Faso
| | - Boukary Ouedraogo
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso.,Direction des systèmes d'information en santé, Ministère de la santé, Ouagadougou, Burkina Faso
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17
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Toh KB, Bliznyuk N, Valle D. Improving national level spatial mapping of malaria through alternative spatial and spatio-temporal models. Spat Spatiotemporal Epidemiol 2021; 36:100394. [PMID: 33509423 DOI: 10.1016/j.sste.2020.100394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/28/2022]
Abstract
The most common approach to create spatial prediction of malaria in the literature is to approximate a Gaussian process model using stochastic partial differential equation (SPDE). We compared SPDE to computationally faster alternatives, generalized additive model (GAM) and state-of-the-art machine learning method gradient boosted trees (GBM), with respect to their predictive skill for country-level malaria prevalence mapping. We also evaluated the intuition that incorporation of past data and the use of spatio-temporal models may improve predictive accuracy of present spatial distribution of malaria. Model performances varied among the countries and setting with SPDE and GAM performed well generally. The inclusion of past data is beneficial for GAM and GBM, but not for SPDE. We further investigated the weaknesses of SPDE at spatio-temporal setting and GAM at the edges of the countries. Taken together, we believe that spatial/spatio-temporal SPDE models should be evaluated alongside with the alternatives or at least GAM.
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Affiliation(s)
- Kok Ben Toh
- School of Natural Resources and Environment, University of Florida, 103 Black Hall, Gainesville, Florida.
| | - Nikolay Bliznyuk
- Department of Agricultural and Biological Engineering, University of Florida, 1741 Museum Road, Gainesville, Florida
| | - Denis Valle
- School of Forest Resources and Conservation, University of Florida, 136 Newins-Ziegler Hall, Gainesville, Florida
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18
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Scully J, Mosnier E, Carbunar A, Roux E, Djossou F, Garçeran N, Musset L, Sanna A, Demar M, Nacher M, Gaudart J. Spatio-Temporal Dynamics of Plasmodium falciparum and Plasmodium vivax in French Guiana: 2005-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031077. [PMID: 33530386 PMCID: PMC7908074 DOI: 10.3390/ijerph18031077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 12/05/2022]
Abstract
Aims: This study examines the dynamics of malaria as influenced by meteorological factors in French Guiana from 2005 to 2019. It explores spatial hotspots of malaria transmission and aims to determine the factors associated with variation of hotspots with time. Methods: Data for individual malaria cases came from the surveillance system of the Delocalized Centers for Prevention and Care (CDPS) (n = 17) from 2005–2019. Meteorological data was acquired from the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) database. The Box–Jenkins autoregressive integrated moving average (ARIMA) model tested stationarity of the time series, and the impact of meteorological indices (issued from principal component analysis—PCA) on malaria incidence was determined with a general additive model. Hotspot characterization was performed using spatial scan statistics. Results: The current sample includes 7050 eligible Plasmodium vivax (n = 4111) and Plasmodium falciparum (n = 2939) cases from health centers across French Guiana. The first and second PCA-derived meteorological components (maximum/minimum temperature/minimum humidity and maximum humidity, respectively) were significantly negatively correlated with total malaria incidence with a lag of one week and 10 days, respectively. Overall malaria incidence decreased across the time series until 2017 when incidence began to trend upwards. Hotspot characterization revealed a few health centers that exhibited spatial stability across the entire time series: Saint Georges de l’Oyapock and Antecume Pata for P. falciparum, and Saint Georges de l’Oyapock, Antecume Pata, Régina and Camopi for P. vivax. Conclusions: This study highlighted changing malaria incidence in French Guiana and the influences of meteorological factors on transmission. Many health centers showed spatial stability in transmission, albeit not temporal. Knowledge of the areas of high transmission as well as how and why transmission has changed over time can inform strategies to reduce the transmission of malaria in French Guiana. Hotspots should be further investigated to understand other influences on local transmission, which will help to facilitate elimination.
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Affiliation(s)
- Jenna Scully
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Correspondence: (J.S.); (J.G.)
| | - Emilie Mosnier
- Infectious and Tropical Disease Unit, Cayenne Hospital, 97306 Cayenne, French Guiana; (E.M.); (F.D.)
- INSERM, IRD, SESSTIM, Health Economics & Social Sciences & Health Information Processing, Aix Marseille University, 13385 Marseille, France
| | - Aurel Carbunar
- Delocalized Prevention and Care Centers, Cayenne Hospital, 97306 Cayenne, French Guiana; (A.C.); (N.G.)
| | - Emmanuel Roux
- ESPACE-DEV (IRD, University of Reunion Island, University of the West Indies, University of French Guiana, University of Montpellier), 34000 Montpellier, France;
- LMI Sentinela, International Joint Laboratory ‘Sentinela’ (Fiocruz, UnB, IRD), Rio de Janeiro, RJ 21040-900, Brazil
| | - Félix Djossou
- Infectious and Tropical Disease Unit, Cayenne Hospital, 97306 Cayenne, French Guiana; (E.M.); (F.D.)
