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Sample records for changing malaria risk

  1. Climate change and malaria risk in the European part of Russia in 21st century

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    Shartova, N.; Malkhazova, S.

    2009-04-01

    The purpose of this research is development of prognostic model of malaria risk for European part of Russia (EPR) in the 21st century according to climate scenario IPCC "A2". The following issues have been formulated to reach the goal of the research: define the basic epidemiological parameters describing malaria situation and methods of data processing; creating of maps of malaria risk; analysis of changes in malaria distribution for predictable future climate conditions in comparison with conditions of a modern climate. A lot of reasons (biological, social and economic) impact on malaria distribution. Nevertheless, incubation period of the parasite first of all depends on temperature. This is a primary factor that defines a potential area of infection, ability and specificity to transmit malaria. According to this, the model is based on the relationship between climate (average daily temperature) and the intensity of malaria transmission. The object of research is malaria parasite Plasmodium vivax, which has for Russia (particularly for EPR) the greatest importance because it has the lowest minimal temperature threshold for development. Climate data is presented by daily average temperatures of air for three analyzed periods. 1961 -1989 describes a modern climate and corresponds to the minimum 30-year period that is necessary for an assessment of climate and changes connected with biotic components. Prognostic malaria model is based on predicted daily average temperatures for 2046-2065 (the middle of century) and 2089-2100 (the end of century). All data sets for EPR are presented in the grid 2x2. The conclusion on possible changes in malaria distribution and transmission in the middle and the end of the 21st century: There is going to be the increase of duration of effective temperatures period (period when parasite development is possible), period of effective susceptibility to infection of mosquitoes (period when malaria transmission cycle is possible); shift

  2. Climate change and malaria risk in Russia in 21st century

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    Malkhazova, S.; Shartova, N.

    2010-09-01

    The purpose of this research is development of prognostic model of malaria risk for Russia in the 21st century according to climate scenario IPCC "А2". The following issues have been formulated to reach the goal of the research: - define the basic epidemiological parameters describing malaria situation and methods of data processing; - creating of maps of malaria risk; - analysis of changes in malaria distribution for predictable future climate conditions in comparison with conditions of a modern climate. A lot of reasons (biological, social and economic) impact on malaria distribution. Nevertheless, incubation period of the parasite first of all depends on temperature. This is a primary factor that defines a potential area of infection, ability and specificity to transmit malaria. According to this, the model is based on the relationship between climate (average daily temperature) and the intensity of malaria transmission. The object of research is malaria parasite Plasmodium vivax, which has for Russia the greatest importance because it has the lowest minimal temperature threshold for development. Climate data is presented by daily average temperatures of air for three analyzed periods. 1961 -1989 describes a modern climate and corresponds to the minimum 30-year period that is necessary for an assessment of climate and changes connected with biotic components. Prognostic malaria model is based on predicted daily average temperatures for 2046-2065 (the middle of century) and 2089-2100 (the end of century). All data sets are presented in the grid 2х20. The conclusion on possible changes in malaria distribution and transmission in the middle and the end of the 21st century: There is going to be the increase of duration of effective temperatures period (period when parasite development is possible), period of effective susceptibility to infection of mosquitoes (period when malaria transmission cycle is possible); shift of the beginning of malaria transmission

  3. The Impact of Regional Climate Change on Malaria Risk due to Greenhouse Forcing and Land-Use Changes in Tropical Africa

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    Fink, Andreas H.; Morse, Andrew P.; Paeth, Heiko

    2011-01-01

    Background: Climate change will probably alter the spread and transmission intensity of malaria in Africa. Objectives: In this study, we assessed potential changes in the malaria transmission via an integrated weather–disease model. Methods: We simulated mosquito biting rates using the Liverpool Malaria Model (LMM). The input data for the LMM were bias-corrected temperature and precipitation data from the regional model (REMO) on a 0.5° latitude–longitude grid. A Plasmodium falciparum infection model expands the LMM simulations to incorporate information on the infection rate among children. Malaria projections were carried out with this integrated weather–disease model for 2001 to 2050 according to two climate scenarios that include the effect of anthropogenic land-use and land-cover changes on climate. Results: Model-based estimates for the present climate (1960 to 2000) are consistent with observed data for the spread of malaria in Africa. In the model domain, the regions where malaria is epidemic are located in the Sahel as well as in various highland territories. A decreased spread of malaria over most parts of tropical Africa is projected because of simulated increased surface temperatures and a significant reduction in annual rainfall. However, the likelihood of malaria epidemics is projected to increase in the southern part of the Sahel. In most of East Africa, the intensity of malaria transmission is expected to increase. Projections indicate that highland areas that were formerly unsuitable for malaria will become epidemic, whereas in the lower-altitude regions of the East African highlands, epidemic risk will decrease. Conclusions: We project that climate changes driven by greenhouse-gas and land-use changes will significantly affect the spread of malaria in tropical Africa well before 2050. The geographic distribution of areas where malaria is epidemic might have to be significantly altered in the coming decades. PMID:21900078

  4. Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania

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    Larisa Ivanescu

    2016-01-01

    Full Text Available The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers’ immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007–2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority.

  5. Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania.

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    Ivanescu, Larisa; Bodale, Ilie; Florescu, Simin-Aysel; Roman, Constantin; Acatrinei, Dumitru; Miron, Liviu

    2016-01-01

    The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers' immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007-2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority.

  6. Malaria ecology and climate change

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    McCord, G. C.

    2016-05-01

    Understanding the costs that climate change will exact on society is crucial to devising an appropriate policy response. One of the channels through while climate change will affect human society is through vector-borne diseases whose epidemiology is conditioned by ambient ecology. This paper introduces the literature on malaria, its cost on society, and the consequences of climate change to the physics community in hopes of inspiring synergistic research in the area of climate change and health. It then demonstrates the use of one ecological indicator of malaria suitability to provide an order-of-magnitude assessment of how climate change might affect the malaria burden. The average of Global Circulation Model end-of-century predictions implies a 47% average increase in the basic reproduction number of the disease in today's malarious areas, significantly complicating malaria elimination efforts.

  7. Malaria risk factors in north-east Tanzania

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    Mtove George

    2011-04-01

    Full Text Available Abstract Background Understanding the factors which determine a household's or individual's risk of malaria infection is important for targeting control interventions at all intensities of transmission. Malaria ecology in Tanzania appears to have reduced over recent years. This study investigated potential risk factors and clustering in face of changing infection dynamics. Methods Household survey data were collected in villages of rural Muheza district. Children aged between six months and thirteen years were tested for presence of malaria parasites using microscopy. A multivariable logistic regression model was constructed to identify significant risk factors for children. Geographical information systems combined with global positioning data and spatial scan statistic analysis were used to identify clusters of malaria. Results Using an insecticide-treated mosquito net of any type proved to be highly protective against malaria (OR 0.75, 95% CI 0.59-0.96. Children aged five to thirteen years were at higher risk of having malaria than those aged under five years (OR 1.71, 95% CI 1.01-2.91. The odds of malaria were less for females when compared to males (OR 0.62, 95% CI 0.39-0.98. Two spatial clusters of significantly increased malaria risk were identified in two out of five villages. Conclusions This study provides evidence that recent declines in malaria transmission and prevalence may shift the age groups at risk of malaria infection to older children. Risk factor analysis provides support for universal coverage and targeting of long-lasting insecticide-treated nets (LLINs to all age groups. Clustering of cases indicates heterogeneity of risk. Improved targeting of LLINs or additional supplementary control interventions to high risk clusters may improve outcomes and efficiency as malaria transmission continues to fall under intensified control.

  8. Bayesian modelling of geostatistical malaria risk data

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    L. Gosoniu

    2006-11-01

    Full Text Available Bayesian geostatistical models applied to malaria risk data quantify the environment-disease relations, identify significant environmental predictors of malaria transmission and provide model-based predictions of malaria risk together with their precision. These models are often based on the stationarity assumption which implies that spatial correlation is a function of distance between locations and independent of location. We relax this assumption and analyse malaria survey data in Mali using a Bayesian non-stationary model. Model fit and predictions are based on Markov chain Monte Carlo simulation methods. Model validation compares the predictive ability of the non-stationary model with the stationary analogue. Results indicate that the stationarity assumption is important because it influences the significance of environmental factors and the corresponding malaria risk maps.

  9. Bayesian modelling of geostatistical malaria risk data.

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    Gosoniu, L; Vounatsou, P; Sogoba, N; Smith, T

    2006-11-01

    Bayesian geostatistical models applied to malaria risk data quantify the environment-disease relations, identify significant environmental predictors of malaria transmission and provide model-based predictions of malaria risk together with their precision. These models are often based on the stationarity assumption which implies that spatial correlation is a function of distance between locations and independent of location. We relax this assumption and analyse malaria survey data in Mali using a Bayesian non-stationary model. Model fit and predictions are based on Markov chain Monte Carlo simulation methods. Model validation compares the predictive ability of the non-stationary model with the stationary analogue. Results indicate that the stationarity assumption is important because it influences the significance of environmental factors and the corresponding malaria risk maps.

  10. Impact of climate change on global malaria distribution.

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    Caminade, Cyril; Kovats, Sari; Rocklov, Joacim; Tompkins, Adrian M; Morse, Andrew P; Colón-González, Felipe J; Stenlund, Hans; Martens, Pim; Lloyd, Simon J

    2014-03-04

    Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution.

  11. Changing malaria transmission and implications in China towards National Malaria Elimination Programme between 2010 and 2012.

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    Jian-hai Yin

    Full Text Available BACKGROUND: Towards the implementation of national malaria elimination programme in China since 2010, the epidemiology of malaria has changed dramatically, and the lowest malaria burden was achieved yearly. It is time to analyze the changes of malaria situation based on surveillance data from 2010 to 2012 to reconsider the strategies for malaria elimination. METHODS AND PRINCIPAL FINDINGS: Malaria epidemiological data was extracted from the provincial annual reports in China between 2010 and 2012. The trends of the general, autochthonous and imported malaria were analyzed, and epidemic areas were reclassified according to Action Plan of China Malaria Elimination (2010-2020. As a result, there reported 2743 malaria cases with a continued decline in 2012, and around 7% autochthonous malaria cases accounted. Three hundred and fifty-three individual counties from 19 provincial regions had autochthonous malaria between 2010 and 2012, and only one county was reclassified into Type I (local infections detected in 3 consecutive years and the annual incidences ≥ 1/10,000 again. However, the imported malaria cases reported of each year were widespread, and 598 counties in 29 provinces were suffered in 2012. CONCLUSIONS/SIGNIFICANCE: Malaria was reduced significantly from 2010 to 2012 in China, and malaria importation became an increasing challenge. It is necessary to adjust or update the interventions for subsequent malaria elimination planning and resource allocation.

  12. Mapping Malaria Transmission Risk in Northern Morocco Using Entomological and Environmental Data

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    E. Adlaoui; Faraj, C; El Bouhmi, M.; El Aboudi, A.; S. Ouahabi; Tran, A.; Fontenille, D.; El Aouad, R

    2011-01-01

    Malaria resurgence risk in Morocco depends, among other factors, on environmental changes as well as the introduction of parasite carriers. The aim of this paper is to analyze the receptivity of the Loukkos area, large wetlands in Northern Morocco, to quantify and to map malaria transmission risk in this region using biological and environmental data. This risk was assessed on entomological risk basis and was mapped using environmental markers derived from satellite imagery. Maps showing spat...

  13. RISK FOR MALARIA IN UNITED STATES DONORS DEFERRED FOR TRAVEL TO MALARIA-ENDEMIC AREAS

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    Spencer, Bryan; Steele, Whitney; Custer, Brian; Kleinman, Steven; Cable, Ritchard; Wilkinson, Susan; Wright, David

    2009-01-01

    BACKGROUND Deferral for travel to malaria-endemic areas excludes many blood donors in the United States. Most transfusion-transmitted malaria is associated with lengthy residence in malaria-endemic areas rather than routine travel. This study compares the impact of existing deferral requirements to the risk that a presenting donor with malaria travel history harbors malaria parasites under current and hypothetical alternate regulations. STUDY DESIGN AND METHODS Deferred donors from six blood centers were sampled to estimate a national cohort of donors deferred annually for malaria travel to different geographic regions. Risk for malaria infection following travel to each region, and distribution of incubation periods for each malaria species were estimated for U.S. travelers. Region-specific travel risks were used to estimate the risk that a presenting blood donor with malaria travel might asymptomatically harbor malaria parasites at different intervals following return to the United States. RESULTS Travel to Africa presents risk for malaria infection >1000 times that of travel to malaria-endemic parts of Mexico, yet Mexico accounts for >10 times as many deferred donors. Shortening the deferral period from 12 to 3 months for travelers to Mexico increases the risk of collecting a contaminated unit by only 1 unit per 57 years (sensitivity analysis, 1 every 29 - 114 years), at annual gain of >56,000 donations. CONCLUSION This study provides the first systematic appraisal of the U.S. requirements for donor qualification regarding travel to malarial areas. Consideration should be given to relaxing the guidelines for travel to very low-risk areas such as Mexico. PMID:19903290

  14. The incidence of malaria in travellers to South-East Asia: is local malaria transmission a useful risk indicator?

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    Jänisch Thomas

    2010-10-01

    Full Text Available Abstract Background The presence of ongoing local malaria transmission, identified though local surveillance and reported to regional WHO offices, by S-E Asian countries, forms the basis of national and international chemoprophylaxis recommendations in western countries. The study was designed to examine whether the strategy of using malaria transmission in a local population was an accurate estimate of the malaria threat faced by travellers and a correlate of malaria in returning travellers. Methods Malaria endemicity was described from distribution and intensity in the local populations of ten S-E Asian destination countries over the period 2003-2008 from regionally reported cases to WHO offices. Travel acquired malaria was collated from malaria surveillance reports from the USA and 12 European countries over the same period. The numbers of travellers visiting the destination countries was based on immigration and tourism statistics collected on entry of tourists to the destination countries. Results In the destination countries, mean malaria rates in endemic countries ranged between 0.01 in Korea to 4:1000 population per year in Lao PDR, with higher regional rates in a number of countries. Malaria cases imported into the 13 countries declined by 47% from 140 cases in 2003 to 66 in 2008. A total of 608 cases (27.3% Plasmodium falciparum (Pf were reported over the six years, the largest number acquired in Indonesia, Thailand and Korea. Four countries had an incidence > 1 case per 100,000 traveller visits; Burma (Myanmar, Indonesia, Cambodia and Laos (range 1 to 11.8-case per 100,000 visits. The remaining six countries rates were Conclusion The intensity of malaria transmission particularly sub-national activity did not correlate with the risk of travellers acquiring malaria in the large numbers of arriving visitors. It is proposed to use a threshold incidence of > 1 case per 100,000 visits to consider targeted malaria prophylaxis

  15. Visualizing the uncertainty in the relationship between seasonal average climate and malaria risk

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    MacLeod, D. A.; Morse, A. P.

    2014-12-01

    Around $1.6 billion per year is spent financing anti-malaria initiatives, and though malaria morbidity is falling, the impact of annual epidemics remains significant. Whilst malaria risk may increase with climate change, projections are highly uncertain and to sidestep this intractable uncertainty, adaptation efforts should improve societal ability to anticipate and mitigate individual events. Anticipation of climate-related events is made possible by seasonal climate forecasting, from which warnings of anomalous seasonal average temperature and rainfall, months in advance are possible. Seasonal climate hindcasts have been used to drive climate-based models for malaria, showing significant skill for observed malaria incidence. However, the relationship between seasonal average climate and malaria risk remains unquantified. Here we explore this relationship, using a dynamic weather-driven malaria model. We also quantify key uncertainty in the malaria model, by introducing variability in one of the first order uncertainties in model formulation. Results are visualized as location-specific impact surfaces: easily integrated with ensemble seasonal climate forecasts, and intuitively communicating quantified uncertainty. Methods are demonstrated for two epidemic regions, and are not limited to malaria modeling; the visualization method could be applied to any climate impact.

  16. Predicting and mapping malaria under climate change scenarios: the potential redistribution of malaria vectors in Africa

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    Kangalawe Richard YM

    2010-04-01

    Full Text Available Abstract Background Malaria is rampant in Africa and causes untold mortality and morbidity. Vector-borne diseases are climate sensitive and this has raised considerable concern over the implications of climate change on future disease risk. The problem of malaria vectors (Anopheles mosquitoes shifting from their traditional locations to invade new zones is an important concern. The vision of this study was to exploit the sets of information previously generated by entomologists, e.g. on geographical range of vectors and malaria distribution, to build models that will enable prediction and mapping the potential redistribution of Anopheles mosquitoes in Africa. Methods The development of the modelling tool was carried out through calibration of CLIMEX parameters. The model helped estimate the potential geographical distribution and seasonal abundance of the species in relation to climatic factors. These included temperature, rainfall and relative humidity, which characterized the living environment for Anopheles mosquitoes. The same parameters were used in determining the ecoclimatic index (EI. The EI values were exported to a GIS package for special analysis and proper mapping of the potential future distribution of Anopheles gambiae and Anophles arabiensis within the African continent under three climate change scenarios. Results These results have shown that shifts in these species boundaries southward and eastward of Africa may occur rather than jumps into quite different climatic environments. In the absence of adequate control, these predictions are crucial in understanding the possible future geographical range of the vectors and the disease, which could facilitate planning for various adaptation options. Conclusion Thus, the outputs from this study will be helpful at various levels of decision making, for example, in setting up of an early warning and sustainable strategies for climate change and climate change adaptation for malaria

  17. Prevalence and risk factors of malaria in Ethiopia

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    Ayele Dawit G

    2012-06-01

    Full Text Available Abstract Background More than 75% of the total area of Ethiopia is malarious, making malaria the leading public health problem in Ethiopia. The aim of this study was to investigate the prevalence rate and the associated socio-economic, geographic and demographic factors of malaria based on the rapid diagnosis test (RDT survey results. Methods From December 2006 to January 2007, a baseline malaria indicator survey in Amhara, Oromiya and Southern Nation Nationalities and People (SNNP regions of Ethiopia was conducted by The Carter Center. This study uses this data. The method of generalized linear model was used to analyse the data and the response variable was the presence or absence of malaria using the rapid diagnosis test (RDT. Results The analyses show that the RDT result was significantly associated with age and gender. Other significant covariates confounding variables are source of water, trip to obtain water, toilet facility, total number of rooms, material used for walls, and material used for roofing. The prevalence of malaria for households with clean water found to be less. Malaria rapid diagnosis found to be higher for thatch and stick/mud roof and earth/local dung plaster floor. Moreover, spraying anti-malaria to the house was found to be one means of reducing the risk of malaria. Furthermore, the housing condition, source of water and its distance, gender, and ages in the households were identified in order to have two-way interaction effects. Conclusion Individuals with poor socio-economic conditions are positively associated with malaria infection. Improving the housing condition of the household is one of the means of reducing the risk of malaria. Children and female household members are the most vulnerable to the risk of malaria. Such information is essential to design improved strategic intervention for the reduction of malaria epidemic in Ethiopia.

  18. GIS and Remote Sensing for Malaria Risk Mapping, Ethiopia

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    Ahmed, A.

    2014-11-01

    Integrating malaria data into a decision support system (DSS) using Geographic Information System (GIS) and remote sensing tool can provide timely information and decision makers get prepared to make better and faster decisions which can reduce the damage and minimize the loss caused. This paper attempted to asses and produce maps of malaria prone areas including the most important natural factors. The input data were based on the geospatial factors including climatic, social and Topographic aspects from secondary data. The objective of study is to prepare malaria hazard, Vulnerability, and element at risk map which give the final output, malaria risk map. The malaria hazard analyses were computed using multi criteria evaluation (MCE) using environmental factors such as topographic factors (elevation, slope and flow distance to stream), land use/ land cover and Breeding site were developed and weighted, then weighted overlay technique were computed in ArcGIS software to generate malaria hazard map. The resulting malaria hazard map depicts that 19.2 %, 30.8 %, 25.1 %, 16.6 % and 8.3 % of the District were subjected to very high, high, moderate, low and very low malaria hazard areas respectively. For vulnerability analysis, health station location and speed constant in Spatial Analyst module were used to generate factor maps. For element at risk, land use land cover map were used to generate element at risk map. Finally malaria risk map of the District was generated. Land use land cover map which is the element at risk in the District, the vulnerability map and the hazard map were overlaid. The final output based on this approach is a malaria risk map, which is classified into 5 classes which is Very High-risk area, High-risk area, Moderate risk area, Low risk area and Very low risk area. The risk map produced from the overlay analysis showed that 20.5 %, 11.6 %, 23.8 %, 34.1 % and 26.4 % of the District were subjected to very high, high, moderate, low and very low

  19. Precipitation Based Malaria Patterns in the Amazon -- Will Deforestation Alter Risk?

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    Olson, S. H.; Durieux, L.; Elguero, E.; Foley, J.; Gagnon, R.; Guegan, J.; Patz, J.

    2007-12-01

    The World Health Organization, estimates that forty-two percent of malaria cases are "associated with policies and practices regarding land use, deforestation, water resource management, settlement siting and modified house design". This estimate was drawn from expert opinion and studies performed at local scales, but little research has investigated the cumulative impacts of land use and land cover changes occurring in the Amazon Basin on malaria. Much less is understood about the impact of changing land use and subsequent precipitation regimes on malaria risk. To understand how land use practices may alter malaria patterns in the Basin we present an analysis of municipio (n=755) malaria case data and monthly precipitation patterns between 1996 and 1999. Climate data originated from the CRU TS 2.1 half-degree grid resolution climate data set. We present a hierarchical (random coefficients) log-linear Poisson model relating malaria incidence to precipitation for both municipos and states. At the Basin scale precipitation and cases show strong relationships. Precipitation and cases are asynchronous across the period of observation, but detailed inspection of states and individual municipios reveal geographic dependencies of precipitation and malaria incidence. Future research will link the patterns of precipitation and malaria to anticipated changes in climate from deforestation in the Basin.

  20. High resolution niche models of malaria vectors in northern Tanzania: a new capacity to predict malaria risk?

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    Manisha A Kulkarni

    Full Text Available BACKGROUND: Malaria transmission rates in Africa can vary dramatically over the space of a few kilometres. This spatial heterogeneity reflects variation in vector mosquito habitat and presents an important obstacle to the efficient allocation of malaria control resources. Malaria control is further complicated by combinations of vector species that respond differently to control interventions. Recent modelling innovations make it possible to predict vector distributions and extrapolate malaria risk continentally, but these risk mapping efforts have not yet bridged the spatial gap to guide on-the-ground control efforts. METHODOLOGY/PRINCIPAL FINDINGS: We used Maximum Entropy with purpose-built, high resolution land cover data and other environmental factors to model the spatial distributions of the three dominant malaria vector species in a 94,000 km(2 region of east Africa. Remotely sensed land cover was necessary in each vector's niche model. Seasonality of precipitation and maximum annual temperature also contributed to niche models for Anopheles arabiensis and An. funestus s.l. (AUC 0.989 and 0.991, respectively, but cold season precipitation and elevation were important for An. gambiae s.s. (AUC 0.997. Although these niche models appear highly accurate, the critical test is whether they improve predictions of malaria prevalence in human populations. Vector habitat within 1.5 km of community-based malaria prevalence measurements interacts with elevation to substantially improve predictions of Plasmodium falciparum prevalence in children. The inclusion of the mechanistic link between malaria prevalence and vector habitat greatly improves the precision and accuracy of prevalence predictions (r(2 = 0.83 including vector habitat, or r(2 = 0.50 without vector habitat. Predictions including vector habitat are unbiased (observations vs. model predictions of prevalence: slope = 1.02. Using this model, we generate a high resolution map of predicted

  1. Climate change unlikely to increase malaria burden in West Africa

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    Yamana, Teresa K.; Bomblies, Arne; Eltahir, Elfatih A. B.

    2016-11-01

    The impact of climate change on malaria transmission has been hotly debated. Recent conclusions have been drawn using relatively simple biological models and statistical approaches, with inconsistent predictions. Consequently, the Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC AR5) echoes this uncertainty, with no clear guidance for the impacts of climate change on malaria transmission, yet recognizing a strong association between local climate and malaria. Here, we present results from a decade-long study involving field observations and a sophisticated model simulating village-scale transmission. We drive the malaria model using select climate models that correctly reproduce historical West African climate, and project reduced malaria burden in a western sub-region and insignificant impact in an eastern sub-region. Projected impacts of climate change on malaria transmission in this region are not of serious concern.

  2. The impact of endemic and epidemic malaria on the risk of stillbirth in two areas of Tanzania with different malaria transmission patterns

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    Mutabingwa TK

    2006-10-01

    Full Text Available Abstract Background The impact of malaria on the risk of stillbirth is still under debate. The aim of the present analysis was to determine comparative changes in stillbirth prevalence between two areas of Tanzania with different malaria transmission patterns in order to estimate the malaria attributable component. Methods A retrospective analysis was completed of stillbirth differences between primigravidae and multigravidae in relation to malaria cases and transmission patterns for two different areas of Tanzania with a focus on the effects of the El Niño southern climatic oscillation (ENSO. One area, Kagera, experiences outbreaks of malaria, and the other area, Morogoro, is holoendemic. Delivery and malaria data were collected over a six year period from records of the two district hospitals in these locations. Results There was a significantly higher prevalence of low birthweight in primigravidae compared to multigravidae for both data sets. Low birthweight and stillbirth prevalence (17.5% and 4.8% were significantly higher in Kilosa compared to Ndolage (11.9% and 2.4%. There was a significant difference in stillbirth prevalence between Ndolage and Kilosa between malaria seasons (2.4% and 5.6% respectively, p Conclusion Malaria exposure during pregnancy has a delayed effect on birthweight outcomes, but a more acute effect on stillbirth risk.

  3. Mapping malaria risk in Bangladesh using Bayesian geostatistical models.

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    Reid, Heidi; Haque, Ubydul; Clements, Archie C A; Tatem, Andrew J; Vallely, Andrew; Ahmed, Syed Masud; Islam, Akramul; Haque, Rashidul

    2010-10-01

    Background malaria-control programs are increasingly dependent on accurate risk maps to effectively guide the allocation of interventions and resources. Advances in model-based geostatistics and geographical information systems (GIS) have enabled researchers to better understand factors affecting malaria transmission and thus, more accurately determine the limits of malaria transmission globally and nationally. Here, we construct Plasmodium falciparum risk maps for Bangladesh for 2007 at a scale enabling the malaria-control bodies to more accurately define the needs of the program. A comprehensive malaria-prevalence survey (N = 9,750 individuals; N = 354 communities) was carried out in 2007 across the regions of Bangladesh known to be endemic for malaria. Data were corrected to a standard age range of 2 to less than 10 years. Bayesian geostatistical logistic regression models with environmental covariates were used to predict P. falciparum prevalence for 2- to 10-year-old children (PfPR(2-10)) across the endemic areas of Bangladesh. The predictions were combined with gridded population data to estimate the number of individuals living in different endemicity classes. Across the endemic areas, the average PfPR(2-10) was 3.8%. Environmental variables selected for prediction were vegetation cover, minimum temperature, and elevation. Model validation statistics revealed that the final Bayesian geostatistical model had good predictive ability. Risk maps generated from the model showed a heterogeneous distribution of PfPR(2-10) ranging from 0.5% to 50%; 3.1 million people were estimated to be living in areas with a PfPR(2-10) greater than 1%. Contemporary GIS and model-based geostatistics can be used to interpolate malaria risk in Bangladesh. Importantly, malaria risk was found to be highly varied across the endemic regions, necessitating the targeting of resources to reduce the burden in these areas.

