1
|
Anwar MN, Smith L, Devine A, Mehra S, Walker CR, Ivory E, Conway E, Mueller I, McCaw JM, Flegg JA, Hickson RI. Mathematical models of Plasmodium vivax transmission: A scoping review. PLoS Comput Biol 2024; 20:e1011931. [PMID: 38483975 DOI: 10.1371/journal.pcbi.1011931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/26/2024] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Plasmodium vivax is one of the most geographically widespread malaria parasites in the world, primarily found across South-East Asia, Latin America, and parts of Africa. One of the significant characteristics of the P. vivax parasite is its ability to remain dormant in the human liver as hypnozoites and subsequently reactivate after the initial infection (i.e. relapse infections). Mathematical modelling approaches have been widely applied to understand P. vivax dynamics and predict the impact of intervention outcomes. Models that capture P. vivax dynamics differ from those that capture P. falciparum dynamics, as they must account for relapses caused by the activation of hypnozoites. In this article, we provide a scoping review of mathematical models that capture P. vivax transmission dynamics published between January 1988 and May 2023. The primary objective of this work is to provide a comprehensive summary of the mathematical models and techniques used to model P. vivax dynamics. In doing so, we aim to assist researchers working on mathematical epidemiology, disease transmission, and other aspects of P. vivax malaria by highlighting best practices in currently published models and highlighting where further model development is required. We categorise P. vivax models according to whether a deterministic or agent-based approach was used. We provide an overview of the different strategies used to incorporate the parasite's biology, use of multiple scales (within-host and population-level), superinfection, immunity, and treatment interventions. In most of the published literature, the rationale for different modelling approaches was driven by the research question at hand. Some models focus on the parasites' complicated biology, while others incorporate simplified assumptions to avoid model complexity. Overall, the existing literature on mathematical models for P. vivax encompasses various aspects of the parasite's dynamics. We recommend that future research should focus on refining how key aspects of P. vivax dynamics are modelled, including spatial heterogeneity in exposure risk and heterogeneity in susceptibility to infection, the accumulation of hypnozoite variation, the interaction between P. falciparum and P. vivax, acquisition of immunity, and recovery under superinfection.
Collapse
Affiliation(s)
- Md Nurul Anwar
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
- Department of Mathematics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Lauren Smith
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Angela Devine
- Division of Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Somya Mehra
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Camelia R Walker
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Elizabeth Ivory
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Eamon Conway
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - Ivo Mueller
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
| | - James M McCaw
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Jennifer A Flegg
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Roslyn I Hickson
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
- Commonwealth Scientific and Industrial Research Organisation, Townsville, Australia
| |
Collapse
|
2
|
Haldar K, Alam MS, Koepfli C, Lobo NF, Phru CS, Islam MN, Faiz A, Khan WA, Haque R. Bangladesh in the era of malaria elimination. Trends Parasitol 2023; 39:760-773. [PMID: 37500334 DOI: 10.1016/j.pt.2023.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023]
Abstract
Bangladesh has dramatically reduced malaria by 93% from 2008 to 2020. The strategy has been district-wise, phased elimination; however, the last districts targeted for elimination include remote, forested regions which present several challenges for prevention, detection, and treatment of malaria. These districts border Myanmar which harbors Plasmodium falciparum malaria parasites resistant to artemisinins, key drugs used in artemisinin-based combination therapies (ACTs) that have been vital for control programs. Challenges in monitoring emergence of artemisinin resistance (AR), tracking parasite reservoirs, changes in vector behavior and responses to insecticides, as well as other environmental and host factors (including the migration of Forcibly Displaced Myanmar Nationals; FDMNs) may pose added hazards in the final phase of eliminating malaria in Bangladesh.
Collapse
Affiliation(s)
- Kasturi Haldar
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, IN, USA; Boler-Parseghian Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana, IN, USA; Eck Institute of Global Health, University of Notre Dame, Notre Dame, Indiana, IN, USA.