- Amazonian Ecosystems and Tropical Diseases, EA3593, University of French Guiana, 97300 Cayenne, French Guiana
| | - Nicolas Garçeran
- Delocalized Prevention and Care Centers, Cayenne Hospital, 97306 Cayenne, French Guiana; (A.C.); (N.G.)
| | - Lise Musset
- Parasitology Laboratory, Malaria National Reference Center, French Guiana Pasteur Institute, 97300 Cayenne, French Guiana;
| | - Alice Sanna
- French Guiana Regional Health Agency, 97306 Cayenne, French Guiana;
| | - Magalie Demar
- Parasitology & Mycology Laboratory, Cayenne Hospital, 97306 Cayenne, French Guiana;
| | - Mathieu Nacher
- French Guiana and West Indies Clinical Investigation Center-INSERM 1424, Cayenne Hospital, 97306 Cayenne, French Guiana;
| | - Jean Gaudart
- Aix Marseille University, IRD, INSERM, APHM, La Timone Hospital, Biostatistics and ICT, 13385 Marseille, France
- Correspondence: (J.S.); (J.G.)
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19
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Zheng Y, Zhang X, Wang X, Wang K, Cui Y. Predictive study of tuberculosis incidence by time series method and Elman neural network in Kashgar, China. BMJ Open 2021; 11:e041040. [PMID: 33478962 PMCID: PMC7825257 DOI: 10.1136/bmjopen-2020-041040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Kashgar, located in Xinjiang, China has a high incidence of tuberculosis (TB) making prevention and control extremely difficult. In addition, there have been very few prediction studies on TB incidence here. We; therefore, considered it a high priority to do prediction analysis of TB incidence in Kashgar, and so provide a scientific reference for eventual prevention and control. DESIGN Time series study. SETTING KASHGAR, CHINA Kashgar, China. METHODS We used a single Box-Jenkins method and a Box-Jenkins and Elman neural network (ElmanNN) hybrid method to do prediction analysis of TB incidence in Kashgar. Root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) were used to measure the prediction accuracy. RESULTS After careful analysis, the single autoregression (AR) (1, 2, 8) model and the AR (1, 2, 8)-ElmanNN (AR-Elman) hybrid model were established, and the optimal neurons value of the AR-Elman hybrid model is 6. In the fitting dataset, the RMSE, MAE and MAPE were 6.15, 4.33 and 0.2858, respectively, for the AR (1, 2, 8) model, and 3.78, 3.38 and 0.1837, respectively, for the AR-Elman hybrid model. In the forecasting dataset, the RMSE, MAE and MAPE were 10.88, 8.75 and 0.2029, respectively, for the AR (1, 2, 8) model, and 8.86, 7.29 and 0.2006, respectively, for the AR-Elman hybrid model. CONCLUSIONS Both the single AR (1, 2, 8) model and the AR-Elman model could be used to predict the TB incidence in Kashgar, but the modelling and validation scale-dependent measures (RMSE, MAE and MAPE) in the AR (1, 2, 8) model were inferior to those in the AR-Elman hybrid model, which indicated that the AR-Elman hybrid model was better than the AR (1, 2, 8) model. The Box-Jenkins and ElmanNN hybrid method therefore can be highlighted in predicting the temporal trends of TB incidence in Kashgar, which may act as the potential for far-reaching implications for prevention and control of TB.
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Affiliation(s)
- Yanling Zheng
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Xueliang Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Xijiang Wang
- Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Kai Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Yan Cui
- Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
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20
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Evolution of Malaria Incidence in Five Health Districts, in the Context of the Scaling Up of Seasonal Malaria Chemoprevention, 2016 to 2018, in Mali. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020840. [PMID: 33478166 PMCID: PMC7844620 DOI: 10.3390/ijerph18020840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
Context: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation. Methods: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors. Results: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative humidity, rainfall, and minimum temperature components. The average monthly incidence and the relative humidity varied according to the health district, and the average temperature and rainfall were similar. A decrease in incidence was observed in children under five years old in 2017 and 2018 compared to 2016. Conclusion: A decrease in the incidence of malaria was observed after the SMC rounds. SMC should be applied at optimal periods.
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21
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Ugwu CLJ, Zewotir T. Evaluating the Effects of Climate and Environmental Factors on Under-5 Children Malaria Spatial Distribution Using Generalized Additive Models (GAMs). J Epidemiol Glob Health 2020; 10:304-314. [PMID: 33009733 PMCID: PMC7758859 DOI: 10.2991/jegh.k.200814.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 06/20/2020] [Indexed: 11/09/2022] Open
Abstract
Although malaria burden has declined globally following scale up of intervention, the disease has remained a leading cause of hospitalization and deaths among children aged under-5 years in Nigeria. Malaria is known to be related to climate and environmental conditions. Previous research has usually studied the effects of these factors, neglecting possible correlation between them, high correlation among variables is a source of multicollinearity that induces overfitting in regression modelling. In this paper, a factor analysis was first introduced to circumvent the issue of multicollinearity and a Generalized Additive Model (GAM) was subsequently explored to identify the important risk factors that might influence the prevalence of childhood malaria in Nigeria. The GAM incorporated the complexity of the survey data, while simultaneously modelling the nonlinear and spatial random effects to allow a more precise identification of the major malaria risk factors that influence the geographical distribution of the disease. From our findings, the three latent factor components (constituted by humidity, precipitation, potential evapotranspiration, and wet days/maximum and minimum temperature/proximity to permanent waters, respectively) were significantly associated with malaria prevalence. Our analysis also detected statistically significant and nonlinear effect of altitude: the risk of malaria increased with lower values but declined sharply with higher values. A significant spatial variability in under-5 malaria prevalence across the survey clusters was also observed; malaria burden was higher in the northern part of Nigeria. Investigating the impact of important risk factors and geographical location on childhood malaria is of high relevance for the sustainable development goals (SDGs) 2015–2030 Agenda on malaria eradication, and we believe that the information obtained from this study and the generated risk maps can be useful to effectively target intervention efforts to high-risk areas based on climate and environmental context.
