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Msellemu D, Tanner M, Yadav R, Moore SJ. Occupational exposure to malaria, leishmaniasis and arbovirus vectors in endemic regions: A systematic review. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2024; 6:100185. [PMID: 39027087 PMCID: PMC11252614 DOI: 10.1016/j.crpvbd.2024.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/26/2024] [Accepted: 06/01/2024] [Indexed: 07/20/2024]
Abstract
Vector-borne diseases, including dengue, leishmaniasis and malaria, may be more common among individuals whose occupations or behaviours bring them into frequent contact with these disease vectors outside of their homes. A systematic review was conducted to ascertain at-risk occupations and situations that put individuals at increased risk of exposure to these disease vectors in endemic regions and identify the most suitable interventions for each exposure. The review was conducted in accordance with PRISMA guidelines on articles published between 1945 and October 2021, searched in 16 online databases. The primary outcome was incidence or prevalence of dengue, leishmaniasis or malaria. The review excluded ecological and qualitative studies, abstracts only, letters, commentaries, reviews, and studies of laboratory-acquired infections. Studies were appraised, data extracted, and a descriptive analysis conducted. Bite interventions for each risk group were assessed. A total of 1170 articles were screened and 99 included. Malaria, leishmaniasis and dengue were presented in 47, 41 and 24 articles, respectively; some articles presented multiple conditions. The most represented populations were soldiers, 38% (43 of 112 studies); refugees and travellers, 15% (17) each; migrant workers, 12.5% (14); miners, 9% (10); farmers, 5% (6); rubber tappers and missionaries, 1.8% (2) each; and forest workers, 0.9% (1). Risk of exposure was categorised into round-the-clock or specific times of day/night dependent on occupation. Exposure to these vectors presents a critical and understudied concern for outdoor workers and mobile populations. When devising interventions to provide round-the-clock vector bite protection, two populations are considered. First, mobile populations, characterized by their high mobility, may find potential benefits in insecticide-treated clothing, though more research and optimization are essential. Treated clothing offers personal vector protection and holds promise for economically disadvantaged individuals, especially when enabling them to self-treat their clothing to repel vectors. Secondly, semi-permanent and permanent settlement populations can receive a combination of interventions that offer both personal and community protection, including spatial repellents, suitable for extended stays. Existing research is heavily biased towards tourism and the military, diverting attention and resources from vulnerable populations where these interventions are most required like refugee populations as well as those residing in sub-Saharan Africa.
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Affiliation(s)
- Daniel Msellemu
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Rajpal Yadav
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- Academy of Public Health Entomology, Udaipur, 313 002, India
| | - Sarah J. Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- The Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Tengeru, Arusha, Tanzania
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Bawate C, Callender-Carter ST, Guyah B, Ouma C. Factors influencing patients' adherence to malaria artemisinin-based combination therapy in Kamuli District, Uganda. Malar J 2024; 23:1. [PMID: 38166910 PMCID: PMC10759708 DOI: 10.1186/s12936-023-04824-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Patients' adherence to artemisinin-based combination therapy (ACT) is a malaria control strategy. Studies report varied experiences regarding patients' adherence to ACT. The study aimed at determining factors influencing patients' adherence to ACT for malaria in Kamuli, Uganda. METHODS In a longitudinal study, 1266 participants at 8 public health facilities were enrolled. Equal numbers (422) were assigned to the three arms (no follow-up, day 2 and day 4). To establish the mean difference between groups, Student t-test was used and a chi-square test was used for proportionality. A multivariate logistic regression analysis was used to establish the influence of predictor variables on the dependent