| | - Mohammed Shafiul Alam
- Infectious Disease Division, International Center of Diarrheal Diseases, Bangladesh, (icddr, b), Dhaka, Bangladesh
| | - Cristian Koepfli
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, IN, USA; Eck Institute of Global Health, University of Notre Dame, Notre Dame, Indiana, IN, USA
| | - Neil F Lobo
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, IN, USA; Eck Institute of Global Health, University of Notre Dame, Notre Dame, Indiana, IN, USA
| | - Ching Shwe Phru
- Infectious Disease Division, International Center of Diarrheal Diseases, Bangladesh, (icddr, b), Dhaka, Bangladesh
| | | | - Abul Faiz
- Dev Care Foundation, Dhaka, Bangladesh
| | - Wasif Ali Khan
- Infectious Disease Division, International Center of Diarrheal Diseases, Bangladesh, (icddr, b), Dhaka, Bangladesh
| | - Rashidul Haque
- Infectious Disease Division, International Center of Diarrheal Diseases, Bangladesh, (icddr, b), Dhaka, Bangladesh
| |
Collapse
|
3
|
Aubourg MA, Al-Amin HM, Sunkara A, Chetan S, Monroe A, Phru CS, Haque R, Khan WA, Hendershot A, Alam MS, Lobo NF. Human behaviour directs household-level exposure to malaria vectors in Bandarban, Bangladesh. Malar J 2022; 21:355. [PMID: 36443751 PMCID: PMC9706855 DOI: 10.1186/s12936-022-04375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bangladesh has reduced malaria incidence and mortality by over 75% between 2010 and 2020. Widespread long-lasting insecticidal net (LLIN) distribution and use is one of the measures responsible for this success. Recalcitrant malaria hotspots within the Chittagong Hill Tracts districts suggest important drivers of malaria risk may remain uncharacterized. METHODS Towards understanding how household-level human behaviour impacts exposure to mosquitoes, parallel human landing catches and human behavioural observations were conducted in four households for 6 months (May-October) over the rainy season in the Bandarban District. Analysis quantifies spatiotemporal human behaviour-adjusted exposure to Anopheles with and without LLINs. RESULTS This small-scale operational study demonstrates that human spatial and temporal presence along with LLIN use drives exposure to Anopheles. Though the four households had both outdoor and indoor exposure, especially in the evening (1800-2000 h) and early morning (0400-0500 h), data points to household-based heterogeneity in malaria exposure even with similar LLIN access. CONCLUSION Incorporating human behaviour into exposure estimates can be used to understand the efficacy and limitations of local vector control strategies and identify gaps in protection, as well as where present intervention strategies may be optimized.
Collapse
Affiliation(s)
- Matthew A Aubourg
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Hasan Mohammad Al-Amin
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.,QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Anoop Sunkara
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Sanjna Chetan
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Ching Swe Phru
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wasif A Khan
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Allison Hendershot
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Mohammad Shafiul Alam
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Neil F Lobo
- Department of Biological Sciences, 321 Galvin Life Science Center, University of Notre Dame, Notre Dame, IN, 46556, USA
| |
Collapse
|
4
|
Huwe T, Kibria MG, Johora FT, Phru CS, Jahan N, Hossain MS, Khan WA, Price RN, Ley B, Alam MS, Koepfli C. Heterogeneity in prevalence of subclinical Plasmodium falciparum and Plasmodium vivax infections but no parasite genomic clustering in the Chittagong Hill Tracts, Bangladesh. Malar J 2022; 21:218. [PMID: 35836171 PMCID: PMC9281141 DOI: 10.1186/s12936-022-04236-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/22/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Malaria remains endemic in Bangladesh, with the majority of cases occurring in forested, mountainous region in the Chittagong Hill Tracts (CHT). This area is home to Bengali and diverse groups of indigenous people (Pahari) residing largely in mono-ethnic villages. METHODS 1002 individuals of the 9 most prominent Pahari and the Bengali population were randomly selected and screened by RDT and qPCR. Parasites were genotyped by msp2 and deep sequencing of 5 amplicons (ama1-D3, cpmp, cpp, csp, and msp7) for Plasmodium falciparum (n = 20), and by microsatellite (MS) typing of ten loci and amplicon sequencing of msp1 for Plasmodium vivax (n = 21). Population structure was analysed using STRUCTURE software. Identity-by-state (IBS) was calculated as a measure of parasite relatedness and used to generate relatedness networks. RESULTS The prevalence of P. falciparum and P. vivax infection was 0.7% by RDT (P. falciparum 6/1002; P. vivax 0/1002, mixed: 1/1002) and 4% by qPCR (P. falciparum 21/1002; P. vivax 16/1002, mixed: 5/1002). Infections were highly clustered, with 64% (27/42) of infections occurring in only two Pahari groups, the Khumi and Mro. Diversity was high; expected heterozygosity was 0.93 for P. falciparum and 0.81 for P. vivax. 85.7% (18/21) of P. vivax and 25% (5/20) of P. falciparum infections were polyclonal. No population structure was evident for either species, suggesting high transmission and gene flow among Pahari groups. CONCLUSIONS High subclinical infection prevalence and genetic diversity mirror ongoing transmission. Control activities should be specifically directed to Pahari groups at greatest risk.
