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Tine R, Herrera S, Badji MA, Daniels K, Ndiaye P, Smith Gueye C, Tairou F, Slutsker L, Hwang J, Ansah E, Littrell M. Defining operational research priorities to improve malaria control and elimination in sub-Saharan Africa: results from a country-driven research prioritization setting process. Malar J 2023; 22:219. [PMID: 37517990 PMCID: PMC10387205 DOI: 10.1186/s12936-023-04654-8] [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: 05/09/2023] [Accepted: 07/22/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND In order to reignite gains and accelerate progress toward improved malaria control and elimination, policy, strategy, and operational decisions should be derived from high-quality evidence. The U.S. President's Malaria Initiative (PMI) Insights project together with the Université Cheikh Anta Diop of Dakar, Senegal, conducted a broad stakeholder consultation process to identify pressing evidence gaps in malaria control and elimination across sub-Saharan Africa (SSA), and developed a priority list of country-driven malaria operational research (OR) and programme evaluation (PE) topics to address these gaps. METHODS Five key stakeholder groups were engaged in the process: national malaria programmes (NMPs), research institutions in SSA, World Health Organization (WHO) representatives in SSA, international funding agencies, and global technical partners who support malaria programme implementation and research. Stakeholders were engaged through individual or small group interviews and an online survey, and asked about key operational challenges faced by NMPs, pressing evidence gaps in current strategy and implementation guidance, and priority OR and PE questions to address the challenges and gaps. RESULTS Altogether, 47 interviews were conducted with 82 individuals, and through the online survey, input was provided by 46 global technical partners. A total of 33 emergent OR and PE topics were identified through the consultation process and were subsequently evaluated and prioritized by an external evaluation committee of experts from NMPs, research institutions, and the WHO. The resulting prioritized OR and PE topics predominantly focused on generating evidence needed to close gaps in intervention coverage, address persistent challenges faced by NMPs in the implementation of core strategic interventions, and inform the effective deployment of new tools. CONCLUSION The prioritized research list is intended to serve as a key resource for informing OR and PE investments, thereby ensuring future investments focus on generating the evidence needed to strengthen national strategies and programme implementation and facilitating a more coordinated and impactful approach to malaria operational research.
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Affiliation(s)
- Roger Tine
- Université Cheikh Anta Diop, Dakar, Senegal
| | | | | | - Kyle Daniels
- PMI Insights Project/University of California, San Francisco Malaria Elimination Initiative, San Francisco, USA
| | | | - Cara Smith Gueye
- PMI Insights Project/University of California, San Francisco Malaria Elimination Initiative, San Francisco, USA
| | | | | | - Jimee Hwang
- U.S. President's Malaria Initiative, Malaria Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Evelyn Ansah
- University of Health and Allied Sciences, Accra, Ghana
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Tavares W, Morais J, Martins JF, Scalsky RJ, Stabler TC, Medeiros MM, Fortes FJ, Arez AP, Silva JC. Malaria in Angola: recent progress, challenges and future opportunities using parasite demography studies. Malar J 2022; 21:396. [PMID: 36577996 PMCID: PMC9795141 DOI: 10.1186/s12936-022-04424-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Over the past two decades, a considerable expansion of malaria interventions has occurred at the national level in Angola, together with cross-border initiatives and regional efforts in southern Africa. Currently, Angola aims to consolidate malaria control and to accelerate the transition from control to pre-elimination, along with other country members of the Elimination 8 initiative. However, the tremendous heterogeneity in malaria prevalence among Angolan provinces, as well as internal population movements and migration across borders, represent major challenges for the Angolan National Malaria Control Programme. This review aims to contribute to the understanding of factors underlying the complex malaria situation in Angola and to encourage future research studies on transmission dynamics and population structure of Plasmodium falciparum, important areas to complement host epidemiological information and to help reenergize the goal of malaria elimination in the country.
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Affiliation(s)
- Wilson Tavares
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Joana Morais
- Instituto Nacional de Investigação Em Saúde, INIS, Luanda, Angola
| | - José F. Martins
- Programa Nacional de Controlo da Malária, PNCM, Luanda, Angola
| | - Ryan J. Scalsky
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, USA
| | - Thomas C. Stabler
- grid.416786.a0000 0004 0587 0574Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - Márcia M. Medeiros
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Filomeno J. Fortes
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Ana Paula Arez
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Joana C. Silva
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, USA ,grid.411024.20000 0001 2175 4264Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
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Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095444. [PMID: 35564842 PMCID: PMC9101176 DOI: 10.3390/ijerph19095444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/22/2022]
Abstract
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute’s critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The I2 statistics and Egger’s test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were Hookworm (48%), Ascaris lumbricoides (37%), and Trichuris trichiura (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
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Laporta GZ, Grillet ME, Rodovalho SR, Massad E, Sallum MAM. Reaching the malaria elimination goal in Brazil: a spatial analysis and time-series study. Infect Dis Poverty 2022; 11:39. [PMID: 35382896 PMCID: PMC8981179 DOI: 10.1186/s40249-022-00945-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Since 2015, the Global Technical Strategy (GTS) for Malaria 2016–2030 has been adopted by the World Health Organization (WHO) as a comprehensive framework to accelerate progress for malaria elimination in endemic countries. This strategy sets the target of reducing global malaria incidence and mortality rates by 90% in 2030. Here it is sought to evaluate Brazil’s achievements towards reaching the WHO GTS milestone in 2030. Considering the total number of new malaria cases in 2015, the main research question is: will Brazil reach the malaria elimination goal in 2030? Methods Analytical strategies were undertaken using the SIVEP-malaria official databases of the Brazilian Malaria Control Programme for the Brazilian Amazon region from 2009 to 2020. Spatial and time-series analyses were applied for identifying municipalities that support the highest numbers of malaria cases over the years. Forecast analysis was used for predicting the estimated number of new cases in Brazil in 2025–2050. Results Brazil has significantly reduced the number of new malaria cases in 2020 in comparison with 2015 in the states of Acre (− 56%), Amapá (− 75%), and Amazonas (− 21%); however, they increased in the states of Pará (156%), Rondônia (74%), and Roraima (362%). Forecast of the predicted number of new malaria cases in 2030 is 74,764 (95% CI: 41,116–141,160) in the Brazilian Amazon. Conclusions It is likely that Brazil will reduce the number of new malaria cases in the Brazilian Amazon in 2030 in relation to that in 2015. Herein forecast shows a reduction by 46% (74,754 in 2030 forecast/137,982 in 2015), but this reduction is yet far from the proposed reduction under the WHO GTS 2030 milestone (90%). Stable and unbeatable transmission in the Juruá River Valley, Manaus, and Lábrea still support endemic malaria in the Brazilian Amazon. Today’s cross-border malaria is impacting the state of Roraima unprecedently. If this situation is maintained, the malaria elimination goal (zero cases) may not be reached before 2050. An enhanced political commitment is vital to ensure optimal public health intervention designs in the post-2030 milestones for malaria elimination. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00945-5.