  4. Iron status predicts malaria risk in Malawian preschool children.

    Directory of Open Access Journals (Sweden)

    Femkje A M Jonker

    Full Text Available INTRODUCTION: Iron deficiency is highly prevalent in pre-school children in developing countries and an important health problem in sub-Saharan Africa. A debate exists on the possible protective effect of iron deficiency against malaria and other infections; yet consensus is lacking due to limited data. Recent studies have focused on the risks of iron supplementation but the effect of an individual's iron status on malaria risk remains unclear. Studies of iron status in areas with a high burden of infections often are exposed to bias. The aim of this study was to assess the predictive value of baseline iron status for malaria risk explicitly taking potential biases into account. METHODS AND MATERIALS: We prospectively assessed the relationship between baseline iron deficiency (serum ferritin <30 µg/L and malaria risk in a cohort of 727 Malawian preschool children during a year of follow-up. Data were analyzed using marginal structural Cox regression models and confounders were selected using causal graph theory. Sensitivity of results to bias resulting from misclassification of iron status by concurrent inflammation and to bias from unmeasured confounding were assessed using modern causal inference methods. RESULTS AND CONCLUSIONS: The overall incidence of malaria parasitemia and clinical malaria was 1.9 (95% CI 1.8-2.0 and 0.7 (95% CI 0.6-0.8 events per person-year, respectively. Children with iron deficiency at baseline had a lower incidence of malaria parasitemia and clinical malaria during a year of follow-up; adjusted hazard ratio's 0.55 (95%-CI:0.41-0.74 and 0.49 (95%-CI:0.33-0.73, respectively. Our results suggest that iron deficiency protects against malaria parasitemia and clinical malaria in young children. Therefore the clinical importance of treating iron deficiency in a pre-school child should be weighed carefully against potential harms. In malaria endemic areas treatment of iron deficiency in children requires sustained

  5. Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases; Center for Global Health.   Date Released: 9/23/2010.

  6. Mapping Malaria Transmission Risk in Northern Morocco Using Entomological and Environmental Data

    Directory of Open Access Journals (Sweden)

    E. Adlaoui

    2011-01-01

    Full Text Available Malaria resurgence risk in Morocco depends, among other factors, on environmental changes as well as the introduction of parasite carriers. The aim of this paper is to analyze the receptivity of the Loukkos area, large wetlands in Northern Morocco, to quantify and to map malaria transmission risk in this region using biological and environmental data. This risk was assessed on entomological risk basis and was mapped using environmental markers derived from satellite imagery. Maps showing spatial and temporal variations of entomological risk for Plasmodium vivax and P. falciparum were produced. Results showed this risk to be highly seasonal and much higher in rice fields than in swamps. This risk is lower for Afrotropical P. falciparum strains because of the low infectivity of Anopheles labranchiae, principal malaria vector in Morocco. However, it is very high for P. vivax mainly during summer corresponding to the rice cultivation period. Although the entomological risk is high in Loukkos region, malaria resurgence risk remains very low, because of the low vulnerability of the area.

  7. Mapping malaria transmission risk in northern morocco using entomological and environmental data.

    Science.gov (United States)

    Adlaoui, E; Faraj, C; El Bouhmi, M; El Aboudi, A; Ouahabi, S; Tran, A; Fontenille, D; El Aouad, R

    2011-01-01

    Malaria resurgence risk in Morocco depends, among other factors, on environmental changes as well as the introduction of parasite carriers. The aim of this paper is to analyze the receptivity of the Loukkos area, large wetlands in Northern Morocco, to quantify and to map malaria transmission risk in this region using biological and environmental data. This risk was assessed on entomological risk basis and was mapped using environmental markers derived from satellite imagery. Maps showing spatial and temporal variations of entomological risk for Plasmodium vivax and P. falciparum were produced. Results showed this risk to be highly seasonal and much higher in rice fields than in swamps. This risk is lower for Afrotropical P. falciparum strains because of the low infectivity of Anopheles labranchiae, principal malaria vector in Morocco. However, it is very high for P. vivax mainly during summer corresponding to the rice cultivation period. Although the entomological risk is high in Loukkos region, malaria resurgence risk remains very low, because of the low vulnerability of the area.

  8. Predicting malaria vector distribution under climate change scenarios in China: Challenges for malaria elimination

    Science.gov (United States)

    Ren, Zhoupeng; Wang, Duoquan; Ma, Aimin; Hwang, Jimee; Bennett, Adam; Sturrock, Hugh J. W.; Fan, Junfu; Zhang, Wenjie; Yang, Dian; Feng, Xinyu; Xia, Zhigui; Zhou, Xiao-Nong; Wang, Jinfeng

    2016-02-01

    Projecting the distribution of malaria vectors under climate change is essential for planning integrated vector control activities for sustaining elimination and preventing reintroduction of malaria. In China, however, little knowledge exists on the possible effects of climate change on malaria vectors. Here we assess the potential impact of climate change on four dominant malaria vectors (An. dirus, An. minimus, An. lesteri and An. sinensis) using species distribution models for two future decades: the 2030 s and the 2050 s. Simulation-based estimates suggest that the environmentally suitable area (ESA) for An. dirus and An. minimus would increase by an average of 49% and 16%, respectively, under all three scenarios for the 2030 s, but decrease by 11% and 16%, respectively in the 2050 s. By contrast, an increase of 36% and 11%, respectively, in ESA of An. lesteri and An. sinensis, was estimated under medium stabilizing (RCP4.5) and very heavy (RCP8.5) emission scenarios. in the 2050 s. In total, we predict a substantial net increase in the population exposed to the four dominant malaria vectors in the decades of the 2030 s and 2050 s, considering land use changes and urbanization simultaneously. Strategies to achieve and sustain malaria elimination in China will need to account for these potential changes in vector distributions and receptivity.

  9. Reduced risk for placental malaria in iron deficient women

    NARCIS (Netherlands)

    Senga, E.L.; Harper, G.; Koshy, G.; Kazembe, P.N.; Brabin, B.J.

    2011-01-01

    Background: Nutritional iron deficiency may limit iron availability to the malaria parasite reducing infection risk, and/or impair host immunity thereby increasing this risk. In pregnant women, there is evidence of an adverse effect with iron supplementation, but the few reported studies are strongl

  10. Prevalence of malaria and use of malaria risk reduction measures among resettled pregnant women in South Sudan

    DEFF Research Database (Denmark)

    Dræbel, Tania; Gueth Kueil, Bill; Meyrowitsch, Dan Wolf

    2013-01-01

    Background: The study assessed aspects of malaria infection, prevention and treatment in a population of resettled pregnant women in South Sudan. Methods: During April and May 2008, a cross-sectional study was carried out to estimate malaria prevalence and to assess the use of malaria risk...... reduction measures and their associations with selected background characteristics. Two hundred and twenty women were tested for malaria parasitaemia and questioned about their malaria prevention and treatment practices. Results: The results showed a prevalence of Plasmodium falciparum parasitaemia of 9.......1%. No statistically significant associations were observed between selected background characteristics and malaria infection status. However, school attendance was significantly associated with insecticide-treated net ownership (OR¼ 6.52, 95% CI 2.37–17.94; p ¼ 0.001) and access to malaria diagnosis and treatment (OR...

  11. Prevalence of Malaria and Use of Malaria Risk Reduction Measures among Returning Pregnant Women in South Sudan

    DEFF Research Database (Denmark)

    Dræbel, Tania Aase; Gueth Kueil, Bill; Meyrowitsch, Dan Wolf

    2013-01-01

    Background The study assessed aspects of malaria infection, prevention and treatment in a population of resettled pregnant women in South Sudan. Methods During April and May 2008, a cross-sectional study was carried out to estimate malaria prevalence and to assess the use of malaria risk reduction...... measures and their associations with selected background characteristics. Two hundred and twenty women were tested for malaria parasitaemia and questioned about their malaria prevention and treatment practices. Results The results showed a prevalence of Plasmodium falciparum parasitaemia of 9.......1%. No statistically significant associations were observed between selected background characteristics and malaria infection status. However, school attendance was significantly associated with insecticide-treated net ownership (OR = 6.52, 95% CI 2.37–17.94; p = 0.001) and access to malaria diagnosis and treatment...

  12. Malaria

    Science.gov (United States)

    ... and can even be fatal. SymptomsWhat are the symptoms of malaria?The symptoms of malaria include:High fever (can often be 104° F ... give someone else malaria?If I do get malaria, should I travel while I have symptoms? Other organizationsInternational Society of Travel MedicineCenters for Disease ...

  13. Malaria Treatment Policy Change and Implementation: The Case of Uganda

    Directory of Open Access Journals (Sweden)

    Miriam Nanyunja

    2011-01-01

    Full Text Available Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

  14. Malaria treatment policy change and implementation: the case of Uganda.

    Science.gov (United States)

    Nanyunja, Miriam; Nabyonga Orem, Juliet; Kato, Frederick; Kaggwa, Mugagga; Katureebe, Charles; Saweka, Joaquim

    2011-01-01

    Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

  15. The importance of temperature fluctuations in understanding mosquito population dynamics and malaria risk

    Science.gov (United States)

    Nelson, William A.; Paaijmans, Krijn P.; Thomas, Matthew B.; Bjørnstad, Ottar N.

    2017-01-01

    Temperature is a key environmental driver of Anopheles mosquito population dynamics; understanding its central role is important for these malaria vectors. Mosquito population responses to temperature fluctuations, though important across the life history, are poorly understood at a population level. We used stage-structured, temperature-dependent delay-differential equations to conduct a detailed exploration of the impacts of diurnal and annual temperature fluctuations on mosquito population dynamics. The model allows exploration of temperature-driven temporal changes in adult age structure, giving insights into the population’s capacity to vector malaria parasites. Because of temperature-dependent shifts in age structure, the abundance of potentially infectious mosquitoes varies temporally, and does not necessarily mirror the dynamics of the total adult population. In addition to conducting the first comprehensive theoretical exploration of fluctuating temperatures on mosquito population dynamics, we analysed observed temperatures at four locations in Africa covering a range of environmental conditions. We found both temperature and precipitation are needed to explain the observed malaria season in these locations, enhancing our understanding of the drivers of malaria seasonality and how temporal disease risk may shift in response to temperature changes. This approach, tracking both mosquito abundance and age structure, may be a powerful tool for understanding current and future malaria risk.

  16. Seasonal changes in human immune responses to malaria

    DEFF Research Database (Denmark)

    Hviid, L; Theander, T G

    1993-01-01

    Cellular as well as humorol immune responses to malaria antigens fluctuate in time in individuals living in molono-endemic areas, particularly where malaria transmission is seasonal. The most pronounced changes are seen in association with clinical attacks, but osymptomatic infection can also lead...... to apparent immune depression. However, recent data have shown that seasonal variation in cellular immune responses may occur even in the absence of detectable porositaemia. Here, Lars Hviid and Thor G. Theonder review the seasonal variation in human immune responses to malaria, and discuss its possible...

  17. Risk factors for malaria infection among rubber tappers living in a malaria control program area in southern Thailand.

    Science.gov (United States)

    Pattanasin, Sarika; Satitvipawee, Pratana; Wongklang, Warunnee; Viwatwongkasem, Chukiat; Bhumiratana, Adisak; Soontornpipit, Pichitpong; Jareinpituk, Sutthi

    2012-11-01

    Rubber tappers work begins at midnight during the feeding time of Anopheles maculatus and An. minimus, two common malaria vectors in southern Thailand. We studied the association between rubber tapper behavior and malaria infections as reported to the Notified Disease Surveillance System during 2010 in Prachuab Khiri Khan Province, Thailand. In that province insecticide treated bednets are distributed free to the population and insecticide residual spraying is performed annually. A random sample of 394 rubber tapper households was interviewed from October 2010 to May 2011. Twenty-six households (6.6%) had at least one family member who contracted malaria during 2010. Poisson regression was used to identify potential characteristics associated with malaria. Multilevel Poisson regression was used to test for simultaneous effects of tapper behavior and household risk for malaria infection. The estimated incidence rate ratio (IRR) for contracting malaria among those owning a farming hut was 2.9 (95% CI 1.1-7.3, p Thailand may increase.

  18. High heterogeneity in Plasmodium falciparum risk illustrates the need for detailed mapping to guide resource allocation: a new malaria risk map of the Lao People's Democratic Republic

    Directory of Open Access Journals (Sweden)

    Phompida Samlane

    2010-02-01

    Full Text Available Abstract Background Accurate information on the geographical distribution of malaria is important for efficient resource allocation. The Lao People's Democratic Republic has experienced a major decline in malaria morbidity and mortality in the past decade. However, efforts to respond effectively to these changes have been impeded by lack of detailed data on malaria distribution. In 2008, a countrywide survey on Plasmodium falciparum diagnosed in health centres and villages was initiated to develop a detailed P. falciparum risk map with the aim to identify priority areas for malaria control, estimate population at risk, and guide resource allocation in the Lao People's Democratic Republic. Methods P. falciparum incidence data were collected from point-referenced villages and health centres for the period 2006-2008 during a country-wide survey between December 2008 and January 2009. Using the highest recorded annual rate, continuous surfaces of P. falciparum incidence were produced by the inverse distance weighted interpolation technique. Results Incidence rates were obtained from 3,876 villages and 685 health centres. The risk map shows that P. falciparum is highly heterogeneous in the northern and central regions of the country with large areas of no transmission. In the southern part, transmission is pervasive and the risk of P. falciparum is high. It was estimated that 3.4 million people (60% of the population live at risk of malaria. Conclusions This paper presents the first comprehensive malaria risk map of the Lao People's Democratic Republic based entirely on empirical data. The estimated population at risk is substantially lower than previous estimates, reflecting the presence of vast areas with focal or no malaria transmission as identified in this study. These findings provide important guidance for malaria control interventions in the Lao People's Democratic Republic, and underline the need for detailed data on malaria to accurately

  19. Changing patterns of malaria during 1996-2010 in an area of moderate transmission in Southern Senegal

    Directory of Open Access Journals (Sweden)

    Vaillant Michel T

    2011-07-01

    Full Text Available Abstract Background Malaria is reportedly receding in different epidemiological settings, but local long-term surveys are limited. At Mlomp dispensary in south-western Senegal, an area of moderate malaria transmission, year-round, clinically-suspected malaria was treated with monotherapy as per WHO and national policy in the 1990s. Since 2000, there has been a staggered deployment of artesunate-amodiaquine after parasitological confirmation; this was adopted nationally in 2006. Methods Data were extracted from clinic registers for the period between January 1996 and December 2010, analysed and modelled. Results Over the 15-year study period, the risk of malaria decreased about 32-times (from 0.4 to 0.012 episodes person-year, while anti-malarial treatments decreased 13-times (from 0.9 to 0.07 treatments person-year and consultations for fever decreased 3-times (from 1.8 to 0.6 visits person-year. This was paralleled by changes in the age profile of malaria patients so that the risk of malaria is now almost uniformly distributed throughout life, while in the past malaria used to concern more children below 16 years of age. Conclusions This study provides direct evidence of malaria risk receding between 1996-2010 and becoming equal throughout life where transmission used to be moderate. Infection rates are no longer enough to sustain immunity. Temporally, this coincides with deploying artemisinin combinations on parasitological confirmation, but other contributing causes are unclear.

  20. Malaria.

    Science.gov (United States)

    Dupasquier, Isabelle

    1989-01-01

    Malaria, the greatest pandemia in the world, claims an estimated one million lives each year in Africa alone. While it may still be said that for the most part malaria is found in what is known as the world's poverty belt, cases are now frequently diagnosed in western countries. Due to resistant strains of malaria which have developed because of…

  1. Large-scale malaria survey in Cambodia: Novel insights on species distribution and risk factors

    Directory of Open Access Journals (Sweden)

    Doung Socheat

    2007-03-01

    Full Text Available Abstract Background In Cambodia, estimates of the malaria burden rely on a public health information system that does not record cases occurring among remote populations, neither malaria cases treated in the private sector nor asymptomatic carriers. A global estimate of the current malaria situation and associated risk factors is, therefore, still lacking. Methods A large cross-sectional survey was carried out in three areas of multidrug resistant malaria in Cambodia, enrolling 11,652 individuals. Fever and splenomegaly were recorded. Malaria prevalence, parasite densities and spatial distribution of infection were determined to identify parasitological profiles and the associated risk factors useful for improving malaria control programmes in the country. Results Malaria prevalence was 3.0%, 7.0% and 12.3% in Sampovloun, Koh Kong and Preah Vihear areas. Prevalences and Plasmodium species were heterogeneously distributed, with higher Plasmodium vivax rates in areas of low transmission. Malaria-attributable fevers accounted only for 10–33% of malaria cases, and 23–33% of parasite carriers were febrile. Multivariate multilevel regression analysis identified adults and males, mostly involved in forest activities, as high risk groups in Sampovloun, with additional risks for children in forest-fringe villages in the other areas along with an increased risk with distance from health facilities. Conclusion These observations point to a more complex malaria situation than suspected from official reports. A large asymptomatic reservoir was observed. The rates of P. vivax infections were higher than recorded in several areas. In remote areas, malaria prevalence was high. This indicates that additional health facilities should be implemented in areas at higher risk, such as remote rural and forested parts of the country, which are not adequately served by health services. Precise malaria risk mapping all over the country is needed to assess the

  2. Malaria-induced changes in host odors enhance mosquito attraction.

    Science.gov (United States)

    De Moraes, Consuelo M; Stanczyk, Nina M; Betz, Heike S; Pulido, Hannier; Sim, Derek G; Read, Andrew F; Mescher, Mark C

    2014-07-29

    Vector-borne pathogens may alter traits of their primary hosts in ways that influence the frequency and nature of interactions between hosts and vectors. Previous work has reported enhanced mosquito attraction to host organisms infected with malaria parasites but did not address the mechanisms underlying such effects. Here we document malaria-induced changes in the odor profiles of infected mice (relative to healthy individuals) over the course of infection, as well as effects on the attractiveness of infected hosts to mosquito vectors. We observed enhanced mosquito attraction to infected mice during a key period after the subsidence of acute malaria symptoms, but during which mice remained highly infectious. This attraction corresponded to an overall elevation in the volatile emissions of infected mice observed during this period. Furthermore, data analyses--using discriminant analysis of principal components and random forest approaches--revealed clear differences in the composition of the volatile blends of infected and healthy individuals. Experimental manipulation of individual compounds that exhibited altered emission levels during the period when differential vector attraction was observed also elicited enhanced mosquito attraction, indicating that compounds being influenced by malaria infection status also mediate vector host-seeking behavior. These findings provide important insights into the cues that mediate vector attraction to hosts infected with transmissible stages of malaria parasites, as well as documenting characteristic changes in the odors of infected individuals that may have potential value as diagnostic biomarkers of infection.

  3. Relative risk estimation for malaria disease mapping based on stochastic SIR-SI model in Malaysia

    Science.gov (United States)

    Samat, Nor Azah; Ma'arof, Syafiqah Husna Mohd Imam

    2016-10-01

    Disease mapping is a study on the geographical distribution of a disease to represent the epidemiology data spatially. The production of maps is important to identify areas that deserve closer scrutiny or more attention. In this study, a mosquito-borne disease called Malaria is the focus of our application. Malaria disease is caused by parasites of the genus Plasmodium and is transmitted to people through the bites of infected female Anopheles mosquitoes. Precautionary steps need to be considered in order to avoid the malaria virus from spreading around the world, especially in the tropical and subtropical countries, which would subsequently increase the number of Malaria cases. Thus, the purpose of this paper is to discuss a stochastic model employed to estimate the relative risk of malaria disease in Malaysia. The outcomes of the analysis include a Malaria risk map for all 16 states in Malaysia, revealing the high and low risk areas of Malaria occurrences.

  4. Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America

    Directory of Open Access Journals (Sweden)

    Hiwat Hélène

    2012-01-01

    Full Text Available Abstract Background Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP. Malaria was endemic in the forested interior, where especially the stabile village communities were affected. Case description The interventions of the MM-MP included new strategies for prevention, vector control, case management, behavioral change communication (BCC/information, education and communication (IEC, and strengthening of the health system (surveillance, monitoring and evaluation and epidemic detection system. After a slow first year with non-satisfying scores for the performance indicators, the MM-MP truly engaged in its intervention activities in 2006 and kept its performance up until the end of 2009. A total of 69,994 long-lasting insecticide-treated nets were distributed and more than 15,000 nets re-impregnated. In high-risk areas, this was complemented with residual spraying of insecticides. Over 10,000 people were screened with active case detection in outbreak and high-risk areas. Additional notification points were established and the national health system was strengthened. Discussion and evaluation In the current paper, the MM-MP is evaluated both on account of the targets established within the programme and on account of its impact on the malaria situation in Suriname. Malaria vector populations, monitored in sentinel sites, collapsed after 2006 and concurrently the number of national malaria cases decreased from 8,618 in 2005 to 1,509 in 2009. Malaria transmission risk shifted from the stabile village communities to the mobile gold mining communities, especially those along the French Guiana border. Conclusions The novel strategies for malaria control introduced in Suriname within the MM-MP have led to a significant decrease in the national malaria burden. The challenge is to further reduce malaria using the available strategies as

  5. Action plan to regain unnecessary deferred blood donors due to malaria risk in Turkey.

    Science.gov (United States)

    Değirmenci, Aysu; Döşkaya, Mert; Caner, Ayşe; Nergis, Sebnem; Gül, Kadri; Aydınok, Yeşim; Ertop, Tufan; Aksoy, Nurten; Korkmaz, Metin; Alkan, Mehmet Ziya; Üner, Ahmet; Gürüz, Yüksel

    2012-06-01

    Malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The present study aimed for the first time, to investigate malaria in "donors deferred for malaria risk" and to determine the regional rates of malaria deferral in Turkey. Blood samples were collected from several Blood Banks of southeastern provinces where local malaria cases still exist and from Blood Bank of Ege University Medical School (EUMS) located in western Turkey where malaria is eradicated decades ago. Plasmodium spp. and specific antibodies were investigated by stained smears, antigen detection, PCR and ELISA. Among the donors deferred for malaria risk, Plasmodium spp. were not detected by microscopy, PCR or antigen detection. Seroprevalances were 2% and 3.92% in western and southeastern regions, respectively. Rate of donor deferral for malaria risk was 0.9% in EUMS and deferrals were exclusively because of travel to southeastern Turkey. In southeastern provinces, deferrals were mainly due to malaria like fever history. The present study first time assessed regional rates of donor deferral due to malaria risk in Turkey. Previously, malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The results of the study showed that 97% of the deferrals were unnecessary. In conclusion, to reduce unnecessary donor deferrals in Turkey, in addition to comprehensive questioning for malaria history, the usage of a malaria antibody screening method should be initiated prior to deferral decision.

  6. Malaria in east African highlands during the past 30 years: impact of environmental changes

    Directory of Open Access Journals (Sweden)

    Yousif El - Safi Himeidan

    2012-08-01

    Full Text Available East African highlands are one of the most populated regions in Africa. The population densities in the highlands ranged between 158 persons/km2 in Ethiopia to 410 persons/km2 in Rwanda. According to the United Nations Population Fund, the region has the world's highest population growth rate. These factors are likely behind the high rates of poverty among the populations. As there were no employment opportunities other than agricultural, this demographic pressure of poor populations have included in an extensive unprecedented land use and land cover changes such as modification of bushland, woodland, and grassland on hillsides to farmland and transformation of papyrus swamps in valley bottoms to dairy pastures and cropland and changing of fallows on hillsides from short or seasonal to longer or perennial. Areas harvested for food crops were therefore increased by more than 100% in most of the highlands. The lost of forest areas, mainly due to subsistence agriculture, between 1990 - 2010 ranged between 8000 ha in Rwanda to 2838000 ha in Ethiopia. These unmitigated environmental changes in the highlands led to rise temperature and optimizing the spread and survival of malaria vectors and development of malaria parasites. Malaria in highlands was initially governed by low ambient temperature, trend of malaria transmission was therefore increased and several epidemics were observed in late 1980s and early 2000s. Although, malaria is decreasing through intensified interventions since mid 2000s onwards, these environmental changes might expose population in the highlands of east Africa to an increase risk of malaria and its epidemic particularly if the current interventions are not sustained.

  7. Choice of scale for integrating land use in malaria risk monitoring

    Science.gov (United States)

    Spangler, K. R.; Zaitchik, B. F.; Pan, W.; Vittor, A.; Patz, J.

    2011-12-01

    There were nearly 37,000 reported cases of malaria in Peru in 2009 alone. With over 30% of the population identified as being at "high risk" for exposure, detailed risk mapping, along with early detection and warning systems, are in critical need. While there is evidence that the increased formation of puddles arising from deforestation increases the breeding of the rainforest's primary malaria vector, Anopheles darlingi, neither the spatial structure of land uses/land cover changes (LUCC) nor the area of influence of LUCC on mosquito density has been systematically addressed. The radius of influence that LUCC - particularly areas of deforested land and other regions likely to see increases in stagnant water formation - has on mosquito presence is of particular importance, both for the design of warning systems and to inform future malaria transmission studies. Here, we present the results of satellite-based analysis of land use patterns and mosquito density along the Iquitos-Nauta road in the Peruvian Amazon. Comparing supervised classifications of Landsat images of the Iquitos region from 1996 and 2001 , land cover features around each of 832 mosquito sites were tabulated by percent at six different radii: 250m, 500m, 1000m, 2000m, 3000m, and 5000m. These results were then used as inputs in a mosquito prediction model that determined the most pertinent spatial scale necessary to predict both adult and larvae Anopheles mosquitoes (darlingi, benerocchi, oswaldoi, mattogrossenis, and rangeli). The application of this study is to provide a systematic means of determining which areas are at the highest risk of malaria infection in order to inform design of warning systems and future studies of land use and malaria in the Amazonian frontier.