variable. Statistical significance was established at p < 0.05. RESULTS A total of 844 patients were analysed. The median age was 20 years, majority (64.3%) were females. Overall patients' adherence was 588/844 (69.7%). At bivariate level, age (t-test = 2.258, p = 0.024), household head (χ2 = 14.484, p = 0.002), employment status (χ2 = 35.886, p < 0.0001), patients' preference of ACT to other anti-malarials (χ2 = 15.981, p < 0.0001), giving a patient/caregiver instructions on how to take the medication (χ2 = 7.134, p = 0.011), being satisfied with getting ACT at facility (χ2 = 48.261, p < 0.0001), patient/caregiver knowing the drug prescribed (χ2 = 5.483, p = 0.019), patient history of saving ACT medicines (χ2 = 39.242, p < 0.0001), and patient ever shared ACT medicines (χ2 = 30.893, p < 0.0001) were all associated with patients' adherence to ACT. Multivariate analysis demonstrated that adhering to ACT is 3.063 times higher for someone satisfied with getting ACT at the facility (OR = 3.063; p < 0.0001), 4.088 times for someone with history of saving ACT medicines (OR = 4.088; p < 0.0001), 2.134 times for someone who shared ACT (OR = 2.134; p = 0.03), and 2.817 times for someone with a household head (OR = 2.817; p = 0.008). CONCLUSION Patients' adherence to ACT is generally good in the studied population. However, patients' tendencies to save ACT for future use and sharing among family members is a threat, amidst the benefits associated with adherence. There is a need to educate all about adherence to medicines as prescribed, and tighten government medicine supply chain to avoid stock-outs.
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Affiliation(s)
- Charles Bawate
- Kamuli General Hospital-Kamuli District Local Government, Kamuli, Uganda.
| | | | - Bernard Guyah
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Collins Ouma
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
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Patouillard E, Han S, Lauer J, Barschkett M, Arcand JL. The Macroeconomic Impact of Increasing Investments in Malaria Control in 26 High Malaria Burden Countries: An Application of the Updated EPIC Model. Int J Health Policy Manag 2023; 12:7132. [PMID: 38618809 PMCID: PMC10590221 DOI: 10.34172/ijhpm.2023.7132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 09/04/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Malaria remains a major public health problem. While globally malaria mortality affects predominantly young children, clinical malaria affects all age groups throughout life. Malaria not only threatens health but also child education and adult productivity while burdening government budgets and economic development. Increased investments in malaria control can contribute to reduce this burden but have an opportunity cost for the economy. Quantifying the net economic value of investing in malaria can encourage political and financial commitment. METHODS We adapted an existing macroeconomic model to simulate the effects of reducing malaria on the gross domestic product (GDP) of 26 high burden countries while accounting for the opportunity costs of increased investments in malaria. We compared two scenarios differing in their level of malaria investment and associated burden reduction: sustaining malaria control at 2015 intervention coverage levels, time at which coverage levels reached their historic peak and scaling-up coverage to reach the 2030 global burden reduction targets. We incorporated the effects that reduced malaria in children and young adolescents may have on the productivity of working adults and on the future size of the labour force augmented by educational returns, skills, and experience. We calibrated the model using estimates from linked epidemiologic and costing models on these same scenarios and from published country-specific macroeconomic data. RESULTS Scaling-up malaria control could produce a dividend of US$ 152 billion in the modelled countries, equivalent to 0.17% of total GDP projected over the study period across the 26 countries. Assuming a larger share of malaria investments is paid out from domestic savings, the dividend would be smaller but still significant, ranging between 0.10% and 0.14% of total projected GDP. Annual GDP gains were estimated to increase over time. Lower income and higher burden countries would experience higher gains. CONCLUSION Intensified malaria control can produce a multiplied return despite the opportunity cost of greater investments.