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Affiliation(s)
- Chigozie Louisa Jane Ugwu
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Private Bag X54001 Durban 4000, 3630 Westville, Durban, South Africa
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Private Bag X54001 Durban 4000, 3630 Westville, Durban, South Africa
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22
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Ateba FF, Sagara I, Sogoba N, Touré M, Konaté D, Diawara SI, Diakité SAS, Diarra A, Coulibaly MD, Dolo M, Dolo A, Sacko A, Thiam SM, Sissako A, Sangaré L, Diakité M, Koita OA, Cissoko M, Traore SF, Winch PJ, Febrero-Bande M, Shaffer JG, Krogtad DJ, Marker HC, Doumbia S, Gaudart J. Spatio-Temporal Dynamic of Malaria Incidence: A Comparison of Two Ecological Zones in Mali. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4698. [PMID: 32629876 PMCID: PMC7370019 DOI: 10.3390/ijerph17134698] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 02/06/2023]
Abstract
Malaria transmission largely depends on environmental, climatic, and hydrological conditions. In Mali, malaria epidemiological patterns are nested within three ecological zones. This study aimed at assessing the relationship between those conditions and the incidence of malaria in Dangassa and Koila, Mali. Malaria data was collected through passive case detection at community health facilities of each study site from June 2015 to January 2017. Climate and environmental data were obtained over the same time period from the Goddard Earth Sciences (Giovanni) platform and hydrological data from Mali hydraulic services. A generalized additive model was used to determine the lagged time between each principal component analysis derived component and the incidence of malaria cases, and also used to analyze the relationship between malaria and the lagged components in a multivariate approach. Malaria transmission patterns were bimodal at both sites, but peak and lull periods were longer lasting for Koila study site. Temperatures were associated with malaria incidence in both sites. In Dangassa, the wind speed (p = 0.005) and river heights (p = 0.010) contributed to increasing malaria incidence, in contrast to Koila, where it was humidity (p < 0.001) and vegetation (p = 0.004). The relationships between environmental factors and malaria incidence differed between the two settings, implying different malaria dynamics and adjustments in the conception and plan of interventions.
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Affiliation(s)
- François Freddy Ateba
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
- Department of Mathematics, University of Quebec at Montreal (UQAM), Montréal, QC H2X 3Y7, Canada
| | - Issaka Sagara
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
- Department of Public Health Education and Research, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali;
| | - Nafomon Sogoba
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Mahamoudou Touré
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Drissa Konaté
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Sory Ibrahim Diawara
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Séidina Aboubacar Samba Diakité
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Ayouba Diarra
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Mamadou D. Coulibaly
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Mathias Dolo
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Amagana Dolo
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Aissata Sacko
- Department of Public Health Education and Research, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali;
| | - Sidibe M’baye Thiam
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Aliou Sissako
- Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (A.S.); (L.S.); (O.A.K.)
| | - Lansana Sangaré
- Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (A.S.); (L.S.); (O.A.K.)
| | - Mahamadou Diakité
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Ousmane A. Koita
- Laboratory of Applied Molecular Biology (LBMA), Science and Technologies Faculty (FST), University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (A.S.); (L.S.); (O.A.K.)
| | - Mady Cissoko
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
- APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, Aix Marseille Université, 13005 Marseille, France
| | - Sékou Fantamady Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
| | - Peter John Winch
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (P.J.W.); (H.C.M.)
| | - Manuel Febrero-Bande
- Department of Statistics, Mathematical Analysis and Optimization, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Jeffrey G. Shaffer
- Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America, 1440 Canal Street New Orleans, LA 70112, USA; (J.G.S.); (D.J.K.)
| | - Donald J. Krogtad
- Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America, 1440 Canal Street New Orleans, LA 70112, USA; (J.G.S.); (D.J.K.)
| | - Hannah Catherine Marker
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (P.J.W.); (H.C.M.)
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
- Department of Public Health Education and Research, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali;
| | - Jean Gaudart
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali; (F.F.A.); (I.S.); (N.S.); (M.T.); (D.K.); (S.I.D.); (S.A.S.D.); (A.D.); (M.D.C.); (M.D.); (A.D.); (S.M.T.); (M.D.); (M.C.); (S.F.T.)
- APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, Aix Marseille Université, 13005 Marseille, France
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23
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Dieng S, Ba EH, Cissé B, Sallah K, Guindo A, Ouedraogo B, Piarroux M, Rebaudet S, Piarroux R, Landier J, Sokhna C, Gaudart J. Spatio-temporal variation of malaria hotspots in Central Senegal, 2008-2012. BMC Infect Dis 2020; 20:424. [PMID: 32552759 PMCID: PMC7301493 DOI: 10.1186/s12879-020-05145-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/10/2020] [Indexed: 12/01/2022] Open
Abstract
Background In malaria endemic areas, identifying spatio-temporal hotspots is becoming an important element of innovative control strategies targeting transmission bottlenecks. The aim of this work was to describe the spatio-temporal variation of malaria hotspots in central Senegal and to identify the meteorological, environmental, and preventive factors that influence this variation. Methods This study analysed the weekly incidence of malaria cases recorded from 2008 to 2012 in 575 villages of central Senegal (total population approximately 500,000) as part of a trial of seasonal malaria chemoprevention (SMC). Data on weekly rainfall and annual vegetation types were obtained for each village through remote sensing. The time series of weekly malaria incidence for the entire study area was divided into periods of high and low transmission using change-point analysis. Malaria hotspots were detected during each transmission period with the SaTScan method. The effects of rainfall, vegetation type, and SMC intervention on the spatio-temporal variation of malaria hotspots were assessed using a General Additive Mixed Model. Results The malaria incidence for the entire area varied between 0 and 115.34 cases/100,000 person weeks during the study period. During high transmission periods, the cumulative malaria incidence rate varied between 7.53 and 38.1 cases/100,000 person-weeks, and the number of hotspot villages varied between 62 and 147. During low transmission periods, the cumulative malaria incidence rate varied between 0.83 and 2.73 cases/100,000 person-weeks, and the number of hotspot villages varied between 10 and 43. Villages with SMC were less likely to be hotspots (OR = 0.48, IC95%: 0.33–0.68). The association between rainfall and hotspot status was non-linear and depended on both vegetation type and amount of rainfall. The association between village location in the study area and hotspot status was also shown. Conclusion In our study, malaria hotspots varied over space and time according to a combination of meteorological, environmental, and preventive factors. By taking into consideration the environmental and meteorological characteristics common to all hotspots, monitoring of these factors could lead targeted public health interventions at the local level. Moreover, spatial hotspots and foci of malaria persisting during LTPs need to be further addressed. Trial registration The data used in this work were obtained from a clinical trial registered on July 10, 2008 at www.clinicaltrials.gov under NCT00712374.
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Affiliation(s)
- Sokhna Dieng
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France. .,Ecole des Hautes Etudes en Santé Publique, Rennes, France.
| | - El Hadj Ba
- UMR VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Sénégal
| | - Badara Cissé
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF) Diamniadio, Dakar, Sénégal
| | - Kankoe Sallah
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,AP-HP, Hôpital Bichat, Unité de Recherche Clinique PNVS, Paris, France
| | - Abdoulaye Guindo
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,Research and Training Center - Ogobara K Doumbo, FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Boukary Ouedraogo
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,Direction des Systèmes d'Information en santé, Ministère de la santé, Ouagadougou, Burkina Faso
| | - Martine Piarroux
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Stanislas Rebaudet
- APHM, Assistance Publique - Hôpitaux de Marseille, Marseille, France.,Hôpital Européen, Marseille, France
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jordi Landier
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France
| | - Cheikh Sokhna
- UMR VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Sénégal
| | - Jean Gaudart
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, Marseille, France
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24
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Dieng S, Michel P, Guindo A, Sallah K, Ba EH, Cissé B, Carrieri MP, Sokhna C, Milligan P, Gaudart J. Application of Functional Data Analysis to Identify Patterns of Malaria Incidence, to Guide Targeted Control Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114168. [PMID: 32545302 PMCID: PMC7312547 DOI: 10.3390/ijerph17114168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 11/16/2022]
Abstract
We introduce an approach based on functional data analysis to identify patterns of malaria incidence to guide effective targeting of malaria control in a seasonal transmission area. Using functional data method, a smooth function (functional data or curve) was fitted from the time series of observed malaria incidence for each of 575 villages in west-central Senegal from 2008 to 2012. These 575 smooth functions were classified using hierarchical clustering (Ward’s method), and several different dissimilarity measures. Validity indices were used to determine the number of distinct temporal patterns of malaria incidence. Epidemiological indicators characterizing the resulting malaria incidence patterns were determined from the velocity and acceleration of their incidences over time. We identified three distinct patterns of malaria incidence: high-, intermediate-, and low-incidence patterns in respectively 2% (12/575), 17% (97/575), and 81% (466/575) of villages. Epidemiological indicators characterizing the fluctuations in malaria incidence showed that seasonal outbreaks started later, and ended earlier, in the low-incidence pattern. Functional data analysis can be used to identify patterns of malaria incidence, by considering their temporal dynamics. Epidemiological indicators derived from their velocities and accelerations, may guide to target control measures according to patterns.
