1
|
Popkin-Hall ZR, Carey-Ewend K, Aghakhanian F, Oriero EC, Seth MD, Kashamuka MM, Ngasala B, Ali IM, Mukomena ES, Mandara CI, Kharabora O, Sendor R, Simkin A, Amambua-Ngwa A, Tshefu A, Fola AA, Ishengoma DS, Bailey JA, Parr JB, Lin JT, Juliano JJ. Population Genomics of Plasmodium malariae from Four African Countries. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.07.24313132. [PMID: 39314932 PMCID: PMC11419228 DOI: 10.1101/2024.09.07.24313132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Plasmodium malariae is geographically widespread but neglected and may become more prevalent as P. falciparum declines. We completed the largest genomic study of African P. malariae to-date by performing hybrid capture and sequencing of 77 isolates from Cameroon (n=7), the Democratic Republic of the Congo (n=16), Nigeria (n=4), and Tanzania (n=50) collected between 2015 and 2021. There is no evidence of geographic population structure. Nucleotide diversity was significantly lower than in co-localized P. falciparum isolates, while linkage disequilibrium was significantly higher. Genome-wide selection scans identified no erythrocyte invasion ligands or antimalarial resistance orthologs as top hits; however, targeted analyses of these loci revealed evidence of selective sweeps around four erythrocyte invasion ligands and six antimalarial resistance orthologs. Demographic inference modeling suggests that African P. malariae is recovering from a bottleneck. Altogether, these results suggest that P. malariae is genomically atypical among human Plasmodium spp. and panmictic in Africa.
Collapse
Affiliation(s)
- Zachary R. Popkin-Hall
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
| | - Kelly Carey-Ewend
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Farhang Aghakhanian
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
| | - Eniyou C. Oriero
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Misago D. Seth
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Billy Ngasala
- Muhimbili University of Health and Allied Sciences, Bagamoyo, Tanzania
| | - Innocent M. Ali
- Faculty of Biochemistry, University of Dschang, Dschang, Cameroon
| | - Eric Sompwe Mukomena
- Programme nationale de lutte contre le paludisme, Democratic Republic of Congo
- School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | | | - Oksana Kharabora
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
| | - Rachel Sendor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Alfred Simkin
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, RI USA 02906
| | - Alfred Amambua-Ngwa
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at LSHTM, Fajara, The Gambia
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Abebe A. Fola
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, RI USA 02906
| | - Deus S. Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Biochemistry, Kampala International University in Tanzania, Dar es Salaam, Tanzania
| | - Jeffrey A. Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, RI USA 02906
- Center for Computational Molecular Biology, Brown University, RI, USA 02906
| | - Jonathan B. Parr
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
- Division of Infectious Diseases, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Curriculum of Genetics and Molecular Biology, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
| | - Jessica T. Lin
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
- Division of Infectious Diseases, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Jonathan J. Juliano
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC USA 27599
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Division of Infectious Diseases, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Curriculum of Genetics and Molecular Biology, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
| |
Collapse
|
2
|
Peters MAE, King AA, Wale N. Red blood cell dynamics during malaria infection challenge the assumptions of mathematical models of infection dynamics. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.10.575051. [PMID: 38260611 PMCID: PMC10802624 DOI: 10.1101/2024.01.10.575051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
For decades, mathematical models have been used to understand the course and outcome of malaria infections (i.e., infection dynamics) and the evolutionary dynamics of the parasites that cause them. A key conclusion of these models is that red blood cell (RBC) availability is a fundamental driver of infection dynamics and parasite trait evolution. The extent to which this conclusion holds will in part depend on model assumptions about the host-mediated processes that regulate RBC availability i.e., removal of uninfected RBCs and supply of RBCs. Diverse mathematical functions have been used to describe host-mediated RBC supply and clearance, but it remains unclear whether they adequately capture the dynamics of RBC supply and clearance during infection. Here, we use a unique dataset, comprising time-series measurements of erythrocyte (i.e., mature RBC) and reticulocyte (i.e., newly supplied RBC) densities during Plasmodium chabaudi malaria infection, and a quantitative data-transformation scheme to elucidate whether RBC dynamics conform to common model assumptions. We found that RBC clearance and supply are not well described by mathematical functions commonly used to model these processes. Furthermore, the temporal dynamics of both processes vary with parasite growth rate in a manner again not captured by existing models. Together, these finding suggest that new model formulations are required if we are to explain and ultimately predict the within-host population dynamics and evolution of malaria parasites.
