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Bello IS, Olajubu TO, Osundiya OO, Salami OT, Ibrahim AO, Ahmed AA. Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with non-communicable diseases. SAGE Open Med 2023; 11:20503121231164259. [PMID: 37026104 PMCID: PMC10071164 DOI: 10.1177/20503121231164259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/01/2023] [Indexed: 04/03/2023] Open
Abstract
Objective: The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly. Methods: A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done. Results: Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant ( p = 0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension ( p = 0.37), overweight/obesity ( p = 0.77), or diabetes ( p = 0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets ( p = 0.64) or insecticide sprays ( p = 0.45). Conclusion: The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions.
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Affiliation(s)
- Ibrahim Sebutu Bello
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | | | - Oluwasina Tajudeen Salami
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | - Abdulakeem Ayanleye Ahmed
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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Pradhan S, Hore S, Maji SK, Manna S, Maity A, Kundu PK, Maity K, Roy S, Mitra S, Dam P, Mondal R, Ghorai S, Jawed JJ, Dutta S, Das S, Mandal S, Mandal S, Kati A, Sinha S, Maity AB, Dolai TK, Mandal AK, İnce İA. Study of epidemiological behaviour of malaria and its control in the Purulia district of West Bengal, India (2016-2020). Sci Rep 2022; 12:630. [PMID: 35022476 PMCID: PMC8755807 DOI: 10.1038/s41598-021-04399-x] [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] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Purulia is a malaria-prone district in West Bengal, India, with approximately half of the blocks defined as malaria endemic. We analyzed the malaria case in each block of the Purulia district from January 1, 2016, to December 31, 2020. As per the API, 20 blocks of Purulia were assigned to four different categories (0-3) and mapped using ArcGIS software. An exponential decay model was fitted to forecast the trend of malaria cases for each block of Purulia (2021-2025). There was a sharp decrease in total malaria cases and API from 2016 to 2020 due to the mass distribution of LLINs. The majority of cases (72.63%) were found in ≥ 15-year age group. Males were more prone to malaria (60.09%). Malaria was highly prevalent among Scheduled Tribes (48.44%). Six blocks were reported in Category 3 (high risk) and none in Category 0 (no risk) in 2016, while no blocks were determined to be in Category 3, and three blocks were in Category 0 in 2020. The exponential decay model prediction is oriented towards gaining malaria-free status in thirteen blocks of Purulia by 2025. This study will incite the government to uphold and strengthen the current efforts to meet the malaria elimination goals.
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Affiliation(s)
- Sayantan Pradhan
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
- Hematology Department, Nil Ratan Sircar Medical College & Hospital, Kolkata, 700014, India
| | - Samrat Hore
- Department of Statistics, Tripura University, Agartala, Tripura, 799022, India
| | - Suman Kumar Maji
- District Public Health Centre, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, 723101, India
| | - Simi Manna
- Department of Bio-Medical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, 721102, India
| | - Abhijit Maity
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Pratip Kumar Kundu
- Calcutta School of Tropical Medicine, College Square, Kolkata, West Bengal, 700073, India
| | - Krishna Maity
- Department of Statistics, VisvaBharati University, Bolpur, West Bengal, 731204, India
| | - Stabak Roy
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Saptarshi Mitra
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Paulami Dam
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Rittick Mondal
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Suvankar Ghorai
- Department of Microbiology, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Junaid Jibran Jawed
- School of Biotechnology, Presidency University - 2nd Campus, Kolkata, West Bengal, 700156, India
| | - Subhadeep Dutta
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Sandip Das
- Department of Botany, School of Sciences, Durgapur Regional Centre, Netaji Subhas Open University, West Burdwan, Kolkata, West Bengal, 713214, India
| | - Sukhendu Mandal
- Laboratory of Molecular Bacteriology, Department of Microbiology, University of Calcutta, Kolkata, 700019, India
| | - Sanjib Mandal
- Department of Economics, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Ahmet Kati
- Department of Biotechnology, Institution of Health Sciences, University of Health Sciences, Uskudar, Istanbul, 34668, Turkey
| | - Sangram Sinha
- Department of Botany, Vivekananda Mahavidyalaya, Haripal, Hoogly, West Bengal, 712405, India
| | - Amit Bikram Maity
- Department of Otorhinolaryngology, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, 723101, India
| | - Tuphan Kanti Dolai
- Hematology Department, Nil Ratan Sircar Medical College & Hospital, Kolkata, 700014, India.
| | - Amit Kumar Mandal
- Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India.