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Affiliation(s)
- Gabriel Zorello Laporta
- Graduate Research and Innovation Program, Centro Universitario FMABC, Santo André, SP, Brazil.
| | - Maria Eugenia Grillet
- Laboratory of Parasite and Vector Biology, Institute of Zoology and Tropical Ecology, School of Sciences, Central University of Venezuela, Caracas, Venezuela
| | - Sheila Rodrigues Rodovalho
- Technical Unit of Transmissible Diseases and Current Health Assessment, Pan American Health Organization (PAHO/WHO), Brasília, DF, Brazil
| | - Eduardo Massad
- School of Applied Mathematics, Getulio Vargas Foundation, Rio de Janeiro, RJ, Brazil
| | - Maria Anice Mureb Sallum
- Epidemiology Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
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Pradhan MM, Pradhan S, Dutta A, Shah NK, Valecha N, Joshi PL, Pradhan K, Grewal Daumerie P, Banerji J, Duparc S, Mendis K, Sharma SK, Murugasampillay S, Anvikar AR. Impact of the malaria comprehensive case management programme in Odisha, India. PLoS One 2022; 17:e0265352. [PMID: 35324920 PMCID: PMC8947122 DOI: 10.1371/journal.pone.0265352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background
The Comprehensive Case Management Project (CCMP), was a collaborative implementation research initiative to strengthen malaria early detection and complete treatment in Odisha State, India.
Methods
A two-arm quasi-experimental design was deployed across four districts in Odisha, representing a range of malaria endemicity: Bolangir (low), Dhenkanal (moderate), Angul (high), and Kandhamal (hyper). In each district, a control block received routine malaria control measures, whereas a CCMP block received a range of interventions to intensify surveillance, diagnosis, and case management. Impact was evaluated by difference-in-difference (DID) analysis and interrupted time-series (ITS) analysis of monthly blood examination rate (MBER) and monthly parasite index (MPI) over three phases: phase 1 pre-CCMP (2009–2012) phase 2 CCMP intervention (2013–2015), and phase 3 post-CCMP (2016–2017).
Results
During CCMP implementation, adjusting for control blocks, DID and ITS analysis indicated a 25% increase in MBER and a 96% increase in MPI, followed by a –47% decline in MPI post-CCMP, though MBER was maintained. Level changes in MPI between phases 1 and 2 were most marked in Dhenkanal and Angul with increases of 976% and 287%, respectively, but declines in Bolangir (−57%) and Kandhamal (−22%). Between phase 2 and phase 3, despite the MBER remaining relatively constant, substantial decreases in MPI were observed in Dhenkanal (−78%), and Angul (−59%), with a more modest decline in Bolangir (−13%), and an increase in Kandhamal (14%).
Conclusions
Overall, CCMP improved malaria early detection and treatment through the enhancement of the existing network of malaria services which positively impacted case incidence in three districts. In Kandhamal, which is hyperendemic, the impact was not evident. However, in Dhenkanal and Angul, areas of moderate-to-high malaria endemicity, CCMP interventions precipitated a dramatic increase in case detection and a subsequent decline in malaria incidence, particularly in previously difficult-to-reach communities.
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Affiliation(s)
- Madan M. Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
- * E-mail:
| | - Sreya Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, India
- Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, India
| | - Naman K. Shah
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Neena Valecha
- National Institute of Malaria Research, New Delhi, India
| | - Pyare L. Joshi
- Independent Malariologist, Gallup, Washington, D.C., United States of America
| | | | | | - Jaya Banerji
- Medicines for Malaria Venture, Geneva, Switzerland
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Alegana VA, Macharia PM, Muchiri S, Mumo E, Oyugi E, Kamau A, Chacky F, Thawer S, Molteni F, Rutazanna D, Maiteki-Sebuguzi C, Gonahasa S, Noor AM, Snow RW. Plasmodium falciparum parasite prevalence in East Africa: Updating data for malaria stratification. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000014. [PMID: 35211700 PMCID: PMC7612417 DOI: 10.1371/journal.pgph.0000014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
The High Burden High Impact (HBHI) strategy for malaria encourages countries to use multiple sources of available data to define the sub-national vulnerabilities to malaria risk, including parasite prevalence. Here, a modelled estimate of Plasmodium falciparum from an updated assembly of community parasite survey data in Kenya, mainland Tanzania, and Uganda is presented and used to provide a more contemporary understanding of the sub-national malaria prevalence stratification across the sub-region for 2019. Malaria prevalence data from surveys undertaken between January 2010 and June 2020 were assembled form each of the three countries. Bayesian spatiotemporal model-based approaches were used to interpolate space-time data at fine spatial resolution adjusting for population, environmental and ecological covariates across the three countries. A total of 18,940 time-space age-standardised and microscopy-converted surveys were assembled of which 14,170 (74.8%) were identified after 2017. The estimated national population-adjusted posterior mean parasite prevalence was 4.7% (95% Bayesian Credible Interval 2.6-36.9) in Kenya, 10.6% (3.4-39.2) in mainland Tanzania, and 9.5% (4.0-48.3) in Uganda. In 2019, more than 12.7 million people resided in communities where parasite prevalence was predicted ≥ 30%, including 6.4%, 12.1% and 6.3% of Kenya, mainland Tanzania and Uganda populations, respectively. Conversely, areas that supported very low parasite prevalence (<1%) were inhabited by approximately 46.2 million people across the sub-region, or 52.2%, 26.7% and 10.4% of Kenya, mainland Tanzania and Uganda populations, respectively. In conclusion, parasite prevalence represents one of several data metrics for disease stratification at national and sub-national levels. To increase the use of this metric for decision making, there is a need to integrate other data layers on mortality related to malaria, malaria vector composition, insecticide resistance and bionomic, malaria care-seeking behaviour and current levels of unmet need of malaria interventions.