Collapse
|
3
|
B M S, H C V, Singhal R, Singh K, N SN, Tripathi PK, Singh P, Eapen A, Singh SP, Sinha DP, Malla WA, Gupta SK, Yadav CP, Singh P, Aggarwal CS, P Choudhary V, Sharma R, Jain T, Sharma A, Anvikar AR, Goel A, Rahi M. Community perspective and healthcare assessment in malaria endemic states of India: a cross-sectional study protocol. BMJ Open 2024; 14:e081856. [PMID: 38964800 PMCID: PMC11227780 DOI: 10.1136/bmjopen-2023-081856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/18/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION India's contribution to the malaria burden was highest in South-East Asia Region in 2021, accounting for 79% of the estimated malaria cases and 83% of malaria-related deaths. Intensified Malaria Control Programme supported by Global Funds to Fight against AIDS, Tuberculosis and Malaria has deployed crucial interventions to reduce the overall burden of malaria in India. Evaluation of utilisation of malaria elimination interventions by the community and assessment of the healthcare system is underway in eleven high malaria endemic states in India. Health system preparedness for malaria elimination, logistics, and supply chain management of diagnostic kits and anti-malarial drugs in addition to the knowledge, attitude and practice of the healthcare workers is also being assessed. METHODS AND ANALYSIS The study is being undertaken in 11 malaria endemic states with a variable annual parasite incidence of malaria. In total, 47 districts (administrative unit of malaria control operations) covering 37 976 households are to be interviewed and assessed. We present here the protocol following which the study is being undertaken at the behest and approval of Ministry of Health and Family Welfare in India. ETHICS AND DISSEMINATION No patients were involved in the study. Study findings will be shared with Institutional ethics board of National Institute for Malaria Research New Delhi (NIMR) in a timely, comprehensive, accurate, unbiased, unambiguous and transparent manner and to the National Vector-borne Disease (Malaria) Control Programme officers and the Community public who participated. Important findings will be communicated through community outreach meetings which are existing in the Health system. Results will be informed to study participants via local fieldwork supervised by District Malaria Officers. Also findings will be published in reputed journals based on Indian Council of Medical Research (ICMR) publication policy.The ICMR-NIMR ethics committee approved the study via letter No. NIMR/ECM/2023/Feb/14 dated 24 April 2023 for version 5. All standard ethical practices will be followed.
Collapse
Affiliation(s)
- Shrinivasa B M
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - Vani H C
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - Richa Singhal
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - Kuldeep Singh
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - Sujith Nath N
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | | | - Piyush Singh
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - Alex Eapen
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - S P Singh
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | - D P Sinha
- ICMR- National Institute of Malaria Research (NIMR), New Delhi, India
| | | | | | - Chander Prakash Yadav
- ICMR- National Institute of Cancer Prevention and Research (NICPR), Noida, UP, India
| | - Pallika Singh
- National Center for Vector-Borne Diseases Control (NCVBDC), Delhi, India
| | - C S Aggarwal
- National Center for Vector-Borne Diseases Control (NCVBDC), Delhi, India
| | - Vinod P Choudhary
- National Center for Vector-Borne Diseases Control (NCVBDC), Delhi, India
| | - Rinku Sharma
- National Center for Vector-Borne Diseases Control (NCVBDC), Delhi, India
| | - Tanu Jain
- National Center for Vector-Borne Diseases Control (NCVBDC), Delhi, India
| | - Amit Sharma
- International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | | | - Atul Goel
- National Centre for Disease Control (NCDC), New Delhi, India
- Directorate General of Health Services (DGHS), New Delhi, India
| | - Manju Rahi
- ICMR- Vector Control Research Centre (VCRC), Puducherry, India
| |
Collapse
|
4
|
Popkin-Hall ZR, Niaré K, Crudale R, Simkin A, Fola AA, Sanchez JF, Pannebaker DL, Giesbrecht DJ, Kim IE, Aydemir Ö, Bailey JA, Valdivia HO, Juliano JJ. High-Throughput Genotyping of Plasmodium vivax in the Peruvian Amazon via Molecular Inversion Probes. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.27.24309599. [PMID: 38978652 PMCID: PMC11230302 DOI: 10.1101/2024.06.27.24309599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Plasmodium vivax transmission occurs throughout the tropics and is an emerging threat in areas of Plasmodium falciparum decline, causing relapse infections that complicate treatment and control. Targeted sequencing for P. falciparum has been widely deployed to detect population structure and the geographic spread of antimalarial and diagnostic resistance. However, there are fewer such tools for P. vivax . Leveraging global variation data, we designed four molecular inversion probe (MIP) genotyping panels targeting geographically differentiating SNPs, neutral SNPs, putative antimalarial resistance genes, and vaccine candidate genes. We deployed these MIP panels on 866 infections from the Peruvian Amazon and identified transmission networks with clonality (IBD>0.99), copy number variation in Pvdbp and multiple Pvrbps , fixation of putative antimalarial resistance, and balancing selection in 13 vaccine candidate genes. Our MIP panels are the broadest genotyping panel currently available and are poised for successful deployment in other regions of P. vivax transmission.