Collapse
Affiliation(s)
- Tiffany Huwe
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA
| | - Mohammad Golam Kibria
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
| | - Fatema Tuj Johora
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
- Georgia State University, Atlanta, GA, USA
| | - Ching Swe Phru
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
| | - Nusrat Jahan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
| | - Mohammad Sharif Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
| | - Wasif Ali Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh
| | - Ric N Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia.
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (Icddr, B), Dhaka, Bangladesh.
| | - Cristian Koepfli
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, USA.
| |
Collapse
|
5
|
Bhowmick IP, Nirmolia T, Pandey A, Subbarao SK, Nath A, Senapati S, Tripathy D, Pebam R, Nag S, Roy R, Dasgupta D, Debnath J, Gogoi K, Gogoi K, Borah L, Chanda R, Borgohain A, Mog C, Sarkar U, Gogoi P, Debnath B, Debbarma J, Ranjan Bhattacharya D, Joshi PL, Kaur H, Narain K. Dry Post Wintertime Mass Surveillance Unearths a Huge Burden of P. vivax, and Mixed Infection with P. vivax P. falciparum, a Threat to Malaria Elimination, in Dhalai, Tripura, India. Pathogens 2021; 10:pathogens10101259. [PMID: 34684207 PMCID: PMC8541100 DOI: 10.3390/pathogens10101259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
With India aiming to achieve malaria elimination by 2030, several strategies have been put in place. With that aim, mass surveillance is now being conducted in some malaria-endemic pockets. As dry season mass surveillance has been shown to have its importance in targeting the reservoir, a study was undertaken to assess the parasite load by a sensitive molecular method during one of the mass surveys conducted in the dry winter period. It was executed in two malaria-endemic villages of Dhalai District, Tripura, in northeast India, also reported as P. falciparum predominated area. The present study found an enormous burden of Rapid Diagnostic Test negative malaria cases with P. vivax along with P. vivax and P. falciparum mixed infections during the mass surveillance from febrile and afebrile cases in dry winter months (February 2021–March 2021). Of the total 150 samples tested, 72 (48%) were positive and 78 (52%) negative for malaria by PCR. Out of the 72 positives, 6 (8.33%) were P. falciparum, 40 (55.55%) P. vivax, and 26 (36.11%) mixed infections. Out of 78 malaria negative samples, 6 (7.7%) were with symptoms, while among the total malaria positive, 72 cases 7 (9.8%) were with symptoms, and 65 (90.2%) were asymptomatic. Out of 114 samples tested by both microscopy and PCR, 42 samples turned out to be submicroscopic with 4 P. falciparum, 23 P. vivax, and 15 mixed infections. Although all P. vivax submicroscopic infections were asymptomatic, three P. falciparum cases were found to be febrile. Evidence of malaria transmission was also found in the vectors in the winter month. The study ascertained the use of molecular diagnostic techniques in detecting the actual burden of malaria, especially of P. vivax, in mass surveys. As Jhum cultivators in Tripura are at high risk, screening for the malarial reservoirs in pre-Jhum months can help with malaria control and elimination.
Collapse
Affiliation(s)
- Ipsita Pal Bhowmick
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
- Correspondence:
| | - Tulika Nirmolia
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Apoorva Pandey
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, Delhi 110029, India; (A.P.); (H.K.)
| | - Sarala K. Subbarao
- Formerly National Institute of Malaria Research-ICMR, Delhi 110077, India;
| | - Aatreyee Nath
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Susmita Senapati
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Debabrata Tripathy
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Rocky Pebam
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Suman Nag
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Rajashree Roy
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Dipanjan Dasgupta
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Jayanta Debnath
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Kongkona Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Karuna Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Lakhyajit Borah
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | | | - Arup Borgohain
- Northeastern Space Applications Centre, Department of Space, Government of India, Umiam 793103, India; (A.N.); (R.P.); (A.B.)
| | - Chelapro Mog
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Ujjwal Sarkar
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Phiroz Gogoi
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Bishal Debnath
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Jyotish Debbarma
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Dibya Ranjan Bhattacharya
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| | - Pyare Lal Joshi
- Formerly National Vector Borne Disease Control Program (NVBDCP), Delhi 110054, India;
| | - Harpreet Kaur
- Indian Council of Medical Research (ICMR), Ramalingaswami Bhavan, Delhi 110029, India; (A.P.); (H.K.)
