1
|
Gebreegziabher E, Raoliarison A, Ramananjato A, Fanomezana A, Rafaliarisoa M, Ralisata S, Razafindrakoto J, Smith JL, Ahmed J, Smith Gueye C. Identifying and characterizing high-risk populations in pilot malaria elimination districts in Madagascar: a mixed-methods study. Malar J 2024; 23:121. [PMID: 38664837 PMCID: PMC11046788 DOI: 10.1186/s12936-024-04927-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In Madagascar, the districts of Antsirabe II, Faratsiho and Antsiranana I have relatively low malaria incidence rates and have been selected by the National Malaria Control Programme for pilot elimination strategies. The districts have residual transmission despite increasing coverage and quality of malaria services. This study sought to identify priority subpopulations at highest risk for malaria and collect information on intervention preferences and methods that will inform subnational tailoring of malaria service delivery. METHODS This mixed methods study employed (i) a quantitative malaria risk factor assessment in Antsirabe II and Faratsiho comprising a test-negative frequency matched case-control study and a qualitative risk factor assessment in Antsiranana I; and (ii) a qualitative formative assessment in all three districts. For the case-control study, a mixed effects logistic regression was used with age, sex and district included as fixed effects and health facility included as a random effect. The qualitative risk factor assessment used semi-structured interview guides and key informant interviews. For the qualitative formative assessment in the three districts, a summary report was generated following semi-structured interviews and focus group discussions with high-risk populations (HRPs) and stakeholders. RESULTS In Antsirabe II and Faratsiho districts, rice agriculture workers, outdoor/manual workers, particularly miners, and those with jobs that required travel or overnight stays, especially itinerant vendors, had higher odds of malaria infection compared to other (non-rice) agricultural workers. In Antsiranana I, respondents identified non-rice farmers, mobile vendors, and students as HRPs. Risk factors among these groups included overnight stays and travel patterns combined with a lack of malaria prevention tools. HRPs reported treatment cost and distance to the health facility as barriers to care and expressed interest in presumptive treatment and involvement of gatekeepers or people who have influence over intervention access or participation. CONCLUSIONS The study results illustrate the value of in-depth assessments of risk behaviours, access to services and prevention tools, surveillance and prevention strategies, and the involvement of gatekeepers in shaping subnational tailoring to reach previously unreached populations and address residual transmission in elimination settings.
Collapse
Affiliation(s)
- Elisabeth Gebreegziabher
- Malaria Elimination Initiative, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Andry Raoliarison
- US President's Malaria Initiative (PMI), PMI Impact Malaria, Antananarivo, Madagascar
| | | | | | - Martin Rafaliarisoa
- US President's Malaria Initiative (PMI), PMI Impact Malaria, Antananarivo, Madagascar
| | - Sandy Ralisata
- US President's Malaria Initiative (PMI), PMI Impact Malaria, Antananarivo, Madagascar
| | | | - Jennifer L Smith
- Malaria Elimination Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Jehan Ahmed
- U.S. President's Malaria Initiative (PMI), PMI Impact Malaria, Washington, DC, USA
| | - Cara Smith Gueye
- Malaria Elimination Initiative, University of California San Francisco, San Francisco, CA, USA.
- U.S. President's Malaria Initiative (PMI), PMI Impact Malaria, Washington, DC, USA.
| |
Collapse
|
2
|
Eppley TM, Borgerson C, Patel ER, Herrera JP, Kirkby AE, Golden CD, Andriamahaihavana M, Andrianandrasana L, Bóveda A, Gibson D, Jaofeno LJ, Rakotondrasoa F, Ramahaleo TA, Rasamisoa DC, Ratelolahy F, Razafindramanana J, Spira C, Welch C, Vasey N. A habitat stronghold on the precipice: A call-to-action for supporting lemur conservation in northeast Madagascar. Am J Primatol 2024; 86:e23483. [PMID: 36851838 DOI: 10.1002/ajp.23483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/10/2023] [Accepted: 02/18/2023] [Indexed: 03/01/2023]
Abstract
The northeast of Madagascar is as diverse as it is threatened. The area bordering the Analanjirofo and SAVA regions contains six protected areas and at least 22 lemur species. Many applied research and conservation programs have been established in the region with the aim of ensuring both wildlife and people thrive in the long term. While most of the remaining humid evergreen forest of northeast Madagascar is formally protected, the local human population depends heavily on the land, and unsustainable natural resource use threatens this biodiversity hotspot. Drawing from our collective experiences managing conservation activities and research programs in northeast Madagascar, we discuss the major threats to the region and advocate for eight conservation activities that help reduce threats and protect the environment, providing specific examples from our own programs. These include (1) empowering local conservation actors, (2) ensuring effectively protected habitat, (3) expanding reforestation, (4) establishing and continuing long-term research and monitoring, (5) reducing food insecurity, (6) supporting environmental education, (7) promoting sustainable livelihoods, and (8) expanding community health initiatives. Lastly, we provide a list of actions that individuals can take to join us in supporting and promoting lemur conservation.