  8. Investigation of host candidate malaria-associated risk/protective SNPs in a Brazilian Amazonian population.

    Directory of Open Access Journals (Sweden)

    Simone da Silva Santos

    Full Text Available The Brazilian Amazon is a hypo-endemic malaria region with nearly 300,000 cases each year. A variety of genetic polymorphisms, particularly in erythrocyte receptors and immune response related genes, have been described to be associated with susceptibility and resistance to malaria. In order to identify polymorphisms that might be associated with malaria clinical outcomes in a Brazilian Amazonian population, sixty-four human single nucleotide polymorphisms in 37 genes were analyzed using a Sequenom massARRAY iPLEX platform. A total of 648 individuals from two malaria endemic areas were studied, including 535 malaria cases (113 individuals with clinical mild malaria, 122 individuals with asymptomatic infection and 300 individuals with history of previous mild malaria and 113 health controls with no history of malaria. The data revealed significant associations (p<0.003 between one SNP in the IL10 gene (rs1800896 and one SNP in the TLR4 gene (rs4986790 with reduced risk for clinical malaria, one SNP in the IRF1 gene (rs2706384 with increased risk for clinical malaria, one SNP in the LTA gene (rs909253 with protection from clinical malaria and one SNP in the TNF gene (RS1800750 associated with susceptibility to clinical malaria. Also, a new association was found between a SNP in the CTL4 gene (rs2242665, located at the major histocompatibility complex III region, and reduced risk for clinical malaria. This study represents the first association study from an Amazonian population involving a large number of host genetic polymorphisms with susceptibility or resistance to Plasmodium infection and malaria outcomes. Further studies should include a larger number of individuals, refined parameters and a fine-scale map obtained through DNA sequencing to increase the knowledge of the Amazonian population genetic diversity.

  9. Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America

    NARCIS (Netherlands)

    Hiwat, H.; Hardjopawiro, L.S.; Takken, W.; Villegas, L.

    2012-01-01

    Background Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP). Malaria was endemic in the forested interior, where especially the stabile village communities were affected. Case descriptio

  10. Malaria Transmission Risk Factor In West Java (Epidemiology Study About Vector, Plasmodium parasite and Environmental Risk Factors For Malaria Cases

    Directory of Open Access Journals (Sweden)

    Lukman Hakim

    2010-06-01

    Full Text Available Since the territory is divided with the province of Banten, in West Java there are five regencies that defined as malaria endemic area, there are Ciamis, Tasikmalaya, Garut, Cianjur and Sukabumi. Sufferer, concentrated in southern coastal areas (Indonesian Ocean starting from the beach of Kalipucang at Ciamis up to coast of Cikakak at Sukabumi which borders the province of Banten and also mountain and plantations areas. Malaria morbidity incidence risk factors is differ in each of these endemic areas. In general is the presence of malaria patients without symptoms who can be a source of infection that so difficult to know its existence. Still the number of standing water that can become mosqui-to breeding places of Anopheles spp, such as fish pond, small puddle on the riverside, shrimp pond, mangrove forests that potentially at the beginning of the rainy season, the fields during rice that potential when the rice growing and the river that potential in the dry season. The existence of high population mobility and also the number of vegetation in the surrounding residential population and the existence of cattle are placed close to settle-ments.

  11. The detection and treatment of Plasmodium falciparum malaria: Time for change

    Directory of Open Access Journals (Sweden)

    Nosten F

    2004-01-01

    Full Text Available In most countries where malaria is endemic, P. falciparum malaria is on the rise. This is primarily due to the spread of drug-resistant strains. Drug resistance is mediated by spontaneous changes in the parasite genome that allow resistant parasites to escape the action of the drugs. The spread of drug resistance increases the transmission of malaria parasites. The consequences for the populations at risk are profound both in terms of consequences for health and economy. In order to halt the progression of drug resistance, we need to change the way antimalarials are used. As in tuberculosis and HIV/AIDS, we must use a combination of drugs for the treatment of malaria. Taking into account the pharmacokinetic and pharmacodynamic properties of the various anti-malarial agents, artemisinin-based combination therapy (ACT seems to be the best option. This strategy should be used in conjunction with early diagnosis and appropriate vector control measures to achieve reduction in the emergence and spread of drug resistance.

  12. Mitigating Future Avian Malaria Threats to Hawaiian Forest Birds from Climate Change

    Science.gov (United States)

    Atkinson, Carter T.; LaPointe, Dennis A.; Samuel, Michael D.

    2017-01-01

    Avian malaria, transmitted by Culex quinquefasciatus mosquitoes in the Hawaiian Islands, has been a primary contributor to population range limitations, declines, and extinctions for many endemic Hawaiian honeycreepers. Avian malaria is strongly influenced by climate; therefore, predicted future changes are expected to expand transmission into higher elevations and intensify and lengthen existing transmission periods at lower elevations, leading to further population declines and potential extinction of highly susceptible honeycreepers in mid- and high-elevation forests. Based on future climate changes and resulting malaria risk, we evaluated the viability of alternative conservation strategies to preserve endemic Hawaiian birds at mid and high elevations through the 21st century. We linked an epidemiological model with three alternative climatic projections from the Coupled Model Intercomparison Project to predict future malaria risk and bird population dynamics for the coming century. Based on climate change predictions, proposed strategies included mosquito population suppression using modified males, release of genetically modified refractory mosquitoes, competition from other introduced mosquitoes that are not competent vectors, evolved malaria-tolerance in native honeycreepers, feral pig control to reduce mosquito larval habitats, and predator control to improve bird demographics. Transmission rates of malaria are predicted to be higher than currently observed and are likely to have larger impacts in high-elevation forests where current low rates of transmission create a refuge for highly-susceptible birds. As a result, several current and proposed conservation strategies will be insufficient to maintain existing forest bird populations. We concluded that mitigating malaria transmission at high elevations should be a primary conservation goal. Conservation strategies that maintain highly susceptible species like Iiwi (Drepanis coccinea) will likely benefit

  13. Malaria prophylaxis: identifying risk groups for non-compliance.

    Science.gov (United States)

    Held, T K; Weinke, T; Mansmann, U; Trautmann, M; Pohle, H D

    1994-01-01

    To investigate behaviour in the use of drug prophylaxis against malaria and the risk factors for non-compliance, 507 European or North American travelers returning from endemic areas were studied retrospectively at Berlin in a 11-year period from 1980 to 1990. Compliance was significantly correlated with shorter travel duration: the group with good compliance stayed 37.2 +/- 38.5 days (mean +/- SD) in contrast to 69.8 +/- 93.5 days in the group of patients with no compliance (p = 0.00001). Older patients were significantly more compliant than patients aged 54 years vs. 175/476 at travel destination (Southern and East African regions; p = 0.0054), age ( or = 55 years, respectively; p = 0.0001), and reason of travel (package tours; p = 0.0001). CART analysis confirmed logistic regression analysis with respect to age and travel type, and revealed that patients using only one information source were significantly more compliant than those using two or more information sources. Travel agencies were nearly as well informed as Institutes of Tropical Medicine, but family doctors had a significant incidence of giving wrong advice. This study should enable medical personnel dealing with prophylactic advice against malaria to identify patients at high risk for non-compliance, and to educate them more carefully than other travellers regarding antimalarial drug prophylaxis.

  14. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries

    Directory of Open Access Journals (Sweden)

    Coutinho Francisco AB

    2011-05-01

    Full Text Available Abstract Background In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used Methods Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. Results The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. Conclusions The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

  15. Independent Associations of Maternal Education and Household Wealth with Malaria Risk in Children

    OpenAIRE

    2014-01-01

    Despite evidence that they play similar but independent roles, maternal education and household wealth are usually conflated in studies of the effects of socioeconomic status (SES) on malaria risk. Demographic and Health Survey and Malaria Indicator Survey data from nine countries in sub-Saharan Africa were used to explore the relationship of malaria parasitemia in children with SES factors at individual and cluster scales, controlling for urban/rural residence and other important covariates....

  16. Lack of patient risk counselling and a broader provider training affect malaria control in remote Somalia Kenya border: Qualitative assessment.

    Science.gov (United States)

    Asgary, Ramin; Grigoryan, Zoya; Naderi, Ramesh; Allan, Richard

    2012-01-01

    Effectiveness of providing health education solely via mass media and the providers' targeted training in malaria control needs further exploration. During pre-epidemic season, we conducted a qualitative study of 40 providers and community leaders using focus groups, comprehensive semi-structured interviews and consultation observations. Interviews were transcribed, coded and analysed for major themes. Community leaders believe that they can acquire malaria from contaminated water, animal products, air or garbage. Consequently, they under-utilise bed nets and other protective measures due to perceived continued exposure to other potential malaria sources. Practitioners do not provide individualised health counselling and risk assessment to patients during sick visits, leading to a range of misconceptions about malaria based on limited knowledge from rumours and mass media, and a strong belief in the curative power of traditional medicine. Providers overdiagnose malaria clinically and underutilise available tests due to time constraints, and the lack of training and resources to correctly diagnose other illnesses. Subsequently, misdiagnoses lead them to question the efficacy of recommended treatments. Promoting counselling during clinical encounters to address patient misconception and change risky behaviour is warranted. Wider-ranging ongoing training could enable providers to properly diagnose and manage differential diagnoses to manage malaria better.

  17. Malaria.

    Science.gov (United States)

    Heck, J E

    1991-03-01

    Human malaria is caused by four species of the genus plasmodium. The sexual stage of the parasite occurs in the mosquito and asexual reproduction occurs in man. Symptoms of fever, chills, headache, and myalgia result from the invasion and rupture of erythrocytes. Merozoites are released from erythrocytes and invade other cells, thus propagating the infection. The most vulnerable hosts are nonimmune travelers, young children living in the tropics, and pregnant women. P. falciparum causes the most severe infections because it infects RBCs of all ages and has the propensity to develop resistance to antimalarials. Rapid diagnosis can be made with a malarial smear, and treatment should be initiated promptly. In some regions (Mexico, Central America except Panama, and North Africa) chloroquine phosphate is effective therapy. In subsaharan Africa, South America, and Southeast Asia, chloroquine resistance has become widespread, and other antimalarials are necessary. The primary care physician should have a high index of suspicion for malaria in the traveler returning from the tropics. Malaria should also be suspected in the febrile transfusion recipient and newborns of mothers with malaria.

  18. Assessing Malaria Risks in Greater Mekong Subregion based on Environmental Parameters

    Science.gov (United States)

    Kiang, Richard; Soika, Valerii; Adimi, Farida; Nigro, Joseph

    2005-01-01

    At 4,200 km, the Mekong River is the tenth longest river in the world. It directly and indirectly influences the lives of hundreds of millions of inhabitants in its basin. The riparian countries - Thailand, Myanmar, Cambodia, Laos, Vietnam, and a small part of China - form the Greater Mekong Subregion (GMS). This geographical region has the misfortune of being the world's epicenter of falciparum malaria, which is the most severe form of malaria caused by Plasmodium falciparum. Depending on the country, approximately 50 to 90% of all malaria cases are due to this species. In the Malaria Modeling and Surveillance Project, we have been developing techniques to enhance public health s decision capability for malaria risk assessments and controls. The main objectives are: 1) identifying the potential breeding sites for major vector species; 2) implementing a malaria transmission model to identify the key factors that sustain or intensify malaria transmission; and 3) implementing a risk algorithm to predict the occurrence of malaria and its transmission intensity. The potential benefits are: 1) increased warning time for public health organizations to respond to malaria outbreaks; 2) optimized utilization of pesticide and chemoprophylaxis; 3) reduced likelihood of pesticide and drug resistance; and 4) reduced damage to environment. Environmental parameters important to malaria transmission include temperature, relative humidity, precipitation, and vegetation conditions. The NASA Earth science data sets that have been used for malaria surveillance and risk assessment include AVHRR Pathfinder, TRMM, MODIS, NSIPP, and SIESIP. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records. Socioeconomic factors that may influence malaria transmissions will also be incorporated into the predictive models.

  19. Malaria and Travelers

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria and Travelers Recommend on Facebook Tweet Share Compartir ... may be at risk for infection. Determine if malaria transmission occurs at the destinations Obtain a detailed ...

  20. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions.

    Science.gov (United States)

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J; Curriero, Frank C

    2015-12-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting.

  1. [Malaria in Morocco: from pre-elimination to elimination, what risks for the future?].

    Science.gov (United States)

    Trari, B; Carnevale, P

    2011-10-01

    By basing itself essentially on the data of literature, this work redraw the historic periods of malaria in Morocco since 1912 at this day. The analysis of entomological, historic and current epidemiological situations of malaria in the Maghreb countries allows to identify elements of reflection on the risk in Morocco.

  2. Malaria Hyperendemicity and Risk for Artemisinin Resistance among Illegal Gold Miners, French Guiana.

    Science.gov (United States)

    Pommier de Santi, Vincent; Djossou, Félix; Barthes, Nicolas; Bogreau, Hervé; Hyvert, Georges; Nguyen, Christophe; Pelleau, Stéphane; Legrand, Eric; Musset, Lise; Nacher, Mathieu; Briolant, Sébastien

    2016-05-01

    To assess the prevalence of malaria among illegal gold miners in the French Guiana rainforest, we screened 205 miners during May-June 2014. Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. Patients reported self-medication with artemisinin-based combination therapy. Risk for emergence and spread of artemisinin resistance among gold miners in the rainforest is high.

  3. Cost effective malaria risk control using remote sensing and environmental data

    Science.gov (United States)

    Rahman, Md. Z.; Roytman, Leonid; Kadik, Abdel Hamid

    2012-06-01

    Malaria transmission in many part of the world specifically in Bangladesh and southern African countries is unstable and epidemic. An estimate of over a million cases is reported annually. Malaria is heterogeneous, potentially due to variations in ecological settings, socio-economic status, land cover, and agricultural practices. Malaria control only relies on treatment and supply of bed networks. Drug resistance to these diseases is widespread. Vector control is minimal. Malaria control in those countries faces many formidable challenges such as inadequate accessibility to effective treatment, lack of trained manpower, inaccessibility of endemic areas, poverty, lack of education, poor health infrastructure and low health budgets. Health facilities for malaria management are limited, surveillance is inadequate, and vector control is insufficient. Control can only be successful if the right methods are used at the right time in the right place. This paper aims to improve malaria control by developing malaria risk maps and risk models using satellite remote sensing data by identifying, assessing, and mapping determinants of malaria associated with environmental, socio-economic, malaria control, and agricultural factors.

  4. Challenges for modelling spatio-temporal variations of malaria risk in Malawi

    Science.gov (United States)

    Lowe, R.; Chirombo, J.; Tompkins, A. M.

    2012-04-01

    Malaria is the leading cause of morbidity and mortality in Malawi with more than 6 million episodes reported each year. Malaria poses a huge economic burden to Malawi in terms of the direct cost of treating malaria patients and also indirect costs resulting from workdays lost in agriculture and industry and absenteeism from school. Malawi implements malaria control activities within the Roll Back Malaria framework, with the objective to provide those most at risk (i.e. children under five years, pregnant woman and individuals with suppressed immune systems) access to personal and community protective measures. However, at present there is no mechanism by which to target the most 'at risk' populations ahead of an impending epidemic. Malaria transmission is influenced by variations in meteorological conditions, which impact the biology of the mosquito and the availability of breeding sites, but also socio-economic conditions such as levels of urbanisation, poverty and education, which influence human vulnerability and vector habitat. The many potential drivers of malaria, both extrinsic, such as climate, and intrinsic, such as population immunity are often difficult to disentangle. This presents a challenge for modelling of malaria risk in space and time. Using an age-stratified spatio-temporal dataset of malaria cases at the district level from July 2004 - June 2011, we use a spatio-temporal modelling framework to model variations in malaria risk in Malawi. Climatic and topographic variations are accounted for using an interpolation method to relate gridded products to administrative districts. District level data is tested in the model to account for confounding factors, including the proportion of the population living in urban areas; residing in traditional housing; with no toilet facilities; who do not attend school, etc, the number of health facilities per population and yearly estimates of insecticide-treated mosquito net distribution. In order to account for

  5. Malaria

    Science.gov (United States)

    2011-06-01

    glands , and are inoculated into host during subsequent blood meal. 7. In human host, sporozoites leave blood and infect hepatocytes. 8-10...reach the mosquito’s salivary glands lodge there and are inoculated into a new host when the mosquito takes an- other blood meal. In humans...from 53-year-old patient who died of chloroquine-resistant falciparum malaria. x600 Figure 10.77 Mature schizont (arrow) in capillary in parathyroid

  6. Estimating risk factors of urban malaria in Blantyre, Malawi:A spatial regression analysis

    Institute of Scientific and Technical Information of China (English)

    Lawrence N Kazembe; Don P Mathanga

    2016-01-01

    Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities that have markedly low prevalence of malaria. Methods: We used a case-control study design, with cases being children under the age of five years diagnosed with malaria, and matched controls obtained at hospital and communities. The data were obtained from Ndirande health facility catchment area. We then fitted a multivariate spatial logistic model of malaria risk. Covariate and risk factors in the model included child-specific, household and environmental risk factor (nearness to garden, standing water, river and swamps). The spatial component was assumed to follow a Gaussian process and model fitted using Bayesian inference. Results: Our findings showed that children who visited rural areas were 6 times more likely to have malaria than those who did not [odds ratio (OR)=6.66, 95%confidence interval (CI):4.79–9.61]. The risk of malaria increased with age of the child (OR=1.01, 95%CI:1.003–1.020), but reduced with high socio-economic status compared to lower status (OR=0.39, 95%CI:0.25–0.54 for the highest level and OR=0.67, 95%CI:0.47–0.94 for the medium level). Although nearness to a garden, river and standing water showed increased risk, these effects were not significant. Furthermore, significant spatial clusters of risk emerged, which does suggest other factors do explain malaria risk vari-ability apart from those established above. Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration, emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.

  7. Estimating risk factors of urban malaria in Blantyre, Malawi: A spatial regression analysis

    Institute of Scientific and Technical Information of China (English)

    Lawrence N.Kazembe; Don P.Mathanga

    2016-01-01

    Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities that have markedly low prevalence of malaria.Methods: We used a case-control study design, with cases being children under the age of five years diagnosed with malaria, and matched controls obtained at hospital and communities. The data were obtained from Ndirande health facility catchment area. We then fitted a multivariate spatial logistic model of malaria risk. Covariate and risk factors in the model included child-specific, household and environmental risk factor(nearness to garden, standing water, river and swamps). The spatial component was assumed to follow a Gaussian process and model fitted using Bayesian inference.Results: Our findings showed that children who visited rural areas were 6 times more likely to have malaria than those who did not [odds ratio(OR) = 6.66, 95% confidence interval(CI): 4.79–9.61]. The risk of malaria increased with age of the child(OR = 1.01,95% CI: 1.003–1.020), but reduced with high socio-economic status compared to lower status(OR = 0.39, 95% CI: 0.25–0.54 for the highest level and OR = 0.67, 95% CI: 0.47–0.94 for the medium level). Although nearness to a garden, river and standing water showed increased risk, these effects were not significant. Furthermore, significant spatial clusters of risk emerged, which does suggest other factors do explain malaria risk variability apart from those established above.Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration,emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.

  8. Malaria healthcare policy change in Kenya: Implications on sales and marketing of antimalarials

    Directory of Open Access Journals (Sweden)

    Peter K. Ngure , Lorraine Nyaoke & David Minja

    2012-03-01

    Full Text Available Background & objectives: Malaria healthcare policy change in Kenya aimed at improving the control of malariabut faced a number of challenges in implementation related to marketing of the drugs. This research investigatedthe effect of the change of the national malaria policy on drug sales and strategic marketing responses ofantimalarial pharmaceutical companies in Kenya.Study design: A descriptive cross-sectional design was employed to describe the existing state of antimalarialsmarket in Kenya after the change of the malaria healthcare policy.Results & conclusion: Policy change did result in an increase in the sales of Coartem®. Novartis Pharma recordeda 97% growth in sales of Coartem® between 2003 and 2004. However, this increase was not experienced by allthe companies. Further, SPs (which had been replaced as first-line therapy for malaria registered good sales. Inmost cases, these sales were higher than the sales of Coartem®. Generally, the sales contribution of SPs andgeneric antimalarial medicines exceeded that of Coartem® for most distributors. The most common changemade to marketing strategies by distributors (62.5% was to increase imports of antimalarials. A total of 40% ofthe manufacturers preferred to increase their budgetary allocation for marketing activities. In view of the factthat continued sale of SP drugs and limited availability of AL poses the risk of increasing the incidence ofmalaria in Kenya, it is therefore, recommended that pharmacy surveillance systems be strengthened to ensuredrugs that have been rendered non-viable or that prescription-only medicines are not sold contrary to the nationalguidelines.

  9. Impact of highland topography changes on exposure to malaria vectors and immunity in western Kenya

    Directory of Open Access Journals (Sweden)

    Eliningaya Kweka

    2016-10-01

    Full Text Available Background: It is almost an axiom that in the African highlands (above 1500m transmission of P. falciparum is limited primarily by low ambient temperature and that small changes in temperature could result in temporary favourable conditions for unstable transmission within populations that have acquired little functional immunity. The pattern of malaria transmission in the highland plateau ecosystems is less distinct due to the flat topography and diffuse hydrology resulting from numerous streams. The non-homogeneous distribution of larval breeding habitats in east African highlands obviously affects Anopheles spatial distribution which, consequently, leads to heterogeneous human exposure to malaria. Another delicate parameter in the fragile transmission risk of malaria in the highlands is the rapid loss of primary forest due to subsistence agriculture. The implication of this change in land cover on malaria transmission is that deforestation can lead to changes in microclimate of both adult and larval habitats hence increase larvae survival, population density, and gametocytes development in adult mosquitoes. Deforestation has been documented to enhancing vectorial capacity of Anopheles gambiae by nearly 100% compared to forested areas. Method: The study was conducted in five different ecosystems in the western Kenya highlands, two U-shaped valleys (Iguhu, Emutete, two V-shaped valleys (Marani, Fort-Ternan and one plateau (Shikondi for 16 months among 6-15 years old children. Exposure to malaria was tested using circum-sporozoite protein (CSP and merozoite surface protein (MSP immunochromatographic antibody tests. Malaria parasite was examined using different tools which include microscopy based on blood smears, Rapid diagnostic test based on HRP 2 proteins and serology based on human immune response to parasite and vector antigens have been also examined in the highlands in comparison with different topographical systems of western Kenya

  10. Migrants and malaria risk factors: a study of the Thai-Myanmar border.

    Science.gov (United States)

    Tipmontree, Rungrawee; Fungladda, Wijitr; Kaewkungwal, Jaranit; Tempongko, M A Sandra B; Schelp, Frank-Peter

    2009-11-01

    The objective of this study was to investigate factors influencing self-reported malaria among migrants living along the Thai-Myanmar border. Songkaria Village, with 1600 inhabitants and 290 households in Sangkhla Buri District, Kanchanaburi Province, was selected for the study due to its intense malaria transmission. One hundred twenty-five households were randomly selected. Household members were interviewed about the history of malaria, socioeconomic status and knowledge and practices in regard to malaria using a structured questionnaire. Of the respondents, 10%, 42%, and 48% belonged to the Thai, Mon, and Karen ethnic groups, respectively. About 40 % of Thai and Karen migrants and almost 30% of Mon migrants reported having suffered from malaria at least once. Multivariate analysis focused on migrants. The results identified three independent factors for previous malaria: a high risk occupation, ie working primarily in the forest [odds ratio (OR), 3.55; 95% confidence interval 1.3-10.0], ability to read Thai [OR, 4.13 (1.5-11.7)], and correct knowledge about malaria symptoms [OR, 5.18 (1.1-23.5)]. Working conditions among migrants played a major role in acquiring malaria. They could not afford to apply additional preventive measures, such as using a mosquito net or repellent to be used while working. The concept of enhancing the environment for migrants to enable them to protect themselves against malaria needs to be examined. Ways and means of improving the economic conditions of migrants should be considered to minimize exposure to the vector.

  11. Assessing the Role of Climate Change in Malaria Transmission in Africa

    Directory of Open Access Journals (Sweden)

    E. T. Ngarakana-Gwasira

    2016-01-01

    Full Text Available The sensitivity of vector borne diseases like malaria to climate continues to raise considerable concern over the implications of climate change on future disease dynamics. The problem of malaria vectors shifting from their traditional locations to invade new zones is of important concern. A mathematical model incorporating rainfall and temperature is constructed to study the transmission dynamics of malaria. The reproduction number obtained is applied to gridded temperature and rainfall datasets for baseline climate and future climate with aid of GIS. As a result of climate change, malaria burden is likely to increase in the tropics, the highland regions, and East Africa and along the northern limit of falciparum malaria. Falciparum malaria will spread into the African highlands; however it is likely to die out at the southern limit of the disease.

  12. Influences of intermittent preventive treatment and persistent multiclonal Plasmodium falciparum infections on clinical malaria risk.

    Directory of Open Access Journals (Sweden)

    Anne Liljander

    Full Text Available BACKGROUND: Intermittent preventive treatment (IPT of malaria involves administration of curative doses of antimalarials at specified time points to vulnerable populations in endemic areas, regardless whether a subject is known to be infected. The effect of this new intervention on the development and maintenance of protective immunity needs further understanding. We have investigated how seasonal IPT affects the genetic diversity of Plasmodium falciparum infections and the risk of subsequent clinical malaria. MATERIAL AND METHODS: The study included 2227 Ghanaian children (3-59 months who were given sulphadoxine-pyrimethamine (SP bimonthly, artesunate plus amodiaquine (AS+AQ monthly or bimonthly, or placebo monthly for six months spanning the malaria transmission season. Blood samples collected at three post-interventional surveys were analysed by genotyping of the polymorphic merozoite surface protein 2 gene. Malaria morbidity and anaemia was monitored during 12 months follow-up. RESULTS: Monthly IPT with AS+AQ resulted in a marked reduction in number of concurrent clones and only children parasite negative just after the intervention period developed clinical malaria during follow-up. In the placebo group, children without parasites as well as those infected with ≥2 clones had a reduced risk of subsequent malaria. The bimonthly SP or AS+AQ groups had similar number of clones as placebo after intervention; however, diversity and parasite negativity did not predict the risk of malaria. An interaction effect showed that multiclonal infections were only associated with protection in children without intermittent treatment. CONCLUSION: Molecular typing revealed effects of the intervention not detected by ordinary microscopy. Effective seasonal IPT temporarily reduced the prevalence and genetic diversity of P. falciparum infections. The reduced risk of malaria in children with multiclonal infections only seen in untreated children suggests that

  13. Participatory Risk Mapping of Malaria Vector Exposure in Northern South America using Environmental and Population Data.