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Affiliation(s)
- Edith Patouillard
- Department of Health Financing and Economics, World Health Organization, Geneva, Switzerland
| | - Seoni Han
- Korea Institute for International Economic Policy, Sejong, Korea
| | - Jeremy Lauer
- Strathclyde Business School, University of Strathclyde, Glasgow, UK
| | - Mara Barschkett
- Federal Institute for Population Research and Department of Public Economics, German Institute of Economic Research (DIW Berlin), Berlin, Germany
| | - Jean-Louis Arcand
- Global Development Network, New Delhi, India
- Mohammed VI Polytechnic University, Rabat, Morocco
- Foundation for Studies and Research on International Development (FERDI), Clermont Ferrand, France
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Ekasari W, Fatmawati D, Khoiriah SM, Baqiuddin WA, Nisa HQ, Maharupini AAS, Wahyuni TS, Oktarina RD, Suhartono E, Sahu RK. Antimalarial Activity of Extract and Fractions of Sauropus androgynus (L.) Merr. SCIENTIFICA 2022; 2022:3552491. [PMID: 36119646 PMCID: PMC9477630 DOI: 10.1155/2022/3552491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Sauropus androgynus (L.) Merr., in the Indonesian local name known as "Katuk," is a tropical shrub plant of the family Euphorbiaceae. Based on genus and chemotaxonomic approaches, as well as in vitro testing of Plasmodium falciparum, leaves of S. androgynus are presumed to have an active compound content as an antimalarial. The current study aims to investigate the antimalarial activity of 96% ethanol extract and fractions of S. androgynus leaves. The ethanolic extract was fractionated using the vacuum liquid chromatography (VLC) method with three solvents of different polarities (n-hexane, chloroform, and 96% ethanol). The fraction obtained was then evaluated for antimalarial activity against P. falciparum 3D7 strain. The ethanolic extract was evaluated for antimalarial suppressive and prophylactic activity against P. berghei-infected mice, as well as inhibitory activity against the heme detoxification process in vitro. Fractionation of ethanolic extract resulted in seven combined fractions, with the most active fraction being FV (50% inhibitory concentration (IC50) = 2.042 µg/mL). The ethanolic extract showed good parasitic suppressive (therapeutic) activity with a median effective dose (ED50) value of 15.35 mg/kg body weight. In a prophylactic test, ethanolic extract showed parasite growth inhibitory activity of 67.74 ± 9.21% after the administration of 400 mg/kg body weight for 4 days before infection, and 65.30 ± 10.44% after the administration of 200 mg/kg body weight for 8 consecutive days (4 days before and after infection). The ethanolic extract also showed an effect in inhibiting the formation of β-hematin of about 26.87-79.36% at a concentration of 0.1-4 mg/mL and an IC50 value of 0.479 mg/mL. The S. androgynus leaves were shown to have antimalarial activity in vitro and in vivo, where ethanolic extract were more active compared with the fraction obtained. The antimalarial properties of the extract showed a higher suppressive activity than prophylactic activity.
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Affiliation(s)
- Wiwied Ekasari
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Dwi Fatmawati
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Siti M. Khoiriah
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Wenda A. Baqiuddin
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Hawi Q. Nisa
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Adinda A. S. Maharupini
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Tutik S. Wahyuni
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Rice D. Oktarina
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Airlangga University, Surabaya 60115, East Java, Indonesia
| | - Eko Suhartono
- Department of Medical Chemistry/Biochemistry, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin 70122, South Kalimantan, Indonesia
| | - Ram K. Sahu
- Department of Pharmaceutical Science, Assam University (A Central University), Silchar 788011, Assam, India
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When Local Trade-Offs between SDGs Turn Out to Be Wealth-Dependent: Interaction between Expanding Rice Cultivation and Eradicating Malaria in Rwanda. SUSTAINABILITY 2022. [DOI: 10.3390/su14042100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Interactions between SDGs are increasingly mapped and mediating factors that determine whether existing synergies or trade-offs can be identified. However, if and how the wealth status of the concerned population shapes whether SDG interaction constitutes a vicious or virtuous circle is largely overlooked. This article focuses on interaction between SDG2 (nutrition) and SDG3 (health), in particular, the relationship between rice production intensification and the fight against malaria, and thus the role of wealth in explaining the trade-off. This study employed a large-scale survey of rural households (n = 3968) in eastern Rwanda, conducted at a time when a rapid expansion of rice fields co-existed with a strong resurgence of malaria. Logistic regression shows that rice-cultivating households faced significant higher malaria risk, as proxied by fever incidence, confirming the negative externality of agricultural intensification on public health through offering a habitat for vector-borne diseases. Even though rice-cultivating households tend to be higher up the local wealth distribution than those outside the rice sector, its distributional effects are generally biased against the poor. Poorer households outside the rice sector hardly share in the benefits from increased rice production but suffer the consequences in terms of increased malaria risk. The case thus draws attention to the importance of using a distributional lens when analyzing interaction between SDGs locally.