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Affiliation(s)
- Victor A. Alegana
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
| | - Peter M. Macharia
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Samuel Muchiri
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Eda Mumo
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Elvis Oyugi
- Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya
| | - Alice Kamau
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Frank Chacky
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Sumaiyya Thawer
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Molteni
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Damian Rutazanna
- National Malaria Control Division, Ministry of Health, Kampala, Uganda
| | - Catherine Maiteki-Sebuguzi
- National Malaria Control Division, Ministry of Health, Kampala, Uganda
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Abdisalan M. Noor
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Robert W. Snow
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Nsanzabana C. Time to scale up molecular surveillance for anti-malarial drug resistance in sub-saharan Africa. Malar J 2021; 20:401. [PMID: 34645475 PMCID: PMC8513315 DOI: 10.1186/s12936-021-03942-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/05/2021] [Indexed: 02/02/2023] Open
Abstract
Artemisinin resistance has emerged and spread in the Greater Mekong Sub-region (GMS), followed by artemisinin-based combination therapy failure, due to both artemisinin and partner drug resistance. More worrying, artemisinin resistance has been recently reported and confirmed in Rwanda. Therefore, there is an urgent need to strengthen surveillance systems beyond the GMS to track the emergence or spread of artemisinin and partner drug resistance in other endemic settings. Currently, anti-malarial drug efficacy is monitored primarily through therapeutic efficacy studies (TES). Even though essential for anti-malarial drug policy change, these studies are difficult to conduct, expensive, and may not detect the early emergence of resistance. Additionally, results from TES may take years to be available to the stakeholders, jeopardizing their usefulness. Molecular markers are additional and useful tools to monitor anti-malarial drug resistance, as samples collected on dried blood spots are sufficient to monitor known and validated molecular markers of resistance, and could help detecting and monitoring the early emergence of resistance. However, molecular markers are not monitored systematically by national malaria control programmes, and are often assessed in research studies, but not in routine surveillance. The implementation of molecular markers as a routine tool for anti-malarial drug resistance surveillance could greatly improve surveillance of anti-malarial drug efficacy, making it possible to detect resistance before it translates to treatment failures. When possible, ex vivo assays should be included as their data could be useful complementary, especially when no molecular markers are validated.
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Affiliation(s)
- Christian Nsanzabana
- Department of Medicine, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. .,University of Basel, P.O. Box, 4003, Basel, Switzerland.
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Yukich JO, Scott C, Silumbe K, Larson BA, Bennett A, Finn TP, Hamainza B, Conner RO, Porter TR, Keating J, Steketee RW, Eisele TP, Miller JM. Cost-Effectiveness of Focal Mass Drug Administration and Mass Drug Administration with Dihydroartemisinin-Piperaquine for Malaria Prevention in Southern Province, Zambia: Results of a Community-Randomized Controlled Trial. Am J Trop Med Hyg 2020; 103:46-53. [PMID: 32618249 PMCID: PMC7416981 DOI: 10.4269/ajtmh.19-0661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Community-wide administration of antimalarial drugs in therapeutic doses is a potential tool to prevent malaria infection and reduce the malaria parasite reservoir. To measure the effectiveness and cost of using the antimalarial drug combination dihydroartemisinin–piperaquine (DHAp) through different community-wide distribution strategies, Zambia’s National Malaria Control Centre conducted a three-armed community-randomized controlled trial. The trial arms were as follows: 1) standard of care (SoC) malaria interventions, 2) SoC plus focal mass drug administration (fMDA), and 3) SoC plus MDA. Mass drug administration consisted of offering all eligible individuals DHAP, irrespective of a rapid diagnostic test (RDT) result. Focal mass drug administration consisted of offering DHAP to all eligible individuals who resided in a household where anyone tested positive by RDT. Results indicate that the costs of fMDA and MDA per person targeted and reached are similar (US$9.01 versus US$8.49 per person, respectively, P = 0.87), but that MDA was superior in all cost-effectiveness measures, including cost per infection averted, cost per case averted, cost per death averted, and cost per disability-adjusted life year averted. Subsequent costing of the MDA intervention in a non-trial, operational setting yielded significantly lower costs per person reached (US$2.90). Mass drug administration with DHAp also met the WHO thresholds for “cost-effective interventions” in the Zambian setting in 90% of simulations conducted using a probabilistic sensitivity analysis based on trial costs, whereas fMDA met these criteria in approximately 50% of simulations. A sensitivity analysis using costs from operational deployment and trial effectiveness yielded improved cost-effectiveness estimates. Mass drug administration may be a cost-effective intervention in the Zambian context and can help reduce the parasite reservoir substantially. Mass drug administration was more cost-effective in relatively higher transmission settings. In all scenarios examined, the cost-effectiveness of MDA was superior to that of fMDA.