| | - Kanwar Narain
- Regional Medical Research Center-Northeast Region (RMRC-NE)-ICMR, Dibrugarh 786001, India; (T.N.); (S.S.); (D.T.); (S.N.); (R.R.); (D.D.); (J.D.); (K.G.); (K.G.); (L.B.); (C.M.); (U.S.); (P.G.); (B.D.); (J.D.); (D.R.B.); (K.N.)
| |
Collapse
|
6
|
Ley B, Alam MS, Kibria MG, Marfurt J, Phru CS, Ami JQ, Thriemer K, Auburn S, Jahan N, Johora FT, Hossain MS, Koepfli C, Khan WA, Price RN. Glucose-6-phosphate dehydrogenase activity in individuals with and without malaria: Analysis of clinical trial, cross-sectional and case-control data from Bangladesh. PLoS Med 2021; 18:e1003576. [PMID: 33891581 PMCID: PMC8064587 DOI: 10.1371/journal.pmed.1003576] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/01/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) activity is dependent upon G6PD genotype and age of the red blood cell (RBC) population, with younger RBCs having higher activity. Peripheral parasitemia with Plasmodium spp. induces hemolysis, replacing older RBCs with younger cells with higher G6PD activity. This study aimed to assess whether G6PD activity varies between individuals with and without malaria or a history of malaria. METHODS AND FINDINGS Individuals living in the Chittagong Hill Tracts of Bangladesh were enrolled into 3 complementary studies: (i) a prospective, single-arm clinical efficacy trial of patients (n = 175) with uncomplicated malaria done between 2014 and 2015, (ii) a cross-sectional survey done between 2015 and 2016 (n = 999), and (iii) a matched case-control study of aparasitemic individuals with and without a history of malaria done in 2020 (n = 506). G6PD activity was compared between individuals with and without malaria diagnosed by microscopy, rapid diagnostic test (RDT), or polymerase chain reaction (PCR), and in aparasitemic participants with and without a history of malaria. In the cross-sectional survey and clinical trial, 15.5% (182/1,174) of participants had peripheral parasitemia detected by microscopy or RDT, 3.1% (36/1,174) were positive by PCR only, and 81.4% (956/1,174) were aparasitemic. Aparasitemic individuals had significantly lower G6PD activity (median 6.9 U/g Hb, IQR 5.2-8.6) than those with peripheral parasitemia detected by microscopy or RDT (7.9 U/g Hb, IQR 6.6-9.8, p < 0.001), but G6PD activity similar to those with parasitemia detected by PCR alone (submicroscopic parasitemia) (6.1 U/g Hb, IQR 4.8-8.6, p = 0.312). In total, 7.7% (14/182) of patients with malaria had G6PD activity < 70% compared to 25.0% (248/992) of participants with submicroscopic or no parasitemia (odds ratio [OR] 0.25, 95% CI 0.14-0.44, p < 0.001). In the case-control study, the median G6PD activity was 10.3 U/g Hb (IQR 8.8-12.2) in 253 patients with a history of malaria and 10.2 U/g Hb (IQR 8.7-11.8) in 253 individuals without a history of malaria (p = 0.323). The proportion of individuals with G6PD activity < 70% was 11.5% (29/253) in the cases and 15.4% (39/253) in the controls (OR 0.7, 95% CI 0.41-1.23, p = 0.192). Limitations of the study included the non-contemporaneous nature of the clinical trial and cross-sectional survey. CONCLUSIONS Patients with acute malaria had significantly higher G6PD activity than individuals without malaria, and this could not be accounted for by a protective effect of G6PD deficiency. G6PD-deficient patients with malaria may have higher than expected G6PD enzyme activity and an attenuated risk of primaquine-induced hemolysis compared to the risk when not infected.
Collapse
Affiliation(s)
- Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
- * E-mail:
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Golam Kibria
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jutta Marfurt
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Ching Swe Phru
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jenifar Quaiyum Ami
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Sarah Auburn
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Nusrat Jahan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Tuj Johora
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sharif Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Cristian Koepfli
- Eck Institute for Global Health, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, United States of America
| | - Wasif Ali Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
7
|
Emeto TI, Adegboye OA, Rumi RA, Khan MUI, Adegboye M, Khan WA, Rahman M, Streatfield PK, Rahman KM. Disparities in Risks of Malaria Associated with Climatic Variability among Women, Children and Elderly in the Chittagong Hill Tracts of Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9469. [PMID: 33348771 PMCID: PMC7766360 DOI: 10.3390/ijerph17249469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/04/2022]
Abstract
Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1-7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8-7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7-27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9-25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar settings.