    Science.gov (United States)

    Fuller, D O; Troyo, A; Alimi, T O; Beier, J C

    2014-03-01

    Malaria elimination remains a major public health challenge in many tropical regions, including large areas of northern South America. In this study, we present a new high spatial resolution (90 × 90 m) risk map for Colombia and surrounding areas based on environmental and human population data. The map was created through a participatory multi-criteria decision analysis in which expert opinion was solicited to determine key environmental and population risk factors, different fuzzy functions to standardize risk factor inputs, and variable factor weights to combine risk factors in a geographic information system. The new risk map was compared to a map of malaria cases in which cases were aggregated to the municipio (municipality) level. The relationship between mean municipio risk scores and total cases by muncípio showed a weak correlation. However, the relationship between pixel-level risk scores and vector occurrence points for two dominant vector species, Anopheles albimanus and An. darlingi, was significantly different (p < 0.05) from a random point distribution, as was a pooled point distribution for these two vector species and An. nuneztovari. Thus, we conclude that the new risk map derived based on expert opinion provides an accurate spatial representation of risk of potential vector exposure rather than malaria transmission as shown by the pattern of malaria cases, and therefore it may be used to inform public health authorities as to where vector control measures should be prioritized to limit human-vector contact in future malaria outbreaks.

  14. A cross-sectional analysis of traditional medicine use for malaria alongside free antimalarial drugs treatment amongst adults in high-risk malaria endemic provinces of Indonesia

    Science.gov (United States)

    Suswardany, Dwi Linna; Sibbritt, David W.; Supardi, Sudibyo; Pardosi, Jerico F.; Chang, Sungwon; Adams, Jon

    2017-01-01

    Background The level of traditional medicine use, particularly Jamu use, in Indonesia is substantial. Indonesians do not always seek timely treatment for malaria and may seek self-medication via traditional medicine. This paper reports findings from the first focused analyses of traditional medicine use for malaria in Indonesia and the first such analyses worldwide to draw upon a large sample of respondents across high-risk malaria endemic areas. Methods A sub-study of the Indonesia Basic Health Research/Riskesdas Study 2010 focused on 12,226 adults aged 15 years and above residing in high-risk malaria-endemic provinces. Logistic regression was undertaken to determine the significant associations for traditional medicine use for malaria symptoms. Findings Approximately one in five respondents use traditional medicine for malaria symptoms and the vast majority experiencing multiple episodes of malaria use traditional medicine alongside free antimalarial drug treatments. Respondents consuming traditional medicine for general health/common illness purposes every day (odds ratio: 3.75, 95% Confidence Interval: 2.93 4.79), those without a hospital in local vicinity (odds ratio: 1.31, 95% Confidence Interval: 1.10 1.57), and those living in poorer quality housing, were more likely to use traditional medicine for malaria symptoms. Conclusion A substantial percentage of those with malaria symptoms utilize traditional medicine for treating their malaria symptoms. In order to promote safe and effective malaria treatment, all providing malaria care in Indonesia need to enquire with their patients about possible traditional medicine use. PMID:28329019

  15. Deconstructing the Risk for Malaria in United States Donors Deferred for Travel to Mexico

    Science.gov (United States)

    Spencer, Bryan; Kleinman, Steven; Custer, Brian; Cable, Ritchard; Wilkinson, Susan L; Steele, Whitney; High, Patrick M; Wright, David

    2013-01-01

    Background More than 66,000 blood donors are deferred annually in the U.S. due to travel to malaria-endemic areas of Mexico. Mexico accounts for the largest share of malaria travel deferrals, yet it has extremely low risk for malaria transmission throughout most of its national territory, suggesting a suboptimal balance between blood safety and availability. This study sought to determine whether donor deferral requirements might be relaxed for parts of Mexico without compromising blood safety. Study Design and Methods Travel destination was recorded from a representative sample of presenting blood donors deferred for malaria travel from six blood centers during 2006. We imputed to these donors reporting Mexican travel a risk for acquiring malaria equivalent to Mexican residents in the destination location, adjusted for length of stay. We extrapolated these results to the overall U.S. blood donor population. Results Risk for malaria in Mexico varies significantly across endemic areas and is greatest in areas infrequently visited by study donors. Over 70% of blood donor deferrals were triggered by travel to the state of Quintana Roo on the Yucatán Peninsula, an area of very low malaria transmission. Eliminating the travel deferral requirement for all areas except the state of Oaxaca might result in the recovery of almost 65,000 blood donors annually at risk of approximately one contaminated unit collected every 20 years. Conclusion Deferral requirements should be relaxed for presenting donors who travelled to areas within Mexico that confer exceptionally small risks for malaria, such as Quintana Roo. PMID:21564102

  16. Environmental factors as determinants of malaria risk. A descriptive study on the northern coast of Peru.

    Science.gov (United States)

    Guthmann, J P; Llanos-Cuentas, A; Palacios, A; Hall, A J

    2002-06-01

    We conducted a series of studies on the northern Pacific coast of Peru to determine environmental risk factors for malaria. We report in this paper the results of both a descriptive study of incidence and a prevalence survey of malaria. Both studies showed that the area was at low risk for malaria. The malaria incidence rate was 40/1000 p.a. during the study period, and the prevalence of infection was 0.9% (95% CI: 0.4-1.7) before and 1.4% (95% CI: 0.8-2.2) after the high incidence period. However, the risk of malaria varied according to season, village and even house within a single village. Incidence rates increased from February (2.6/1000 p.a.) to May (12.9/1000 p.a.) and decreased during the second part of the year. Most of the cases were clustered in four villages that constituted only 21% of the total population of the area. Houses where multiple cases were recorded were often located near a source of water. Our observations suggested that environmental factors, and particularly the presence of water for irrigation around villages and houses, played a major role in determining the risk of malaria. These observations were extended through an entomological study and a case-control study, to be published elsewhere.

  17. Social and behavior change communication in the fight against malaria in Mozambique

    Science.gov (United States)

    Arroz, Jorge Alexandre Harrison

    2017-01-01

    ABSTRACT Long-lasting insecticide-treated nets and/or indoor residual spraying, associated with case management, are key interventions in the control of malaria in Africa. The objective of this study is to comment on the role of social and behavior change communication as a potential key intervention in the control of malaria in Mozambique.

  18. Changing pattern of malaria in Bissau, Guinea Bissau

    DEFF Research Database (Denmark)

    Rodrigues, Amabelia; Schellenberg, Joanna Armstrong; Kofoed, Poul-Erik

    2008-01-01

    OBJECTIVE: To describe the epidemiology of malaria in Guinea-Bissau, in view of the fact that more funds are available now for malaria control in the country. METHODS: From May 2003 to May 2004, surveillance for malaria was conducted among children less than 5 years of age at three health centres...... of the children who presented at a health centre were clinically diagnosed with malaria, but only 13% of outpatient children who tested for malaria had malaria parasitaemia. Only 44% (963/2193) of children admitted to hospital with a diagnosis of malaria had parasitaemia. The proportion of positive cases...... increased with age. Among hospitalized children with malaria parasitaemia, those less than 2 years old were more likely to have moderate anaemia (RR = 1.27; 95% CI: 1.02-1.56) (P = 0.03) or severe anaemia (RR = 1.67; 95% CI: 1.25-2.24) (P = 0.0005) than older children. The prevalence of malaria parasitaemia...

  19. [Changes in malaria prevalence and management of fevers from 2000 to 2012 in Casamance, Senegal].

    Science.gov (United States)

    Brasseur, P; Raccurt, C; Badiane, M; Cisse, M; Trape, J-F; Sokhna, C

    2015-02-01

    Before 2006 in Senegal, in the absence of clinical diagnosis, all fever cases were considered as malaria and treated with chloroquine. Between 2004-2006, to face the dramatic increase of Plasmodium falciparum resistance to chloroquine, the combination of amodiaquine plus sulfadoxine-pyriméthamine was recommended for treatment. In 2006, rapid diagnostic tests were introduced and the treatment with a combination of artesunate plus amodiaquine (ASAQ) became the national recommendation for malaria treatment in 2007. This coincided with a decrease of the prevalence of malaria cases and change in fever management. Since 1995 in Mlomp in Casamance, thin and thick blood smear examination has systematically been done in patients with fever and clinical signs of malaria, and treatment with ASAQ given as experimental procedure. Between 2000 and 2012, 70,892 outpatients were attending the health center, and 51.2% of them for fever. Among these fever cases, 72.4% were suspected of malaria and 27.6% were identified as bacterial and viral infections. Confirmed malaria cases decreased dramatically from 1365 in 2000 to 53 in 2012. While comparing the 2 periods 2000-2006 and 2007-2012, the number of fever cases decreased by half, the number of fever identified as non malaria doubled and malaria treatment given decreased by 86%. Improvement of fever management in Mlomp has contributed to a better identification of their cause and to a decrease of inappropriate malaria treatments.

  20. Conflict in Neighboring Countries, a Great Risk for Malaria Elimination in Southwestern Iran: Narrative Review Article.

    Directory of Open Access Journals (Sweden)

    Maryam Molaee Zadeh

    2014-12-01

    Full Text Available The intensity of the conflict such as war is one of the determinants of the flow of migrants and refuges with consequence of introducing infectious disease to other countries. This paper investigates the relationship between malaria incidence and forced immigration due to war from neighboring countries in Dezful district, southwestern Iran. All available data and accessible archived documentary records on malaria cases in the period 1988-2011 in Dezful Health Centers were reviewed. Retrospective analysis of routine surveillance data from the Health authority of Dezful district was conducted to assess the trend of malaria incidence and prevalence in the last two decades. Malaria transmission dynamics was described using surveillance indicators viz, Annual Parasite Incidence (API, Slide Positivity Rate (SPR, Annual Blood Examination Rate (ABER and based on personal information of patients. Two peaks of malaria incidence occurred during past two decades. The first one arisen by Iran-Iraq war due to residential instability in Dezful while the API reached to 8 per 1000. The second peak happened after to civil war of Afghanistan began which caused large immigrates moved into the study area. During the second peak, API reached 1.7 per 1000 at maximum and the majority of patients were immigrants. This study describes the linkage between incidence and prevalence of malaria and immigration due to civil conflict. Therefore, malaria screening of immigrants and early warning programme are effective to prevent outbreak of disease in a potential risk area such Dezful.

  1. Malaria morbidity and temperature variation in a low risk Kenyan district: a case of overdiagnosis?

    Science.gov (United States)

    Njuguna, John; Muita, James; Mundia, George

    2009-05-01

    Diagnosis of malaria using only clinical means leads to overdiagnosis. This has implications due to safety concerns and the recent introduction of more expensive drugs. Temperature is a major climatic factor influencing the transmission dynamics of malaria. This study looked at trends in malaria morbidity in the low risk Kenyan district of Nyandarua, coupled with data on temperature and precipitation for the years 2003-2006. July had the highest number of cases (12.2% of all cases) followed by August (10.2% of all cases). July and August also had the lowest mean maximum temperatures, 20.1 and 20.2 °C respectively. April, July and August had the highest rainfall, with daily means of 4.0, 4.3 and 4.9 mm, respectively. Observation showed that the coldest months experienced the highest number of cases of malaria. Despite the high rainfall, transmission of malaria tends to be limited by low temperatures due to the long duration required for sporogony, with fewer vectors surviving. These cold months also tend to have the highest number of cases of respiratory infections. There is a possibility that some of these were misdiagnosed as malaria based on the fact that only a small proportion of malaria cases were diagnosed using microscopy or rapid diagnostic tests. We conclude that overdiagnosis may be prevalent in this district and there may be a need to design an intervention to minimise it.

  2. Mind the gap: house structure and the risk of malaria in Uganda.

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    Humphrey Wanzirah

    Full Text Available Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. We assessed how house design may affect mosquito house entry and malaria risk in Uganda.100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878 were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves or traditional (all other homes.A total of 113,618 female Anopheles were collected over 6,765 nights. 6,816 routine blood smears were taken of which 1,061 (15.6% were malaria parasite positive. 2,582 episodes of uncomplicated malaria were diagnosed after 1,569 person years of follow-up, giving an overall incidence of 1.6 episodes per person year at risk. The human biting rate was lower in modern homes than in traditional homes (adjusted incidence rate ratio (IRR 0.48, 95% confidence interval (CI 0.37-0.64, p<0.001. The odds of malaria infection were lower in modern homes across all the sub-counties (adjusted odds ratio 0.44, 95%CI 0.30-0.65, p<0.001, while malaria incidence was lower in modern homes in Kihihi (adjusted IRR 0.61, 95%CI 0.40-0.91, p = 0.02 but not in Walukuba or Nagongera.House design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas.

  3. Malaria prevalence, risk factors and spatial distribution in a hilly forest area of Bangladesh.

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    Ubydul Haque

    Full Text Available BACKGROUND: Malaria is a major public health concern in Bangladesh and it is highly endemic in the Chittagong Hill Tracts where prevalence was 11.7% in 2007. One sub-district, Rajasthali, had a prevalence of 36%. Several interventions were introduced in early 2007 to control malaria. This study was undertaken to evaluate the impacts of these intensive early stage interventions on malaria in Bangladesh. This prevalence study assesses whether or not high malaria prevalence remains, and if so, which areas and individuals remain at high risk of infection. METHODS AND PRINCIPAL FINDINGS: A 2-stage cluster sampling technique was used to sample 1,400 of 5,322 (26.3% households in Rajasthali, and screened using a rapid diagnostic test (Falci-vax. Overall malaria prevalence was 11.5%. The proportions of Plasmodium falciparum, Plasmodium vivax and infection with both species were 93.2%, 1.9% and 5.0%, respectively. Univariate, multivariate logistic regression, and spatial cluster analyses were performed separately. Sex, age, number of bed nets, forest cover, altitude and household density were potential risk factors. A statistically significant malaria cluster was identified. Significant differences among risk factors were observed between cluster and non-cluster areas. CONCLUSION AND SIGNIFICANCE: Malaria has significantly decreased within 2 years after onset of intervention program. Both aspects of the physical and social environment, as well as demographic characteristics are associated with spatial heterogeneity of risk. The ability to identify and locate these areas provides a strategy for targeting interventions during initial stages of intervention programs. However, in high risk clusters of transmission, even extensive coverage by current programs leaves transmission ongoing at reduced levels. This indicates the need for continued development of new strategies for identification and treatment as well as improved understanding of the patterns and

  4. Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study

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    Enweronu-Laryea Christabel C

    2013-01-01

    Full Text Available Abstract Background Congenital malaria is defined as malaria parasitaemia in the first week of life. The reported prevalence of congenital malaria in sub-Saharan Africa is variable (0 - 46%. Even though the clinical significance of congenital malaria parasitaemia is uncertain, anti-malarial drugs are empirically prescribed for sick newborns by frontline health care workers. Data on prevalence of congenital malaria in high-risk newborns will inform appropriate drug use and timely referral of sick newborns. Methods Blood samples of untreated newborns less than 1 week of age at the time of referral to Korle Bu Teaching hospital in Accra, Ghana during the peak malaria seasons (April to July of 2008 and 2010 were examined for malaria parasites by, i Giemsa-stained thick and thin blood smears for parasite count and species identification, ii histidine-rich protein- and lactic dehydrogenase-based rapid diagnosis tests, or iii polymerase chain reaction amplification of the merozoite surface protein 2 gene, for identification of sub-microscopic parasitaemia. Other investigations were also done as clinically indicated. Results In 2008, nine cases of Plasmodium falciparum parasitaemia were diagnosed by microscopy in 405 (2.2% newborns. All the nine newborns had low parasite densities (≤50 per microlitre. In 2010, there was no case of parasitaemia by either microscopy or rapid diagnosis tests in 522 newborns; however, 56/467 (12% cases of P. falciparum were detected by polymerase chain reaction. Conclusion Congenital malaria is an uncommon cause of clinical illness in high-risk untreated newborns referred to a tertiary hospital in the first week of life. Empirical anti-malarial drug treatment for sick newborns without laboratory confirmation of parasitaemia is imprudent. Early referral of sick newborns to hospitals with resources and skills for appropriate care is recommended.

  5. Urban malaria risk in sub-Saharan Africa: where is the evidence?

    Science.gov (United States)

    Byrne, Neville

    2007-03-01

    It is essential that the precautions that are advisable for travel in sub-Saharan Africa, including antimalarial prophylaxis, are supported by evidence. Sub-Saharan Africa accounts for 90% of global malaria cases and the more serious falciparum form predominates. The risk of malaria transmission is qualitatively much greater in rural than urban areas. However, there is little quantitative data on the risk in urban areas on which to base a risk assessment. Rapid urban population growth and trends of tourism to urban-only (rather than rural) areas both support the need to focus attention on the level of risk in malaria endemic African cities. There is evidence in urban settings that the reduced intensity of malaria transmission is due to a decline in the level of parasitism in the local population and reduced anophelism. The most useful evidence for an urban risk assessment is the entomological inoculation rate (EIR) which is generally below 30 infective bites per person per year. Transmission is acknowledged to be much lower in central urban areas compared with peri-urban areas or rural areas. Transmission is local and focal because the anopheles mosquito has a limited flight range of several kilometres. The risk assessment should examine nocturnal activities outside an air-conditioned environment (because the anopheline mosquito only bites between dusk and dawn) and the level of adherence to accompanying protective measures. Several studies have noted the protection air-conditioning provides against malaria. Evidence of low occupational risk for airline crew, unprotected by prophylaxis, from brief layovers of several nights in quality hotels in 8 endemic cities is explored. A literature search examines the evidence of environmental surveys and entomological inoculation rates. The limitations of the available data are discussed, including the highly focal nature of malaria transmission.

  6. Independent Associations of Maternal Education and Household Wealth with Malaria Risk in Children

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    José G. Siri

    2014-03-01

    Full Text Available Despite evidence that they play similar but independent roles, maternal education and household wealth are usually conflated in studies of the effects of socioeconomic status (SES on malaria risk. Demographic and Health Survey and Malaria Indicator Survey data from nine countries in sub-Saharan Africa were used to explore the relationship of malaria parasitemia in children with SES factors at individual and cluster scales, controlling for urban/rural residence and other important covariates. In multilevel logistic regression modeling, completion of six years of maternal schooling was associated with significantly lower odds of infection in children (OR = 0.73, as was a household wealth index at the 40th percentile compared to the lowest percentile (OR = 0.48. These relationships were nonlinear, with significant quadratic terms for both education and wealth. Cluster-level wealth index was also associated with a reduction in risk (OR = 0.984 for a one percentile increase in mean wealth index, as was urban residence (OR = 0.59. Among other covariates, increasing child's age and household size category were positively correlated with infection, and sleeping under an insecticide-treated bednet the previous night (OR = 0.80 was associated with a moderate reduction in risk. Considerable variation in parameter estimates was observed among country-specific models. Future work should clearly distinguish between maternal education and household resources in assessing malaria risk, and malaria prevention and control efforts should be aware of the potential benefits of supporting the development of human capital.

  7. Towards a risk map of malaria for Sri Lanka: the importance of house location relative to vector breeding sites

    DEFF Research Database (Denmark)

    Van Der Hoek, Wim; Konradsen, Flemming; Amerasinghe, Priyanie H

    2003-01-01

    BACKGROUND: In Sri Lanka, the major malaria vector Anopheles culicifacies breeds in pools formed in streams and river beds and it is likely that people living close to such breeding sites are at higher risk of malaria than people living further away. This study was done to quantify the importance...... of house location relative to vector breeding sites for the occurrence of malaria in order to assess the usefulness of this parameter in future malaria risk maps. Such risk maps could be important tools for planning efficient malaria control measures. METHODS: In a group of seven villages in north central...... Sri Lanka, malaria cases were compared with community controls for distance from house to breeding sites and a number of other variables, including type of housing construction and use of anti-mosquito measures. The presence of An. culicifacies in bedrooms was determined by indoor insecticide spray...

  8. Population Density, Climate Variables and Poverty Synergistically Structure Spatial Risk in Urban Malaria in India

    Science.gov (United States)

    Santos-Vega, Mauricio; Bouma, Menno J; Kohli, Vijay; Pascual, Mercedes

    2016-01-01

    Background The world is rapidly becoming urban with the global population living in cities projected to double by 2050. This increase in urbanization poses new challenges for the spread and control of communicable diseases such as malaria. In particular, urban environments create highly heterogeneous socio-economic and environmental conditions that can affect the transmission of vector-borne diseases dependent on human water storage and waste water management. Interestingly India, as opposed to Africa, harbors a mosquito vector, Anopheles stephensi, which thrives in the man-made environments of cities and acts as the vector for both Plasmodium vivax and Plasmodium falciparum, making the malaria problem a truly urban phenomenon. Here we address the role and determinants of within-city spatial heterogeneity in the incidence patterns of vivax malaria, and then draw comparisons with results for falciparum malaria. Methodology/principal findings Statistical analyses and a phenomenological transmission model are applied to an extensive spatio-temporal dataset on cases of Plasmodium vivax in the city of Ahmedabad (Gujarat, India) that spans 12 years monthly at the level of wards. A spatial pattern in malaria incidence is described that is largely stationary in time for this parasite. Malaria risk is then shown to be associated with socioeconomic indicators and environmental parameters, temperature and humidity. In a more dynamical perspective, an Inhomogeneous Markov Chain Model is used to predict vivax malaria risk. Models that account for climate factors, socioeconomic level and population size show the highest predictive skill. A comparison to the transmission dynamics of falciparum malaria reinforces the conclusion that the spatio-temporal patterns of risk are strongly driven by extrinsic factors. Conclusion/significance Climate forcing and socio-economic heterogeneity act synergistically at local scales on the population dynamics of urban malaria in this city. The

  9. Risk factors for low birth-weight in areas with varying malaria transmission in Korogwe, Tanzania: implications for malaria control

    DEFF Research Database (Denmark)

    Mmbando, Bruno Paul; Cole-Lewis, H; Sembuche, S;

    2008-01-01

    at determining whether there was a difference in rates of LBW in areas of varying malaria transmission intensity in Korogwe, Tanzania. Retrospective data for one year (June 2004-May 2005) in three maternal and child health (MCH) clinics in the district were analysed. Villages were stratified into three strata......: lowlands-semi urban (average altitude of 320m), lowlands-rural (below 600m) and highlands (> or =600m). There was a significant decreasing trend of rate of LBW from rural lowlands to highlands (chi2trend = 7.335, P=0.007). Adjusting for covariates, women in parity-two were at reduced risk of delivering LBW...

  10. Dynamics of socioeconomic risk factors for neglected tropical diseases and malaria in an armed conflict.

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    Thomas Fürst

    Full Text Available BACKGROUND: Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Côte d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs and malaria. METHODOLOGY: The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Côte d'Ivoire, shortly before and after the 2002/2003 armed conflict. PRINCIPAL FINDINGS: There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict. CONCLUSION: New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects.

  11. Development of nutritionally at-risk young children is predicted by malaria, anemia, and stunting in Pemba, Zanzibar

    Science.gov (United States)

    Nutritionally at-risk children suffer delays in physical growth and motor and language development. Infectious diseases such as malaria pose an additional risk. We examined the cross-sectional relationships among malaria infection, hemoglobin (Hb) concentration, length-for-age Z-scores (LAZ), motor ...

  12. Behavioral change communications on malaria prevention in Ghana.

    Science.gov (United States)

    Tweneboah-Koduah, Ernest Yaw; Braimah, Mahama; Otuo, Priscilla Ntriwaa

    2012-01-01

    The purpose of this study is to assess the various communications strategies designed to promote insecticide-treated nets (ITN) use among pregnant women and children. This study is an exploratory study into the communications activities by institutions involved in malaria prevention in Ghana. In-depth interviews were conducted and the data were analyzed. We found that most of the interventions are aimed at encouraging the target markets to acquire ITNs, although most messages on malaria prevention are not integrated. Several challenges were noted, including financial constraints, lack of human resources, cultural barriers, negative publicity, and negative perceptions on malaria.

  13. The influence of mosquito resting behaviour and associated microclimate for malaria risk

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    Thomas Matthew B

    2011-07-01

    Full Text Available Abstract Background The majority of the mosquito and parasite life-history traits that combine to determine malaria transmission intensity are temperature sensitive. In most cases, the process-based models used to estimate malaria risk and inform control and prevention strategies utilize measures of mean outdoor temperature. Evidence suggests, however, that certain malaria vectors can spend large parts of their adult life resting indoors. Presentation of hypothesis If significant proportions of mosquitoes are resting indoors and indoor conditions differ markedly from ambient conditions, simple use of outdoor temperatures will not provide reliable estimates of malaria transmission intensity. To date, few studies have quantified the differential effects of indoor vs outdoor temperatures explicitly, reflecting a lack of proper understanding of mosquito resting behaviour and associated microclimate. Testing the hypothesis Published records from 8 village sites in East Africa revealed temperatures to be warmer indoors than outdoors and to generally show less daily variation. Exploring the effects of these temperatures on malaria parasite development rate suggested indoor-resting mosquitoes could transmit malaria between 0.3 and 22.5 days earlier than outdoor-resting mosquitoes. These differences translate to increases in transmission risk ranging from 5 to approaching 3,000%, relative to predictions based on outdoor temperatures. The pattern appears robust for low- and highland areas, with differences increasing with altitude. Implications of the hypothesis Differences in indoor vs outdoor environments lead to large differences in the limits and the intensity of malaria transmission. This finding highlights a need to better understand mosquito resting behaviour and the associated microclimate, and to broaden assessments of transmission ecology and risk to consider the potentially important role of endophily.

  14. Risk factors for helminth, malaria, and HIV infection in pregnancy in Entebbe, Uganda.

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    Patrick William Woodburn

    Full Text Available BACKGROUND: Infections during pregnancy may have serious consequences for both mother and baby. Assessment of risk factors for infections informs planning of interventions and analysis of the impact of infections on health outcomes. OBJECTIVES: To describe risk factors for helminths, malaria and HIV in pregnant Ugandan women before intervention in a trial of de-worming in pregnancy. METHODS: The trial recruited 2,507 pregnant women between April 2003 and November 2005. Participants were interviewed and blood and stool samples obtained; location of residence at enrolment was mapped. Demographic, socioeconomic, behavioral and other risk factors were modelled using logistic regression. RESULTS: There was a high prevalence of helminth, malaria and HIV infection, as previously reported. All helminths and malaria parasitemia were more common in younger women, and education was protective against every infection. Place of birth and/or tribe affected all helminths in a pattern consistent with the geographical distribution of helminth infections in Uganda. Four different geohelminths (hookworm, Trichuris, Ascaris and Trichostrongylus showed a downwards trend in prevalence during the enrolment period. There was a negative association between hookworm and HIV, and between hookworm and low CD4 count among HIV-positive women. Locally, high prevalence of schistosomiasis and HIV occurred in lakeshore communities. CONCLUSIONS: Interventions for helminths, malaria and HIV need to target young women both in and out of school. Antenatal interventions for malaria and HIV infection must continue to be promoted. Women originating from a high risk area for a helminth infection remain at high risk after migration to a lower-risk area, and vice versa, but overall, geohelminths seem to be becoming less common in this population. High risk populations, such as fishing communities, require directed effort against schistosomiasis and HIV infection.