- Centre for Nanotechnology Sciences, Raiganj University, North Dinajpur, West Bengal, 733134, India.
| | - İkbal Agah İnce
- Department of Medical Microbiology, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Ataşehir, Istanbul, 34752, Turkey.
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Mbagwu SI, Filgueira L. Differential Expression of CD31 and Von Willebrand Factor on Endothelial Cells in Different Regions of the Human Brain: Potential Implications for Cerebral Malaria Pathogenesis. Brain Sci 2020; 10:E31. [PMID: 31935960 PMCID: PMC7016814 DOI: 10.3390/brainsci10010031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/15/2022] Open
Abstract
Cerebral microvascular endothelial cells (CMVECs) line the vascular system of the brain and are the chief cells in the formation and function of the blood brain barrier (BBB). These cells are heterogeneous along the cerebral vasculature and any dysfunctional state in these cells can result in a local loss of function of the BBB in any region of the brain. There is currently no report on the distribution and variation of the CMVECs in different brain regions in humans. This study investigated microcirculation in the adult human brain by the characterization of the expression pattern of brain endothelial cell markers in different brain regions. Five different brain regions consisting of the visual cortex, the hippocampus, the precentral gyrus, the postcentral gyrus, and the rhinal cortex obtained from three normal adult human brain specimens were studied and analyzed for the expression of the endothelial cell markers: cluster of differentiation 31 (CD31) and von-Willebrand-Factor (vWF) through immunohistochemistry. We observed differences in the expression pattern of CD31 and vWF between the gray matter and the white matter in the brain regions. Furthermore, there were also regional variations in the pattern of expression of the endothelial cell biomarkers. Thus, this suggests differences in the nature of vascularization in various regions of the human brain. These observations also suggest the existence of variation in structure and function of different brain regions, which could reflect in the pathophysiological outcomes in a diseased state.
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Affiliation(s)
- Smart Ikechukwu Mbagwu
- Anatomy Unit, Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
- Department of Anatomy, Faculty of Basic Medical Sciences, Nnamdi Azikiwe University, 435101 Nnewi Campus, Nigeria
| | - Luis Filgueira
- Anatomy Unit, Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
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Hoffmeister B, Aguilar Valdez AD. Hypertension is associated with an increased risk for severe imported falciparum malaria: a tertiary care hospital based observational study from Berlin, Germany. Malar J 2019; 18:410. [PMID: 31810471 PMCID: PMC6898961 DOI: 10.1186/s12936-019-3007-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/16/2019] [Indexed: 12/19/2022] Open
Abstract
Background Increasing numbers of aging individuals with chronic co-morbidities travel to regions where falciparum malaria is endemic. Non-communicable diseases are now leading risk factors for death in such countries. Thus, the influence of chronic diseases on the outcome of falciparum malaria is an issue of major importance. Aim of the present study was to assess whether non-communicable diseases increase the risk for severe imported falciparum malaria. Methods A retrospective observational study of all adult cases with imported falciparum malaria hospitalized between 2001 and 2015 in the tertiary care Charité University Hospital, Berlin, was performed. Results A total of 536 adult patients (median age 37 years; 31.3% female) were enrolled. Of these, 329 (61.4%) originated from endemic countries, 207 patients (38.6%) from non-endemic regions. Criteria for severe malaria were fulfilled in 68 (12.7%) cases. With older age, lack of previous malaria episodes, being a tourist, and delayed presentation, well-characterized risk factors were associated with severe malaria in univariate analysis. After adjustment for these potential confounders hypertension (adjusted odds ratio aOR, 3.06 95% confidence interval, CI 1.34–7.02), cardiovascular diseases (aOR, 8.20 95% CI 2.30–29.22), and dyslipidaemia (aOR, 6.08 95% CI 1.13–32.88) were individual diseases associated with severe disease in multivariable logistic regression. Hypertension proved an independent risk factor among individuals of endemic (aOR, 4.83, 95% CI 1.44–16.22) as well as of non-endemic origin (aOR, 3.60 95% CI 1.05–12.35). Conclusions In imported falciparum malaria hypertension and its related diseases are risk factors for severe disease.