Collapse
|
5
|
Mbishi JV, Chombo S, Luoga P, Omary HJ, Paulo HA, Andrew J, Addo IY. Malaria in under-five children: prevalence and multi-factor analysis of high-risk African countries. BMC Public Health 2024; 24:1687. [PMID: 38915034 PMCID: PMC11197209 DOI: 10.1186/s12889-024-19206-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Malaria remains a significant public health challenge in Sub-Saharan Africa (SSA), particularly affecting under-five (UN5) children. Despite global efforts to control the disease, its prevalence in high-risk African countries continues to be alarming, with records of substantial morbidity and mortality rates. Understanding the association of multiple childhood, maternal, and household factors with malaria prevalence, especially among vulnerable young populations, is crucial for effective intervention strategies. OBJECTIVE This study examines the prevalence of malaria among UN5 children in selected high-risk SSA countries and analyzes its association with various childhood, maternal, and household factors. METHODS Data from the Malaria Indicator Surveys (MIS) spanning from 2010 to 2023 were analyzed. A weighted sample of 35,624 UN5 children from seven countries in sub-Saharan Africa (SSA) known for high malaria prevalence was considered in the analyses. Descriptive statistics and modified Poisson regression analysis were used to assess the association of multiple factors with malaria prevalence. Stata version 15 software was used in analyzing the data and statistical significance was set at a 5% significance level. RESULTS The overall pooled prevalence of malaria among the studied population was 26.2%, with substantial country-specific variations observed. In terms of child factors, a child's age was significantly associated with malaria prevalence (APR = 1.010, 95% CI: 1.007-1.012). Children of mothers with higher education levels (APR for higher education = 0.586, 95% CI: 0.425-0.806) and Fansidar uptake during pregnancy (APR = 0.731, 95% CI: 0.666-0.802) were associated with lower malaria risk. Children from middle-wealth (APR = 0.783, 95% CI: 0.706-0.869) and rich (APR = 0.499, 95% CI: 0.426-0.584) households had considerably lower malaria prevalence compared to those from poor households. Additionally, rural residency was associated with a higher risk of malaria compared to urban residency (APR = 1.545, 95% CI: 1.255-1.903). CONCLUSION The study highlights a notable malaria prevalence among under-five (UN5) children in high-risk SSA countries, influenced significantly by factors such as maternal education, Fansidar uptake during pregnancy, socioeconomic status, and residency. These findings underscore the importance of targeted malaria prevention strategies that address these key determinants to effectively reduce the malaria burden in this vulnerable population.
Collapse
Affiliation(s)
| | - Suleiman Chombo
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Pankras Luoga
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Huda Jaffar Omary
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Heavenlight A Paulo
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | | | - Isaac Yeboah Addo
- Research Fellow and Tutor, Concord Clinical School, University of Sydney, Sydney, Australia
- Research Fellow, University of New South Wales, Sydney, Australia
| |
Collapse
|
6
|
Bagala I, Namuganga JF, Nayebare P, Cuu G, Katairo T, Nabende I, Gonahasa S, Nassali M, Tukwasibwe S, Dorsey G, Nankabirwa J, Kitaka SB, Kiguli S, Greenhouse B, Ssewanyana I, Kamya MR, Briggs J. Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: a serial cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.09.24308673. [PMID: 38947039 PMCID: PMC11213087 DOI: 10.1101/2024.06.09.24308673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status. Methods Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering. Results More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints. Conclusions Results indicate that a larger number of children were infected by the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.