  15. Changes in white blood cells and platelets in children with falciparum malaria: relationship to disease outcome.

    Science.gov (United States)

    Ladhani, Shamez; Lowe, Brett; Cole, Andrew O; Kowuondo, Ken; Newton, Charles R J C

    2002-12-01

    Little is known about the changes in white blood cells and platelets in children with falciparum malaria in endemic areas. We measured the white cell count (WCC) and platelets of 230 healthy children from the community, 1369 children admitted to hospital with symptomatic malaria, and 1461 children with other medical conditions. Children with malaria had a higher WCC compared with community controls, and leucocytosis was strongly associated with younger age, deep breathing, severe anaemia, thrombocytopenia and death. The WCC was not associated with a positive blood culture. In children with malaria, high lymphocyte and low monocyte counts were independently associated with mortality. A platelet count of less than 150 x 109/l was found in 56.7% of children with malaria, and was associated with age, prostration and parasite density, but not with bleeding problems or mortality. The mean platelet volume was also higher in children with malaria compared with other medical conditions. This may reflect early release from the bone marrow in response to peripheral platelet destruction. Thus, leucocytosis was associated with both severity and mortality in children with falciparum malaria, irrespective of bacteraemia, whereas thrombocytopenia, although very common, was not associated with adverse outcome.

  16. Assessing the risk of self-diagnosed malaria in urban informal settlements of Nairobi using self-reported morbidity survey

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    Mugisha Frederick

    2007-05-01

    Full Text Available Abstract Background Because of the belief that Nairobi is a low risk zone for malaria, little empirical data exists on malaria risk in the area. The aim of this study was to explore the risk of perceived malaria and some associated factors in Nairobi informal settlements using self-reported morbidity survey. Methods The survey was conducted from May to August 2004 on 7,288 individuals in two informal settlements of Nairobi. Participants were asked to report illnesses they experienced in the past 14 days. Logistic regression was used to estimate the odds of perceived-malaria. The model included variables such as site of residence, age, ethnicity and number of reported symptoms. Results Participants reported 165 illnesses among which malaria was the leading cause (28.1%. The risk of perceived-malaria was significantly higher in Viwandani compared to Korogocho (OR 1.61, 95%CI: 1.10–2.26. Participants in age group 25–39 years had significantly higher odds of perceived-malaria compared to those under-five years (OR 2.07, 95%CI: 1.43–2.98. The Kikuyu had reduced odds of perceived-malaria compared to other ethnic groups. Individuals with five and more symptoms had higher odds compared to those with no symptoms (OR 23.69, 95%CI: 12.98–43.23. Conclusion Malaria was the leading cause of illness as perceived by the residents in the two informal settlements. This was rational as the number of reported symptoms was highly associated with the risk of reporting the illness. These results highlight the need for a more comprehensive assessment of malaria epidemiology in Nairobi to be able to offer evidence-based guidance to policy on malaria in Kenya and particularly in Nairobi.

  17. Quantifying the Number of Pregnancies at Risk of Malaria in 2007: A Demographic Study

    NARCIS (Netherlands)

    Dellicour, S.; Tatem, A.J.; Guerra, C.A.; Snow, R.W.; ter Kuile, F.O.

    2010-01-01

    Background: Comprehensive and contemporary estimates of the number of pregnancies at risk of malaria are not currently available, particularly for endemic areas outside of Africa. We derived global estimates of the number of women who became pregnant in 2007 in areas with Plasmodium falciparum and P

  18. The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India)

    OpenAIRE

    2006-01-01

    Background & objectives: Recently there were reports from all over India about changing spectrumof clinical presentation of severe malaria. The present study was planned to study the same in thenorthwest India.Methods: This prospective study was conducted on patients of severe malaria admitted in a classifiedmalaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India) during 1994 and 2001.It included adult patients of both sexes belonging to all age groups. The diagnosis o...

  19. High Resolution Niche Models of Malaria Vectors in Northern Tanzania: A New Capacity to Predict Malaria Risk?

    OpenAIRE

    Kulkarni, Manisha A; Desrochers, Rachelle E; Kerr, Jeremy T.

    2010-01-01

    Background Malaria transmission rates in Africa can vary dramatically over the space of a few kilometres. This spatial heterogeneity reflects variation in vector mosquito habitat and presents an important obstacle to the efficient allocation of malaria control resources. Malaria control is further complicated by combinations of vector species that respond differently to control interventions. Recent modelling innovations make it possible to predict vector distributions and extrapolate malaria...

  20. Reversible audiometric threshold changes in children with uncomplicated malaria

    DEFF Research Database (Denmark)

    Adjei, George O; Goka, Bamenla Q; Kitcher, Emmanuel

    2013-01-01

    Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs) with hearing...... is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n = 37), artemether-lumefantrine (n = 35), or amodiaquine (n = 8) in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared...... evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels...

  1. Antibody-dependent cellular inhibition is associated with reduced risk against febrile malaria in a longitudinal cohort study involving Ghanaian children

    DEFF Research Database (Denmark)

    Tiendrebeogo, Regis W; Adu, Bright; Singh, Susheel K;

    2015-01-01

    studies (LCS). We investigated the relationship between ADCI activity of immunoglobulin G before malaria season and risk of malaria in a LCS involving Ghanaian children. High ADCI activity was significantly associated with reduced risk against malaria. Findings here suggest a potential usefulness...

  2. Using serological measures to monitor changes in malaria transmission in Vanuatu

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    Clements Archie

    2010-06-01

    Full Text Available Abstract Background With renewed interest in malaria elimination, island environments present unique opportunities to achieve this goal. However, as transmission decreases, monitoring and evaluation programmes need increasingly sensitive tools to assess Plasmodium falciparum and Plasmodium vivax exposure. In 2009, to assess the role of serological markers in evaluating malaria transmission, a cross-sectional seroprevalence study was carried out in Tanna and Aneityum, two of the southernmost islands of the Vanuatu archipelago, areas where malaria transmission has been variably reduced over the past few decades. Methods Malaria transmission was assessed using serological markers for exposure to P. falciparum and P. vivax. Filter blood spot papers were collected from 1,249 people from Tanna, and 517 people from Aneityum to assess the prevalence of antibodies to two P. falciparum antigens (MSP-119 and AMA-1 and two P. vivax antigens (MSP-119 and AMA-1. Age-specific prevalence was modelled using a simple catalytic conversion model based on maximum likelihood to generate a community seroconversion rate (SCR. Results Overall seropositivity in Tanna was 9.4%, 12.4% and 16.6% to P. falciparum MSP-119, AMA-1 and Schizont Extract respectively and 12.6% and 15.0% to P. vivax MSP-119 and AMA-1 respectively. Serological results distinguished between areas of differential dominance of either P. vivax or P. falciparum and analysis of age-stratified results showed a step in seroprevalence occurring approximately 30 years ago on both islands, indicative of a change in transmission intensity at this time. Results from Aneityum suggest that several children may have been exposed to malaria since the 2002 P. vivax epidemic. Conclusion Seroepidemiology can provide key information on malaria transmission for control programmes, when parasite rates are low. As Vanuatu moves closer to malaria elimination, monitoring changes in transmission intensity and identification

  3. Malaria in India: Challenges and opportunities

    Indian Academy of Sciences (India)

    A P Dash; Neena Valecha; A R Anvikar; A Kumar

    2008-11-01

    India contributes about 70% of malaria in the South East Asian Region of WHO. Although annually India reports about two million cases and 1000 deaths attributable to malaria, there is an increasing trend in the proportion of Plasmodium falciparum as the agent. There exists heterogeneity and variability in the risk of malaria transmission between and within the states of the country as many ecotypes/paradigms of malaria have been recognized. The pattern of clinical presentation of severe malaria has also changed and while multi-organ failure is more frequently observed in falciparum malaria, there are reports of vivax malaria presenting with severe manifestations. The high burden populations are ethnic tribes living in the forested pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk of morbidity and mortality due to malaria in the country. Drug resistance, insecticide resistance, lack of knowledge of actual disease burden along with new paradigms of malaria pose a challenge for malaria control in the country. Considering the existing gaps in reported and estimated morbidity and mortality, need for estimation of true burden of malaria has been stressed. Administrative, financial, technical and operational challenges faced by the national programme have been elucidated. Approaches and priorities that may be helpful in tackling serious issues confronting malaria programme have been outlined.

  4. Managing Climate Change Risks

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R. [CSIRO Atmospheric Research, PMB1 Aspendale, Victoria 3195 (Australia)

    2003-07-01

    Issues of uncertainty, scale and delay between action and response mean that 'dangerous' climate change is best managed within a risk assessment framework that evolves as new information is gathered. Risk can be broadly defined as the combination of likelihood and consequence; the latter measured as vulnerability to greenhouse-induced climate change. The most robust way to assess climate change damages in a probabilistic framework is as the likelihood of critical threshold exceedance. Because vulnerability is dominated by local factors, global vulnerability is the aggregation of many local impacts being forced beyond their coping ranges. Several case studies, generic sea level rise and temperature, coral bleaching on the Great Barrier Reef and water supply in an Australian catchment, are used to show how local risk assessments can be assessed then expressed as a function of global warming. Impacts treated thus can be aggregated to assess global risks consistent with Article 2 of the UNFCCC. A 'proof of concept' example is then used to show how the stabilisation of greenhouse gases can constrain the likelihood of exceeding critical thresholds at both the both local and global scale. This analysis suggests that even if the costs of reducing greenhouse gas emissions and the benefits of avoiding climate damages can be estimated, the likelihood of being able to meet a cost-benefit target is limited by both physical and socio-economic uncertainties. In terms of managing climate change risks, adaptation will be most effective at reducing vulnerability likely to occur at low levels of warming. Successive efforts to mitigate greenhouse gases will reduce the likelihood of reaching levels of global warming from the top down, with the highest potential temperatures being avoided first, irrespective of contributing scientific uncertainties. This implies that the first cuts in emissions will always produce the largest economic benefits in terms of avoided

  5. [Malaria in Algerian Sahara].

    Science.gov (United States)

    Hammadi, D; Boubidi, S C; Chaib, S E; Saber, A; Khechache, Y; Gasmi, M; Harrat, Z

    2009-08-01

    Thanks to the malaria eradication campaign launched in Algeria in 1968, the number of malaria cases fell down significantly from 95,424 cases in 1960 to 30 cases in 1978. At that time the northern part of the country was declared free of Plasmodium falciparum. Only few cases belonging to P. vivax persisted in residual foci in the middle part of the country. In the beginning of the eighties, the south of the country was marked by an increase of imported malaria cases. The resurgence of the disease in the oases coincided with the opening of the Trans-Saharan road and the booming trade with the neighbouring southern countries. Several authors insisted on the risk of introduction of malaria or its exotic potential vectors in Algeria via this new road. Now, the totality of malaria autochthonous cases in Algeria are located in the south of the country where 300 cases were declared during the period (1980-2007). The recent outbreak recorded in 2007 at the borders with Mall and the introduction of Anopheles gambiae into the Algerian territory show the vulnerability of this area to malaria which is probably emphasized by the local environmental changes. The authors assess the evolution of malaria in the Sahara region and draw up the distribution of the anopheles in this area.

  6. Social and environmental malaria risk factors in urban areas of Ouagadougou, Burkina Faso

    Directory of Open Access Journals (Sweden)

    Ouedraogo Herman

    2009-01-01

    Full Text Available Abstract Background Despite low endemicity, malaria remains a major health problem in urban areas where a high proportion of fevers are presumptively treated using anti-malarial drugs. Low acquired malaria immunity, behaviour of city-dwellers, access to health care and preventive interventions, and heterogenic suitability of urban ecosystems for malaria transmission contribute to the complexity of the malaria epidemiology in urban areas. Methods The study was designed to identify the determinants of malaria transmission estimated by the prevalence of anti-circumsporozoite (CSP antibodies, the prevalence and density of Plasmodium falciparum infection, and the prevalence of malarial disease in areas of Ouagadougou, Burkina-Faso. Thick blood smears, dried blood spots and clinical status have been collected from 3,354 randomly chosen children aged 6 months to 12 years using two cross-sectional surveys (during the dry and rainy seasons in eight areas from four ecological strata defined according to building density and land tenure (regular versus irregular. Demographic characteristics, socio-economic information, and sanitary and environmental data concerning the children or their households were simultaneously collected. Dependent variables were analysed using mixed multivariable models with random effects, taking into account the clustering of participants within compounds and areas. Results Overall prevalences of CSP-antibodies and P. falciparum infections were 7.7% and 16.6% during the dry season, and 12.4% and 26.1% during the rainy season, respectively, with significant differences according to ecological strata. Malaria risk was significantly higher among children who i lived in households with lower economic or education levels, iii near the hydrographic network, iv in sparsely built-up areas, v in irregularly built areas, vi who did not use a bed net, vii were sampled during the rainy season or ii had traveled outside of Ouagadougou

  7. Spatial analysis and mapping of malaria risk in Malawi using point-referenced prevalence of infection data

    Directory of Open Access Journals (Sweden)

    Kazembe Lawrence N

    2006-09-01

    Full Text Available Abstract Background Current malaria control initiatives aim at reducing malaria burden by half by the year 2010. Effective control requires evidence-based utilisation of resources. Characterizing spatial patterns of risk, through maps, is an important tool to guide control programmes. To this end an analysis was carried out to predict and map malaria risk in Malawi using empirical data with the aim of identifying areas where greatest effort should be focussed. Methods Point-referenced prevalence of infection data for children aged 1–10 years were collected from published and grey literature and geo-referenced. The model-based geostatistical methods were applied to analyze and predict malaria risk in areas where data were not observed. Topographical and climatic covariates were added in the model for risk assessment and improved prediction. A Bayesian approach was used for model fitting and prediction. Results Bivariate models showed a significant association of malaria risk with elevation, annual maximum temperature, rainfall and potential evapotranspiration (PET. However in the prediction model, the spatial distribution of malaria risk was associated with elevation, and marginally with maximum temperature and PET. The resulting map broadly agreed with expert opinion about the variation of risk in the country, and further showed marked variation even at local level. High risk areas were in the low-lying lake shore regions, while low risk was along the highlands in the country. Conclusion The map provided an initial description of the geographic variation of malaria risk in Malawi, and might help in the choice and design of interventions, which is crucial for reducing the burden of malaria in Malawi.

  8. Risk factors for malaria: a microepidemiological study in a village in Sri Lanka

    DEFF Research Database (Denmark)

    Hoek, Wim van der; Konradsen, F; Dijkstra, D S;

    1998-01-01

    and direct observations. Age below 17 years (relative risk [RR] = 1.66, 95% confidence interval [95% CI] 1.18-2.35), use of bed nets (RR = 0.16, 95% CI 0.05-0.45) and traditional fumigants (RR = 0.58, 95% CI 0.37-0.93) were independent predictors of malaria. People using anti-mosquito pyrethrum coils had...... a higher risk for malaria than people living in houses where they were not used (RR = 1.46, 95% CI 1.03-2.07). The build-up of Anopheles culicifacies populations before the start of the transmission season had taken place in a stream near the village. Living close to the stream was a risk factor...

  9. Reversible Audiometric Threshold Changes in Children with Uncomplicated Malaria

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    George O. Adjei

    2013-01-01

    Full Text Available Background. Plasmodium falciparum malaria, as well as certain antimalarial drugs, is associated with hearing impairment in adults. There is little information, however, on the extent, if any, of this effect in children, and the evidence linking artemisinin combination therapies (ACTs with hearing is inconclusive. Methods. Audiometry was conducted in children with uncomplicated malaria treated with artesunate-amodiaquine (n=37, artemether-lumefantrine (n=35, or amodiaquine (n=8 in Accra, Ghana. Audiometry was repeated 3, 7, and 28 days later and after 9 months. Audiometric thresholds were compared with those of a control group of children (n=57 from the same area. Findings. During the acute stage, hearing threshold levels of treated children were significantly elevated compared with controls (P<0.001. The threshold elevations persisted up to 28 days, but no differences in hearing thresholds were evident between treated children and controls after 9 months. The hearing thresholds of children treated with the two ACT regimens were comparable but lower than those of amodiaquine-treated children during acute illness. Interpretation. Malaria is the likely cause of the elevated hearing threshold levels during the acute illness, a finding that has implications for learning and development in areas of intense transmission, as well as for evaluating potential ototoxicity of new antimalarial drugs.

  10. Malaria in Africa: vector species' niche models and relative risk maps.

    Directory of Open Access Journals (Sweden)

    Alexander Moffett

    Full Text Available A central theoretical goal of epidemiology is the construction of spatial models of disease prevalence and risk, including maps for the potential spread of infectious disease. We provide three continent-wide maps representing the relative risk of malaria in Africa based on ecological niche models of vector species and risk analysis at a spatial resolution of 1 arc-minute (9 185 275 cells of approximately 4 sq km. Using a maximum entropy method we construct niche models for 10 malaria vector species based on species occurrence records since 1980, 19 climatic variables, altitude, and land cover data (in 14 classes. For seven vectors (Anopheles coustani, A. funestus, A. melas, A. merus, A. moucheti, A. nili, and A. paludis these are the first published niche models. We predict that Central Africa has poor habitat for both A. arabiensis and A. gambiae, and that A. quadriannulatus and A. arabiensis have restricted habitats in Southern Africa as claimed by field experts in criticism of previous models. The results of the niche models are incorporated into three relative risk models which assume different ecological interactions between vector species. The "additive" model assumes no interaction; the "minimax" model assumes maximum relative risk due to any vector in a cell; and the "competitive exclusion" model assumes the relative risk that arises from the most suitable vector for a cell. All models include variable anthrophilicity of vectors and spatial variation in human population density. Relative risk maps are produced from these models. All models predict that human population density is the critical factor determining malaria risk. Our method of constructing relative risk maps is equally general. We discuss the limits of the relative risk maps reported here, and the additional data that are required for their improvement. The protocol developed here can be used for any other vector-borne disease.

  11. Environmental risk factors for clinical malaria: a case-control study in the Grau region of Peru.

    Science.gov (United States)

    Guthmann, J P; Hall, A J; Jaffar, S; Palacios, A; Lines, J; Llanos-Cuentas, A

    2001-01-01

    The role of environmental risk factors in clinical malaria has been studied mainly in Africa and Asia, few investigations have been carried out in Latin America. Field observations in northern coastal Peru, where the prevalence of malaria is high during the agricultural season, suggested that the risk of disease varied according to the characteristics of the house and the house environment. Environmental determinants of the risk of clinical malaria were therefore investigated through a case-control study: 323 clinical cases of malaria, recruited through community-based active case-finding, and 969 age-, sex- and village-matched controls were recruited into the study over a period of 12 months ending June 1997. Residual spraying of houses in the previous 6 months, living more than 100 m from a canal, a level of education equal to primary school or above and working in agriculture conferred significant protection from the risk of developing clinical malaria. The presence of spaces between the wall and roof in the subject's bedroom (eaves) and a house aged > 4 years statistically significantly increased the risk of disease. Based on these results we discuss possible control measures for malaria in this area of the country.

  12. Transmission Intensity and Drug Resistance in Malaria Population Dynamics : Implications for Climate Change

    NARCIS (Netherlands)

    Artzy-Randrup, Yael; Alonso, David; Pascual, Mercedes

    2010-01-01

    Although the spread of drug resistance and the influence of climate change on malaria are most often considered separately, these factors have the potential to interact through altered levels of transmission intensity. The influence of transmission intensity on the evolution of drug resistance has b

  13. Mapping of Malaria Vectors at District Level in India: Changing Scenario and Identified Gaps.

    Science.gov (United States)

    Singh, Poonam; Lingala, Mercy Aparna L; Sarkar, Soma; Dhiman, Ramesh C

    2017-02-01

    Malaria is one of the six major vector-borne diseases in India, the endemicity of which changes with changes in ecological, climatic, and sociodevelopmental conditions. The anopheline vectors are greatly affected by ecological conditions such as deforestation, urbanization, climate and lifestyle. Despite the advent of tools such as Geographic Information System (GIS), the updated information on the distribution of anopheline vectors of malaria is not available. In India, the plan for vector control is organized at subcentral level but information about vectors is unavailable even at the district level. Therefore, a systematic presentation of vector distribution has been made to provide maps in respect of major vector species. A search of the literature for major vector species, that is, Anopheles culicifacies, Anopheles fluviatilis, Anopheles stephensi, Anopheles minimus, and Anopheles dirus sensu lato, since 1927 till 2015 was carried out. Data have been presented as present, absent, and no information about vector species during pre-eradication (1927-1958), posteradication (1959-1999), and current scenario (2000-2015). Vectors' distribution and malaria endemicity were mapped using Arc GIS. Of 630 districts of India, major vectors An. culicifacies, An. fluviatilis, and An. stephensi were present in 420, 241, and 243 districts, respectively. In 183 districts, there is no information on any major malaria vector species although 27 of them from the states of Arunachal Pradesh, Jharkhand, Manipur, and Mizoram are highly endemic for malaria, having incidences of 2-40 cases/1000/year. The identified gaps in vector distribution, particularly in malaria endemic areas, necessitate further surveys so as to generate the missing information.

  14. The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India

    Directory of Open Access Journals (Sweden)

    D.K. Kochar, S.K. Kochar, R.P. Agrawal, M. Sabir, K.C. Nayak, T.D. Agrawal, V.P. Purohit , R.P. Gupta

    2006-09-01

    Full Text Available Background & objectives: Recently there were reports from all over India about changing spectrumof clinical presentation of severe malaria. The present study was planned to study the same in thenorthwest India.Methods: This prospective study was conducted on patients of severe malaria admitted in a classifiedmalaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India during 1994 and 2001.It included adult patients of both sexes belonging to all age groups. The diagnosis of Plasmodiumfalciparum was confirmed by demonstrating asexual form of parasites in peripheral blood smear. Allpatients were treated with i.v./oral quinine. The specific complications were treated by standard WHOprotocol. The data for individual complications for both the years were analysed by applying chisquaretest.Results: In a prospective study in 1994 the spectrum of complication was dominated by cerebralmalaria (25.75% followed by jaundice (11.47%, bleeding tendencies (9.59%, severe anaemia(5.83%, shock (5.26%, Acute respiratory distress syndrome—ARDS (3.01%, renal failure (2.07%and hypoglycemia (2.07% whereas in 2001 it was dominated by jaundice (58.85% followed bysevere anaemia (26.04%, bleeding tendencies (25.52%, shock (10.94%, cerebral malaria (10.94%,renal failure (6.25%, ARDS (2.08% and hypoglycemia (1.56%. The sharp difference for presence ofjaundice and severe anaemia in 2001 and cerebral malaria in 1994 was statistically significant. Similarly,the important cause of mortality in 2001 was multiple organ dysfunction syndrome (71.10% withpredominant presentation of jaundice and renal failure, whereas in 1994, it was cerebral malaria (77.96%.Interpretation & conclusion: The observation of changing spectrum of severe malaria in this studyand a significant increase in presentation with jaundice as an important manifestation is highly essentialfor primary, secondary and tertiary level health care providers for proper diagnosis and management.

  15. Reduced risk of uncomplicated malaria episodes in children with a+-thalassemia in northeastern Tanzania

    DEFF Research Database (Denmark)

    Enevold, Anders; Lusingu, John P; Mmbando, Bruno

    2008-01-01

    the susceptibility to uncomplicated malaria. We compared the risk of suffering from febrile, uncomplicated malaria between individuals carrying three common RBC polymorphisms (sickle cell trait, alpha(+)-thalassemia, and glucose-6-phosphate-dehydrogenase deficiency) and controls. The study was performed in an area......The prevalence of human red blood cell (RBC) polymorphisms is high in areas of intense Plasmodium falciparum transmission, and individuals carrying these genetic traits are believed to be partially protected against severe malaria. However, it remains uncertain how RBC polymorphisms affect...

  16. Integrating rapid risk mapping and mobile phone call record data for strategic malaria elimination planning

    Science.gov (United States)

    2014-01-01

    Background As successful malaria control programmes re-orientate towards elimination, the identification of transmission foci, targeting of attack measures to high-risk areas and management of importation risk become high priorities. When resources are limited and transmission is varying seasonally, approaches that can rapidly prioritize areas for surveillance and control can be valuable, and the most appropriate attack measure for a particular location is likely to differ depending on whether it exports or imports malaria infections. Methods/Results Here, using the example of Namibia, a method for targeting of interventions using surveillance data, satellite imagery, and mobile phone call records to support elimination planning is described. One year of aggregated movement patterns for over a million people across Namibia are analyzed, and linked with case-based risk maps built on satellite imagery. By combining case-data and movement, the way human population movements connect transmission risk areas is demonstrated. Communities that were strongly connected by relatively higher levels of movement were then identified, and net export and import of travellers and infection risks by region were quantified. These maps can aid the design of targeted interventions to maximally reduce the number of cases exported to other regions while employing appropriate interventions to manage risk in places that import them. Conclusions The approaches presented can be rapidly updated and used to identify where active surveillance for both local and imported cases should be increased, which regions would benefit from coordinating efforts, and how spatially progressive elimination plans can be designed. With improvements in surveillance systems linked to improved diagnosis of malaria, detailed satellite imagery being readily available and mobile phone usage data continually being collected by network providers, the potential exists to make operational use of such valuable

  17. Using a new high resolution regional model for malaria that accounts for population density and surface hydrology to determine sensitivity of malaria risk to climate drivers

    Science.gov (United States)

    Tompkins, Adrian; Ermert, Volker; Di Giuseppe, Francesca

    2013-04-01

    In order to better address the role of population dynamics and surface hydrology in the assessment of malaria risk, a new dynamical disease model been developed at ICTP, known as VECTRI: VECtor borne disease community model of ICTP, TRIeste (VECTRI). The model accounts for the temperature impact on the larvae, parasite and adult vector populations. Local host population density affects the transmission intensity, and the model thus reproduces the differences between peri-urban and rural transmission noted in Africa. A new simple pond model framework represents surface hydrology. The model can be used on with spatial resolutions finer than 10km to resolve individual health districts and thus can be used as a planning tool. Results of the models representation of interannual variability and longer term projections of malaria transmission will be shown for Africa. These will show that the model represents the seasonality and spatial variations of malaria transmission well matching a wide range of survey data of parasite rate and entomological inoculation rate (EIR) from across West and East Africa taken in the period prior to large-scale interventions. The model is used to determine the sensitivity of malaria risk to climate variations, both in rainfall and temperature, and then its use in a prototype forecasting system coupled with ECMWF forecasts will be demonstrated.