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Affiliation(s)
- Bodo Hoffmeister
- Department of Respiratory Medicine, Clinic-Group Ernst von Bergmann, Potsdam and Bad Belzig, Niemegker Straße 45, 14806, Bad Belzig, Germany.
| | - Abner Daniel Aguilar Valdez
- Department of Endocrinology, Clinic Group Ernst von Bergmann, Potsdam and Bad Belzig, Niemegker Straße 45, 14806, Bad Belzig, Germany
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Del Prete V, Mateo-Urdiales A, Bueno-Cavanillas A, Ferrara P. Malaria prevention in the older traveller: a systematic review. J Travel Med 2019; 26:5562848. [PMID: 31509199 DOI: 10.1093/jtm/taz067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/14/2019] [Accepted: 08/27/2019] [Indexed: 12/15/2022]
Abstract
Older travellers are at higher risk of malaria-related morbidity and mortality compared with younger people. Yet, prevention of malaria in this specific group of travellers is a long-standing issue in travel medicine. The aim of this research was to synthetize the existing evidence about this important topic, highlighting older travellers' attitudes and practises toward malaria prevention. Searches were performed on PubMed, Embase, EuropePMC, Web of Science, WHOLIS and LILACS databases for relevant studies reporting malaria prevention measures in older travellers. To measure malaria prevention in the older traveller population, the main information outcomes were obtained from the ABCD framework that included travellers' 'Awareness' towards pre-travel health advice, their utilisation of 'Bite-prevention measures' and adherence to 'Chemoprophylaxis'. Data on 'Diagnosis'-related outcomes were excluded for not being measures of malaria prevention. Three evaluators independently selected studies, extracted data and assessed the quality of the included articles. The research protocol was registered with PROSPERO (protocol number CRD42019124202). Out of the 899 titles and abstracts screened, 13 articles were included in this review synthesis. These studies included a wide range of interventions for malaria prevention: no relevant differences in pre-travel healthcare attendance were found depending on age; older travellers were found to be less likely to comply with bite-prevention measures; three high-quality studies reported that adherence to chemoprophylaxis significantly increased with age, while three studies did not find age-related differences in travellers' adherence. Overall, prevention of malaria in the older traveller has received limited attention from the scientific community. Older travellers seem to be less likely to comply with bite-prevention measures, but there was high heterogeneity across the reports. This population group demands particular attention and tailored health advice before travelling to malaria endemic areas. More research is required on how to improve malaria prevention in the older traveller.
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Affiliation(s)
- Viola Del Prete
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Mateo-Urdiales
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
- School of Public Health, Health Education North West, Manchester, UK
| | | | - Pietro Ferrara
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Akselrod H, Swierzbinski MJ, Zheng Z, Keiser J, Parenti DM, Simon GL. Characteristics and Severity of Disease among 100 Cases of Imported Malaria Seen at a U.S. University Hospital, 2000-2017. Am J Trop Med Hyg 2019; 99:1511-1517. [PMID: 30350769 DOI: 10.4269/ajtmh.18-0608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Malaria acquired in endemic areas poses a substantial risk to travelers arriving in or returning to the United States. Timely diagnosis and recognition of severe illness are crucial; however, many U.S.-based clinicians lack familiarity with this disease. We conducted a retrospective review of 100 cases of malaria in adults seen at a single urban university hospital during 2000-2017. Descriptive and analytical statistics were calculated, including logistic regression modeling case severity. Most of the patients presented with Plasmodium falciparum (76%), most commonly after travel from sub-Saharan Africa (94%). Prior malaria experience was common (50%), but adherence to a prophylactic regimen was exceedingly rare (4%). Twenty-one patients had severe malaria, including 10 with cerebral malaria. Severity was predicted by high parasitemia, bandemia, hypoglycemia, and hypotension at the time of presentation. In 24 patients, the initial treatment regimen was changed, usually because of the appearance of clinical deterioration or drug toxicity. One patient required intravenous artesunate. All patients survived, although one suffered fetal loss. Among 30 patients initially evaluated at other institutions, 43% had been treated for an alternative diagnosis. The most common reasons for transfer of patients to our hospital were inadequate facilities and lack of expertise with malaria. There needs to be increased awareness among U.S.-based travelers and clinicians regarding malaria as a potentially lethal condition, emphasizing the use of appropriate prophylaxis. Our simple model of disease severity could serve frontline physicians when deciding which patients should be admitted to the intensive care unit or transferred for higher level care.