Collapse
Affiliation(s)
- Irene Bagala
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Gloria Cuu
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Thomas Katairo
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Isaiah Nabende
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Martha Nassali
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - Joaniter Nankabirwa
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Sarah Kiguli
- Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Isaac Ssewanyana
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Central Public Health Laboratory, Butabika, Uganda
| | - Moses R Kamya
- Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | |
Collapse
|
7
|
Ishengoma DS, Mandara CI, Bakari C, Fola AA, Madebe RA, Seth MD, Francis F, Buguzi C, Moshi R, Garimo I, Lazaro S, Lusasi A, Aaron S, Chacky F, Mohamed A, Njau RJA, Kitau J, Rasmussen C, Bailey JA, Juliano JJ, Warsame M. Evidence of artemisinin partial resistance in North-western Tanzania: clinical and drug resistance markers study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.31.24301954. [PMID: 38352311 PMCID: PMC10863006 DOI: 10.1101/2024.01.31.24301954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Background Artemisinin-based combination therapies (ACTs) are the recommended antimalarial drugs for the treatment of uncomplicated malaria. The recent emergence of artemisinin partial resistance (ART-R) in Rwanda, Uganda and Eritrea is of great concern. In Tanzania, a nationwide molecular malaria surveillance in 2021 showed a high prevalence of the Kelch13 (K13) 561H mutation in Plasmodium falciparum from the north-western region, close to the border with Rwanda and Uganda. This study was conducted in 2022 to evaluate the efficacy of artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) for the treatment of uncomplicated falciparum malaria and to confirm the presence of ART-R in Tanzania. Methods This single-arm study evaluated the efficacy of AL and ASAQ in eligible children aged six months to 10 years at Bukangara Dispensary in Karagwe District, Kagera Region. Clinical and parasitological responses were monitored for 28 days according to standard WHO protocol. Mutations in K13 gene and extended haplotypes with these mutations were analysed using Sanger and whole genome sequencing data, respectively. Findings 176 children (88 in each AL and ASAQ group) were enrolled and all achieved the defined outcomes. PCR-corrected adequate clinical and parasitological response (ACPR) was 98.3% (95% CI: 90.8-100) and 100.0% (95% CI: 95.8-100) for AL and ASAQ, respectively. Parasitaemia on day 3 was observed in 11/88 (12.5%) and 17/88 (19.3%) in the AL and ASAQ groups, respectively. The half-life of parasitaemia was significantly higher (>6.5 hrs) in patients with parasitaemia on day 3 and/or mutations in K13 gene at enrolment. Most patients with parasitaemia on day 3 (8/11 = 72.7% in the AL group and 10/17 = 58.8% in the ASAQ group) had 561H mutation at enrolment. The parasites with K13 mutations were not similar to those from south-east Asia and Rwanda, but had the same core haplotype of a new 561H haplotype reported in Kagera in 2021. Interpretation These findings confirm the presence of ART-R in Tanzania. A context-specific strategy to respond to artemisinin partial resistance is urgently needed. Although both AL and ASAQ showed high efficacy, increased vigilance for reduced efficacy of these ACTs and detection of ART-R in other parts of the country is critical.
Collapse
Affiliation(s)
- Deus S. Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Harvard T.H Chan School of Public Health, Boston, MA, USA
- Faculty of Pharmaceutical Sciences, Monash University, VIC, Australia
- Department of Biochemistry, Kampala International University in Tanzania, Dar es Salaam, Tanzania
| | | | - Catherine Bakari
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Abebe A. Fola
- Department of Pathology and Laboratory Medicine and Center for Computational Molecular Biology, Brown University, Providence, RI, USA
| | - Rashid A. Madebe
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Misago D. Seth
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Creyton Buguzi
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Ramadhan Moshi
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Issa Garimo
- National Malaria Control Program (NMCP), Dodoma, Tanzania
| | - Samwel Lazaro
- National Malaria Control Program (NMCP), Dodoma, Tanzania
| | | | - Sijenunu Aaron
- National Malaria Control Program (NMCP), Dodoma, Tanzania
| | - Frank Chacky
- National Malaria Control Program (NMCP), Dodoma, Tanzania
| | - Ally Mohamed
- National Malaria Control Program (NMCP), Dodoma, Tanzania