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Ridha MR, Kasman K, Liani E, Indriati L, Indriati L. Malaria Situation in The South Kalimantan Province, 2010–2018. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i22021.140-147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Malaria has caused high morbidity and mortality rates and has decreased the productivity of human resources and national development. Malaria is endemic in several districts in South Kalimantan. Purpose: This study aims to describe the malaria situation in South Kalimantan by examining the malaria cases, Case Fatality Rate (CFR), Annual Parasite Incidence (API), and Slide Parasite Rate (SPR) in the South Kalimantan Province during the period of 2010–2018. Method: This research was a descriptive study with the South Kalimantan population, who were at risk of getting malaria. This study adopted a total participation technique and included all the cases of malaria recorded in the electronic- Surveillance Information System of Malaria (e-SISMAL) data of South Kalimantan province in the period 2010–2018. The study used secondary data from the South Kalimantan Provincial Health Office during 2010–2018. The data included the number of malaria cases, morbidity, and the mortality rate of malaria. The data collected was analyzed using CFR, API, and the SPR formulae. Results: The number of malaria cases in South Kalimantan from 2010 to 2018 fluctuated. The highest number of malaria cases occurred in 2011, while a decreasing trend was observed up to 2018. At the same time, the number of deaths during 2012–2018 increased. The death rate from 2010–2018 decreased in South Kalimantan. Conclusion: The number of cases as well as deaths caused due to malaria in South Kalimantan continues to decrease. By 2025, all districts in South Kalimantan could be free from malaria.
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Mbohou Nchetnkou C, Nyabeyeu Nyabeyeu H, Kojom Foko LP, Lehman LG. Comparison of the fluorescence microscopy Cyscope® with light microscopy for malaria diagnosis in a small and active surveillance in Cameroon. Trop Med Health 2020; 48:61. [PMID: 32742185 PMCID: PMC7385968 DOI: 10.1186/s41182-020-00234-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/28/2020] [Indexed: 12/27/2022] Open
Abstract
Background Malaria has a negative impact on the activities of companies in endemic countries especially in Cameroon. In this regard, an increasingly growing number of companies have started to include management of malarious patients in their health policies. In the present study, we will evaluate the diagnostic performances of a fluorescence microscopy (FM), Cyscope® microscope, in the detection of malaria parasites. Methods A cross-sectional study was conducted among employees of two companies of the town of Douala on 21 and 22 March 2017. Sociodemographic information of employees was collected using a questionnaire form. Blood samples of ~ 10 μL were collected by venipuncture for the diagnosis of malaria using FM and light microscopy (LM). Performances of FM with respect to sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV and NPV), positive and negative likelihood rates (PLR and NLR), accuracy, reliability, and Kappa index were calculated using LM as gold standard. Results In total, 442 employees, aged 37.8 ± 9.7 years old on average, were included in the study. Prevalence of malaria using FM and LM was 39.2% and 17%, respectively (p < 0.01). Plasmodium falciparum and P. vivax were the two species involved in malaria infection cases. In terms of developmental stages, 68%, 45.3%, and 1.3% of employees carried gametocytes, trophozoites, and schizonts, respectively. Findings on diagnostic performances of FM were as follows: Se = 84%, Sp = 69.95%, PPV = 63.58%, NPV = 95.5%, accuracy = 89.36%, and reliability = 53.95%. Sensitivity of Cyscope® microscope increased as a function of parasitemia with values ranging from 76.92% at parasitemia between 1 and 500 parasites/μL to 91.11% at parasitemia between 501 and 5000 parasites/μL. The geometric mean parasite density was1850 parasites per μL of blood (range 1600-40,000), and most of employees (60.8%) had moderate parasitemia. The performances of FM were similar between febrile and afebrile patients. Conclusions This study showed good performances of Cyscope® microscope and outlines that this diagnostic tool could be used in management of malaria at workplace.