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Affiliation(s)
- Joshua O Yukich
- Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Callie Scott
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington
| | | | - Bruce A Larson
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California
| | - Timothy P Finn
- Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Busiku Hamainza
- National Malaria Control Centre, Zambia Ministry of Health, Lusaka, Zambia
| | - Ruben O Conner
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington
| | - Travis R Porter
- Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Joseph Keating
- Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Richard W Steketee
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington
| | - Thomas P Eisele
- Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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9
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Adeniji E, Asante KP, Boahen O, Compaoré G, Coulibaly B, Kaali S, Kabore Y, Lamy M, Lusingu J, Malabeja A, Mens P, Orsini M, Otieno L, Otieno W, Owusu-Agyei S, Oyieko J, Pirçon JY, Praet N, Roman F, Sie A, Sing’oei V, Sirima SB, Sylla K, Tine R, Tiono AB, Tivura M, Usuf E, Wéry S. Estimating Annual Fluctuations in Malaria Transmission Intensity and in the Use of Malaria Control Interventions in Five Sub-Saharan African Countries. Am J Trop Med Hyg 2020; 103:1883-1892. [PMID: 32959764 PMCID: PMC7646796 DOI: 10.4269/ajtmh.19-0795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 08/07/2020] [Indexed: 11/08/2022] Open
Abstract
RTS,S/AS01E malaria vaccine safety, effectiveness, and impact will be assessed in pre- and post-vaccine introduction studies, comparing the occurrence of malaria cases and adverse events in vaccinated versus unvaccinated children. Because those comparisons may be confounded by potential year-to-year fluctuations in malaria transmission intensity and malaria control intervention usage, the latter should be carefully monitored to adequately adjust the analyses. This observational cross-sectional study is assessing Plasmodium falciparum parasite prevalence (PfPR) and malaria control intervention usage over nine annual surveys performed at peak parasite transmission. Plasmodium falciparum parasite prevalence was measured by microscopy and nucleic acid amplification test (quantitative PCR) in parallel in all participants, and defined as the proportion of infected participants among participants tested. Results of surveys 1 (S1) and 2 (S2), conducted in five sub-Saharan African countries, including some participating in the Malaria Vaccine Implementation Programme (MVIP), are reported herein; 4,208 and 4,199 children were, respectively, included in the analyses. Plasmodium falciparum parasite prevalence estimated using microscopy varied between study sites in both surveys, with the lowest prevalence in Senegalese sites and the highest in Burkina Faso. In sites located in the MVIP areas (Kintampo and Kombewa), PfPR in children aged 6 months to 4 years ranged from 24.8% to 27.3%, depending on the study site and the survey. Overall, 89.5% and 86.4% of children used a bednet in S1 and S2, of whom 68.7% and 77.9% used impregnated bednets. No major difference was observed between the two surveys in terms of PfPR or use of malaria control interventions.
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Affiliation(s)
- RTS,S Epidemiology EPI-MAL-005 Study Group The RTS,S Epidemiology EPI-MAL-005 study group is composed of (per alphabetical order):
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
- Aixial c/o GSK, Wavre, Belgium
- National Institute for Medical Research (NIMR), Korogwe, Tanzania
- University of Copenhagen, Copenhagen, Denmark
- Parasitology Unit, Department of Medical Microbiology, Academic Medical Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- 4Clinics c/o GSK, Wavre, Belgium
- KEMRI - Walter Reed Project, US Army Medical Research Directorate-Kenya, Kombewa, Kenya
- GSK, Wavre, Belgium
- Département de Parasitologie, Centre de Recherche de Keur Socé, Faculté de Médecine, Université Cheikh Anta Diop, Dakar, Senegal
- Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Elisha Adeniji
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Owusu Boahen
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | | | | | - Seyram Kaali
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Youssouf Kabore
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | | | - John Lusingu
- National Institute for Medical Research (NIMR), Korogwe, Tanzania
- University of Copenhagen, Copenhagen, Denmark
| | | | - Petra Mens
- Parasitology Unit, Department of Medical Microbiology, Academic Medical Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Lucas Otieno
- KEMRI - Walter Reed Project, US Army Medical Research Directorate-Kenya, Kombewa, Kenya
| | - Walter Otieno
- KEMRI - Walter Reed Project, US Army Medical Research Directorate-Kenya, Kombewa, Kenya
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Janet Oyieko
- KEMRI - Walter Reed Project, US Army Medical Research Directorate-Kenya, Kombewa, Kenya
| | | | | | | | - Ali Sie
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Valentine Sing’oei
- KEMRI - Walter Reed Project, US Army Medical Research Directorate-Kenya, Kombewa, Kenya
| | - Sodiomon B. Sirima
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - Khadime Sylla
- Département de Parasitologie, Centre de Recherche de Keur Socé, Faculté de Médecine, Université Cheikh Anta Diop, Dakar, Senegal
| | - Roger Tine
- Département de Parasitologie, Centre de Recherche de Keur Socé, Faculté de Médecine, Université Cheikh Anta Diop, Dakar, Senegal
| | - Alfred B. Tiono
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - Mathilda Tivura
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Effua Usuf
- Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Combining next-generation indoor residual spraying and drug-based malaria control strategies: observational evidence of a combined effect in Mali. Malar J 2020; 19:293. [PMID: 32799873 PMCID: PMC7429948 DOI: 10.1186/s12936-020-03361-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ségou Region in central Mali is an area of high malaria burden with seasonal transmission. The region reports high access to and use of long-lasting insecticidal nets (LLINs), though the principal vector, Anopheles gambiae, is resistant to pyrethroids. From 2011 until 2016, several high-burden districts of Ségou also received indoor residual spraying (IRS), though in 2014 concerns about pyrethroid resistance prompted a shift in IRS products to a micro-encapsulated formulation of the organophosphate insecticide pirimiphos-methyl. Also in 2014, the region expanded a pilot programme to provide seasonal malaria chemoprevention (SMC) to children aged 3-59 months in two districts. The timing of these decisions presented an opportunity to estimate the impact of both interventions, deployed individually and in combination, using quality-assured passive surveillance data. METHODS A non-randomized, quasi-experimental