Collapse
Affiliation(s)
- Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Reza A. Rumi
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Mahboob-Ul I. Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | | | - Wasif A. Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka 1212, Bangladesh;
| | - Peter K. Streatfield
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.A.R.); (M.-U.I.K.); (W.A.K.); (P.K.S.)
| | - Kazi M. Rahman
- North Coast Public Health Unit, New South Wales Health, Lismore, NSW 2480, Australia;
- The University of Sydney, University Centre for Rural Health, Lismore, NSW 2480, Australia
| |
Collapse
|
8
|
Matin MA, Sarkar NDP, Phru CS, Ley B, Thriemer K, Price RN, Peeters Grietens K, Ali Khan W, Alam MS, Gryseels C. Precarity at the Margins of Malaria Control in the Chittagong Hill Tracts in Bangladesh: A Mixed-Methods Study. Pathogens 2020; 9:pathogens9100840. [PMID: 33066621 PMCID: PMC7602388 DOI: 10.3390/pathogens9100840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 01/12/2023] Open
Abstract
Bangladesh has achieved significant progress towards malaria elimination, although health service delivery for malaria remains challenging in remote forested areas such as the Chittagong Hill Tracts (CHT). The aim of this study was to investigate perceptions of malaria and its treatment among the local population to inform contextualized strategies for rolling out radical cure for P. vivax in Bangladesh. The study comprised two sequential strands whereby the preliminary results of a qualitative strand informed the development of a structured survey questionnaire used in the quantitative strand. Results show that ethnic minority populations in the CHT live in precarious socio-economic conditions which increase their exposure to infectious diseases, and that febrile patients often self-treat, including home remedies and pharmaceuticals, before attending a healthcare facility. Perceived low quality of care and lack of communication between Bengali health providers and ethnic minority patients also affects access to public healthcare. Malaria is viewed as a condition that affects vulnerable people weakened by agricultural work and taking away blood is perceived to increase such vulnerability. Healthcare providers that initiate and sustain a dialogue about these issues with ethnic minority patients may foster the trust that is needed for local malaria elimination efforts.
Collapse
Affiliation(s)
- Mohammad Abdul Matin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh; (M.A.M.); (C.S.P.); (W.A.K.); (M.S.A.)
| | - Nandini D. P. Sarkar
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, 2000 Antwerp, Belgium; (N.D.P.S.); (K.P.G.)
| | - Ching Swe Phru
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh; (M.A.M.); (C.S.P.); (W.A.K.); (M.S.A.)
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Rocklands Drive Casuarina, Darwin Northern Territory 0810, Australia; (B.L.); (K.T.); (R.N.P.)
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Rocklands Drive Casuarina, Darwin Northern Territory 0810, Australia; (B.L.); (K.T.); (R.N.P.)
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Rocklands Drive Casuarina, Darwin Northern Territory 0810, Australia; (B.L.); (K.T.); (R.N.P.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LG, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvith Road, Tungphyathai, Bangkok 10400, Thailand
| | - Koen Peeters Grietens
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, 2000 Antwerp, Belgium; (N.D.P.S.); (K.P.G.)
| | - Wasif Ali Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh; (M.A.M.); (C.S.P.); (W.A.K.); (M.S.A.)
| | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh; (M.A.M.); (C.S.P.); (W.A.K.); (M.S.A.)
| | - Charlotte Gryseels
- Department of Public Health, Institute of Tropical Medicine (ITM), Nationalestraat 155, 2000 Antwerp, Belgium; (N.D.P.S.); (K.P.G.)