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Affiliation(s)
- Hana Akselrod
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Matthew J Swierzbinski
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Zhaonian Zheng
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - John Keiser
- Department of Pathology, George Washington University School of Medicine and Health Sciences; Washington, District of Columbia
| | - David M Parenti
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Gary L Simon
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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8
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Ramos-Sesma V, Górgolas-Hernández Mora M, Ramos-Rincón JM. The elderly traveller. Rev Clin Esp 2018; 218:426-434. [PMID: 29685639 DOI: 10.1016/j.rce.2018.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 10/28/2022]
Abstract
Improved living conditions and advances in medicine have extended life expectancy and quality of life, resulting in an increasing number of elderly travellers. Pathophysiological changes and treatments can reduce the efficacy of vaccines and facilitate drug interactions. Elderly travellers have various characteristics that should be considered when offering pre-trip counselling, which should include proper management of chronic diseases that are susceptible to worsening during the trip, as well as an appropriate study and follow-up after the trip. We performed a narrative review of the main problems of elderly travellers.
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Affiliation(s)
- V Ramos-Sesma
- Servicio de Medicina Interna, Hospital Marina Alta, Denia, Alicante, España
| | | | - J M Ramos-Rincón
- Servicio de Medicina Interna, Hospital General Universitario de Alicante; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche; ISABIAL - FISABIO, Alicante, España.
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Wyss K, Wångdahl A, Vesterlund M, Hammar U, Dashti S, Naucler P, Färnert A. Obesity and Diabetes as Risk Factors for Severe Plasmodium falciparum Malaria: Results From a Swedish Nationwide Study. Clin Infect Dis 2017; 65:949-958. [PMID: 28510633 PMCID: PMC5848256 DOI: 10.1093/cid/cix437] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/07/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Noncommunicable diseases and obesity are increasing in prevalence globally, also in populations at risk of malaria. We sought to investigate if comorbidity, in terms of chronic diseases and obesity, is associated with severe Plasmodium falciparum malaria. METHODS We performed a retrospective observational study in adults (≥18 years of age) diagnosed with malaria in Sweden between January 1995 and May 2015. We identified cases through the surveillance database at the Public Health Agency of Sweden and reviewed clinical data from 18 hospitals. Multivariable logistic regression was used to assess associations between comorbidities and severe malaria. RESULTS Among 937 adults (median age, 37 years; 66.5% were male), patients with severe malaria had higher prevalence of chronic diseases (28/92 [30.4%]) compared with nonsevere cases (151/845 [17.9%]) (P = .004). Charlson comorbidity score ≥1 was associated with severe malaria (adjusted odds ratio [aOR], 2.63 [95% confidence interval {CI}, 1.45-4.77), as was diabetes among individual diagnoses (aOR, 2.98 [95% CI, 1.25-7.09]). Median body mass index was higher among severe (29.3 kg/m2) than nonsevere cases (24.7 kg/m2) (P < .001). Obesity was strongly associated with severe malaria, both independently (aOR, 5.58 [95% CI, 2.03-15.36]) and in combination with an additional metabolic risk factor (hypertension, dyslipidemia, or diabetes) (aOR, 6.54 [95% CI, 1.87-22.88]). The associations were observed among nonimmune travelers as well as immigrants from endemic areas. CONCLUSIONS Comorbidities, specifically obesity and diabetes, are previously unidentified risk factors for severe malaria in adults diagnosed with P. falciparum. Noncommunicable diseases should be considered in the acute management and prevention of malaria.
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Affiliation(s)
- Katja Wyss
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
- Emergency Medicine and
- Infectious Diseases, Karolinska University Hospital, Stockholm
| | - Andreas Wångdahl
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
- Department of Infectious Diseases, Västerås Central Hospital, and
| | - Maria Vesterlund
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
| | - Ulf Hammar
- Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Saduddin Dashti
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
| | - Pontus Naucler
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
- Infectious Diseases, Karolinska University Hospital, Stockholm
| | - Anna Färnert
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, and Departments of
- Infectious Diseases, Karolinska University Hospital, Stockholm
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