time series approach was used to analyse monthly trends in malaria case incidence at the district level. Districts were stratified by intervention status: an SMC district, an IRS district, an IRS + SMC district, and control districts that received neither IRS nor SMC in 2014. The numbers of positive rapid diagnostic test (RDT +) results reported at community health facilities were aggregated and epidemiological curves showing the incidence of RDT-confirmed malaria cases per 10,000 person-months were plotted for the total all-ages and for the under 5 year old (u5) population. The cumulative incidence of RDT + malaria cases observed from September 2014 to February 2015 was calculated in each intervention district and compared to the cumulative incidence reported from the same period in the control districts. RESULTS Cumulative peak-transmission all-ages incidence was lower in each of the intervention districts compared to the control districts: 16% lower in the SMC district; 28% lower in the IRS district; and 39% lower in the IRS + SMC district. The same trends were observed in the u5 population: incidence was 15% lower with SMC, 48% lower with IRS, and 53% lower with IRS + SMC. The SMC-only intervention had a more moderate effect on incidence reduction initially, which increased over time. The IRS-only intervention had a rapid, comparatively large impact initially that waned over time. The impact of the combined interventions was both rapid and longer lasting. CONCLUSION Evaluating the impact of IRS with an organophosphate and SMC on reducing incidence rates of passive RDT-confirmed malaria cases in Ségou Region in 2014 suggests that combining the interventions had a greater effect than either intervention used individually in this high-burden region of central Mali with pyrethroid-resistant vectors and high rates of household access to LLINs.
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11
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Runge M, Molteni F, Mandike R, Snow RW, Lengeler C, Mohamed A, Pothin E. Applied mathematical modelling to inform national malaria policies, strategies and operations in Tanzania. Malar J 2020; 19:101. [PMID: 32122342 PMCID: PMC7053121 DOI: 10.1186/s12936-020-03173-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND More than ever, it is crucial to make the best use of existing country data, and analytical tools for developing malaria control strategies as the heterogeneity in malaria risk within countries is increasing, and the available malaria control tools are expanding while large funding gaps exist. Global and local policymakers, as well as funders, increasingly recognize the value of mathematical modelling as a strategic tool to support decision making. This case study article describes the long-term use of modelling in close collaboration with the National Malaria Control Programme (NMCP) in Tanzania, the challenges encountered and lessons learned. CASE DESCRIPTION In Tanzania, a recent rebound in prevalence led to the revision of the national malaria strategic plan with interventions targeted to the malaria risk at the sub-regional level. As part of the revision, a mathematical malaria modelling framework for setting specific predictions was developed and used between 2016 and 2019 to (1) reproduce setting specific historical malaria trends, and (2) to simulate in silico the impact of future interventions. Throughout the project, multiple stakeholder workshops were attended and the use of mathematical modelling interactively discussed. EVALUATION In Tanzania, the model application created an interdisciplinary and multisectoral dialogue platform between modellers, NMCP and partners and contributed to the revision of the national malaria strategic plan by simulating strategies suggested by the NMCP. The uptake of the modelling outputs and sustained interest by the NMCP were critically associated with following factors: (1) effective sensitization to the NMCP, (2) regular and intense communication, (3) invitation for the modellers to participate in the strategic plan process, and (4) model application tailored to the local context. CONCLUSION Empirical data analysis and its use for strategic thinking remain the cornerstone for evidence-based decision-making. Mathematical impact modelling can support the process both by unifying all stakeholders in one strategic process and by adding new key evidence required for optimized decision-making. However, without a long-standing partnership, it will be much more challenging to sensibilize programmes to the usefulness and sustained use of modelling and local resources within the programme or collaborating research institutions need to be mobilized.
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Affiliation(s)
- Manuela Runge
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Molteni
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- National Malaria Control Programme, Ministry of Health Community Development Gender Elderly and Children, Dodoma, Tanzania
| | - Renata Mandike
- National Malaria Control Programme, Ministry of Health Community Development Gender Elderly and Children, Dodoma, Tanzania
| | - Robert W Snow
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, OX3 7LJ, UK
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Christian Lengeler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ally Mohamed
- National Malaria Control Programme, Ministry of Health Community Development Gender Elderly and Children, Dodoma, Tanzania
| | - Emilie Pothin
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
- CHAI, Clinton Health Access Initative, Boston, USA.
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12
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Castaño MS, Ndeffo-Mbah ML, Rock KS, Palmer C, Knock E, Mwamba Miaka E, Ndung’u JM, Torr S, Verlé P, Spencer SEF, Galvani A, Bever C, Keeling MJ, Chitnis N. Assessing the impact of aggregating disease stage data in model predictions of human African trypanosomiasis transmission and control activities in Bandundu province (DRC). PLoS Negl Trop Dis 2020; 14:e0007976. [PMID: 31961872 PMCID: PMC6994134 DOI: 10.1371/journal.pntd.0007976] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 01/31/2020] [Accepted: 12/06/2019] [Indexed: 11/19/2022] Open
Abstract
Since the turn of the century, the global community has made great progress towards the elimination of gambiense human African trypanosomiasis (HAT). Elimination programs, primarily relying on screening and treatment campaigns, have also created a rich database of HAT epidemiology. Mathematical models calibrated with these data can help to fill remaining gaps in our understanding of HAT transmission dynamics, including key operational research questions such as whether integrating vector control with current intervention strategies is needed to achieve HAT elimination. Here we explore, via an ensemble of models and simulation studies, how including or not disease stage data, or using more updated data sets affect model predictions of future control strategies.