Collapse
Affiliation(s)
- Timothy M Eppley
- Conservation Science and Wildlife Health, San Diego Zoo Wildlife Alliance, Escondido, California, USA
- Department of Anthropology, Portland State University, Portland, Oregon, USA
| | - Cortni Borgerson
- Department of Anthropology, Montclair State University, Montclair, New Jersey, USA
- Madagascar Health and Environmental Research (MAHERY), Maroantsetra, Madagascar
| | - Erik R Patel
- Lemur Conservation Foundation, Myakka City, Florida, USA
| | - James P Herrera
- Duke Lemur Center SAVA Conservation, Duke University, Durham, North Carolina, USA
| | - Andrew E Kirkby
- Birdlife International, Conservation Department, Cambridge, UK
| | - Christopher D Golden
- Madagascar Health and Environmental Research (MAHERY), Maroantsetra, Madagascar
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - McAntonin Andriamahaihavana
- Mention Zoologie et Biodiversité Animale, Faculté des Sciences, Université d'Antananarivo, Antananarivo, Madagascar
| | | | - Antonio Bóveda
- Wildlife Conservation Society, Madagascar Program, Antananarivo, Madagascar
| | - Dean Gibson
- Conservation Science and Wildlife Health, San Diego Zoo Wildlife Alliance, Escondido, California, USA
| | | | | | | | - Delaïd C Rasamisoa
- Conservation Science and Wildlife Health, San Diego Zoo Wildlife Alliance, Escondido, California, USA
| | - Felix Ratelolahy
- Wildlife Conservation Society, Madagascar Program, Antananarivo, Madagascar
| | - Josia Razafindramanana
- Mention Anthropobiologie et Développement Durable, Faculté des Sciences, Université d'Antananarivo, Antananarivo, Madagascar
| | - Charlotte Spira
- Wildlife Conservation Society, Madagascar Program, Antananarivo, Madagascar
| | - Charles Welch
- Duke Lemur Center SAVA Conservation, Duke University, Durham, North Carolina, USA
| | - Natalie Vasey
- Department of Anthropology, Portland State University, Portland, Oregon, USA
| |
Collapse
|
3
|
Mutinda J, Mwamburi SM, Oduor KO, Vincent Omolo M, Ntabo RM, Gathiru JM, Mwangangi J, Nonoh JOM. Profiles of bacterial communities and environmental factors associated with proliferation of malaria vector mosquitoes within the Kenyan Coast. Access Microbiol 2023; 5:acmi000606.v4. [PMID: 37691847 PMCID: PMC10484320 DOI: 10.1099/acmi.0.000606.v4] [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: 04/11/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023] Open
Abstract
Background Since Anopheles mosquitoes which transmit and maintain the malaria parasite breed in the outdoor environment, there is an urgent need to manage these mosquito breeding sites. In order to elaborate more on the ecological landscape of mosquito breeding sites, the bacterial community structure and their interactions with physicochemical factors in mosquito larval habitats was characterised in Kwale County (Kenya), where malaria is endemic. Methods The physical characteristics and water physicochemical parameters of the habitats were determined and recorded. Water samples were also collected from the identified sites for total metagenomic DNA extraction in order to characterise the bacterial communities within the breeding sites. Results and Discussion Sites where mosquito larvae were found were described as positive and those without mosquito larvae as negative. Electrical conductivity, total dissolved solids, salinity and ammonia were lower in the rainy season than in the dry season, which also coincided with a high proportion of positive sites. Pseudomonadota was the most common phyla recovered in all samples followed by Bacteroidota and then Actinomycetota. The presence or absence of mosquito larvae in a potential proliferation site was not related to the bacterial community structure in the sampled sites, but was positively correlated with bacterial richness and evenness. Conclusion Generally, the presence of Anopheles mosquito larvae was found to be positively correlated with rainy season, bacterial richness and evenness, and negatively correlated with electrical conductivity, total dissolved solids, salinity and ammonia. The findings of this study have implications for predicting the potential of environmental water samples to become mosquito proliferation sites.