- Correspondence: ; Tel.: +324-8561-8475
| |
Collapse
|
9
|
Sinha I, Sayeed AA, Uddin D, Wesolowski A, Zaman SI, Faiz MA, Ghose A, Rahman MR, Islam A, Karim MJ, Saha A, Rezwan MK, Shamsuzzaman AKM, Jhora ST, Aktaruzzaman MM, Chang HH, Miotto O, Kwiatkowski D, Dondorp AM, Day NPJ, Hossain MA, Buckee C, Maude RJ. Mapping the travel patterns of people with malaria in Bangladesh. BMC Med 2020; 18:45. [PMID: 32127002 PMCID: PMC7055101 DOI: 10.1186/s12916-020-1512-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Spread of malaria and antimalarial resistance through human movement present major threats to current goals to eliminate the disease. Bordering the Greater Mekong Subregion, southeast Bangladesh is a potentially important route of spread to India and beyond, but information on travel patterns in this area are lacking. METHODS Using a standardised short survey tool, 2090 patients with malaria were interviewed at 57 study sites in 2015-2016 about their demographics and travel patterns in the preceding 2 months. RESULTS Most travel was in the south of the study region between Cox's Bazar district (coastal region) to forested areas in Bandarban (31% by days and 45% by nights), forming a source-sink route. Less than 1% of travel reported was between the north and south forested areas of the study area. Farmers (21%) and students (19%) were the top two occupations recorded, with 67 and 47% reporting travel to the forest respectively. Males aged 25-49 years accounted for 43% of cases visiting forests but only 24% of the study population. Children did not travel. Women, forest dwellers and farmers did not travel beyond union boundaries. Military personnel travelled the furthest especially to remote forested areas. CONCLUSIONS The approach demonstrated here provides a framework for identifying key traveller groups and their origins and destinations of travel in combination with knowledge of local epidemiology to inform malaria control and elimination efforts. Working with the NMEP, the findings were used to derive a set of policy recommendations to guide targeting of interventions for elimination.
Collapse
Affiliation(s)
- Ipsita Sinha
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | | | - Didar Uddin
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Amy Wesolowski
- John Hopkins Bloomberg School of Public Health, Baltimore, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Sazid Ibna Zaman
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- BRAC (Building Resources Across Communities), BRAC Centre, Mohakhali, Dhaka, Bangladesh
| | - M Abul Faiz
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Dev Care Foundation, Dhaka, Bangladesh
| | - Aniruddha Ghose
- Chittagong Medical College and Hospital, Chittagong, Bangladesh
| | | | - Akramul Islam
- BRAC (Building Resources Across Communities), BRAC Centre, Mohakhali, Dhaka, Bangladesh
| | - Mohammad Jahirul Karim
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
- Filariasis Elimination, STH Control, Dhaka, Bangladesh
| | - Anjan Saha
- National Malaria Elimination Programme, Dhaka, Bangladesh
| | - M Kamar Rezwan
- Vector-Borne Disease Control, World Health Organization, Dhaka, Bangladesh
| | | | - Sanya Tahmina Jhora
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
| | - M M Aktaruzzaman
- Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh
- National Malaria Elimination Programme, Dhaka, Bangladesh
| | - Hsiao-Han Chang
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Olivo Miotto
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Big Data Institute, University of Oxford, Oxford, UK
| | - Dominic Kwiatkowski
- Big Data Institute, University of Oxford, Oxford, UK
- Wellcome Sanger Institute, Hinxton, Cambridge, UK
| | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - M Amir Hossain
- Chittagong Medical College and Hospital, Chittagong, Bangladesh
| | - Caroline Buckee
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Richard J Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| |
Collapse
|
10
|
Knowledge, attitudes, and practices regarding malaria control among the slash and burn cultivators in Rangamati Hill tracts of Bangladesh. Malar J 2019; 18:216. [PMID: 31238990 PMCID: PMC6593565 DOI: 10.1186/s12936-019-2849-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/19/2019] [Indexed: 12/02/2022] Open
Abstract
Background Slash and burn cultivators are a significant risk group for malaria in South-East Asia. As envisaged in the National Strategic Plan for Malaria Elimination, Bangladesh aims to achieve zero indigenous malaria transmission by 2030. For the national plan to move from malaria control to malaria elimination, targeting the population of slash and burn cultivators is of overriding importance. Methods The study used an explorative mixed method design to investigate the knowledge, attitudes, and practices (KAP) regarding malaria prevention and treatment in an endemic area of Bangladesh. Adult slash and burn cultivators in two sub-districts of the Rangamati District were selected and interviewed. Four focus group discussions were conducted, and this was followed by a cross-sectional quantitative survey with 200 participants. Results The respondents’ general knowledge about malaria transmission and modes of prevention and treatment was good. However, there were some gaps regarding knowledge about specific aspects of malaria transmission and in particular about the increased risk associated with their occupation. Despite a much-reduced incidence of malaria in the study area, the respondents perceived the disease as life-threatening and knew that it needs rapid attention from a health worker. Moreover, the specific services offered by the local community health workers for malaria diagnosis and treatment were highly appreciated. Finally, the use of insecticide-treated mosquito nets (ITN) was considered as important and this intervention was uniformly stated as the main malaria prevention method. Conclusions The findings from this study on promising KAP characteristics in the slash and burn cultivator population are reassuring that the goal of malaria elimination by the year 2030 can be achieved in Bangladesh.