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Affiliation(s)
- Sokhna Dieng
- Sciences Economiques et Sociales de la Santé et Traitement de de l'Information Médicale (SESSTIM), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche médicale (INSERM), Aix Marseille Université, 13005 Marseille, France
| | - Pierre Michel
- Aix Marseille School of Economics (AMSE), Centrale Marseille, Ecoles des Hautes Etudes en Sciences Sociales (EHESS), Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université, 13001 Marseille, France
| | - Abdoulaye Guindo
- Sciences Economiques et Sociales de la Santé et Traitement de de l'Information Médicale (SESSTIM), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche médicale (INSERM), Aix Marseille Université, 13005 Marseille, France
- Mère et Enfant face aux Infections Tropicales (MERIT), Institut de Recherche pour le Développement (IRD), Université Paris 5, 75006 Paris, France
| | - Kankoe Sallah
- Sciences Economiques et Sociales de la Santé et Traitement de de l'Information Médicale (SESSTIM), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche médicale (INSERM), Aix Marseille Université, 13005 Marseille, France
- Unité de Recherche Clinique Paris Nord Val de Seine (PNVS), Hôpital Bichat, Assistance Publique-Hôpitaux de Paris (AP-HP), 75018 Paris, France
| | - El-Hadj Ba
- Unité Mixte de Recherche (UMR), Vecteurs-Infections Tropicales et Méditerranéennes (VITROME), Campus International Institut de Recherche pour le Développement-Université Cheikh Anta Diop (IRD-UCAD) de l'IRD, Dakar CP 18524, Senegal
| | - Badara Cissé
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF) Diamniadio, Dakar BP 7325, Senegal
| | - Maria Patrizia Carrieri
- Sciences Economiques et Sociales de la Santé et Traitement de de l'Information Médicale (SESSTIM), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche médicale (INSERM), Aix Marseille Université, 13005 Marseille, France
| | - Cheikh Sokhna
- Unité Mixte de Recherche (UMR), Vecteurs-Infections Tropicales et Méditerranéennes (VITROME), Campus International Institut de Recherche pour le Développement-Université Cheikh Anta Diop (IRD-UCAD) de l'IRD, Dakar CP 18524, Senegal
| | - Paul Milligan
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Jean Gaudart
- Aix Marseille Université, Assistance Publique-Hôpitaux de Marseille(APHM), INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic and ICT, 13005 Marseille, France
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25
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Cissoko M, Sagara I, Sankaré MH, Dieng S, Guindo A, Doumbia Z, Allasseini B, Traore D, Fomba S, Bendiane MK, Landier J, Dessay N, Gaudart J. Geo-Epidemiology of Malaria at the Health Area Level, Dire Health District, Mali, 2013-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3982. [PMID: 32512740 PMCID: PMC7312793 DOI: 10.3390/ijerph17113982] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/28/2022]
Abstract
Background: According to the World Health Organization, there were more than 228 million cases of malaria globally in 2018, with 93% of cases occurring in Africa; in Mali, a 13% increase in the number of cases was observed between 2015 and 2018; this study aimed to evaluate the impact of meteorological and environmental factors on the geo-epidemiology of malaria in the health district of Dire, Mali. Methods: Meteorological and environmental variables were synthesized using principal component analysis and multiple correspondence analysis, the relationship between malaria incidence and synthetic indicators was determined using a multivariate general additive model; hotspots were detected by SaTScan. Results: Malaria incidence showed high inter and intra-annual variability; the period of high transmission lasted from September to February; health areas characterized by proximity to the river, propensity for flooding and high agricultural yield were the most at risk, with an incidence rate ratio of 2.21 with confidence intervals (95% CI: 1.85-2.58); malaria incidence in Dire declined from 120 to 20 cases per 10,000 person-weeks between 2013 and 2017. Conclusion: The identification of areas and periods of high transmission can help improve malaria control strategies.
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Affiliation(s)
- Mady Cissoko
- Malaria Research and Training Center—Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako 1805, Mali; (I.S.); (A.G.); (J.G.)
- Aix Marseille Université (AMU), Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD), 13005 Marseille, France; (S.D.); (M.K.B.); (J.L.)
- Direction Régionale de la Santé de Tombouctou, Tombouctou 59, Mali; (M.H.S.); (Z.D.); (B.A.)
| | - Issaka Sagara
- Malaria Research and Training Center—Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako 1805, Mali; (I.S.); (A.G.); (J.G.)
- Aix Marseille Université (AMU), Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD), 13005 Marseille, France; (S.D.); (M.K.B.); (J.L.)
| | - Moussa H. Sankaré
- Direction Régionale de la Santé de Tombouctou, Tombouctou 59, Mali; (M.H.S.); (Z.D.); (B.A.)
| | - Sokhna Dieng
- Aix Marseille Université (AMU), Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD), 13005 Marseille, France; (S.D.); (M.K.B.); (J.L.)
| | - Abdoulaye Guindo
- Malaria Research and Training Center—Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako 1805, Mali; (I.S.); (A.G.); (J.G.)