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Affiliation(s)
- María Soledad Castaño
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Martial L. Ndeffo-Mbah
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
- College of Veterinary Medicine and Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Kat S. Rock
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
| | - Cody Palmer
- Institute of Disease Modeling, Seattle, Washington, United States of America
| | - Edward Knock
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Erick Mwamba Miaka
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Kinshasa, the Democratic Republic of the Congo
| | | | - Steve Torr
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Paul Verlé
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Simon E. F. Spencer
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Alison Galvani
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Caitlin Bever
- Institute of Disease Modeling, Seattle, Washington, United States of America
| | - Matt J. Keeling
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
| | - Nakul Chitnis
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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13
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Sousa JDO, de Albuquerque BC, Coura JR, Suárez-Mutis MC. Use and retention of long-lasting insecticidal nets (LLINs) in a malaria risk area in the Brazilian Amazon: a 5-year follow-up intervention. Malar J 2019; 18:100. [PMID: 30909924 PMCID: PMC6434793 DOI: 10.1186/s12936-019-2735-9] [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: 12/10/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Long-lasting insecticidal nets (LLINs) are one of the main vector control strategies recommended by the World Health Organization for the control and elimination of malaria. This study aimed to evaluate the use and retention of LLINs during the 5 years of implementing an integrated control strategy in a malaria-endemic area in the Brazilian Amazon. Methods This intervention study was conducted in localities of the municipality of Barcelos, Amazonas, from 2008 to 2014. Four rural localities situated along the Padauiri River were the object of this study. Two localities (Bacabal-rio Aracá and the São Sebastião district) were used as controls. LLINs were distributed to all residents of the Padauiri River; assessments were made regarding their use and retention via a semistructured questionnaire, a household register, and direct observation during 5 years. Results Overall, 208 individuals participated in the study. In the baseline pilot study (2008), 9.9% of the subjects in the intervention group had slept with mosquito nets the previous night compared with 37.8% of the subjects in the control group. In 2010, this percentage was 43.2% in the intervention group and 50.9% in the control group. Therefore, 1 year after the implementation of the strategy, although there was an increase in the use of mosquito nets in both groups, this increase was significantly higher in the intervention group. This increase in LLINs use did not persist after 5 years of intervention. The households’ evaluation in 2014 showed that 80% of the houses in the intervention group owned at least one LLIN compared with 66% in the control group (p = 0.11); 76% of households in the intervention group owned sufficient LLINs for all family members compared with 50% in the control group (p = 0.007). Conclusions High ownership and retention of the LLINs was observed in the intervention group. At 1 year after the distribution of these LLINs, there was a significant increase in their use that was not maintained over the long term. Control strategies must be permanent; however, exploring new strategies is necessary to ensure that the knowledge acquired further modifies the attitudes and behaviours.
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Affiliation(s)
- Jessica de Oliveira Sousa
- Laboratory of Parasitic Diseases, Institute Oswaldo Cruz/Fiocruz, Av Brasil 4365. Pavilhão Artur Neiva, Rio de Janeiro, RJ, CEP: 21040-900, Brazil.
| | - Bernardino Claudio de Albuquerque
- Foundation of Health Surveillance of Amazonas, Av. Torquato Tapajós, 4.010, Colônia Santo Antônio, Manaus, AM, CEP 69.093-018, Brazil
| | - José Rodrigues Coura
- Laboratory of Parasitic Diseases, Institute Oswaldo Cruz/Fiocruz, Av Brasil 4365. Pavilhão Artur Neiva, Rio de Janeiro, RJ, CEP: 21040-900, Brazil
| | - Martha Cecilia Suárez-Mutis
- Laboratory of Parasitic Diseases, Institute Oswaldo Cruz/Fiocruz, Av Brasil 4365. Pavilhão Artur Neiva, Rio de Janeiro, RJ, CEP: 21040-900, Brazil
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Greenhouse B, Daily J, Guinovart C, Goncalves B, Beeson J, Bell D, Chang MA, Cohen JM, Ding X, Domingo G, Eisele TP, Lammie PJ, Mayor A, Merienne N, Monteiro W, Painter J, Rodriguez I, White M, Drakeley C, Mueller I. Priority use cases for antibody-detecting assays of recent malaria exposure as tools to achieve and sustain malaria elimination. Gates Open Res 2019; 3:131. [PMID: 31172051 PMCID: PMC6545519 DOI: 10.12688/gatesopenres.12897.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 01/12/2023] Open
Abstract
Measurement of malaria specific antibody responses represents a practical and informative method for malaria control programs to assess recent exposure to infection. Technical advances in recombinant antigen production, serological screening platforms, and analytical methods have enabled the identification of several target antigens for laboratory based and point-of-contact tests. Questions remain as to how these serological assays can best be integrated into malaria surveillance activities to inform programmatic decision-making. This report synthesizes discussions from a convening at Institut Pasteur in Paris in June 2017 aimed at defining practical and informative use cases for serology applications and highlights five programmatic uses for serological assays including: documenting the absence of transmission; stratification of transmission; measuring the effect of interventions; informing a decentralized immediate response; and testing and treating P. vivax hypnozoite carriers.