Collapse
|
11
|
Noé A, Zaman SI, Rahman M, Saha AK, Aktaruzzaman MM, Maude RJ. Mapping the stability of malaria hotspots in Bangladesh from 2013 to 2016. Malar J 2018; 17:259. [PMID: 29996835 PMCID: PMC6042289 DOI: 10.1186/s12936-018-2405-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria claims hundreds of thousands of lives each year, most of them children. A "malaria-free world" is the World Health Organization's vision, but elimination from the southeast Asian Region is hampered by factors including anti-malarial resistance and systematic underreporting. Malaria is a significant public health problem in Bangladesh and while there have been recent gains in control, there is large spatial and temporal heterogeneity in the disease burden. This study aims to determine the pattern and stability of malaria hotspots in Bangladesh with the end goal of informing intervention planning for elimination. RESULTS Malaria in Bangladesh exhibited highly seasonal, hypoendemic transmission in geographic hotspots, which remained conserved over time. The southeast areas of the Chittagong Hill Tracts were identified as malaria hotspots for all 4 years examined. Similarly, areas in Sunamganj and Netrakona districts in the Northeast were hotspots for 2013-2016. Highly stable hotspots from 1 year predicted the following year's hotspot locations in the southeast of Bangladesh. Hotspots did not appear to act as sources of spread with no evidence of consistent patterns of contiguous spread or recession of hotspots as high or low transmission seasons progressed. CONCLUSIONS Areas were identified with temporal and spatial clustering of high malaria incidence in Bangladesh. Further studies are required to understand the vector, sociodemographic and disease dynamics within these hotspots. Given the low caseloads occurring in the low transmission seasons, and the conserved nature of malaria hotspots, directing resources towards these areas may be an efficient way to achieve malaria elimination in Bangladesh.
Collapse
Affiliation(s)
- Andrés Noé
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Sazid Ibna Zaman
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Mosiqure Rahman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Anjan Kumar Saha
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - M M Aktaruzzaman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Richard James Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA.
| |
Collapse
|
12
|
Shannon KL, Khan WA, Sack DA, Alam MS, Ahmed S, Prue CS, Khyang J, Ram M, Haq MZ, Akter J, Glass GE, Shields TM, Galagan SR, Nyunt MM, Sullivan DJ. Subclinical Plasmodium falciparum infections act as year-round reservoir for malaria in the hypoendemic Chittagong Hill districts of Bangladesh. Int J Infect Dis 2016; 49:161-9. [PMID: 27350586 DOI: 10.1016/j.ijid.2016.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES An analysis of the risk factors and seasonal and spatial distribution of individuals with subclinical malaria in hypoendemic Bangladesh was performed. METHODS From 2009 to 2012, active malaria surveillance without regard to symptoms was conducted on a random sample (n=3971) and pregnant women (n=589) during a cohort malaria study in a population of 24000. RESULTS The overall subclinical Plasmodium falciparum malaria point prevalence was 1.0% (n=35), but was 3.2% (n=18) for pregnant women. The estimated incidence was 39.9 per 1000 person-years for the overall population. Unlike symptomatic malaria, with a marked seasonal pattern, subclinical infections did not show a seasonal increase during the rainy season. Sixty-nine percent of those with subclinical P. falciparum infections reported symptoms commonly associated with malaria compared to 18% without infection. Males, pregnant women, jhum cultivators, and those living closer to forests and at higher elevations had a higher prevalence of subclinical infection. CONCLUSIONS Hypoendemic subclinical malaria infections were associated with a number of household and demographic factors, similar to symptomatic cases. Unlike clinical symptomatic malaria, which is highly seasonal, these actively detected infections were present year-round, made up the vast majority of infections at any given time, and likely acted as reservoirs for continued transmission.