| | - Ritha J. A. Njau
- Malariologist and Public Health Specialist, Muhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences Dar es Salaam, Tanzania
| | - Jovin Kitau
- World Health Organization Country Office, Dar es Salaam, Tanzania
| | | | - Jeffrey A. Bailey
- Department of Pathology and Laboratory Medicine and Center for Computational Molecular Biology, Brown University, Providence, RI, USA
| | | | - Marian Warsame
- Gothenburg University, Gothenburg, Sweden
- Benadir University, Mogadishu, Somalia
| |
Collapse
|
8
|
Woolley SD, Grigg MJ, Marquart L, Gower J, Piera K, Nair AS, Amante FM, Rajahram GS, William T, Frazer DM, Chalon S, McCarthy JS, Anstey NM, Barber BE. Longitudinal changes in iron homeostasis in human experimental and clinical malaria. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.19.23300265. [PMID: 38196596 PMCID: PMC10775340 DOI: 10.1101/2023.12.19.23300265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background The interaction between iron deficiency and malaria is incompletely understood. We evaluated longitudinal changes in iron homeostasis in volunteers enrolled in malaria volunteer infection studies (VIS) and in Malaysian patients with falciparum and vivax malaria. Methods We retrieved samples and associated data from 55 participants enrolled in malaria VIS, and 171 malaria patients and 30 healthy controls enrolled in clinical studies in Malaysia. Ferritin, hepcidin, erythropoietin, and soluble transferrin receptor (sTfR) were measured by ELISA. Results In the VIS, participants' parasitaemia was correlated with baseline mean corpuscular volume (MCV), but not iron status (ferritin, hepcidin or sTfR). Ferritin, hepcidin and sTfR all increased during the VIS. Ferritin and hepcidin normalised by day 28, while sTfR remained elevated. In VIS participants, baseline iron status (ferritin) was associated with post-treatment increases in liver transaminase levels. In Malaysian malaria patients, hepcidin and ferritin were elevated on admission compared to healthy controls, while sTfR increased following admission. Hepcidin normalised by day 28; however, ferritin and sTfR both remained elevated 4 weeks following admission. Conclusion Our findings demonstrate that parasitaemia is associated with an individual's MCV rather than iron status. The persistent elevation in sTfR 4 weeks post-infection in both malaria VIS and clinical malaria may reflect a causal link between malaria and iron deficiency.
Collapse
Affiliation(s)
- Stephen D Woolley
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - Matthew J Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Louise Marquart
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Jeremy Gower
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kim Piera
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Arya Sheela Nair
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Fiona M Amante
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - David M Frazer
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - James S McCarthy
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Victorian Infectious Diseases Institute, Peter Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Bridget E Barber
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Infectious Diseases Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| |
Collapse
|
9
|
Afrane YA, Abdulai A, Mohammed AR, Akuamoah-Boateng Y, Owusu-Asenso CM, Sraku IK, Yanney SA, Malm K, Lobo NF. First detection of Anopheles stephensi in Ghana using molecular surveillance. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.01.569589. [PMID: 38076990 PMCID: PMC10705536 DOI: 10.1101/2023.12.01.569589] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The invasive Anopheles stephensi mosquito has been rapidly expanding in range in Africa over the last decade, spreading from the Indian sub-continent to several East African countries (Djibouti, Ethiopia, Sudan, Somalia and Kenya) and now in West Africa, Nigeria. The rapid expansion of this invasive vector poses a major threat to current malaria control and elimination efforts. In line with the WHO's strategy to stop the spread of this invasive species by enhancing surveillance and control measures in Africa, we incorporated morphological and molecular surveillance of An. stephensi into routine entomological surveillance of malaria vectors in the city of Accra, Ghana. Here, we report on the first detection of An. stephensi in Ghana. An. stephensi mosquitoes were confirmed using PCR and sequencing of the ITS2 regions. These findings highlight the urgent need for increased surveillance and response strategies to mitigate the spread of An. stephensi in Ghana.