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Affiliation(s)
- Bryan Greenhouse
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
| | | | - Caterina Guinovart
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- PATH, Seattle, WA, USA
| | | | | | - David Bell
- Intellectual Ventures, Bellevue, WA, USA
| | | | | | | | | | - Thomas P. Eisele
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Wuelto Monteiro
- Tropical Medicine Foundation Dr. Heitor Viera Dourado, Manaus, Amazonas, Brazil
| | - John Painter
- Centers of Disease Control and Prevention, Atlanta, GA, USA
| | - Isabel Rodriguez
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
| | | | - Chris Drakeley
- London School of Tropical Medicine & Hygiene, London, UK
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - The Malaria Serology Convening
- Department of Medicine,, University of California San Francisco, San Francisco, CA, USA
- Consultant to UNITAID, Denver, CO, USA
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- PATH, Seattle, WA, USA
- London School of Tropical Medicine & Hygiene, London, UK
- The Burnet Institute, Melbourne, Australia
- Intellectual Ventures, Bellevue, WA, USA
- Centers of Disease Control and Prevention, Atlanta, GA, USA
- Clinton Health Access Initiative (CHAI), Boston, MA, USA
- FIND, Geneva, Switzerland
- Center for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Institut Pasteur, Paris, France
- Tropical Medicine Foundation Dr. Heitor Viera Dourado, Manaus, Amazonas, Brazil
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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15
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Caminade C, McIntyre KM, Jones AE. Impact of recent and future climate change on vector-borne diseases. Ann N Y Acad Sci 2019; 1436:157-173. [PMID: 30120891 PMCID: PMC6378404 DOI: 10.1111/nyas.13950] [Citation(s) in RCA: 217] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/12/2018] [Accepted: 07/17/2018] [Indexed: 12/22/2022]
Abstract
Climate change is one of the greatest threats to human health in the 21st century. Climate directly impacts health through climatic extremes, air quality, sea-level rise, and multifaceted influences on food production systems and water resources. Climate also affects infectious diseases, which have played a significant role in human history, impacting the rise and fall of civilizations and facilitating the conquest of new territories. Our review highlights significant regional changes in vector and pathogen distribution reported in temperate, peri-Arctic, Arctic, and tropical highland regions during recent decades, changes that have been anticipated by scientists worldwide. Further future changes are likely if we fail to mitigate and adapt to climate change. Many key factors affect the spread and severity of human diseases, including mobility of people, animals, and goods; control measures in place; availability of effective drugs; quality of public health services; human behavior; and political stability and conflicts. With drug and insecticide resistance on the rise, significant funding and research efforts must to be maintained to continue the battle against existing and emerging diseases, particularly those that are vector borne.
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Affiliation(s)
- Cyril Caminade
- Department of Epidemiology and Population Health, Institute of Infection and Global HealthUniversity of LiverpoolLiverpoolUK
- NIHR Health Protection Research Unit in Emerging and Zoonotic InfectionsLiverpoolUK
| | - K. Marie McIntyre
- Department of Epidemiology and Population Health, Institute of Infection and Global HealthUniversity of LiverpoolLiverpoolUK
- NIHR Health Protection Research Unit in Emerging and Zoonotic InfectionsLiverpoolUK
| | - Anne E. Jones
- Department of Mathematical SciencesUniversity of LiverpoolLiverpoolUK
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16
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White MT, Walker P, Karl S, Hetzel MW, Freeman T, Waltmann A, Laman M, Robinson LJ, Ghani A, Mueller I. Mathematical modelling of the impact of expanding levels of malaria control interventions on Plasmodium vivax. Nat Commun 2018; 9:3300. [PMID: 30120250 PMCID: PMC6097992 DOI: 10.1038/s41467-018-05860-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 07/23/2018] [Indexed: 01/07/2023] Open
Abstract
Plasmodium vivax poses unique challenges for malaria control and elimination, notably the potential for relapses to maintain transmission in the face of drug-based treatment and vector control strategies. We developed an individual-based mathematical model of P. vivax transmission calibrated to epidemiological data from Papua New Guinea (PNG). In many settings in PNG, increasing bed net coverage is predicted to reduce transmission to less than 0.1% prevalence by light microscopy, however there is substantial risk of rebounds in transmission if interventions are removed prematurely. In several high transmission settings, model simulations predict that combinations of existing interventions are not sufficient to interrupt P. vivax transmission. This analysis highlights the potential options for the future of P. vivax control: maintaining existing public health gains by keeping transmission suppressed through indefinite distribution of interventions; or continued development of strategies based on existing and new interventions to push for further reduction and towards elimination.
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Affiliation(s)
- Michael T White
- Malaria: Parasites and Hosts, Department of Parasites and Insect Vectors, Institut Pasteur, 25-28 Rue du Dr Roux, 75015, Paris, France.
| | - Patrick Walker
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, Norfolk Place, W2 1PG, UK
| | - Stephan Karl
- Vector-borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang 511, Papua New Guinea
- Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, Melbourne University, Melbourne, VIC, 3052, Australia
| | - Manuel W Hetzel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, Switzerland
| | - Tim Freeman
- Rotarians Against Malaria, Port Moresby 121, Papua New Guinea
| | - Andreea Waltmann
- Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, Melbourne University, Melbourne, VIC, 3052, Australia
| | - Moses Laman
- Vector-borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang 511, Papua New Guinea
| | - Leanne J Robinson
- Vector-borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang 511, Papua New Guinea
- Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, Melbourne University, Melbourne, VIC, 3052, Australia
- Burnet Institute, Melbourne, VIC, 3004, Australia
| | - Azra Ghani
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, Norfolk Place, W2 1PG, UK
| | - Ivo Mueller
- Malaria: Parasites and Hosts, Department of Parasites and Insect Vectors, Institut Pasteur, 25-28 Rue du Dr Roux, 75015, Paris, France
- Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, Melbourne University, Melbourne, VIC, 3052, Australia
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17
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Abstract
Health systems underpin disease elimination and eradication programmes. In an elimination and eradication context, innovative research approaches are needed across health systems to assess readiness for programme reorientation, mitigate any decreases in effectiveness of interventions ('effectiveness decay'), and respond to dynamic and changing needs. The malaria eradication research agenda (malERA) Refresh consultative process for the Panel on Health Systems and Policy Research identifies opportunities to build health systems evidence and the tools needed to eliminate malaria from different zones, countries, and regions and to eradicate it globally. The research questions are organised as a portfolio that global health practitioners, researchers, and funders can identify with and support. This supports the promotion of an actionable and more cohesive approach to building the evidence base for scaled-up implementation of findings. Gaps and opportunities discussed in the paper include delivery strategies to meet the changing dynamics of needs of individuals, environments, and malaria programme successes; mechanisms and approaches to best support accelerated policy and financial responsiveness at national and global level to ensure timely response to evidence and needs, including in crisis situations; and systems' readiness tools and decision-support systems.