  18. 气候变化对疟疾影响的研究进展%Advance of study on the impact of climate change on malaria

    Institute of Scientific and Technical Information of China (English)

    裴福全; 张贤昌; 马文军

    2011-01-01

    Malaria is an infectious disease transmitted by mosquitoes.The changes of various climate and environment factors,including global warming which has been becoming evident in recent decades,all may have impacts on the epidemic risk of this disease,causing the changes of malaria epidemic intensity and distribution as well as its vector distribution.This paper reviewed the advances of studies on the relationships between malaria transmission and general meteorological factors,the impacts of seasonal and interannual climate variations and extreme weather events on malaria,the possible impact on malaria already caused by climate change and the projection of climate change's impact on malaria in the future.%疟疾是通过蚊媒传播的感染性疾病.多种气候、环境因素的改变,包括近几十年来明显的全球气候变暖,都可能对该病的流行风险产生影响,使该病的流行及分布、传播媒介的分布发生变化.该文综述了一般气象因素与疟疾传播的关系,季节性与年际气候变异、极端天气事件对疟疾的影响,气候变化对疟疾已产生的可能影响,以及气候变化对未来疟疾影响的预估等方面的研究进展.

  19. ECOLOGICAL CHANGE AS A FACTOR IN RENEWED MALARIA TRANSMISSION IN AN ERADICATED AREA. A LOCALIZED OUTBREAK OF A. AQUASALIS-TRANSMITTED MALARIA ON THE DEMERARA RIVER ESTUARY, BRITISH GUIANA, IN THE FIFTEENTH YEAR OF A. DARLINGI AND MALARIA ERADICATION.

    Science.gov (United States)

    GIGLIOLI, G

    1963-01-01

    In British Guiana, the successful eradication of Anopheles darlingi and malaria from the coastal areas has caused a very rapid increase in the population and has favoured a considerable social and economic improvement and expansion of both agriculture and industry. Housing and industrial developments and the constantly expanding rice cultivation have taken over most of the accessible pasture-lands, displacing the livestock which previously abounded around villages and settlements. Mechanization on the roads and in the fields increases daily, and the horse, the mule, the donkey and the ploughing oxen are gradually becoming obsolete.In some areas these changes have already caused such an upset in the balance between the human and the livestock population that A. aquasalis, a very abundant species all along the coast, but until recently entirely "fixed" by the livestock population, is now shifting its attention from livestock to man. On the Demerara river estuary, an area where malaria transmission was interrupted sixteen years ago and where eradication has been continually maintained, this mosquito has been responsible for a sharp, but localized, outbreak of P. vivax malaria. An entirely new epidemiological problem thus presents itself.Environmental changes, introduced and fostered by successful malaria eradication, may thus cause an anopheline species, potentially capable of malaria transmission, but originally inactive and harmless as a vector, to alter its feeding habits and thereby renew transmission. The immediate and long-term significance of some secondary and potential vectors may therefore require renewed evaluation in the planning of malaria eradication campaigns.

  20. Identification of risk factors for malaria control by focused interventions in Ranchi district, Jharkhand, India

    Directory of Open Access Journals (Sweden)

    Rekha Saxena

    2014-12-01

    Full Text Available Background & objectives: Ranchi, the capital of Jharkhand state is endemic for malaria, particularly the Bundu Primary Health Centre (PHC is the worst affected. Therefore, a study was initiated during 2009 using remote sensing (RS and geographical information system (GIS to identify risk factors responsible for high endemicity in this PHC. Methods: Bundu and Angara in Ranchi district were identified as high and low malaria endemic PHCs based on epidemiological data of three years (2007–09. The habitation, streams, other water body, landform, PHC and village boundary thematic maps were prepared using IRS-P6/LISS III-IV imageries and macro level breeding sites were identified. Digital elevation model (DEM of the PHCs was generated using Cartosat Stereo Pair images and from DEM, slope map was derived to calculate flat area. From slope, aspect map was derived to indicate direction of water flow. Length of perennial streams, area under rocky terrain and buffer zones of 250, 500 and 750 m were constructed around streams. High resolution remote sensing imageries were used to identify micro level breeding sites. Based on macro-micro breeding sites, six villages from each PHC were selected randomly having combination of different parameters representing all ecotypes. Entomological data were collected during 2010–11 in pre- and post-monsoon seasons following standard techniques and analyzed statistically. Differential analysis was attempted to comprehend socioeconomic and other determinants associated with malaria transmission. Results: The study identified eight risk factors responsible for higher malaria endemicity in Bundu in comparison to Angara PHC based on ecological, entomological, socioeconomic and other local parameters. Conclusion: Focused interventions in integrated vector management (IVM mode are required to be carried out in the district for better management and control of disease.

  1. Changes in Serological Immunology Measures in UK and Kenyan Adults Post-Controlled Human Malaria Infection

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    Susanne Helena Hodgson

    2016-10-01

    Full Text Available Background: The timing of infection is closely determined in controlled human malaria infection (CHMI studies, and as such they provide a unique opportunity to dissect changes in immunological responses before and after a single infection. The first Kenyan Challenge Study (KCS (Pan African Clinical Trial Registry: PACTR20121100033272 was performed in 2013 with the aim of establishing the CHMI model in Kenya. This study used aseptic, cryopreserved, attenuated Plasmodium falciparum sporozoites administered by needle and syringe and was the first to evaluate parasite dynamics post-CHMI in individuals with varying degrees of prior exposure to malaria. Methods: We describe detailed serological and functional immunological responses pre- and post-CHMI for participants in the KCS and compare these with those from malaria-naïve UK volunteers who also underwent CHMI (VAC049 (ClinicalTrials.gov NCT01465048 using PfSPZ Challenge. We assessed antibody responses to three key blood-stage merozoite antigens (merozoite surface protein 1 (MSP1, apical membrane protein 1 (AMA1 and reticulocyte-binding protein homolog 5 (RH5 and functional activity using two candidate measures of anti-merozoite immunity; the growth inhibition activity (GIA assay and the antibody-dependent respiratory burst activity (ADRB assay. Results: Clear serological differences were observed pre- and post-CHMI by ELISA between malaria-naïve UK volunteers in VAC049, and Kenyan volunteers who had prior malaria exposure. Antibodies to AMA1 and schizont extract correlated with parasite multiplication rate (PMR post-CHMI in KCS. Serum from volunteer 110 in KCS, who demonstrated a dramatically reduced PMR in vivo, had no in vitro GIA prior to CHMI but the highest level of ADRB activity. A significant difference in ADRB activity was seen between KCS volunteers with minimal and definite prior exposure to malaria and significant increases were seen in ADRB activity post-CHMI in Kenyan volunteers

  2. Malaria and blood transfusion: major issues of blood safety in malaria-endemic countries and strategies for mitigating the risk of Plasmodium parasites.

    Science.gov (United States)

    Abdullah, Saleh; Karunamoorthi, Kaliyaperumal

    2016-01-01

    Malaria inflicts humankind over centuries, and it remains as a major threat to both clinical medicine and public health worldwide. Though hemotherapy is a life-sustaining modality, it continues to be a possible source of disease transmission. Hence, hemovigilance is a matter of grave concern in the malaria-prone third-world countries. In order to pursue an effective research on hemovigilance, a comprehensive search has been conducted by using the premier academic-scientific databases, WHO documents, and English-language search engines. One hundred two appropriate articles were chosen for data extraction, with a particular reference to emerging pathogens transmitted through blood transfusion, specifically malaria. Blood donation screening is done through microscopic examination and immunological assays to improve the safety of blood products by detection major blood-borne pathogens, viz., HIV, HBV, HCV, syphilis, and malarial parasites. Transfusion therapy significantly dwindles the preventable morbidity and mortality attributed to various illnesses and diseases, particularly AIDS, tuberculosis, and malaria. Examination of thick and thin blood smears are performed to detect positivity and to identify the Plasmodium species, respectively. However, all of these existing diagnostic tools have their own limitations in terms of sensitivity, specificity, cost-effectiveness, and lack of resources and skilled personnel. Globally, despite the mandate need of screening blood and its components according to the blood-establishment protocols, it is seldom practiced in the low-income/poverty-stricken settings. In addition, each and every single phase of transfusion chain carries sizable inherent risks from donors to recipients. Interestingly, opportunities also lie ahead to enhance the safety of blood-supply chain and patients. It can be achieved through sustainable blood-management strategies like (1) appropriate usage of precise diagnostic tools/techniques, (2) promoting

  3. Time trends and changes in the distribution of malaria cases in the Brazilian Amazon Region, 2004-2013

    Directory of Open Access Journals (Sweden)

    Isac da SF Lima

    Full Text Available Recent efforts to reduce malaria incidence have had some successes. Nevertheless, malaria persists as a significant public health problem in the Brazilian Amazon. The objective of this study was to describe changes in malaria case characteristics and to identify trends in malaria incidence in the Brazilian Amazon. This study used data from the Malaria Epidemiological Surveillance and Case Notification Information System from 2004 to 2013. The annual parasite incidence (API was calculated and joinpoint regression was used to assess the trends in API over time. There was a sharp increase in API in the state of Acre, followed by two periods of decrease. Pará also presented inconsistent decreases over the study period. Amapá, Amazonas, Rondônia, and Roraima showed statistically significant decreases over the period. The sharpest decrease occurred in Rondônia, with a reduction of 21.7% in the average annual percent change (AAPC (AAPC: -21.7%; 95% confidence interval: -25.4%, -17.8%; p < 0.05. This panorama of malaria incidence highlights the importance of integrating evidence-based malaria surveillance and control. Malaria is highly preventable, and eliminating its transmission should be a goal in coming decades.

  4. Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria

    DEFF Research Database (Denmark)

    Essuman, Vera A; Ntim-Amponsah, Christine T; Astrup, Birgitte S

    2010-01-01

    . Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. Methods and subjects A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching...... Hospital, Accra, from July to August 2002 was done. All children had dilated-fundus examination by direct and indirect ophthalmoscopy. RESULTS: Fifty-eight children aged between six months and nine years were recruited. Twenty six(45%) had CM, 22 with convulsion; 26(45%) had SA and six(10%) had RD. Any...... retinopathy was seen in: CM 19(73%), SA 14(54%), RD 3(50.0%), CM with convulsion 15(68%) and CM without convulsion 4(100%). Comparison between CM versus non-CM groups showed a significant risk relationship between retinal whitening and CM(OR=11.0, CI=2.2- 56.1, p= 0.001). There was no significant association...

  5. Development, Malaria and Adaptation to Climate Change: A Case Study from India

    Science.gov (United States)

    Garg, Amit; Dhiman, R. C.; Bhattacharya, Sumana; Shukla, P. R.

    2009-05-01

    India has reasons to be concerned about climate change. Over 650 million people depend on climate-sensitive sectors, such as rain-fed agriculture and forestry, for livelihood and over 973 million people are exposed to vector borne malarial parasites. Projection of climatic factors indicates a wider exposure to malaria for the Indian population in the future. If precautionary measures are not taken and development processes are not managed properly some developmental activities, such as hydro-electric dams and irrigation canal systems, may also exacerbate breeding grounds for malaria. This article integrates climate change and developmental variables in articulating a framework for integrated impact assessment and adaptation responses, with malaria incidence in India as a case study. The climate change variables include temperature, rainfall, humidity, extreme events, and other secondary variables. Development variables are income levels, institutional mechanisms to implement preventive measures, infrastructure development that could promote malarial breeding grounds, and other policies. The case study indicates that sustainable development variables may sometimes reduce the adverse impacts on the system due to climate change alone, while it may sometimes also exacerbate these impacts if the development variables are not managed well and therefore they produce a negative impact on the system. The study concludes that well crafted and well managed developmental policies could result in enhanced resilience of communities and systems, and lower health impacts due to climate change.

  6. Malaria Risk Assessment for the Republic of Korea Based on Models of Mosquito Distribution

    Science.gov (United States)

    2008-06-01

    unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 treatment, among a myriad of olher factors . Because the Plasmodium parasite is...Yam;lda All. kleilli Rueda All. belellme Rueda VPH 0.8 • 0.6• ~ ~ 0.’ 0.2 0 H P V VPH Figure I, Illustration of the concept of the mal-area as it...the percentage of the sampled area that these parameters cover. The value for VPH could be used as a simplified index of malaria risk to compare

  7. Elevated Blood Lead Levels Are Associated with Reduced Risk of Malaria in Beninese Infants.

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    Violeta Moya-Alvarez

    Full Text Available Elevated blood lead levels (BLL and malaria carry an important burden of disease in West Africa. Both diseases might cause anemia and they might entail long-term consequences for the development and the health status of the child. Albeit the significant impact of malaria on lead levels described in Nigeria, no evaluation of the effect of elevated BLL on malaria risk has been investigated so far.Between 2010 and 2012, blood lead levels of 203 Beninese infants from Allada, a semi-rural area 50km North from Cotonou, were assessed at 12 months of age. To assess lead levels, blood samples were analyzed by mass spectrometry. In parallel, clinical, microbiological and hematological data were collected. More precisely, hemoglobin, serum ferritin, CRP, vitamin B12, folate levels, and Plasmodium falciparum parasitemia were assessed and stool samples were also analyzed.At 12 months, the mean BLL of infants was 7.41 μg/dL (CI: 65.2; 83, and 128 infants (63% had elevated blood lead levels, defined by the CDC as BLL>5 μg/dL. Lead poisoning, defined as BLL>10 μg/dL, was found in 39 infants (19%. Twenty-five infants (12.5% had a positive blood smear at 12 months and 144 infants were anemic (71%, hemoglobin<110 g/L. Elevated blood lead levels were significantly associated with reduced risk of a positive blood smear (AOR = 0.38, P-value = 0.048 and P. falciparum parasite density (beta-estimate = -1.42, P-value = 0.03 in logistic and negative binomial regression multivariate models, respectively, adjusted on clinical and environmental indicators.Our study shows for the first time that BLL are negatively associated with malarial risk considering other risk factors. Malaria is one of the main causes of morbidity and mortality in infants under 5 years worldwide, and lead poisoning is the 6th most important contributor to the global burden of diseases measured in disability adjusted life years (DALYs according to the Institute of Health Metrics. In conclusion, due

  8. The genetic risk of acute seizures in African children with falciparum malaria

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    Kariuki, Symon M; Rockett, Kirk; Clark, Taane G; Reyburn, Hugh; Agbenyega, Tsiri; Taylor, Terrie E; Birbeck, Gretchen L; Williams, Thomas N; Newton, Charles R J C

    2013-01-01

    Purpose It is unclear why some children with falciparum malaria develop acute seizures and what determines the phenotype of seizures. We sought to determine if polymorphisms of malaria candidate genes are associated with acute seizures. Methods Logistic regression was used to investigate genetic associations with malaria-associated seizures (MAS) and complex MAS (repetitive, prolonged, or focal seizures) in four MalariaGEN African sites, namely: Blantyre, Malawi; Kilifi, Kenya; Kumasi, Ghana; and Muheza, Tanzania. The analysis was repeated for five inheritance models (dominant, heterozygous, recessive, additive, and general) and adjusted for potential confounders and multiple testing. Key Findings Complex phenotypes of seizures constituted 71% of all admissions with MAS across the sites. MAS were strongly associated with cluster of differentiation-ligand-rs3092945 in females in Kilifi (p = 0.00068) and interleukin (IL)-17 receptor E-rs708567 in the pooled analysis across the sites (p = 0.00709). Complex MAS were strongly associated with epidermal growth factor module-containing mucin-like hormone receptor (EMR)1-rs373533 in Kumasi (p = 0.00033), but none in the pooled analysis. Focal MAS were strongly associated with IL-20 receptor A-rs1555498 in Muheza (p = 0.00016), but none in the pooled analysis. Prolonged MAS were strongly associated with complement receptor 1-rs17047660 in Kilifi (p = 0.00121) and glucose-6-phosphate dehydrogenase-rs1050828 in females in the pooled analysis (p = 0.00155). Repetitive MAS were strongly associated with EMR1-rs373533 in Kumasi (p = 0.00003) and cystic fibrosis transmembrane conductance receptor-rs17140229 in the pooled analysis (p = 0.00543). MAS with coma/cerebral malaria were strongly associated with EMR1-rs373533 in Kumasi (p = 0.00019) and IL10-rs3024500 in the pooled analysis across the sites (p = 0.00064). Significance We have identified a number of genetic associations that may explain the risk of seizures in >2,000 cases

  9. Climate change and institutional determinants of malaria and schistosomiasis In Gwanda District, Zimbabwe

    DEFF Research Database (Denmark)

    Furu, Peter; Chimbari, Moses; Makuratirwa, Samson;

    2016-01-01

    , environment, agriculture and education. Important sectoral and cross-sectoral policy frameworks, responsibilities and health interventions that may mask the direct effects on disease transmission of climate change and variability and thereby hamper our full understanding of the specific effects of climate......The spatial and temporal distribution of malaria and schistosomiasis are determined by a series of environmental, biological and social factors including institutional determinants of health. A gap in knowledge exists for some specific institutional determinants and their direct or indirect...

  10. Malaria, Intestinal Helminths and Other Risk Factors for Stillbirth in Ghana

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    Nelly J. Yatich

    2010-01-01

    Full Text Available Objective. The objective of the study was to assess Plasmodium/intestinal helminth infection in pregnancy and other risk factors for stillbirth in Ghana. Methods. A cross-sectional study of women presenting for delivery in two hospitals was conducted during November-December 2006. Data collected included sociodemographic information, medical and obstetric histories, and anthropometric measures. Laboratory investigations for the presence of Plasmodium falciparum and intestinal helminths, and tests for hemoglobin levels were also performed. Results. The stillbirth rate was relatively high in this population (5%. Most of the stillbirths were fresh and 24% were macerated. When compared to women with no malaria, women with malaria had increased risk of stillbirth (OR=1.9, 95% CI=1.2–9.3. Other factors associated with stillbirth were severe anemia, low serum folate concentration, past induced abortion, and history of stillbirth. Conclusion. The fact that most of the stillbirths were fresh suggests that higher quality intrapartum care could reduce stillbirth rates.

  11. Using Respondent Driven Sampling to Identify Malaria Risks and Occupational Networks among Migrant Workers in Ranong, Thailand

    Science.gov (United States)

    Wangroongsarb, Piyaporn; Hwang, Jimee; Thwing, Julie; Karuchit, Samart; Kumpetch, Suthon; Rand, Alison; Drakeley, Chris; MacArthur, John R.; Kachur, S. Patrick; Satimai, Wichai; Meek, Sylvia; Sintasath, David M.

    2016-01-01

    Background Ranong Province in southern Thailand is one of the primary entry points for migrants entering Thailand from Myanmar, and borders Kawthaung Township in Myanmar where artemisinin resistance in malaria parasites has been detected. Areas of high population movement could increase the risk of spread of artemisinin resistance in this region and beyond. Methods A respondent-driven sampling (RDS) methodology was used to compare migrant populations coming from Myanmar in urban (Site 1) vs. rural (Site 2) settings in Ranong, Thailand. The RDS methodology collected information on knowledge, attitudes, and practices for malaria, travel and occupational histories, as well as social network size and structure. Individuals enrolled were screened for malaria by microscopy, Real Time-PCR, and serology. Results A total of 619 participants were recruited in Ranong City and 623 participants in Kraburi, a rural sub-district. By PCR, a total of 14 (1.1%) samples were positive (2 P. falciparum in Site 1; 10 P. vivax, 1 Pf, and 1 P. malariae in Site 2). PCR analysis demonstrated an overall weighted prevalence of 0.5% (95% CI, 0–1.3%) in the urban site and 1.0% (95% CI, 0.5–1.7%) in the rural site for all parasite species. PCR positivity did not correlate with serological positivity; however, as expected there was a strong association between antibody prevalence and both age and exposure. Access to long-lasting insecticidal treated nets remains low despite relatively high reported traditional net use among these populations. Conclusions The low malaria prevalence, relatively smaller networks among migrants in rural settings, and limited frequency of travel to and from other areas of malaria transmission in Myanmar, suggest that the risk for the spread of artemisinin resistance from this area may be limited in these networks currently but may have implications for regional malaria elimination efforts. PMID:28033322

  12. Risk Assessment of Malaria Prevalence in Ludian, Yongshan, and Jinggu Counties, Yunnan Province, After 2014 Earthquake Disaster.

    Science.gov (United States)

    Feng, Jun; Xia, Zhigui; Zhang, Li; Cheng, Siyuan; Wang, Rubo

    2016-03-01

    The objective of this study was to investigate malaria prevalence after the 2014 earthquakes in Ludian, Yongshan, and Jinggu counties, Yunnan Province, China. We collected and analyzed epidemiological data and made a risk assessment of transmission probability. From January 2005 to July 2015, 87 malaria cases were reported in the three counties, most of which (81.6%) occurred between 2005 and 2009, with five cases reported in Jinggu County between January 2014 and July 2015, of which one case was reported after the earthquake. In addition, no local transmission occurred in the three counties from 2010, and 95.5% of imported malaria occurred in patients who had returned from Myanmar. The townships of Lehong, Qingsheng, and Weiyuan were the main endemic areas in the three counties. The probability of malaria transmission in the three counties was low, but Jinggu County had a higher risk due to the existence of infected patients and an appropriate vector. With sporadic cases reported annually, close monitoring should continue to enhance early detection of a possible malaria outbreak.

  13. CXCL4 and CXCL10 Predict Risk of Fatal Cerebral Malaria

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    Nana O. Wilson

    2011-01-01

    Full Text Available Plasmodium falciparum in a subset of patients can lead to a diffuse encephalopathy known as cerebral malaria (CM. Despite treatment, mortality caused by CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM involves alterations in cytokine and chemokine expression, local inflammation, vascular injury and repair processes. These diverse factors have limited the rate of discovery of prognostic predictors of fatal CM. Identification of reliable early predictors of CM severity will enable clinicians to adjust this risk with appropriate management of CM. Recent studies revealed that elevated levels of CXCL10 expression in cerebrospinal fluid and peripheral blood plasma independently predicted severe and fatal CM. CXCR3, a promiscuous receptor of CXCL10, plays an important role in pathogenesis of mouse model of CM. In this study the role of corresponding CXCR3 ligands (CXCL11, CXCL10, CXCL9 & CXCL4 in fatal or severe CM was evaluated by comparing their levels in 16 healthy control (HC, 26 mild malaria (MM, 26 cerebral malaria survivors (CMS and 12 non-survivors (CMNS using enzyme linked immunosorbent assay (ELISA. Levels of CXCL4 and CXCL10 were significantly elevated in CMNS patients (p < 0.05 when compared with HC, MM and CMS. Elevated plasma levels of CXCL10 and CXCL4 were tightly associated with CM mortality. Receiver Operating Characteristic (ROC curve analysis revealed that CXCL4 and CXCL10 can discriminate CMNS from MM (p < 0.0001 and CMS (p < 0.0001 with an area under the curve (AUC = 1. These results suggest that CXCL4 and CXCL10 play a prominent role in pathogenesis of CM associated death and may be used as functional or surrogate biomarkers for predicting CM severity.

  14. Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

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    Stuart McCarthy

    2015-01-01

    Full Text Available The Australian Defence Force (ADF has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug’s use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.

  15. Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force.

    Science.gov (United States)

    McCarthy, Stuart

    2015-01-01

    The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.

  16. Landscape ecology and epidemiology of malaria associated with rubber plantations in Thailand: integrated approaches to malaria ecotoping.

    Science.gov (United States)

    Kaewwaen, Wuthichai; Bhumiratana, Adisak

    2015-01-01

    The agricultural land use changes that are human-induced changes in agroforestry ecosystems and in physical environmental conditions contribute substantially to the potential risks for malaria transmission in receptive areas. Due to the pattern and extent of land use change, the risks or negatively ecosystemic outcomes are the results of the dynamics of malaria transmission, the susceptibility of human populations, and the geographical distribution of malaria vectors. This review focused basically on what are the potential effects of agricultural land use change as a result of the expansion of rubber plantations in Thailand and how significant the ecotopes of malaria-associated rubber plantations (MRP) are. More profoundly, this review synthesized the novel concepts and perspectives on applied landscape ecology and epidemiology of malaria, as well as approaches to determine the degree to which an MRP ecotope as fundamental landscape scale can establish malaria infection pocket(s). Malaria ecotoping encompasses the integrated approaches and tools applied to or used in modeling malaria transmission. The scalability of MRP ecotope depends upon its unique landscape structure as it is geographically associated with the infestation or reinfestation of Anopheles vectors, along with the attributes that are epidemiologically linked with the infections. The MRP ecotope can be depicted as the hotspot such that malaria transmission is modeled upon the MRP factors underlying human settlements and movement activities, health behaviors, land use/land cover change, malaria vector population dynamics, and agrienvironmental and climatic conditions. The systemic and uniform approaches to malaria ecotoping underpin the stratification of the potential risks for malaria transmission by making use of remotely sensed satellite imagery or landscape aerial photography using unmanned aerial vehicle (UAV), global positioning systems (GPS), and geographical information systems (GIS).

  17. Landscape Ecology and Epidemiology of Malaria Associated with Rubber Plantations in Thailand: Integrated Approaches to Malaria Ecotoping

    Directory of Open Access Journals (Sweden)

    Wuthichai Kaewwaen

    2015-01-01

    Full Text Available The agricultural land use changes that are human-induced changes in agroforestry ecosystems and in physical environmental conditions contribute substantially to the potential risks for malaria transmission in receptive areas. Due to the pattern and extent of land use change, the risks or negatively ecosystemic outcomes are the results of the dynamics of malaria transmission, the susceptibility of human populations, and the geographical distribution of malaria vectors. This review focused basically on what are the potential effects of agricultural land use change as a result of the expansion of rubber plantations in Thailand and how significant the ecotopes of malaria-associated rubber plantations (MRP are. More profoundly, this review synthesized the novel concepts and perspectives on applied landscape ecology and epidemiology of malaria, as well as approaches to determine the degree to which an MRP ecotope as fundamental landscape scale can establish malaria infection pocket(s. Malaria ecotoping encompasses the integrated approaches and tools applied to or used in modeling malaria transmission. The scalability of MRP ecotope depends upon its unique landscape structure as it is geographically associated with the infestation or reinfestation of Anopheles vectors, along with the attributes that are epidemiologically linked with the infections. The MRP ecotope can be depicted as the hotspot such that malaria transmission is modeled upon the MRP factors underlying human settlements and movement activities, health behaviors, land use/land cover change, malaria vector population dynamics, and agrienvironmental and climatic conditions. The systemic and uniform approaches to malaria ecotoping underpin the stratification of the potential risks for malaria transmission by making use of remotely sensed satellite imagery or landscape aerial photography using unmanned aerial vehicle (UAV, global positioning systems (GPS, and geographical information systems

  18. Adult Javanese migrants to Indonesian Papua at high risk of severe disease caused by malaria.

    Science.gov (United States)

    Baird, J K; Basri, H; Weina, P; MaGuire, J D; Barcus, M J; Picarema, H; Elyazar, I R F; Ayomi, E; Sekartuti

    2003-08-01

    Migrants from Java arrive in hyperendemic Papua, Indonesia lacking exposure to endemic malaria. We evaluated records of evacuation to hospital with a diagnosis of severe malaria from a transmigration village in northeastern Papua. During the first 30 months, 198 residents with severe disease were evacuated (7.5 evacuations/100 person-years). During this period the risk of evacuation for adults (> 15 years of age) was 2.8. (95% CI = 2.1-3.8; P 16; 95% CI > or = 2.0-129; P = 0.0009), and diminished during the second 6 months (RR = 9.4; 95% CI = 2.7-32.8; P < 0.0001) and the third 6 months (RR = 3.7; 95% CI = 1.7-7.9; P = 0.0004). During the next two 6-month intervals, the RR for adults was 1.6 and 1.5 (95 % CI range 0.8-2.6; P < 0.18). Adults lacking chronic exposure were far more likely to progress to severe disease compared to children during initial exposure, but not after chronic exposure to infection.