Collapse
|
10
|
Morlighem C, Chaiban C, Georganos S, Brousse O, van Lipzig NPM, Wolff E, Dujardin S, Linard C. Spatial Optimization Methods for Malaria Risk Mapping in Sub-Saharan African Cities Using Demographic and Health Surveys. GEOHEALTH 2023; 7:e2023GH000787. [PMID: 37811342 PMCID: PMC10558065 DOI: 10.1029/2023gh000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/26/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
Vector-borne diseases, such as malaria, are affected by the rapid urban growth and climate change in sub-Saharan Africa (SSA). In this context, intra-urban malaria risk maps act as a key decision-making tool for targeting malaria control interventions, especially in resource-limited settings. The Demographic and Health Surveys (DHS) provide a consistent malaria data source for mapping malaria risk at the national scale, but their use is limited at the intra-urban scale because survey cluster coordinates are randomly displaced for ethical reasons. In this research, we focus on predicting intra-urban malaria risk in SSA cities-Dakar, Dar es Salaam, Kampala and Ouagadougou-and investigate the use of spatial optimization methods to overcome the effect of DHS spatial displacement. We modeled malaria risk using a random forest regressor and remotely sensed covariates depicting the urban climate, the land cover and the land use, and we tested several spatial optimization approaches. The use of spatial optimization mitigated the effects of DHS spatial displacement on predictive performance. However, this comes at a higher computational cost, and the percentage of variance explained in our models remained low (around 30%-40%), which suggests that these methods cannot entirely overcome the limited quality of epidemiological data. Building on our results, we highlight potential adaptations to the DHS sampling strategy that would make them more reliable for predicting malaria risk at the intra-urban scale.
Collapse
Affiliation(s)
- Camille Morlighem
- Department of GeographyUniversity of NamurNamurBelgium
- ILEEUniversity of NamurNamurBelgium
| | - Celia Chaiban
- Department of GeographyUniversity of NamurNamurBelgium
- ILEEUniversity of NamurNamurBelgium
| | - Stefanos Georganos
- Geomatics UnitDepartment of Environmental and Life SciencesKarlstad UniversityKarlstadSweden
| | - Oscar Brousse
- Institute of Environmental Design and EngineeringUniversity College LondonLondonUK
- Department of Earth and Environmental SciencesKatholieke Universiteit LeuvenLeuvenBelgium
| | | | - Eléonore Wolff
- Department of Geoscience, Environment & SocietyUniversité Libre de BruxellesBrusselsBelgium
| | - Sébastien Dujardin
- Department of GeographyUniversity of NamurNamurBelgium
- ILEEUniversity of NamurNamurBelgium
| | - Catherine Linard
- Department of GeographyUniversity of NamurNamurBelgium
- ILEEUniversity of NamurNamurBelgium
- NARILISUniversity of NamurNamurBelgium
| |
Collapse
|
11
|
Ozodiegwu ID, Ambrose M, Galatas B, Runge M, Nandi A, Okuneye K, Dhanoa NP, Maikore I, Uhomoibhi P, Bever C, Noor A, Gerardin J. Application of mathematical modelling to inform national malaria intervention planning in Nigeria. Malar J 2023; 22:137. [PMID: 37101146 PMCID: PMC10130303 DOI: 10.1186/s12936-023-04563-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: 12/01/2022] [Accepted: 04/15/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND For their 2021-2025 National Malaria Strategic Plan (NMSP), Nigeria's National Malaria Elimination Programme (NMEP), in partnership with the World Health Organization (WHO), developed a targeted approach to intervention deployment at the local government area (LGA) level as part of the High Burden to High Impact response. Mathematical models of malaria transmission were used to predict the impact of proposed intervention strategies on malaria burden. METHODS An agent-based model of Plasmodium falciparum transmission was used to simulate malaria morbidity and mortality in Nigeria's 774 LGAs under four possible intervention strategies from 2020 to 2030. The scenarios represented the previously implemented plan (business-as-usual), the NMSP at an 80% or higher coverage level and two prioritized plans according to the resources available to Nigeria. LGAs were clustered into 22 epidemiological archetypes using monthly rainfall, temperature suitability index, vector abundance, pre-2010 parasite prevalence, and pre-2010 vector control coverage. Routine incidence data were used to parameterize seasonality in each archetype. Each LGA's baseline malaria transmission intensity was calibrated to parasite prevalence in children under the age of five years measured in the 2010 Malaria Indicator Survey (MIS). Intervention coverage in the 2010-2019 period was obtained from the Demographic and Health Survey, MIS, the NMEP, and post-campaign surveys. RESULTS Pursuing a business-as-usual strategy was projected to result in a 5% and 9% increase in malaria incidence in 2025 and 2030 compared with 2020, while deaths were projected to remain unchanged by 2030. The greatest intervention impact was associated with the NMSP scenario with 80% or greater coverage of standard interventions coupled with intermittent preventive treatment in infants and extension of seasonal malaria chemoprevention (SMC) to 404 LGAs, compared to 80 LGAs in 2019. The budget-prioritized scenario with SMC expansion to 310 LGAs, high bed net coverage with new formulations, and increase in effective case management rate at the same pace as historical levels was adopted as an adequate alternative for the resources available. CONCLUSIONS Dynamical models can be applied for relative assessment of the impact of intervention scenarios but improved subnational data collection systems are required to allow increased confidence in predictions at sub-national level.