- Mère et Enfant face aux Infections Tropicales (MERIT), IRD, Université Paris 5, 75006 Paris, France
| | - Zoumana Doumbia
- Direction Régionale de la Santé de Tombouctou, Tombouctou 59, Mali; (M.H.S.); (Z.D.); (B.A.)
| | - Balam Allasseini
- Direction Régionale de la Santé de Tombouctou, Tombouctou 59, Mali; (M.H.S.); (Z.D.); (B.A.)
| | - Diahara Traore
- Programme National de la Lutte contre le Paludisme (PNLP Mali), Bamako 233, Mali; (D.T.); (S.F.)
| | - Seydou Fomba
- Programme National de la Lutte contre le Paludisme (PNLP Mali), Bamako 233, Mali; (D.T.); (S.F.)
| | - Marc Karim Bendiane
- Aix Marseille Université (AMU), Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD), 13005 Marseille, France; (S.D.); (M.K.B.); (J.L.)
| | - Jordi Landier
- Aix Marseille Université (AMU), Institut national de la santé et de la recherche médicale (INSERM), Institut de Recherche pour le Développement (IRD), 13005 Marseille, France; (S.D.); (M.K.B.); (J.L.)
| | - Nadine Dessay
- ESPACE-DEV, UMR228 IRD/UM/UR/UG/UA, Institut de Recherche pour le Développement (IRD), 34093 Montpellier, France;
| | - Jean Gaudart
- Malaria Research and Training Center—Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako 1805, Mali; (I.S.); (A.G.); (J.G.)
- Aix Marseille Université, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, 13005 Marseille, France
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26
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Rouamba T, Samadoulougou S, Tinto H, Alegana VA, Kirakoya-Samadoulougou F. Severe-malaria infection and its outcomes among pregnant women in Burkina Faso health-districts: Hierarchical Bayesian space-time models applied to routinely-collected data from 2013 to 2018. Spat Spatiotemporal Epidemiol 2020; 33:100333. [PMID: 32370941 PMCID: PMC7613547 DOI: 10.1016/j.sste.2020.100333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/15/2019] [Accepted: 12/27/2019] [Indexed: 11/12/2022]
Abstract
Fine-scale hotspots detection is crucial for optimum delivery of essential health-services for reducing severe malaria in pregnancy (MiP) and death cases in Burkina Faso. This study used hierarchical-Bayesian Spatio-temporal modeling to explore space-time patterns and pinpoint health-districts with an exceedance probability of severe MiP incidence and fatality rate. Study also assessed effect of health-district service delivery (readiness) on severe-MiP outcomes. Severe-MiP fatality rate declined considerably while its incidence rate remained unchanged between January-2013 and December-2018. Severe-MiP cases persisted throughout the year with peaks between August and November. These peaks increased 2.5-fold the fatality rate. Furthermore, severe-MiP fatality was higher in health-districts classified as low-readiness (IRR = 2.469, 95%CrI: 1.632–3.738). However, the fatality rate decreased significantly with proper coverage with three doses for intermittent-preventive-treatment with sulphadoxine-pyrimethamine. Severe-MiP burden was heterogeneous spatially and temporally. The study suggested that health-programs should increase health-districts readiness and optimize resource allocation in high burden areas and months.
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Affiliation(s)
- Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, 42, Avenue Kumda-Yonre, Centre National de la Recherche Scientifique et Technologique, 11 BP 218 Ouaga CMS 11, Ouagadougou, Burkina Faso; Centre d'Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Route de Lennik, 808 B-1070, Bruxelles, Belgique.
| | - Sekou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec City, QC G1V 4G5, Canada; Centre for Research on Planning and Development (CRAD), Laval University, Quebec, G1V 0A6, Canada.
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, 42, Avenue Kumda-Yonre, Centre National de la Recherche Scientifique et Technologique, 11 BP 218 Ouaga CMS 11, Ouagadougou, Burkina Faso
| | - Victor A Alegana
- Population Health Theme, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; Geography and Environmental Science, University of Southampton, Southampton SO17 1BJ, UK
| | - Fati Kirakoya-Samadoulougou
- Centre d'Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Route de Lennik, 808 B-1070, Bruxelles, Belgique.
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27
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Effect of Free Healthcare Policy for Children under Five Years Old on the Incidence of Reported Malaria Cases in Burkina Faso by Bayesian Modelling: "Not only the Ears but also the Head of the Hippopotamus". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020417. [PMID: 31936308 PMCID: PMC7014427 DOI: 10.3390/ijerph17020417] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/24/2019] [Accepted: 01/03/2020] [Indexed: 02/02/2023]
Abstract
Burkina Faso has recently implemented an additional strategy, the free healthcare policy, to further improve maternal and child health. This policy targets children under five who bear the brunt of the malaria scourge. The effects of the free-of-charge healthcare were previously assessed in women but not in children. The present study aims at filling this gap by assessing the effect of this policy in children under five with a focus on the induced spatial and temporal changes in malaria morbidity. We used a Bayesian spatiotemporal negative binomial model to investigate the space–time variation in malaria incidence in relation to the implementation of the policy. The analysis relied on malaria routine surveillance data extracted from the national health data repository and spanning the period from January 2013 to December 2018. The model was adjusted for meteorological and contextual confounders. We found that the number of presumed and confirmed malaria cases per 1000 children per month increased between 2013 and 2018. We further found that the implementation of the free healthcare policy was significantly associated with a two-fold increase in the number of tested and confirmed malaria cases compared with the period before the policy rollout. This effect was, however, heterogeneous across the health districts. We attributed the rise in malaria incidence following the policy rollout to an increased use of health services combined with an increased availability of rapid tests and a higher compliance to the “test and treat” policy. The observed heterogeneity in the policy effect was attributed to parallel control interventions, some of which were rolled out at different paces and scales. Our findings call for a sustained and reinforced effort to test all suspected cases so that, alongside an improved case treatment, the true picture of the malaria scourge in children under five emerges clearly (see the hippopotamus almost entirely).
