Urbanization and malaria have a contextual relationship in endemic areas: A temporal and spatial study in Ghana

In West Africa, malaria is one of the leading causes of disease-induced deaths. Existing studies indicate that as urbanization increases, there is corresponding decrease in malaria prevalence. However, in malaria-endemic areas, the prevalence in some rural areas is sometimes lower than in some peri-urban and urban areas. Therefore, the relationship between the degree of urbanization, the impact of living in urban areas, and the prevalence of malaria remains unclear. This study explores this association in Ghana, using epidemiological data at the district level (2015-2018) and data on health, hygiene, and education. We applied a multilevel model and time series decomposition to understand the epidemiological pattern of malaria in Ghana. Then we classified the districts of Ghana into rural, peri-urban, and urban areas using administratively defined urbanization, total built areas, and built intensity. We converted the prevalence time series into cross-sectional data for each district by extracting features from the data. To predict the determinant most impacting according to the degree of urbanization, we used a cluster-specific random forest. We find that prevalence is impacted by seasonality, but the trend of the seasonal signature is not noticeable in urban and peri-urban areas. While urban districts have a slightly lower prevalence, there are still pockets with higher rates within these regions. These areas of high prevalence are linked to proximity to water bodies and waterways, but the rise in these same variables is not associated with the increase of prevalence in peri-urban areas. The increase in nightlight reflectance in rural areas is associated with an increased prevalence. We conclude that urbanization is not the main factor driving the decline in malaria. However, the data indicate that understanding and managing malaria prevalence in urbanization will necessitate a focus on these contextual factors. Finally, we design an interactive tool, 'malDecision' that allows data-supported decision-making.

Insecticide susceptibility status of Anopheles gambiae (s.l.) in and surrounding areas of Lake Tana, northwest Ethiopia

BACKGROUND

Vector control is the most effective malaria control and prevention measure. Among these, IRS and LLINs are the most important chemical insecticide interventions used in malaria prevention and control strategies in Ethiopia. However, the long-term effectiveness of these strategies is under threat due to the emergency and spread of insecticide resistance in the principal malaria vector. Therefore, this study was carried out, under standardized laboratory conditions to assess the killing effect of some insecticides against An. gambiae s.l.

METHODS

Mosquitoes in late instar larvae and pupae stages were collected from different breeding habitats of the study sites using a soup ladle (350 ml capacity). The immature was reared to adults at optimum temperature and humidity in a field insectary using the WHO protocol. Four insecticides representing three chemical classes were used against adult mosquitoes. These were permethrin, deltamethrin, pirimiphos-methyl and bendiocarb. Susceptibility tests were carried out from September to December 2021 using the WHO standard procedures. Mortality rate, variation, interaction effect and knockdown times (KDT50 and KDT95%) were computed using descriptive statistics, multivariate analysis of variance and log-probit regression model using SPSS version 20 software.

RESULTS

Totally, 1300 Anopheles gambiae s.l. were tested to determine the susceptibility status to the four insecticides. Among these, 90.7% of them were susceptible to insecticides, whereas the remaining 9.3% of specimens were resistant to the insecticides. The results of the analysis of variance showed that mortality significantly varied between insecticides (F = 26.06, DF = 3, P < .0001), but not between study locations (F = 1.56, DF = 3, P = 0.212). On the other hand, the mean comparison of dead mosquitoes showed some signs of interaction between bendiocarb and locations, but not other insecticides and locations.

CONCLUSIONS

This study revealed that the knockdown times and effectiveness of different insecticides varied in different study sites. Therefore, insecticide resistance information is very essential for concerned bodies to make informed and evidence-based decisions on vector control.

Whole Genome Sequencing Contributions and Challenges in Disease Reduction Focused on Malaria

Malaria elimination remains an important goal that requires the adoption of sophisticated science and management strategies in the era of the COVID-19 pandemic. The advent of next generation sequencing (NGS) is making whole genome sequencing (WGS) a standard today in the field of life sciences, as PCR genotyping and targeted sequencing provide insufficient information compared to the whole genome. Thus, adapting WGS approaches to malaria parasites is pertinent to studying the epidemiology of the disease, as different regions are at different phases in their malaria elimination agenda. Therefore, this review highlights the applications of WGS in disease management, challenges of WGS in controlling malaria parasites, and in furtherance, provides the roles of WGS in pursuit of malaria reduction and elimination. WGS has invaluable impacts in malaria research and has helped countries to reach elimination phase rapidly by providing required information needed to thwart transmission, pathology, and drug resistance. However, to eliminate malaria in sub-Saharan Africa (SSA), with high malaria transmission, we recommend that WGS machines should be readily available and affordable in the region.