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malERA: An updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication. PLoS Med 2017; 14:e1002452. [PMID: 29190279 PMCID: PMC5708619 DOI: 10.1371/journal.pmed.1002452] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This paper summarises key advances in defining the infectious reservoir for malaria and the measurement of transmission for research and programmatic use since the Malaria Eradication Research Agenda (malERA) publication in 2011. Rapid and effective progress towards elimination requires an improved understanding of the sources of transmission as well as those at risk of infection. Characterising the transmission reservoir in different settings will enable the most appropriate choice, delivery, and evaluation of interventions. Since 2011, progress has been made in a number of areas. The extent of submicroscopic and asymptomatic infections is better understood, as are the biological parameters governing transmission of sexual stage parasites. Limitations of existing transmission measures have been documented, and proof-of-concept has been established for new innovative serological and molecular methods to better characterise transmission. Finally, there now exists a concerted effort towards the use of ensemble datasets across the spectrum of metrics, from passive and active sources, to develop more accurate risk maps of transmission. These can be used to better target interventions and effectively monitor progress toward elimination. The success of interventions depends not only on the level of endemicity but also on how rapidly or recently an area has undergone changes in transmission. Improved understanding of the biology of mosquito-human and human-mosquito transmission is needed particularly in low-endemic settings, where heterogeneity of infection is pronounced and local vector ecology is variable. New and improved measures of transmission need to be operationally feasible for the malaria programmes. Outputs from these research priorities should allow the development of a set of approaches (applicable to both research and control programmes) that address the unique challenges of measuring and monitoring transmission in near-elimination settings and defining the absence of transmission.
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Abstract
Since the turn of the century, a remarkable expansion has been achieved in the range and effectiveness of products and strategies available to prevent, treat, and control malaria, including advances in diagnostics, drugs, vaccines, and vector control. These advances have once again put malaria elimination on the agenda. However, it is clear that even with the means available today, malaria control and elimination pose a formidable challenge in many settings. Thus, currently available resources must be used more effectively, and new products and approaches likely to achieve these goals must be developed. This paper considers tools (both those available and others that may be required) to achieve and maintain malaria elimination. New diagnostics are needed to direct treatment and detect transmission potential; new drugs and vaccines to overcome existing resistance and protect against clinical and severe disease, as well as block transmission and prevent relapses; and new vector control measures to overcome insecticide resistance and more powerfully interrupt transmission. It is also essential that strategies for combining new and existing approaches are developed for different settings to maximise their longevity and effectiveness in areas with continuing transmission and receptivity. For areas where local elimination has been recently achieved, understanding which measures are needed to maintain elimination is necessary to prevent rebound and the reestablishment of transmission. This becomes increasingly important as more countries move towards elimination.
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Rabinovich RN, Drakeley C, Djimde AA, Hall BF, Hay SI, Hemingway J, Kaslow DC, Noor A, Okumu F, Steketee R, Tanner M, Wells TNC, Whittaker MA, Winzeler EA, Wirth DF, Whitfield K, Alonso PL. malERA: An updated research agenda for malaria elimination and eradication. PLoS Med 2017; 14:e1002456. [PMID: 29190300 PMCID: PMC5708604 DOI: 10.1371/journal.pmed.1002456] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Achieving a malaria-free world presents exciting scientific challenges as well as overwhelming health, equity, and economic benefits. WHO and countries are setting ambitious goals for reducing the burden and eliminating malaria through the "Global Technical Strategy" and 21 countries are aiming to eliminate malaria by 2020. The commitment to achieve these targets should be celebrated. However, the need for innovation to achieve these goals, sustain elimination, and free the world of malaria is greater than ever. Over 180 experts across multiple disciplines are engaged in the Malaria Eradication Research Agenda (malERA) Refresh process to address problems that need to be solved. The result is a research and development agenda to accelerate malaria elimination and, in the longer term, transform the malaria community's ability to eradicate it globally.
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Affiliation(s)
- Regina N. Rabinovich
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail: ,
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - B. Fenton Hall
- National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Janet Hemingway
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - David C. Kaslow
- PATH Essential Medicines and PATH Center for Vaccine Innovation and Access, Seattle, Washington, United States of America
| | - Abdisalan Noor
- KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Fredros Okumu
- Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Richard Steketee
- PATH Malaria Control and Elimination Partnership in Africa, Seattle, Washington, United States of America
| | - Marcel Tanner
- Swiss TPH, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Maxine A. Whittaker
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Elizabeth A. Winzeler
- University of California, San Diego, School of Medicine, La Jolla, California, United States of America
| | - Dyann F. Wirth
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Kate Whitfield
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Pedro L. Alonso
- World Health Organization (WHO), Global Malaria Programme (GMP), Geneva, Switzerland
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