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Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso. PLoS Negl Trop Dis 2019; 13:e0007882. [PMID: 31809504 PMCID: PMC6897397 DOI: 10.1371/journal.pntd.0007882] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/25/2019] [Indexed: 12/29/2022] Open
Abstract
Background In Africa, the magnitude of dengue virus (DENV) transmission is largely unknown. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations. Methods To better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1–55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Burkina Faso from December 2014 to February 2017, encompassing a 3-month dengue outbreak in September-November 2016. Acute and convalescent blood samples were collected within an interval of 10–21 days between visits. Acute samples were tested with dengue rapid diagnostic tests (RDT) and a selected subset with RT-PCR, and all acute/convalescent samples with IgM/IgG ELISA. Results Among 2929 non-malarial febrile patients, 740 (25%) were dengue–positive based on RT-PCR and/or IgM/IgG ELISA; 428 out of 777 patients (55%) and 312 out of 2152 (14%) were dengue-positive during outbreak and non-outbreak periods, respectively. There were 11% (316/2929) and 4% (129/2929) patients showing positive for NS1 and IgM, on the RDT, respectively. DENV 2 predominated during the outbreak, whereas DENV 3 predominated before the outbreak. Only 25% of dengue-positive cases were clinically diagnosed with suspected dengue. The odds of requiring observation for ≤3 days (versus routine outpatient care) were 11 times higher among dengue-positive cases than non-dengue cases. In adjusted analyses, dengue-positivity was associated with rash and retro-orbital pain (OR = 2.6 and 7.4, respectively) during the outbreak and with rash and nausea/vomiting (OR = 1.5 and 1.4, respectively) during the non-outbreak period. Conclusion Dengue virus is an important pathogen in Burkina Faso, accounting for a substantial proportion of non-malarial fevers both during and outside outbreak, but is only infrequently suspected by clinicians. Additional longitudinal data would help to further define characteristics of dengue for improved case detection and surveillance. There is not much evidence on dengue in Africa, relative to the Asia-Pacific and Latin American regions. To estimate the proportion of dengue among patients with fever, and to identify clinical features of dengue during outbreak and non-outbreak periods, we studied 2929 patients with non-malarial fever, aged 1–55 years, who attended five primary healthcare centers in Ouagadougou, Burkina Faso. Patients were tested with a rapid test for dengue, and further tests were carried out on paired blood samples taken 10–21 days apart. Overall, a quarter of non-malarial febrile episodes identified between December 2014 and February 2017 were dengue-positive. Dengue-positive cases were 11 times more likely than non-dengue cases to require observation for ≤3 days. During the study period in 2016, there was a dengue outbreak where more than half of non-malarial febrile patients were identified to be dengue-positive. DENV 2 was the main serotype in circulation during the outbreak, whereas DENV 3 was the main serotype before the outbreak. Rash and retro-orbital pain were more frequently found among dengue-positive cases, compared to non-dengue cases, during the outbreak. During the non-outbreak period, rash and nausea/vomiting were more likely in dengue-positive versus non-dengue cases. There was a low level of clinical suspicion of dengue even during the 2016 outbreak. Therefore, a broader use of rapid diagnostic tests and more epidemiologic data would help to improve dengue case detection and surveillance in Burkina Faso.
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Umer MF, Zofeen S, Majeed A, Hu W, Qi X, Zhuang G. Effects of Socio-Environmental Factors on Malaria Infection in Pakistan: A Bayesian Spatial Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1365. [PMID: 30995744 PMCID: PMC6517989 DOI: 10.3390/ijerph16081365] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/07/2019] [Accepted: 04/13/2019] [Indexed: 12/04/2022]
Abstract
The role of socio-environmental factors in shaping malaria dynamics is complex and inconsistent. Effects of socio-environmental factors on malaria in Pakistan at district level were examined. Annual malaria cases data were obtained from Directorate of Malaria Control Program, Pakistan. Meteorological data were supplied by Pakistan Meteorological Department. A major limitation was the use of yearly, rather than monthly/weekly malaria data in this study. Population data, socio-economic data and education score data were downloaded from internet. Bayesian conditional autoregressive model was used to find the statistical association of socio-environmental factors with malaria in Pakistan. From 136/146 districts in Pakistan, >750,000 confirmed malaria cases were included, over a three years' period (2013-2015). Socioeconomic status ((posterior mean value -3.965, (2.5% quintile, -6.297%), (97.5% quintile, -1.754%)) and human population density (-7.41 × 10-4, -0.001406%, -1.05 × 10-4 %) were inversely related, while minimum temperature (0.1398, 0.05275%, 0.2145%) was directly proportional to malaria in Pakistan during the study period. Spatial random effect maps presented that moderate relative risk (RR, 0.75 to 1.24) and high RR (1.25 to 1.99) clusters were scattered throughout the country, outnumbering the ones' with low RR (0.23 to 0.74). Socio-environmental variables influence annual malaria incidence in Pakistan and needs further evaluation.
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Affiliation(s)
- Muhammad Farooq Umer
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Shumaila Zofeen
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Abdul Majeed
- Directorate of Malaria Control Program, Islamabad 44000, Pakistan.