Collapse
Affiliation(s)
- Kerry L Shannon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wasif A Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - David A Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - M Shafiul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabeena Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Chai Shwai Prue
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jacob Khyang
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Malathi Ram
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - M Zahirul Haq
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jasmin Akter
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Gregory E Glass
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA; Department of Geography, University of Florida, Gainesville, Florida, USA
| | - Timothy M Shields
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA
| | - Sean R Galagan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Myaing M Nyunt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David J Sullivan
- Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Rm W4612, Baltimore, MD 21205, USA.
| |
Collapse
|
13
|
Wen S, Harvard KE, Gueye CS, Canavati SE, Chancellor A, Ahmed BN, Leaburi J, Lek D, Namgay R, Surya A, Thakur GD, Whittaker MA, Gosling RD. Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific. Malar J 2016; 15:271. [PMID: 27165296 PMCID: PMC4863339 DOI: 10.1186/s12936-016-1319-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/28/2016] [Indexed: 12/22/2022] Open
Abstract
Background Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission. Methods A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN). Results All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure. Conclusion Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.
Collapse
Affiliation(s)
- Shawn Wen
- Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA
| | - Kelly E Harvard
- Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA.
| | - Cara Smith Gueye
- Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA
| | - Sara E Canavati
- Centre for Biomedical Research, Burnet Institute, 85 Commercial Road, Melbourne, VIC, Australia.,Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Arna Chancellor
- University of Queensland School of Public Health, Level 1, Public Health Building (887), Herston Rd, Herston, QLD, 4006, Australia
| | - Be-Nazir Ahmed
- Department of Microbiology, National Institute of Preventive and Social Medicine, Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh
| | - John Leaburi
- National Vector Borne Disease Control Programme, Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Dysoley Lek
- The National Center For Parasitology, Entomology and Malaria Control, Ministry of Health, Corner street 92, Trapaing Svay village, Sankat Phnom Penh Thmey, Khan Sensok, Phnom Penh, Cambodia
| | - Rinzin Namgay
- Vector-borne Disease Control Programme, Ministry of Health, Gelephu, Royal Government of Bhutan
| | - Asik Surya
- National Malaria Control Programme, Directorate General of Disease Control and Environment Health, Ministry of Health, Jakarta, Republic of Indonesia
| | - Garib D Thakur
- Monitoring and Evaluation Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Maxine Anne Whittaker
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia
| | - Roly D Gosling
- Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA, 94158, USA
| |
Collapse
|
14
|
Wen S, Harvard KE, Gueye CS, Canavati SE, Chancellor A, Ahmed BN, Leaburi J, Lek D, Namgay R, Surya A, Thakur GD, Whittaker MA, Gosling RD. Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific. Malar J 2016; 15:271. [PMID: 27165296 PMCID: PMC4863339 DOI: 10.1186/s12936-016-1319-1#citeas] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/28/2016] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission. METHODS A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN). RESULTS All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure. CONCLUSION Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.
Collapse
Affiliation(s)
- Shawn Wen
- />Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA 94158 USA
| | - Kelly E. Harvard
- />Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA 94158 USA
| | - Cara Smith Gueye
- />Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA 94158 USA
| | - Sara E. Canavati
- />Centre for Biomedical Research, Burnet Institute, 85 Commercial Road, Melbourne, VIC Australia
- />Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400 Thailand
| | - Arna Chancellor
- />University of Queensland School of Public Health, Level 1, Public Health Building (887), Herston Rd, Herston, QLD 4006 Australia
| | - Be-Nazir Ahmed
- />Department of Microbiology, National Institute of Preventive and Social Medicine, Ministry of Health and Family Welfare, Mohakhali, Dhaka, Bangladesh
| | - John Leaburi
- />National Vector Borne Disease Control Programme, Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Dysoley Lek
- />The National Center For Parasitology, Entomology and Malaria Control, Ministry of Health, Corner street 92, Trapaing Svay village, Sankat Phnom Penh Thmey, Khan Sensok, Phnom Penh, Cambodia
| | - Rinzin Namgay
- />Vector-borne Disease Control Programme, Ministry of Health, Gelephu, Royal Government of Bhutan
| | - Asik Surya
- />National Malaria Control Programme, Directorate General of Disease Control and Environment Health, Ministry of Health, Jakarta, Republic of Indonesia
| | - Garib D. Thakur
- />Monitoring and Evaluation Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Maxine Anne Whittaker
- />College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811 Australia
| | - Roly D. Gosling
- />Global Health Group, University of California, 550 16th St, 3rd Floor, San Francisco, CA 94158 USA
| |
Collapse
|
15
|
Geospatial Technology: A Tool to Aid in the Elimination of Malaria in Bangladesh. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2014. [DOI: 10.3390/ijgi4010047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|