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Mitchell CL, Janko MM, Mwandagalirwa MK, Tshefu AK, Edwards JK, Pence BW, Juliano JJ, Emch M. Impact of extractive industries on malaria prevalence in the Democratic Republic of the Congo: a population-based cross-sectional study. Sci Rep 2022; 12:1737. [PMID: 35110617 PMCID: PMC8810856 DOI: 10.1038/s41598-022-05777-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/18/2022] [Indexed: 12/11/2022] Open
Abstract
Extraction of natural resources through mining and logging activities provides revenue and employment across sub-Saharan Africa, a region with the highest burden of malaria globally. The extent to which mining and logging influence malaria transmission in Africa remains poorly understood. Here, we evaluate associations between mining, logging, and malaria in the high transmission setting of the Democratic Republic of the Congo using population-representative malaria survey results and geographic data for environmental features and mining and logging concessions. We find elevated malaria prevalence among individuals in rural areas exposed to mining; however, we also detect significant spatial confounding among locations. Upon correction, effect estimates for mining and logging shifted toward the null and we did not find sufficient evidence to detect an association with malaria. Our findings reveal a complex interplay between mining, logging, space, and malaria prevalence. While mining concessions alone may not drive the high prevalence, unobserved features of mining-exposed areas, such as human migration, changing vector populations, or parasite genetics, may instead be responsible.
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Affiliation(s)
- Cedar L Mitchell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA.
| | - Mark M Janko
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Melchior K Mwandagalirwa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA.,Kinshasa School of Public Health, Hôpital General Provincial de Reference de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Antoinette K Tshefu
- Kinshasa School of Public Health, Hôpital General Provincial de Reference de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA
| | - Jonathan J Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA.,Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC, 27599, USA.,Department of Geography, University of North Carolina, Chapel Hill, NC, USA
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Mitchell CL, Topazian HM, Brazeau NF, Deutsch-Feldman M, Muwonga J, Sompwe E, Tshefu AK, Mwandagalirwa MK, Parr JB, Juliano JJ. Household prevalence of P. falciparum, P. vivax, and P. ovale in the Democratic Republic of the Congo, 2013-2014. Clin Infect Dis 2020; 73:e3966-e3969. [PMID: 33238298 DOI: 10.1093/cid/ciaa1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/20/2020] [Indexed: 11/15/2022] Open
Abstract
In a cross-sectional molecular study in the Democratic Republic of Congo, 78% of households had at least one member infected with Plasmodium falciparum, vivax, and/or ovale spp. 47% of children and 33% of adults tested positive for at least one species. Risk factors varied by species and age group.
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Affiliation(s)
- Cedar L Mitchell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Hillary M Topazian
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Nicholas F Brazeau
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Medical Scientist Training Program, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Molly Deutsch-Feldman
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jeremie Muwonga
- Programme National de la Lutte contre le SIDA, Kinshasa, Democratic Republic of Congo
| | - Eric Sompwe
- Programme National de la Lutte contre le Paludisme, Kinshasa, Democratic Republic of Congo
| | - Antoinette K Tshefu
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Melchior K Mwandagalirwa
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jonathan B Parr
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Jonathan J Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
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Watson OJ, Verity R, Ghani AC, Garske T, Cunningham J, Tshefu A, Mwandagalirwa MK, Meshnick SR, Parr JB, Slater HC. Impact of seasonal variations in Plasmodium falciparum malaria transmission on the surveillance of pfhrp2 gene deletions. eLife 2019; 8:40339. [PMID: 31045490 PMCID: PMC6533063 DOI: 10.7554/elife.40339] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/29/2019] [Indexed: 12/15/2022] Open
Abstract
Ten countries have reported pfhrp2/pfhrp3 gene deletions since the first observation of pfhrp2-deleted parasites in 2012. In a previous study (Watson et al., 2017), we characterised the drivers selecting for pfhrp2/3 deletions and mapped the regions in Africa with the greatest selection pressure. In February 2018, the World Health Organization issued guidance on investigating suspected false-negative rapid diagnostic tests (RDTs) due to pfhrp2/3 deletions. However, no guidance is provided regarding the timing of investigations. Failure to consider seasonal variation could cause premature decisions to switch to alternative RDTs. In response, we have extended our methods and predict that the prevalence of false-negative RDTs due to pfhrp2/3 deletions is highest when sampling from younger individuals during the beginning of the rainy season. We conclude by producing a map of the regions impacted by seasonal fluctuations in pfhrp2/3 deletions and a database identifying optimum sampling intervals to support malaria control programmes.
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Affiliation(s)
- Oliver John Watson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Robert Verity
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Azra C Ghani
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Tini Garske
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Antoinette Tshefu
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Melchior K Mwandagalirwa
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.,Department of Epidemiology, Gillings School for Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School for Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Jonathan B Parr
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Hannah C Slater
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Watson OJ, Slater HC, Verity R, Parr JB, Mwandagalirwa MK, Tshefu A, Meshnick SR, Ghani AC. Modelling the drivers of the spread of Plasmodium falciparum hrp2 gene deletions in sub-Saharan Africa. eLife 2017; 6:25008. [PMID: 28837020 PMCID: PMC5602420 DOI: 10.7554/elife.25008] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
Rapid diagnostic tests (RDTs) have transformed malaria diagnosis. The most prevalent P. falciparum RDTs detect histidine-rich protein 2 (PfHRP2). However, pfhrp2 gene deletions yielding false-negative RDTs, first reported in South America in 2010, have been confirmed in Africa and Asia. We developed a mathematical model to explore the potential for RDT-led diagnosis to drive selection of pfhrp2-deleted parasites. Low malaria prevalence and high frequencies of people seeking treatment resulted in the greatest selection pressure. Calibrating our model against confirmed pfhrp2-deletions in the Democratic Republic of Congo, we estimate a starting frequency of 6% pfhrp2-deletion prior to RDT introduction. Furthermore, the patterns observed necessitate a degree of selection driven by the introduction of PfHRP2-based RDT-guided treatment. Combining this with parasite prevalence and treatment coverage estimates, we map the model-predicted spread of pfhrp2-deletion, and identify the geographic regions in which surveillance for pfhrp2-deletion should be prioritised.
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Affiliation(s)
- Oliver J Watson
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Hannah C Slater
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Robert Verity
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jonathan B Parr
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, United States
| | - Melchior K Mwandagalirwa
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, United States.,Ecole de Santé Publique, Faculté de Medecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoinette Tshefu
- Ecole de Santé Publique, Faculté de Medecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steven R Meshnick
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, United States
| | - Azra C Ghani
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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