Collapse
Affiliation(s)
- Ifeoma D Ozodiegwu
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA.
| | | | - Beatriz Galatas
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Manuela Runge
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Aadrita Nandi
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Kamaldeen Okuneye
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Neena Parveen Dhanoa
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
| | - Ibrahim Maikore
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Abdisalan Noor
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Jaline Gerardin
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA
| |
Collapse
|
12
|
Ndiaye YD, Wong W, Thwing J, Schaffner SS, Tine A, Diallo MA, Deme A, Sy M, Bei AK, Thiaw AB, Daniels R, Ndiaye T, Gaye A, Ndiaye IM, Toure M, Gadiaga N, Sene A, Sow D, Garba MN, Yade MS, Dieye B, Diongue K, Zoumarou D, Ndiaye A, Gomis J, Fall FB, Ndiop M, Diallo I, Sene D, Macinnis B, Seck MC, Ndiaye M, Badiane AS, Hartl DL, Volkman SK, Wirth DF, Ndiaye D. Two decades of molecular surveillance in Senegal reveal changes in known drug resistance mutations associated with historical drug use and seasonal malaria chemoprevention. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.24.23288820. [PMID: 37163114 PMCID: PMC10168519 DOI: 10.1101/2023.04.24.23288820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Drug resistance in Plasmodium falciparum is a major threat to malaria control efforts. We analyzed data from two decades (2000-2020) of continuous molecular surveillance of P. falciparum parasite strains in Senegal to determine how historical changes in drug administration policy may have affected parasite evolution. We profiled several known drug resistance markers and their surrounding haplotypes using a combination of single nucleotide polymorphism (SNP) molecular surveillance and whole-genome sequence (WGS) based population genomics. We observed rapid changes in drug resistance markers associated with the withdrawal of chloroquine and introduction of sulfadoxine-pyrimethamine in 2003. We also observed a rapid increase in Pfcrt K76T and decline in Pfdhps A437G starting in 2014, which we hypothesize may reflect changes in resistance or fitness caused by seasonal malaria chemoprevention (SMC). Parasite populations evolve rapidly in response to drug use, and SMC preventive efficacy should be closely monitored.
Collapse
Affiliation(s)
- Yaye Die Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Wesley Wong
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Julie Thwing
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA ,30329, USA
| | - Stephen S Schaffner
- Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA, 02142, USA
| | - Abdoulaye Tine
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mamadou Alpha Diallo
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Awa Deme
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mouhammad Sy
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Amy K Bei
- Yale School of Public Health, 60 College St, New Haven, CT 06510
| | - Alphonse B Thiaw
- Department of biochemistry and Functional Genomics, Sherbrooke University, 2500 Bd de l'Universite, Sherbrooke, QC J1K 2R1, Canada
| | - Rachel Daniels
- RNA Therapeutics Institute, UMass Chan Medical School, 368 Plantation Street, Worcester MA 01605
| | - Tolla Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Amy Gaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Ibrahima Mbaye Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mariama Toure
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Nogaye Gadiaga
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Aita Sene
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Djiby Sow
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mamane N Garba
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mamadou Samba Yade
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Baba Dieye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Khadim Diongue
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Daba Zoumarou
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Aliou Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Jules Gomis
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Fatou Ba Fall
- Yale School of Public Health, 60 College St, New Haven, CT 06510
| | - Medoune Ndiop
- National Malaria Control Program (NMCP), Rue FN 20, Dakar 25270, Senegal
| | - Ibrahima Diallo
- National Malaria Control Program (NMCP), Rue FN 20, Dakar 25270, Senegal
| | - Doudou Sene
- National Malaria Control Program (NMCP), Rue FN 20, Dakar 25270, Senegal
| | - Bronwyn Macinnis
- Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA, 02142, USA
| | - Mame Cheikh Seck
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Mouhamadou Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Aida S Badiane
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
| | - Daniel L Hartl
- Department of Organismic and Evolutionary Biology, Harvard University, 16 Divinity Avenue, Cambridge, MA, 02138 USA
| | - Sarah K Volkman
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
- Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA, 02142, USA
- Simmons University, 300 The Fenway, Boston, MA, 02115, USA
| | - Dyann F Wirth