  19. Applications of Bayesian approach in modelling risk of malaria-related hospital mortality

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    Simbeye Jupiter S

    2008-02-01

    Full Text Available Abstract Background Malaria is a major public health problem in Malawi, however, quantifying its burden in a population is a challenge. Routine hospital data provide a proxy for measuring the incidence of severe malaria and for crudely estimating morbidity rates. Using such data, this paper proposes a method to describe trends, patterns and factors associated with in-hospital mortality attributed to the disease. Methods We develop semiparametric regression models which allow joint analysis of nonlinear effects of calendar time and continuous covariates, spatially structured variation, unstructured heterogeneity, and other fixed covariates. Modelling and inference use the fully Bayesian approach via Markov Chain Monte Carlo (MCMC simulation techniques. The methodology is applied to analyse data arising from paediatric wards in Zomba district, Malawi, between 2002 and 2003. Results and Conclusion We observe that the risk of dying in hospital is lower in the dry season, and for children who travel a distance of less than 5 kms to the hospital, but increases for those who are referred to the hospital. The results also indicate significant differences in both structured and unstructured spatial effects, and the health facility effects reveal considerable differences by type of facility or practice. More importantly, our approach shows non-linearities in the effect of metrical covariates on the probability of dying in hospital. The study emphasizes that the methodological framework used provides a useful tool for analysing the data at hand and of similar structure.

  20. IgG responses to Anopheles gambiae salivary antigen gSG6 detect variation in exposure to malaria vectors and disease risk

    DEFF Research Database (Denmark)

    Stone, Will; Bousema, Teun; Jones, Sophie;

    2012-01-01

    , IgG responses to gSG6 in individual children showed a strong positive association with household level mosquito exposure. IgG levels for all antigens except AMA-1 were associated with the frequency of malaria episodes following sampling. gSG6 seropositivity was strongly positively associated...... with subsequent malaria incidence (test for trend p¿=¿0.004), comparable to malaria antigens MSP-1 and GLURP R2. Our results show that the gSG6 assay is sensitive to micro-epidemiological variations in exposure to Anopheles mosquitoes, and provides a correlate of malaria risk that is unrelated to immune...

  1. Prevalence, features and risk factors for malaria co-infections amongst visceral leishmaniasis patients from Amudat Hospital, Uganda.

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    Erika van den Bogaart

    Full Text Available BACKGROUND AND METHODOLOGY: Due to geographic overlap of malaria and visceral leishmaniasis (VL, co-infections may exist but have been poorly investigated. To describe prevalence, features and risk factors for VL-malaria co-infections, a case-control analysis was conducted on data collected at Amudat Hospital, Uganda (2000-2006 by Médecins sans Frontières. Cases were identified as patients with laboratory-confirmed VL and malaria at hospital admission or during hospitalization; controls were VL patients with negative malaria smears. A logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection. RESULTS: Of 2414 patients with confirmed VL, 450 (19% were positively diagnosed with concomitant malaria. Most co-infected patients were males, residing in Kenya (69%. While young age was identified by multivariate analysis as a risk factor for concurrent VL and malaria, particularly the age groups 0-4 (odds ratio (OR: 2.44; 95% confidence interval (CI: 1.52-3.92 and 5-9 years (OR: 2.23, 95% CI: 1.45-3-45, mild (OR: 0.53; 95% CI: 0.32-0.88 and moderate (OR: 0.45; 95% CI: 0.27-0.77 anemia negatively correlated with the co-morbidity. VL patients harboring skin infections were nearly three times less likely to have the co-infection (OR: 0.35; 95% CI: 0.17-0.72, as highlighted by the multivariate model. Anorexia was slightly more frequent among co-infected patients (OR: 1.71; 95% CI: 0.96-3.03. The in-hospital case-fatality rate did not significantly differ between cases and controls, being 2.7% and 3.1% respectively (OR: 0.87; 95% CI: 0.46-1.63. CONCLUSIONS: Concurrent malaria represents a common condition among young VL patients living in the Pokot region of Kenya and Uganda. Although these co-morbidities did not result in a poorer prognosis, possibly due to early detection of malaria, a positive trend towards more severe symptoms was identified, indicating that routine

  2. High spatial resolution mapping of malaria transmission risk in the Gambia, west Africa, using LANDSAT TM satellite imagery.

    Science.gov (United States)

    Bøgh, Claus; Lindsay, Steven W; Clarke, Siân E; Dean, Andy; Jawara, Musa; Pinder, Margaret; Thomas, Christopher J

    2007-05-01

    Understanding local variability in malaria transmission risk is critically important when designing intervention or vaccine trials. Using a combination of field data, satellite image analysis, and GIS modeling, we developed a high-resolution map of malaria entomological inoculation rates (EIR) in The Gambia, West Africa. The analyses are based on the variation in exposure to malaria parasites experienced in 48 villages in 1996 and 21 villages in 1997. The entomological inoculation rate (EIR) varied from 0 to 166 infective bites per person per rainy season. Detailed field surveys identified the major Anopheles gambiae s.l. breeding habitats. These habitats were mapped by classification of a LANDSAT TM satellite image with an overall accuracy of 85%. Village EIRs decreased as a power function based on the breeding areas size and proximity. We use this relationship and the breeding habitats to map the variation in EIR over the entire 2500-km(2) study area.

  3. Climate, environment and transmission of malaria.

    Science.gov (United States)

    Rossati, Antonella; Bargiacchi, Olivia; Kroumova, Vesselina; Zaramella, Marco; Caputo, Annamaria; Garavelli, Pietro Luigi

    2016-06-01

    Malaria, the most common parasitic disease in the world, is transmitted to the human host by mosquitoes of the genus Anopheles. The transmission of malaria requires the interaction between the host, the vector and the parasite.The four species of parasites responsible for human malaria are Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae and Plasmodium vivax. Occasionally humans can be infected by several simian species, like Plasmodium knowlesi, recognised as a major cause of human malaria in South-East Asia since 2004. While P. falciparum is responsible for most malaria cases, about 8% of estimated cases globally are caused by P. vivax. The different Plasmodia are not uniformly distributed although there are areas of species overlap. The life cycle of all species of human malaria parasites is characterised by an exogenous sexual phase in which multiplication occurs in several species of Anopheles mosquitoes, and an endogenous asexual phase in the vertebrate host. The time span required for mature oocyst development in the salivary glands is quite variable (7-30 days), characteristic of each species and influenced by ambient temperature. The vector Anopheles includes 465 formally recognised species. Approximately 70 of these species have the capacity to transmit Plasmodium spp. to humans and 41 are considered as dominant vector capable of transmitting malaria. The intensity of transmission is dependent on the vectorial capacity and competence of local mosquitoes. An efficient system for malaria transmission needs strong interaction between humans, the ecosystem and infected vectors. Global warming induced by human activities has increased the risk of vector-borne diseases such as malaria. Recent decades have witnessed changes in the ecosystem and climate without precedent in human history although the emphasis in the role of temperature on the epidemiology of malaria has given way to predisposing conditions such as ecosystem changes, political

  4. [Risk factors for death from severe malaria in children at the Charles de Gaulle pediatric hospital of Ouagadougou (Burkina Faso)].

    Science.gov (United States)

    Kouéta, Fla; Dao, Lassina; Yé, Diarra; Zoungrana, Alice; Kaboré, Aïssata; Sawadogo, Alphonse

    2007-01-01

    To determine the risk factors for death from severe malaria in children in Burkina Faso, we conducted a retrospective case-control study covering a period of 24 months from January 2004 through December 2005, at the Charles de Gaulle Pediatric Hospital in Ouagadougou. Cases (n=72) were defined as all children hospitalized for and dying of confirmed severe malaria. The control subjects (n=72), matched for age, sex and date of hospitalization; were children hospitalized for confirmed severe malaria who were discharged after recovery. Risk factors assessed included: place of residence, socioeconomic level, self-medication, promptness of hospitalization, nutritional status, temperature and parasitemia. Case and control children were compared with pairwise tests. Low socioeconomic level (OR=5.4), late care (OR=15.5), poor nutritional status (OR=7.9) and a parasitemia greater than or equal to 5% (OR=2.8) were associated with a significant increase in the risk of death. In contrast, the malaria deaths were not associated with place of residence (OR=0.5), self-medication (OR=1) or fever of 41 degrees C or higher (OR=1.1). These results show the need for more health education to encourage early care-seeking in the event of fever, community-based interventions, and strengthening of the technical support centers for health facilities, as part of a national poverty reduction program.

  5. The Strategy to Survive Primary Malaria Infection: An Experimental Study on Behavioural Changes in Parasitized Birds.

    Directory of Open Access Journals (Sweden)

    Andrey Mukhin

    Full Text Available Avian malaria parasites (Haemosporida, Plasmodium are of cosmopolitan distribution, and they have a significant impact on vertebrate host fitness. Experimental studies show that high parasitemia often develops during primary malaria infections. However, field studies only occasionally reveal high parasitemia in free-living birds sampled using the traditional methods of mist-netting or trapping, and light chronic infections predominate. The reason for this discrepancy between field observation and experimental data remains insufficiently understood. Since mist-netting is a passive capture method, two main parameters determine its success in sampling infected birds in wildlife, i. e. the presence of parasitized birds at a study site and their mobility. In other words, the trapping probability depends on the survival rate of birds and their locomotor activity during infection. Here we test (1 the mortality rate of wild birds infected with Plasmodium relictum (the lineage pSGS1, (2 the changes in their behaviour during presence of an aerial predator, and (3 the changes in their locomotor activity at the stage of high primary parasitemia.We show that some behavioural features which might affect a bird's survival during a predator attack (time of reaction, speed of flush flight and take off angle did not change significantly during primary infection. However, the locomotor activity of infected birds was almost halved compared to control (non-infected birds during the peak of parasitemia. We report (1 the markedly reduced mobility and (2 the 20% mortality rate caused by P. relictum and conclude that these factors are responsible for the underrepresentation of birds in mist nets and traps during the stage of high primary parasitemia in wildlife. This study indicates that the widespread parasite, P. relictum (pSGS1 influences the behaviour of birds during primary parasitemia. Experimental studies combined with field observations are needed to better

  6. Incidence and risk factors for Malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: A retrospective study

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    Hershey Christine L

    2011-10-01

    Full Text Available Abstract Background United Nations High Commissioner for Refugees (UNHCR refugee camps are located predominantly in rural areas of Africa and Asia in protracted or post-emergency contexts. Recognizing the importance of malaria, pneumonia and diarrheal diseases as major causes of child morbidity and mortality in refugee camps, we analyzed data from the UNHCR Health Information System (HIS to estimate incidence and risk factors for these diseases in refugee children younger than five years of age. Methods Data from 90 UNHCR camps in 16 countries, including morbidity, mortality, health services and refugee health status, were obtained from the UNHCR HIS for the period January 2006 to February 2010. Monthly camp-level data were aggregated to yearly estimates for analysis and stratified by location in Africa (including Yemen or Asia. Poisson regression models with random effects were constructed to identify factors associated with malaria, pneumonia and diarrheal diseases. Spatial patterns in the incidence of malaria, pneumonia and diarrheal diseases were mapped to identify regional heterogeneities. Results Malaria and pneumonia were the two most common causes of mortality, with confirmed malaria and pneumonia each accounting for 20% of child deaths. Suspected and confirmed malaria accounted for 23% of child morbidity and pneumonia accounted for 17% of child morbidity. Diarrheal diseases were the cause of 7% of deaths and 10% of morbidity in children under five. Mean under-five incidence rates across all refugee camps by region were: malaria [Africa 84.7 cases/1000 U5 population/month (95% CI 67.5-102.0, Asia 2.2/1000/month (95% CI 1.4-3.0]; pneumonia [Africa 59.2/1000/month (95% CI 49.8-68.7, Asia 254.5/1000/month (95% CI 207.1-301.8]; and diarrheal disease [Africa 35.5/1000/month (95% CI 28.7-42.4, Asia 69.2/1000/month (95% CI 61.0-77.5]. Measles was infrequent and accounted for a small proportion of child morbidity (503 cases, Conclusions As in

  7. Mapping malaria risk using environmental and anthropic variables Mapeamento do risco de malaria utilizando variáveis ambientais e antrópicas

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    Mauricio Edilberto Rincón-Romero

    2009-09-01

    Full Text Available Despite much research in the identification of areas with malaria, it is urgent to further investigate mapping techniques to achieve better approaches in strategies to prevent, mitigate, and eradicate the mosquito and the illness eventually. By using spatial distributed modeling techniques with Geographical Information Systems (GIS, the study proposes methodology to map malaria risk zoning for the municipality of Buenaventura in Colombia. The model proposed by Craig et al.¹ using climatic information was adapted to the conditions of the study area regarding scale and spatial resolution. Geomorphologic and anthropic variables were added to improve spatial allocation of areas with higher risk of contracting the illness, refining zoning. Then, they were contrasted with the locations reported by health entities², taking into account spatial distribution. The comparison of results shows a decrease in the area obtained initially using the Craig et al. model¹ (1999, from 5,422.4 km² (89.1% of the municipality's territory to 624.3km² (approximately 10% of the municipality's area, yielding a total reduction of 78.8% when environmental and anthropic variables were included in the model. Data show that of the 9,863 cases reported during 2001 to 2005 for 20 selected towns as basis for the amount of surveyed malaria cases², 1,132 were located in the very high-risk areas, 7,662 were in the areas of moderate risk, and 1,066 cases in low-risk areas, showing that 89% of the cases reported fell into the areas with higher risk for malaria.A pesar de muchas investigaciones en la identificación de las zonas con presencia de malaria, es urgente profundizar las técnicas de su mapeo para lograr mejores aproximaciones, para ayudar a focalizar los esfuerzos y recursos en prevención, mitigación y estrategias de erradicación del mosquito y eventualmente de la enfermedad. Usando modelación espacial distribuida con herramientas de Sistemas de Información Geogr

  8. Spatial analysis and mapping of malaria risk in an endemic area, south of Iran: a GIS based decision making for planning of control.

    Science.gov (United States)

    Hanafi-Bojd, A A; Vatandoost, H; Oshaghi, M A; Charrahy, Z; Haghdoost, A A; Zamani, G; Abedi, F; Sedaghat, M M; Soltani, M; Shahi, M; Raeisi, A

    2012-04-01

    Bashagard district is one of the important malaria endemic areas in southern Iran. From this region a total of 16,199 indigenous cases have been reported in recent years. The aim of this study was to determine the situation of the disease and provide the risk map for the area. ArcGIS9.2 was used for mapping spatial distribution of malaria incidence. Hot spots were obtained using evidence-based weighting method for transmission risk. Environmental factors including temperature, relative humidity, altitude, slope and distance to rivers were combined by weighted multi criteria evaluation for mapping malaria hazard area at the district level. Similarly, risk map was developed by overlaying weighted hazard, land use/land cover, population density, malaria incidence, development factors and intervention methods. Our results reveal that the disease mainly occurs in north and east of the study area. Consequently the district is divided into three strata. Appropriate interventions are recommended for each stratum based on national malaria policy. Malaria hazard and risk map, stratification based on relevant information and data analyzing provide a useful method preparedness and early warning system for malaria control, although regular updating is required timely.

  9. Gene expression analysis reveals early changes in several molecular pathways in cerebral malaria-susceptible mice versus cerebral malaria-resistant mice

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    Grau Georges E

    2007-12-01

    Full Text Available Abstract Background Microarray analyses allow the identification and assessment of molecular signatures in whole tissues undergoing pathological processes. To better understand cerebral malaria pathogenesis, we investigated intra-cerebral gene-expression profiles in well-defined genetically cerebral malaria-resistant (CM-R and CM-susceptible (CM-S mice, upon infection by Plasmodium berghei ANKA (PbA. We investigated mouse transcriptional responses at early and late stages of infection by use of cDNA microarrays. Results Through a rigorous statistical approach with multiple testing corrections, we showed that PbA significantly altered brain gene expression in CM-R (BALB/c, and in CM-S (CBA/J and C57BL/6 mice, and that 327 genes discriminated between early and late infection stages, between mouse strains, and between CM-R and CM-S mice. We further identified 104, 56, 84 genes with significant differential expression between CM-R and CM-S mice on days 2, 5, and 7 respectively. The analysis of their functional annotation indicates that genes involved in metabolic energy pathways, the inflammatory response, and the neuroprotection/neurotoxicity balance play a major role in cerebral malaria pathogenesis. In addition, our data suggest that cerebral malaria and Alzheimer's disease may share some common mechanisms of pathogenesis, as illustrated by the accumulation of β-amyloid proteins in brains of CM-S mice, but not of CM-R mice. Conclusion Our microarray analysis highlighted marked changes in several molecular pathways in CM-S compared to CM-R mice, particularly at early stages of infection. This study revealed some promising areas for exploration that may both provide new insight into the knowledge of CM pathogenesis and the development of novel therapeutic strategies.

  10. The challenges of changing national malaria drug policy to artemisinin-based combinations in Kenya

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    Otieno Dorothy N

    2007-05-01

    Full Text Available Abstract Backgound Sulphadoxine/sulphalene-pyrimethamine (SP was adopted in Kenya as first line therapeutic for uncomplicated malaria in 1998. By the second half of 2003, there was convincing evidence that SP was failing and had to be replaced. Despite several descriptive investigations of policy change and implementation when countries moved from chloroquine to SP, the different constraints of moving to artemisinin-based combination therapy (ACT in Africa are less well documented. Methods A narrative description of the process of anti-malarial drug policy change, financing and implementation in Kenya is assembled from discussions with stakeholders, reports, newspaper articles, minutes of meetings and email correspondence between actors in the policy change process. The narrative has been structured to capture the timing of events, the difficulties and hurdles faced and the resolutions reached to the final implementation of a new treatment policy. Results Following a recognition that SP was failing there was a rapid technical appraisal of available data and replacement options resulting in a decision to adopt artemether-lumefantrine (AL as the recommended first-line therapy in Kenya, announced in April 2004. Funding requirements were approved by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM and over 60 million US$ were agreed in principle in July 2004 to procure AL and implement the policy change. AL arrived in Kenya in May 2006, distribution to health facilities began in July 2006 coincidental with cascade in-service training in the revised national guidelines. Both training and drug distribution were almost complete by the end of 2006. The article examines why it took over 32 months from announcing a drug policy change to completing early implementation. Reasons included: lack of clarity on sustainable financing of an expensive therapeutic for a common disease, a delay in release of funding, a lack of comparative efficacy data

  11. Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study.

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    Camila Bôtto-Menezes

    Full Text Available Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW.Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54% were between 20-29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503 reported more than one malaria episode and most malaria episodes (84.5%, 846/1001 were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively. The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19-0.95]; p = 0.037 and among those women who reported higher antenatal care (ANC attendance (OR, 0.32 [95% CI, 0.15-0.70]; p = 0.005.This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance.

  12. Risk factors for house-entry by malaria vectors in a rural town and satellite villages in The Gambia

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    Jasseh Momadou

    2008-01-01

    Full Text Available Abstract Background In the pre-intervention year of a randomized controlled trial investigating the protective effects of house screening against malaria-transmitting vectors, a multi-factorial risk factor analysis study was used to identify factors that influence mosquito house entry. Methods Mosquitoes were sampled using CDC light traps in 976 houses, each on one night, in Farafenni town and surrounding villages during the malaria-transmission season in The Gambia. Catches from individual houses were both (a left unadjusted and (b adjusted relative to the number of mosquitoes caught in four sentinel houses that were operated nightly throughout the period, to allow for night-to-night variation. Houses were characterized by location, architecture, human occupancy and their mosquito control activities, and the number and type of domestic animals within the compound. Results 106,536 mosquitoes were caught, of which 55% were Anopheles gambiae sensu lato, the major malaria vectors in the region. There were seven fold higher numbers of An. gambiae s.l. in the villages (geometric mean per trap night = 43.7, 95% confidence intervals, CIs = 39.5–48.4 than in Farafenni town (6.3, 5.7–7.2 and significant variation between residential blocks (p Conclusion This study demonstrates that the risk of malaria transmission is greatest in rural areas, where large numbers of people sleep in houses made of mud blocks, where the eaves are open, horses are not tethered nearby and where churai is not burnt at night. These factors need to be considered in the design and analysis of intervention studies designed to reduce malaria transmission in The Gambia and other parts of sub-Saharan Africa.

  13. Malaria-associated rubber plantations in Thailand.

    Science.gov (United States)

    Bhumiratana, Adisak; Sorosjinda-Nunthawarasilp, Prapa; Kaewwaen, Wuthichai; Maneekan, Pannamas; Pimnon, Suntorn

    2013-01-01

    Rubber forestry is intentionally used as a land management strategy. The propagation of rubber plantations in tropic and subtropic regions appears to influence the economical, sociological and ecological aspects of sustainable development as well as human well-being and health. Thailand and other Southeast Asian countries are the world's largest producers of natural rubber products; interestingly, agricultural workers on rubber plantations are at risk for malaria and other vector-borne diseases. The idea of malaria-associated rubber plantations (MRPs) encompasses the complex epidemiological settings that result from interactions among human movements and activities, land cover/land use changes, agri-environmental and climatic conditions and vector population dynamics. This paper discusses apparent issues pertaining to the connections between rubber plantations and the populations at high risk for malaria. The following questions are addressed: (i) What are the current and future consequences of rubber plantations in Thailand and Southeast Asia relative to malaria epidemics or outbreaks of other vector-borne diseases? (ii) To what extent is malaria transmission in Thailand related to the forest versus rubber plantations? and (iii) What are the vulnerabilities of rubber agricultural workers to malaria, and how contagious is malaria in these areas?

  14. Prospects for malaria elimination in non-Amazonian regions of Latin America.

    Science.gov (United States)

    Herrera, Sócrates; Quiñones, Martha Lucia; Quintero, Juan Pablo; Corredor, Vladimir; Fuller, Douglas O; Mateus, Julio Cesar; Calzada, Jose E; Gutierrez, Juan B; Llanos, Alejandro; Soto, Edison; Menendez, Clara; Wu, Yimin; Alonso, Pedro; Carrasquilla, Gabriel; Galinski, Mary; Beier, John C; Arévalo-Herrera, Myriam

    2012-03-01

    Latin America contributes 1-1.2 million clinical malaria cases to the global malaria burden of about 300 million per year. In 21 malaria endemic countries, the population at risk in this region represents less than 10% of the total population exposed worldwide. Factors such as rapid deforestation, inadequate agricultural practices, climate change, political instability, and both increasing parasite drug resistance and vector resistance to insecticides contribute to malaria transmission. Recently, several malaria endemic countries have experienced a significant reduction in numbers of malaria cases. This is most likely due to actions taken by National Malaria Control Programs (NMCP) with the support from international funding agencies. We describe here the research strategies and activities to be undertaken by the Centro Latino Americano de Investigación en Malaria (CLAIM), a new research center established for the non-Amazonian region of Latin America by the National Institute of Allergy and Infectious Diseases (NIAID). Throughout a network of countries in the region, initially including Colombia, Guatemala, Panama, and Peru, CLAIM will address major gaps in our understanding of changing malaria epidemiology, vector biology and control, and clinical malaria mainly due to Plasmodium vivax. In close partnership with NMCPs, CLAIM seeks to conduct research on how and why malaria is decreasing in many countries of the region as a basis for developing and implementing new strategies that will accelerate malaria elimination.

  15. Radar Monitoring of Wetlands for Malaria Control

    Science.gov (United States)

    Pope, Kevin O.

    1997-01-01

    Malaria is perhaps the most serious human disease problem. It inflicts millions worldwide and is on the rise in many countries where it was once under control. This rise is in part due to the high costs, both economic and environmental, of current control programs. The search for more cost-effective means to combat malaria has focussed attention on new technologies, one of which is remote sensing. Remote sensing has become an important tool in the effort to control a variety of diseases worldwide and malaria is perhaps one of the most promising. This study is part of the malaria control effort in the Central American country of Belize, which has experienced a resurgence of malaria in the last two decades. The proposed project is a feasibility study of the use of Radarsat (and other similar radar systems) to monitor seasonal changes in the breeding sites of the anopheline mosquito, which is responsible for malaria transmission. We propose that spatial and temporal changes in anopheline mosquito production can be predicted by sensing where and when their breeding sites are flooded. Timely knowledge of anopheline mosquito production is a key factor in control efforts. Such knowledge can be used by local control agencies to direct their limited resources to selected areas and time periods when the human population is at greatest risk. Radar is a key sensor in this application because frequent cloud cover during the peak periods of malaria transmission precludes the use of optical sensors.

  16. Geostatistical modelling of the malaria risk in Mozambique: effect of the spatial resolution when using remotely-sensed imagery.