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
| | - Xin Qi
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Guihua Zhuang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
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Rouamba T, Nakanabo-Diallo S, Derra K, Rouamba E, Kazienga A, Inoue Y, Ouédraogo EK, Waongo M, Dieng S, Guindo A, Ouédraogo B, Sallah KL, Barro S, Yaka P, Kirakoya-Samadoulougou F, Tinto H, Gaudart J. Socioeconomic and environmental factors associated with malaria hotspots in the Nanoro demographic surveillance area, Burkina Faso. BMC Public Health 2019; 19:249. [PMID: 30819132 PMCID: PMC6396465 DOI: 10.1186/s12889-019-6565-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 02/19/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND With limited resources and spatio-temporal heterogeneity of malaria in developing countries, it is still difficult to assess the real impact of socioeconomic and environmental factors in order to set up targeted campaigns against malaria at an accurate scale. Our goal was to detect malaria hotspots in rural area and assess the extent to which household socioeconomic status and meteorological recordings may explain the occurrence and evolution of these hotspots. METHODS Data on malaria cases from 2010 to 2014 and on socioeconomic and meteorological factors were acquired from four health facilities within the Nanoro demographic surveillance area. Statistical cross correlation was used to quantify the temporal association between weekly malaria incidence and meteorological factors. Local spatial autocorrelation analysis was performed and restricted to each transmission period using Kulldorff's elliptic spatial scan statistic. Univariate and multivariable analysis were used to assess the principal socioeconomic and meteorological determinants of malaria hotspots using a Generalized Estimating Equation (GEE) approach. RESULTS Rainfall and temperature were positively and significantly associated with malaria incidence, with a lag time of 9 and 14 weeks, respectively. Spatial analysis showed a spatial autocorrelation of malaria incidence and significant hotspots which was relatively stable throughout the study period. Furthermore, low socioeconomic status households were strongly associated with malaria hotspots (aOR = 1.21, 95% confidence interval: 1.03-1.40). CONCLUSION These fine-scale findings highlight a relatively stable spatio-temporal pattern of malaria risk and indicate that social and environmental factors play an important role in malaria incidence. Integrating data on these factors into existing malaria struggle tools would help in the development of sustainable bottleneck strategies adapted to the local context for malaria control.
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Affiliation(s)
- Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- Center for Research in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Seydou Nakanabo-Diallo
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
| | - Karim Derra
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
| | - Eli Rouamba
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
| | - Adama Kazienga
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
| | - Yasuko Inoue
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- Embassy of Japan in the Republic of Guinea, Conakry, Guinea
| | - Ernest K. Ouédraogo
- Direction Générale de la Météorologie du Burkina Faso, Ouagadougou, Burkina Faso
| | - Moussa Waongo
- Direction Générale de la Météorologie du Burkina Faso, Ouagadougou, Burkina Faso
| | - Sokhna Dieng
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Abdoulaye Guindo
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- MRTC, Malaria and Training Research Center – Ogobara Doumbo, Bamako, Mali
| | - Boukary Ouédraogo
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
- Direction Régionale de la Santé du Centre-Ouest, Ministère de la santé, Koudougou, Burkina Faso
| | - Kankoé Lévi Sallah
- Aix Marseille Univ, IRD, INSERM, UMR1252 Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Seydou Barro
- Directorate of Health Information Systems, Ministry of Health, Ouagadougou, Burkina Faso
| | - Pascal Yaka
- Direction Générale de la Météorologie du Burkina Faso, Ouagadougou, Burkina Faso
| | - Fati Kirakoya-Samadoulougou
- Center for Research in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institute for Research in Health Sciences, National Center for Scientific and Technological Research, Nanoro, Burkina Faso
| | - Jean Gaudart
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Marseille, France
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Landier J, Rebaudet S, Piarroux R, Gaudart J. Spatiotemporal analysis of malaria for new sustainable control strategies. BMC Med 2018; 16:226. [PMID: 30509258 PMCID: PMC6278049 DOI: 10.1186/s12916-018-1224-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 11/20/2018] [Indexed: 12/31/2022] Open
Abstract
Malaria transmission is highly heterogeneous through time and space, and mapping of this heterogeneity is necessary to better understand local dynamics. New targeted policies are needed as numerous countries have placed malaria elimination on their public health agenda for 2030. In this context, developing national health information systems and collecting information at sufficiently precise scales (at least at the 'week' and 'village' scales), is of strategic importance. In a recent study, Macharia et al. relied on extensive prevalence survey data to develop malaria risk maps for Kenya, including uncertainty assessments specifically designed to support decision-making by the National Malaria Control Program. Targeting local persistent transmission or epidemiologic changes is necessary to maintain efficient control, but also to deploy sustainable elimination strategies against identified transmission bottlenecks such as the reservoir of subpatent infections. Such decision-making tools are paramount to allocate resources based on sound scientific evidence and public health priorities.Please see related article: https://malariajournal.biomedcentral.com/articles/10.1186/s12936-018-2489-9 .
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Affiliation(s)
- Jordi Landier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | - Stanislas Rebaudet
- APHM, Assistance Publique - Hôpitaux de Marseille, Marseille, France.,Hôpital Européen, Marseille, France
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean Gaudart
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, Marseille, France.
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