Collapse
Affiliation(s)
| | - Samuel Mwakisha Mwamburi
- Kenya Marine and Fisheries Research Institute, P.O Box 81651- 80100, English Point, Mkomani, Mombasa, Kenya
| | - Kennedy Omondi Oduor
- Kenya Marine and Fisheries Research Institute, P.O Box 81651- 80100, English Point, Mkomani, Mombasa, Kenya
| | - Maurice Vincent Omolo
- Masinde Muliro University of Science and Technology, Centre for African Medicinal and Nutritional Flora and Fauna (CAMNFF), P.O Box 190-50100, Kakamega, Kenya
| | | | | | - Joseph Mwangangi
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research - Coast, Kilifi P.O. Box 428, Kilifi – 80108, Kenya
| | | |
Collapse
|
4
|
Pourtois JD, Tallam K, Jones I, Hyde E, Chamberlin AJ, Evans MV, Ihantamalala FA, Cordier LF, Razafinjato BR, Rakotonanahary RJL, Tsirinomen'ny Aina A, Soloniaina P, Raholiarimanana SH, Razafinjato C, Bonds MH, De Leo GA, Sokolow SH, Garchitorena A. Climatic, land-use and socio-economic factors can predict malaria dynamics at fine spatial scales relevant to local health actors: Evidence from rural Madagascar. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001607. [PMID: 36963091 PMCID: PMC10021226 DOI: 10.1371/journal.pgph.0001607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/23/2023] [Indexed: 02/24/2023]
Abstract
While much progress has been achieved over the last decades, malaria surveillance and control remain a challenge in countries with limited health care access and resources. High-resolution predictions of malaria incidence using routine surveillance data could represent a powerful tool to health practitioners by targeting malaria control activities where and when they are most needed. Here, we investigate the predictors of spatio-temporal malaria dynamics in rural Madagascar, estimated from facility-based passive surveillance data. Specifically, this study integrates climate, land-use, and representative household survey data to explain and predict malaria dynamics at a high spatial resolution (i.e., by Fokontany, a cluster of villages) relevant to health care practitioners. Combining generalized linear mixed models (GLMM) and path analyses, we found that socio-economic, land use and climatic variables are all important predictors of monthly malaria incidence at fine spatial scales, via both direct and indirect effects. In addition, out-of-sample predictions from our model were able to identify 58% of the Fokontany in the top quintile for malaria incidence and account for 77% of the variation in the Fokontany incidence rank. These results suggest that it is possible to build a predictive framework using environmental and social predictors that can be complementary to standard surveillance systems and help inform control strategies by field actors at local scales.
Collapse
Affiliation(s)
- Julie D Pourtois
- Biology Department, Stanford University, Stanford, CA, United States of America
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States of America
| | - Krti Tallam
- Biology Department, Stanford University, Stanford, CA, United States of America
| | - Isabel Jones
- Biology Department, Stanford University, Stanford, CA, United States of America
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States of America
| | - Elizabeth Hyde
- School of Medicine, Stanford University, Stanford, CA, United States of America
| | - Andrew J Chamberlin
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States of America
| | - Michelle V Evans
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Felana A Ihantamalala
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America
- NGO Pivot, Ifanadiana, Madagascar
| | | | | | - Rado J L Rakotonanahary
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America
- NGO Pivot, Ifanadiana, Madagascar
| | | | | | | | - Celestin Razafinjato
- Programme National de Lutte contre le Paludisme, Ministère de la Santé Publique, Antananarivo, Madagascar
| | - Matthew H Bonds
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America
- NGO Pivot, Ifanadiana, Madagascar
| | - Giulio A De Leo
- Biology Department, Stanford University, Stanford, CA, United States of America
- Hopkins Marine Station, Stanford University, Pacific Grove, CA, United States of America
| | - Susanne H Sokolow
- Woods Institute for the Environment, Stanford University, Stanford, CA, United States of America
- Marine Science Institute and Department of Ecology, Evolution and Marine Biology, University of California, Santa Barbara, CA, United States of America
| | - Andres Garchitorena
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- NGO Pivot, Ifanadiana, Madagascar
| |
Collapse
|
5
|