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
- Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA, 02142, USA
| | - Daouda Ndiaye
- International Research Training Center on Genomics and Health Surveillance (CIGASS), Cheikh Anta Diop University, Dakar, 16477, Senegal
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| |
Collapse
|
13
|
Sy F, Berner-Rodoreda A, Asnake T, Getnet M, Amogne W, Bussmann H, Abera H, Bärnighausen T, Deckert A. Exploring computer-aided health decision-making on cervical cancer interventions through deliberative interviews in Ethiopia. NPJ Digit Med 2023; 6:68. [PMID: 37069432 PMCID: PMC10106317 DOI: 10.1038/s41746-023-00808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
Cervical cancer is a significant disease burden in Ethiopia. Mathematical models and computer simulations on disease dynamics can support effective resource allocation. The objectives of this work are (i) to explore the perspectives of health decision-makers on computer-aided predictions supporting cervical cancer interventions, (ii) to identify their information needs from these predictions, and (iii) their willingness to apply the results in their work. We conducted deliberative interviews with 15 health decision-makers and advisors in Ethiopia in autumn 2019. We analyze the data using a five steps framework approach drawing on thematic analysis and find that Ethiopian health decision-makers are willing to use computer-aided predictions in their decisions. Data on HPV prevalence and the cervical cancer burden are scarce but valued highly and decision-makers are particularly interested in the identification of local HPV hotspots. Data-driven mathematical models and computer simulations may increasingly influence health decision-making in Ethiopia.
Collapse
Affiliation(s)
- Frithjof Sy
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
| | | | | | - Misrak Getnet
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wondwossen Amogne
- Infectious Disease Department (TASH) Addis Ababa University, Addis Ababa, Ethiopia
| | - Hermann Bussmann
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Helen Abera
- Infectious Disease Department (TASH) Addis Ababa University, Addis Ababa, Ethiopia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Harvard Center for Population & Development Studies, Harvard University, Cambridge, MA, USA
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Andreas Deckert
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
14
|
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.
Collapse
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
| | | | | |
Collapse
|
15
|
Glozah F, Asampong E, Tabong PTN, Nwameme A, Hornuvo R, Chandi M, Peprah NY, Adongo P, Dako-Gyeke P. Creating interventions to transition long-lasting insecticide net distribution in Ghana. BMJ Open 2022; 12:e063121. [PMID: 35649610 PMCID: PMC9161095 DOI: 10.1136/bmjopen-2022-063121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Mass long-lasting insecticide net (LLIN) distribution campaigns are rolled out, as a part of the Ghana Malaria Strategic plan (2021-2025) which seeks to protect at least 80% of the population at risk with effective malaria prevention interventions. Although the mass LLIN distribution campaign indicates a comprehensive stakeholder engagement approach, it does not systematically transition into the basic primary healthcare structures within the Ghana Health Services. This paper presents the process and outcome of creating an innovative social intervention, which focuses on community mobilisation and capacity building of community health officers. METHODS This study employed a concurrent triangulation mixed methods approach conducted across six districts in Eastern and Volta regions, Ghana. Findings were synthesised, grouped and further distilled to guide the participatory cocreation workshops. Cocreation involved participatory learning in action technique which is a practical, adaptive research strategy which enabled diverse groups and individuals to learn, work and act together in a cooperative manner. RESULTS The results suggest the establishment of a Community Health Advocacy Team (CHAT). This would be necessary in efforts aimed at transitioning LLIN distribution campaign in communities. The role of the CHAT would be centred on key elements of community/social mobilisation and capacity building, all nested in a social and behaviour change communication strategies. CONCLUSION The research team is in the process of assessing the acceptability and feasibility of the CHAT intervention with all stakeholders in the various communities. Assessment of the effectiveness of the CHAT intervention would be done at a later time.
Collapse
Affiliation(s)
- Franklin Glozah
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | - Emmanuel Asampong
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | - Philip Teg-Nefaah Tabong
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | - Adanna Nwameme
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | - Ruby Hornuvo
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | | | | | - Philip Adongo
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| | - Phyllis Dako-Gyeke
- Social and Behavioural Sciences, University of Ghana School of Public Health, Legon, Accra, Greater Accra, Ghana
| |
Collapse
|