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Affiliation(s)
- Christian Mbohou Nchetnkou
- Department of Animal Organisms, Faculty of Science, The University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Hervé Nyabeyeu Nyabeyeu
- Department of Animal Organisms, Faculty of Science, The University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Loick P Kojom Foko
- Department of Animal Organisms, Faculty of Science, The University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Leopold G Lehman
- Department of Animal Organisms, Faculty of Science, The University of Douala, P.O. Box 24157, Douala, Cameroon.,Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, P.O. Box 24157, Douala, Cameroon
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Siya A, Kalule BJ, Ssentongo B, Lukwa AT, Egeru A. Malaria patterns across altitudinal zones of Mount Elgon following intensified control and prevention programs in Uganda. BMC Infect Dis 2020; 20:425. [PMID: 32552870 PMCID: PMC7301530 DOI: 10.1186/s12879-020-05158-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/12/2020] [Indexed: 12/22/2022] Open
Abstract
Background Malaria remains a major tropical vector-borne disease of immense public health concern owing to its debilitating effects in sub-Saharan Africa. Over the past 30 years, the high altitude areas in Eastern Africa have been reported to experience increased cases of malaria. Governments including that of the Republic of Uganda have responded through intensifying programs that can potentially minimize malaria transmission while reducing associated fatalities. However, malaria patterns following these intensified control and prevention interventions in the changing climate remains widely unexplored in East African highland regions. This study thus analyzed malaria patterns across altitudinal zones of Mount Elgon, Uganda. Methods Times-series data on malaria cases (2011–2017) from five level III local health centers occurring across three altitudinal zones; low, mid and high altitude was utilized. Inverse Distance Weighted (IDW) interpolation regression and Mann Kendall trend test were used to analyze malaria patterns. Vegetation attributes from the three altitudinal zones were analyzed using Normalized Difference Vegetation Index (NDVI) was used to determine the Autoregressive Integrated Moving Average (ARIMA) model was used to project malaria patterns for a 7 year period. Results Malaria across the three zones declined over the study period. The hotspots for malaria were highly variable over time in all the three zones. Rainfall played a significant role in influencing malaria burdens across the three zones. Vegetation had a significant influence on malaria in the higher altitudes. Meanwhile, in the lower altitude, human population had a significant positive correlation with malaria cases. Conclusions Despite observed decline in malaria cases across the three altitudinal zones, the high altitude zone became a malaria hotspot as cases variably occurred in the zone. Rainfall played the biggest role in malaria trends. Human population appeared to influence malaria incidences in the low altitude areas partly due to population concentration in this zone. Malaria control interventions ought to be strengthened and strategically designed to achieve no malaria cases across all the altitudinal zones. Integration of climate information within malaria interventions can also strengthen eradication strategies of malaria in such differentiated altitudinal zones.
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Affiliation(s)
- Aggrey Siya
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda. .,Centre for Invasion Biology, Department of Botany and Zoology, Stellenbosch University, Stellenbosch, South Africa.
| | - Bosco John Kalule
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Benard Ssentongo
- College of Agricultural and Environmental Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Akim Tafadzwa Lukwa
- Faculty of Health Sciences, School of Public Health and Family Medicine, Health Economics Unit, University of Cape Town, Cape Town, South Africa
| | - Anthony Egeru
- College of Agricultural and Environmental Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
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