Mitchell CL, Ngasala B, Janko MM, Chacky F, Edwards JK, Pence BW, Mohamed A, Mhamilawa LE, Makene T, Kyaw T, Molteni F, Mkali H, Nyinondi S, Kabula B, Serbantez N, Eckert EL, Kitojo C, Reaves E, Emch M, Juliano JJ. Evaluating malaria prevalence and land cover across varying transmission intensity in Tanzania using a cross-sectional survey of school-aged children. Malar J 2022; 21:80. [PMID: 35264152 PMCID: PMC8905829 DOI: 10.1186/s12936-022-04107-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/24/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Transmission of malaria in sub-Saharan Africa has become increasingly stratified following decades of malaria control interventions. The extent to which environmental and land cover risk factors for malaria may differ across distinct strata of transmission intensity is not well known and could provide actionable targets to maximize the success of malaria control efforts. METHODS This study used cross-sectional malaria survey data from a nationally representative cohort of school-aged children in Tanzania, and satellite-derived measures for environmental features and land cover. Hierarchical logistic regression models were applied to evaluate associations between land cover and malaria prevalence within three distinct strata of transmission intensity: low and unstable, moderate and seasonal, and high and perennial. RESULTS In areas with low malaria transmission, each 10-percentage point increase in cropland cover was associated with an increase in malaria prevalence odds of 2.44 (95% UI: 1.27, 5.11). However, at moderate and higher levels of transmission intensity, no association between cropland cover and malaria prevalence was detected. Small associations were observed between greater grassland cover and greater malaria prevalence in high intensity settings (prevalence odds ratio (POR): 1.10, 95% UI: 1.00, 1.21), and between greater forest cover and reduced malaria prevalence in low transmission areas (POR: 0.74, 95% UI: 0.51, 1.03), however the uncertainty intervals of both estimates included the null. CONCLUSIONS The intensity of malaria transmission appears to modify relationships between land cover and malaria prevalence among school-aged children in Tanzania. In particular, greater cropland cover was positively associated with increased malaria prevalence in areas with low transmission intensity and presents an actionable target for environmental vector control interventions to complement current malaria control activities. As areas are nearing malaria elimination, it is important to re-evaluate environmental risk factors and employ appropriate interventions to effectively address low-level malaria transmission.
Collapse
Affiliation(s)
- Cedar L. Mitchell
- grid.410711.20000 0001 1034 1720Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA
| | - Billy Ngasala
- grid.25867.3e0000 0001 1481 7466Muhimbili University of Health and Allied Sciences, Dar es Salam, Tanzania
| | - Mark M. Janko
- grid.34477.330000000122986657Institute for Health Metrics and Evaluation, University of Washington, Washington, USA
| | - Frank Chacky
- grid.490706.cGender, Elderly and Children, Ministry of Health, Community Development, Dodoma, Tanzania ,grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Jessie K. Edwards
- grid.410711.20000 0001 1034 1720Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA
| | - Brian W. Pence
- grid.410711.20000 0001 1034 1720Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA
| | - Ally Mohamed
- grid.490706.cGender, Elderly and Children, Ministry of Health, Community Development, Dodoma, Tanzania ,grid.415734.00000 0001 2185 2147National Malaria Control Programme, Dodoma, Tanzania
| | - Lwidiko E. Mhamilawa
- grid.25867.3e0000 0001 1481 7466Muhimbili University of Health and Allied Sciences, Dar es Salam, Tanzania
| | - Twilumba Makene
- grid.25867.3e0000 0001 1481 7466Muhimbili University of Health and Allied Sciences, Dar es Salam, Tanzania
| | - Thwai Kyaw
- grid.10698.360000000122483208Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC USA
| | - Fabrizio Molteni
- grid.490706.cGender, Elderly and Children, Ministry of Health, Community Development, Dodoma, Tanzania ,Tropical and Public Health Institute, Basel, Switzerland
| | | | | | | | - Naomi Serbantez
- US President’s Malaria Initiative (PMI), United States Agency for International Development, Dar es Salaam, Tanzania
| | - Erin L. Eckert
- grid.62562.350000000100301493RTI International, Washington, DC USA
| | - Chonge Kitojo
- US President’s Malaria Initiative (PMI), United States Agency for International Development, Dar es Salaam, Tanzania
| | - Erik Reaves
- President’s Malaria Initiative, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Michael Emch
- grid.410711.20000 0001 1034 1720Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Department of Geography, University of North Carolina, Chapel Hill, NC USA
| | - Jonathan J. Juliano
- grid.10698.360000000122483208Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC USA
| |
Collapse
|