    Science.gov (United States)

    Giardina, Federica; Franke, Jonas; Vounatsou, Penelope

    2015-01-01

    The study of malaria spatial epidemiology has benefited from recent advances in geographic information system and geostatistical modelling. Significant progress in earth observation technologies has led to the development of moderate, high and very high resolution imagery. Extensive literature exists on the relationship between malaria and environmental/climatic factors in different geographical areas, but few studies have linked human malaria parasitemia survey data with remote sensing-derived land cover/land use variables and very few have used Earth Observation products. Comparison among the different resolution products to model parasitemia has not yet been investigated. In this study, we probe a proximity measure to incorporate different land cover classes and assess the effect of the spatial resolution of remotely sensed land cover and elevation on malaria risk estimation in Mozambique after adjusting for other environmental factors at a fixed spatial resolution. We used data from the Demographic and Health survey carried out in 2011, which collected malaria parasitemia data on children from 0 to 5 years old, analysing them with a Bayesian geostatistical model. We compared the risk predicted using land cover and elevation at moderate resolution with the risk obtained employing the same variables at high resolution. We used elevation data at moderate and high resolution and the land cover layer from the Moderate Resolution Imaging Spectroradiometer as well as the one produced by MALAREO, a project covering part of Mozambique during 2010-2012 that was funded by the European Union's 7th Framework Program. Moreover, the number of infected children was predicted at different spatial resolutions using AFRIPOP population data and the enhanced population data generated by the MALAREO project for comparison of estimates. The Bayesian geostatistical model showed that the main determinants of malaria presence are precipitation and day temperature. However, the presence

  17. Geostatistical modelling of the malaria risk in Mozambique: effect of the spatial resolution when using remotely-sensed imagery

    Directory of Open Access Journals (Sweden)

    Federica Giardina

    2015-11-01

    Full Text Available The study of malaria spatial epidemiology has benefited from recent advances in geographic information system and geostatistical modelling. Significant progress in earth observation technologies has led to the development of moderate, high and very high resolution imagery. Extensive literature exists on the relationship between malaria and environmental/climatic factors in different geographical areas, but few studies have linked human malaria parasitemia survey data with remote sensing-derived land cover/land use variables and very few have used Earth Observation products. Comparison among the different resolution products to model parasitemia has not yet been investigated. In this study, we probe a proximity measure to incorporate different land cover classes and assess the effect of the spatial resolution of remotely sensed land cover and elevation on malaria risk estimation in Mozambique after adjusting for other environmental factors at a fixed spatial resolution. We used data from the Demographic and Health survey carried out in 2011, which collected malaria parasitemia data on children from 0 to 5 years old, analysing them with a Bayesian geostatistical model. We compared the risk predicted using land cover and elevation at moderate resolution with the risk obtained employing the same variables at high resolution. We used elevation data at moderate and high resolution and the land cover layer from the Moderate Resolution Imaging Spectroradiometer as well as the one produced by MALAREO, a project covering part of Mozambique during 2010-2012 that was funded by the European Union’s 7th Framework Program. Moreover, the number of infected children was predicted at different spatial resolutions using AFRIPOP population data and the enhanced population data generated by the MALAREO project for comparison of estimates. The Bayesian geostatistical model showed that the main determinants of malaria presence are precipitation and day temperature

  18. Successful malaria elimination strategies require interventions that target changing vector behaviours

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    Russell Tanya L

    2013-02-01

    Full Text Available Abstract Background The ultimate long-term goal of malaria eradication was recently placed back onto the global health agenda. When planning for this goal, it is important to remember why the original Global Malaria Eradication Programme (GMEP, conducted with DDT-based indoor residual spraying (IRS, did not achieve its goals. One of the technical reasons for the failure to eliminate malaria was over reliance on a single intervention and subsequently the mosquito vectors developed behavioural resistance so that they did not come into physical contact with the insecticide. Hypothesis and how to test it Currently, there remains a monolithic reliance on indoor vector control. It is hypothesized that an outcome of long-term, widespread control is that vector populations will change over time, either in the form of physiological resistance, changes in the relative species composition or behavioural resistance. The potential for, and consequences of, behavioural resistance was explored by reviewing the literature regarding vector behaviour in the southwest Pacific. Discussion Here, two of the primary vectors that were highly endophagic, Anopheles punctulatus and Anopheles koliensis, virtually disappeared from large areas where DDT was sprayed. However, high levels of transmission have been maintained by Anopheles farauti, which altered its behaviour to blood-feed early in the evening and outdoors and, thereby, avoiding exposure to the insecticides used in IRS. This example indicates that the efficacy of programmes relying on indoor vector control (IRS and long-lasting, insecticide-treated nets [LLINs] will be significantly reduced if the vectors change their behaviour to avoid entering houses. Conclusions Behavioural resistance is less frequently seen compared with physiological resistance (where the mosquito contacts the insecticide but is not killed, but is potentially more challenging to control programmes because the intervention effectiveness

  19. Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon

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    Thais Hetierre Abreu Monteiro

    2015-10-01

    Full Text Available ABSTRACTINTRODUCTION:This study aimed to evaluate basic sanitation and socioeconomic indicators, reported cases of malaria, and risk of contracting malaria in the Ananindeua municipality, State of Pará.METHODS:Data on basic sanitation and socioeconomic dimensions were taken from the Brazilian Institute of Geography and Statistics [ Instituto Brasileiro de Geografia e Estatística (IBGE] 2010 census. Epidemiological malaria information was taken from the Epidemiological Malaria Surveillance Information System [ Sistema de Informação de Vigilância Epidemiológica de Malária (SIVEP/Malaria], between 2003 and 2013 of the Ministry of Health and from the SIVEP/Malaria forms of the municipality's Endemic Diseases Unit for 2,013 cases.RESULTS:Our data do not confirm the correlation among indicators of basic sanitation, socioeconomic conditions, and water supply with malaria cases. Of the 1,557 cases evaluated, most were caused by Plasmodium vivax , with rare cases of Plasmodium falciparum and mixed infections. There were 756 notifications in 2003. The number of reported cases was sharply reduced between 2006 and 2012, but a 142-case outbreak occurred in 2013. Ananindeua municipality's Annual Parasite Index indicated low risk in 2003 and no risk in other years, and the 2,013 cases were predominantly male individuals aged ≥40 years.CONCLUSIONS:Our data confirm the non-endemicity of malaria in the Ananindeua municipality, as the Annual Parasite Indices described for the years 2004-2013 classify it as a risk-free area. However, the 2013 outbreak indicates the need to strengthen prevention, surveillance, and control activities to reduce the risk of new outbreaks and consequent economic and social impacts on the population.

  20. Predictive study on the risk of malaria spreading due to global warming

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Masaji [National Inst. for Environmental Studies, Tsukuba, Ibaraki (Japan)

    1996-12-31

    Global warming will bring about a temperature elevation, and the habitat of vectors of infectious diseases, such as malaria and dengue fever, will spread into subtropical or temperate zone. The purpose of this study is to simulate the spreading of these diseases through reexamination of existing data and collection of some additional information by field survey. From these data, the author will establish the relationship between meteorological conditions, vector density and malaria occurrence. And then he will simulate and predict the malaria epidemics in case of temperature elevation in southeast Asia and Japan.

  1. Malaria and Tropical Travel

    Centers for Disease Control (CDC) Podcasts

    2008-05-15

    Malaria is a serious mosquito-borne disease that can lead to death. This podcast discusses malaria risk when traveling to tropical areas, as well as how to protect yourself and your family from malaria infection.  Created: 5/15/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 5/29/2008.

  2. Local topographic wetness indices predict household malaria risk better than land-use and land-cover in the western Kenya highlands

    Directory of Open Access Journals (Sweden)

    Vulule John M

    2010-11-01

    Full Text Available Abstract Background Identification of high-risk malaria foci can help enhance surveillance or control activities in regions where they are most needed. Associations between malaria risk and land-use/land-cover are well-recognized, but these environmental characteristics are closely interrelated with the land's topography (e.g., hills, valleys, elevation, which also influences malaria risk strongly. Parsing the individual contributions of land-cover/land-use variables to malaria risk requires examining these associations in the context of their topographic landscape. This study examined whether environmental factors like land-cover, land-use, and urban density improved malaria risk prediction based solely on the topographically-determined context, as measured by the topographic wetness index. Methods The topographic wetness index, an estimate of predicted water accumulation in a defined area, was generated from a digital terrain model of the landscape surrounding households in two neighbouring western Kenyan highland communities. Variables determined to best encompass the variance in this topographic wetness surface were calculated at a household level. Land-cover/land-use information was extracted from a high-resolution satellite image using an object-based classification method. Topographic and land-cover variables were used individually and in combination to predict household-level malaria in the communities through an iterative split-sample model fitting and testing procedure. Models with only topographic variables were compared to those with additional predictive factors related to land-cover/land-use to investigate whether these environmental factors improved prediction of malaria based on the shape of the land alone. Results Variables related to topographic wetness proved most useful in predicting the households of individuals contracting malaria in this region of rugged terrain. Other variables related to human modification of the

  3. Estimating risk factors of urban malaria in Blantyre, Malawi: A spatial regression analysis

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    Lawrence N. Kazembe

    2016-05-01

    Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration, emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.

  4. Malaria risk factors in women on intermittent preventive treatment at delivery and their effects on pregnancy outcome in Sanaga-Maritime, Cameroon.

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    Calvin Tonga

    Full Text Available Malaria is known to have a negative impact on pregnant women and their foetuses. The efficacy of Sulfadoxine-Pyrimethamine (SP used for intermittent preventive treatment (IPT is being threatened by increasing levels of resistance. This study assessed malaria risk factors in women on intermittent preventive treatment with SP (IPTp-SP at delivery and their effects on pregnancy outcome in Sanaga-Maritime Division, Cameroon. Socio-economic and obstetrical data of mothers and neonate birth weights were documented. Peripheral blood from 201 mothers and newborns as well as placental and cord blood were used to prepare thick and thin blood films. Maternal haemoglobin concentration was measured. The overall malaria parasite prevalence was 22.9% and 6.0% in mothers and newborns respectively. Monthly income lower than 28000 FCFA and young age were significantly associated with higher prevalence of placental malaria infection (p = 0.0048 and p = 0.019 respectively. Maternal infection significantly increased the risk of infection in newborns (OR = 48.4; p<0.0001. Haemoglobin concentration and birth weight were lower in infected mothers, although not significant. HIV infection was recorded in 6.0% of mothers and increased by 5-folds the risk of malaria parasite infection (OR = 5.38, p = 0.007. Attendance at antenatal clinic and level of education significantly influenced the utilisation of IPTp-SP (p<0.0001 and p = 0.018 respectively. Use of SP and mosquito net resulted in improved pregnancy outcome especially in primiparous, though the difference was not significant. Malaria infection in pregnancy is common and increases the risk of neonatal malaria infection. Preventive strategies are poorly implemented and their utilization has overall reasonable effect on malaria infection and pregnancy outcome.

  5. Effects of Microclimate Condition Changes Due to Land Use and Land Cover Changes on the Survivorship of Malaria Vectors in China-Myanmar Border Region.

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    Daibin Zhong

    Full Text Available In the past decade, developing countries have been experiencing rapid land use and land cover changes, including deforestation and cultivation of previously forested land. However, little is known about the impact of deforestation and land-use changes on the life history of malaria vectors and their effects on malaria transmission. This study examined the effects of deforestation and crop cultivation on the adult survivorship of major malaria mosquitoes, Anopheles sinensis and An. minimus in the China-Myanmar border region. We examined three conditions: indoor, forested, and banana plantation. Mean survival time of An. sinensis in banana plantation environment was significantly longer than those in forested environment, and mosquitoes exhibited the longest longevity in the indoor environment. This pattern held for both males and females, and also for An. minimus. To further test the effect of temperature on mosquito survival, we used two study sites with different elevation and ambient temperatures. Significantly higher survivorship of both species was found in sites with lower elevation and higher ambient temperature. Increased vector survival in the deforested area could have an important impact on malaria transmission in Southeast Asia. Understanding how deforestation impacts vector survivorship can help combat malaria transmission.

  6. Effects of Microclimate Condition Changes Due to Land Use and Land Cover Changes on the Survivorship of Malaria Vectors in China-Myanmar Border Region.

    Science.gov (United States)

    Zhong, Daibin; Wang, Xiaoming; Xu, Tielong; Zhou, Guofa; Wang, Ying; Lee, Ming-Chieh; Hartsel, Joshua A; Cui, Liwang; Zheng, Bin; Yan, Guiyun

    2016-01-01

    In the past decade, developing countries have been experiencing rapid land use and land cover changes, including deforestation and cultivation of previously forested land. However, little is known about the impact of deforestation and land-use changes on the life history of malaria vectors and their effects on malaria transmission. This study examined the effects of deforestation and crop cultivation on the adult survivorship of major malaria mosquitoes, Anopheles sinensis and An. minimus in the China-Myanmar border region. We examined three conditions: indoor, forested, and banana plantation. Mean survival time of An. sinensis in banana plantation environment was significantly longer than those in forested environment, and mosquitoes exhibited the longest longevity in the indoor environment. This pattern held for both males and females, and also for An. minimus. To further test the effect of temperature on mosquito survival, we used two study sites with different elevation and ambient temperatures. Significantly higher survivorship of both species was found in sites with lower elevation and higher ambient temperature. Increased vector survival in the deforested area could have an important impact on malaria transmission in Southeast Asia. Understanding how deforestation impacts vector survivorship can help combat malaria transmission.

  7. Role of An. culicifacies as a vector of malaria in changing ecological scenario of Northeastern states of India

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    Nasreen Akhtar

    2016-01-01

    Full Text Available Background & objectives: Malaria has become endemic and subject of concern in most part of the India especially Northeastern states of India. Surveys before 2000 revealed that Anopheles minimus was major vector responsible for transmission of malaria in this region followed by An. dirus and An. fluviatilis. However, recent studies indicate replacement of An. minimus vector by An. culicifacies due to different ecological changes and change in landuse pattern etc. The objective of present study was to explore the vectorial role of An. culicifacies in transmission of malaria in four malaria endemic states, viz. Assam, Meghalaya, Manipur and Sikkim of India. Methods: The seven surveys were conducted in 176 selected villages belonging to eight districts of the four states in both pre-monsoon (March-April and post-monsoon (September-October seasons from 2010 to 2013. However, in 2011 surveys could not be carried out due to public inconvenience in pre-monsoon season. For vectorial role of all vector species collected, ELISA and PCR were assayed. Results: A total of 19,173 specimens belonging to 30 anopheline species were collected, out of which 4315 belonged to four established vector species. In total, 4183 specimens were processed through ELISA, out of which 236 specimens were found positive for circumsporozoite (CS protein. Further, infectivity was confirmed by PCR in 35 samples, of which 12 samples were found positive for Plasmodium falciparum and three for P. vivax. Out of 12 Plasmodium falciparum positive samples, nine samples were positive for An. culicifacies, two for An. fluviatilis and one for An. minimus. While out of three Plasmodium vivax positive samples, two samples were positive for An. dirus and one sample was positive for An. culicifacies. Interpretation & conclusion: Anopheles culicifacies replaced the An. minimus, the vector of malaria in Northeastern states of India, as it was found to be highly infected with malaria parasite as

  8. Electrochemical impedance spectroscopy to study physiological changes affecting the red blood cell after invasion by malaria parasites.

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    Ribaut, Clotilde; Reybier, Karine; Reynes, Olivier; Launay, Jérôme; Valentin, Alexis; Fabre, Paul Louis; Nepveu, Françoise

    2009-04-15

    The malaria parasite, Plasmodium falciparum, invades human erythrocytes and induces dramatic changes in the host cell. The idea of this work was to use RBC modified electrode to perform electrochemical impedance spectroscopy (EIS) with the aim of monitoring physiological changes affecting the erythrocyte after invasion by the malaria parasite. Impedance cell-based devices are potentially useful to give insight into cellular behavior and to detect morphological changes. The modelling of impedance plots (Nyquist diagram) in equivalent circuit taking into account the presence of the cellular layer, allowed us pointing out specific events associated with the development of the parasite such as (i) strong changes in the host cell cytoplasm illustrated by changes in the film capacity, (ii) perturbation of the ionic composition of the host cell illustrated by changes in the film resistance, (iii) releasing of reducer (lactic acid or heme) and an enhanced oxygen consumption characterized by changes in the charge transfer resistance and in the Warburg coefficient characteristic of the redox species diffusion. These results show that the RBC-based device may help to analyze strategic events in the malaria parasite development constituting a new tool in antimalarial research.

  9. Malaria and under-nutrition: a community based study among under-five children at risk of malaria, south-west Ethiopia.

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    Amare Deribew

    Full Text Available BACKGROUND: The interaction between malaria and under-nutrition is not well elucidated in Ethiopia. The objective of this study was to assess the magnitude of under-nutrition and its correlation with malaria among under-five children in south-west Ethiopia. METHODS: This cross-sectional study was undertaken during March-February, 2009 as part of the baseline assessment of a cluster randomized trial around Gilgel Gibe Hydroelectric dam, south-west Ethiopia. A total of 2410 under-five children were included for anthropometric measurement and blood investigation for the diagnosis of malaria and anemia. The nutritional status of children was determined using the International Reference Population defined by the U.S National Center for Health Statistics (NCHS. Blood film was used to identify malaria parasite and haemoglobin concentration was determined by Hemo Cue analyzer (HemoCue Hb 301, Sweden. RESULTS: Significant proportion (40.4% of under-five children were stunted (height-for-age<-2SD. The prevalence of under-weight was 34.2%. One third and one tenth of the children had anemia and malaria parasite respectively. Older children were more likely to have under-nutrition. There was no association between malaria and under-nutrition. Children who had malaria parasite were 1.5 times more likely to become anaemic compare to children who had no malaria parasite, [OR = 1.5, (95% CI: 1.1-2.0]. CONCLUSION: In this study, there is no association between malaria and under-nutrition. Children who have malaria are more likely to be anaemic. Malaria prevention and control program should consider nutrition interventions particularly anemia.

  10. Pattern of drug utilization for treatment of uncomplicated malaria in urban Ghana following national treatment policy change to artemisinin-combination therapy

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    Tenkorang Ofori

    2009-01-01

    recommendations may change, clinical practice may still be affected by factors other than the decision or ability to diagnose malaria. Age, diagnostic confirmation and suspected concurrent conditions lead to benefit:risk assessments for individual patients by clinicians as to which anti-malarial treatment to prescribe. This has implications for adherence to policy changes aiming to implement effective use of ACT. These results should inform education of health professionals and rational drug use policies to reduce poly-pharmacy, and also suggest a potential positive impact of increased access to testing for malaria both within health facilities and in homes.

  11. Malaria in Pregnancy

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    E E Okpere

    2010-01-01

    Full Text Available Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10, 000 maternal deaths and to at least 200, 000 newborn deaths annually. Malaria is a contributor or aetiologic factor in pregnancy complications including anaemia, spontaneous abortion, prematurity and stillbirths. Pregnancy results in increased incidence and severity of malaria. Cerebral malaria, acute renal failure and severe anaemia, rare complications in adults living in malaria endemic areas, may complicate malaria in pregnancy. Research implicate reduced maternal immunity from increased steroid levels in pregnancy, increased attractiveness of pregnant women to mosquito bites and increased adherence of parasitized erythrocytes to Chondroitin sulphate A expressed in the placentae. This is worse in the first and second pregnancies. With infection with the Human Immunodeficiency Virus [HIV], the effects of malaria in pregnancy are even worse. Over the decades, there have been concerted worldwide collaborative efforts, spearheaded by the World Health Organization [WHO] and including governments and allied agencies to tackle the scourge of malaria in pregnancy. The main thrusts of such efforts have been: to increase the use of insecticide treated mosquito bed nets [ITN]; intermittent preventive treatment of malaria [IPT]; and adequate case treatment of acute malaria attacks in pregnancy. While for IPT, Sulfadoxine-Pyrimethamine [SP] combination has been proven to be of benefit in preventing acute and latent malaria in pregnancy and its associated complications, the WHO has introduced the use of Artemisinin-Combination Therapy [ACT] for the first-line treatment of uncomplicated malaria in pregnancy, the need to confirm malaria before treatment and the enforcement of completion of therapy once started. The Roll Back

  12. [Epidemiology of imported malaria and entomological study of breeding sites of potential risk areas in the province of Khemisset (Morocco)].

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    Larhbali, Y; Belghyti, D; El Guamri, Y; Lahlou, O; El Kharrim, K; Kirami, A; Khamri, Z

    2014-01-01

    No case of autochthonous malaria has been detected in Morocco since 2004. This achievement is due to a national strategy to combat the disease by appropriate and well-organized disease detection and treatment, as well as control of the mosquito vector of the disease, the female Anopheles mosquito. Nonetheless, imported malaria cases have been increasing (75 in 2007), due to the rise in international travel and migration from countries where the disease is endemic. This work is divided into two parts: the first part is a retrospective study of the cases of imported malaria identified by optical microscopy in the Laboratory of Medical Entomology of the Khemisset Provincial Delegation of Health from 2000 to 2010. The second part is an entomological study conducted in 2010 of the Culicidae insect family, especially the Anopheles genus. The results show that of 176,457 requests for parasite testing, 14 were positive. All positive samples came from men older than 23 years. The cases identified are imported from two African countries: the Democratic Republic of Congo (86%) and Ivory Coast (14%). The years of high incidence were 2003 with four cases and 2000, 2004 and 2006 with two cases. The species found are Plasmodium falciparum in 13 cases (93%) and Plasmodium ovale in one case (7%). The vector of autochthonous malaria, which was eliminated in 2004, is Anopheles (Anopheles) labranchiae Fallerouni 1926, and it was the dominant species found in our entomological study (424 larvae). The other species were found in breeding sites in potential at-risk locations in the study area.

  13. Malaria or kalimbe: how to choose?

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    Carme Bernard

    2009-12-01

    Full Text Available Abstract Should the Kalimbe (a traditional Amerindian loincloth be banned, based on its association with an increased risk of malaria? Studies on malaria conducted on Amerindian children in the Oyapock region, French Guiana suggest that there is an argument for replacing the Kalimbe with a modern alternative. However, the wider issue of how the positive (risk reduction and related benefits and negative effects (exacerbation of acculturation processes and associated consequences should be assessed needs to be considered before suggesting a change in ancestral behaviour for medical purposes. A multidisciplinary approach is needed, together with caution and humility from epidemiologists.

  14. Malaria prevention in travelers.

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    Genton, Blaise; D'Acremont, Valérie

    2012-09-01

    A common approach to malaria prevention is to follow the "A, B, C, D" rule: Awareness of risk, Bite avoidance, Compliance with chemoprophylaxis, and prompt Diagnosis in case of fever. The risk of acquiring malaria depends on the length and intensity of exposure; the risk of developing severe disease is primarily determined by the health status of the traveler. These parameters need to be assessed before recommending chemoprophylaxis and/or stand-by emergency treatment. This review discusses the different strategies and drug options available for the prevention of malaria during and post travel.

  15. Amazonian malaria: asymptomatic human reservoirs, diagnostic challenges, environmentally driven changes in mosquito vector populations, and the mandate for sustainable control strategies.

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    da Silva-Nunes, Mônica; Moreno, Marta; Conn, Jan E; Gamboa, Dionicia; Abeles, Shira; Vinetz, Joseph M; Ferreira, Marcelo U

    2012-03-01

    Across the Americas and the Caribbean, nearly 561,000 slide-confirmed malaria infections were reported officially in 2008. The nine Amazonian countries accounted for 89% of these infections; Brazil and Peru alone contributed 56% and 7% of them, respectively. Local populations of the relatively neglected parasite Plasmodium vivax, which currently accounts for 77% of the regional malaria burden, are extremely diverse genetically and geographically structured. At a time when malaria elimination is placed on the public health agenda of several endemic countries, it remains unclear why malaria proved so difficult to control in areas of relatively low levels of transmission such as the Amazon Basin. We hypothesize that asymptomatic parasite carriage and massive environmental changes that affect vector abundance and behavior are major contributors to malaria transmission in epidemiologically diverse areas across the Amazon Basin. Here we review available data supporting this hypothesis and discuss their implications for current and future malaria intervention policies in the region. Given that locally generated scientific evidence is urgently required to support malaria control interventions in Amazonia, we briefly describe the aims of our current field-oriented malaria research in rural villages and gold-mining enclaves in Peru and a recently opened agricultural settlement in Brazil.

  16. Watch out for malaria: still a leading cause of child death worldwide

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    Buonsenso Danilo

    2010-09-01

    Full Text Available Abstract Background Due to the efforts in malaria control promoted by the World Health Organization (WHO, the reported malaria burden is being reduced throughout the world. Nevertheless, malaria remains a leading cause of child death worldwide. Aims purpose of the paper is to summarize the main historical steps in fighting malaria, from the first descriptions to the last ones. Results a case of probable autochthonous malaria has been recently described in Italy, raising concern over the possibility of resurgence of malaria in countries previously interested by this disease. Moreover, both the constant threat of the parasite and vector mosquito developing resistance to medicines and insecticides, and the on-going climate change make the challenge of eradicating malaria really difficult. Therefore, malaria is still an actual disease, requiring adequate programs of surveillance, stronger health systems in poor countries, and efforts in order to develop new and effective tools in malaria control. WHO has definitely demonstrated the effects of "social determinants" on health. So, eradication strategies cannot be based only on a scientific background, because culture, politics, power, resources and wars have a profound impact on health and disease. These elements should be introduced in all the programs of malaria control. Conclusions malaria is still an actual disease with great public health implications, and the approaches for control and prevention should have the appropriate social and political context in addition to the science involved in order to save lives of children at risk.

  17. Development of behaviour change communication strategy for a vaccination-linked malaria control tool in southern Tanzania

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    Mshinda Hassan

    2008-09-01

    Full Text Available Abstract Background Intermittent preventive treatment of malaria in infants (IPTi using sulphadoxine-pyrimethamine and linked to the expanded programme on immunization (EPI is a promising strategy for malaria control in young children. As evidence grows on the efficacy of IPTi as public health strategy, information is needed so that this novel control tool can be put into practice promptly, once a policy recommendation is made to implement it. This paper describes the development of a behaviour change communication strategy to support implementation of IPTi by the routine health services in southern Tanzania, in the context of a five-year research programme evaluating the community effectiveness of IPTi. Methods Mixed methods including a rapid qualitative assessment and quantitative health facility survey were used to investigate communities' and providers' knowledge and practices relating to malaria, EPI, sulphadoxine-pyrimethamine and existing health posters. Results were applied to develop an appropriate behaviour change communication strategy for IPTi involving personal communication between mothers and health staff, supported by a brand name and two posters. Results Malaria in young children was considered to be a nuisance because it causes sleepless nights. Vaccination services were well accepted and their use was considered the mother's responsibility. Babies were generally taken for vaccination despite complaints about fevers and swellings after the injections. Sulphadoxine-pyrimethamine was widely used for malaria treatment and intermittent preventive treatment of malaria in pregnancy, despite widespread rumours of adverse reactions based on hearsay and newspaper reports. Almost all health providers said that they or their spouse were ready to take SP in pregnancy (96%, 223/242. A brand name, key messages and images were developed and pre-tested as behaviour change communication materials. The posters contained public health messages

  18. Malaria surveillance-response strategies in different transmission zones of the People's Republic of China: preparing for climate change

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    Yang Guo-Jing

    2012-12-01

    Full Text Available Abstract Background A sound understanding of malaria transmission patterns in the People’s Republic of China (P.R. China is crucial for designing effective surveillance-response strategies that can guide the national malaria elimination programme (NMEP. Using an established biology-driven model, it is expected that one may design and refine appropriate surveillance-response strategies for different transmission zones, which, in turn, assist the NMEP in the ongoing implementation period (2010–2020 and, potentially, in the post-elimination stage (2020–2050. Methods Environmental data obtained from 676 locations across P.R. China, such as monthly temperature and yearly relative humidity (YRH, for the period 1961–2000 were prepared. Smoothed surface maps of the number of months suitable for parasite survival derived from monthly mean temperature and YRH were generated. For each decade, the final malaria prediction map was overlaid by two masked maps, one showing the number of months suitable for parasite survival and the other the length of YRH map in excess of 60%. Results Considering multiple environmental factors simultaneously, the environmental variables suitable for malaria transmission were found to have shifted northwards, which was especially pronounced in northern P.R. China. The unstable suitable regions (transmission periods between five and six months showed increased transmission intensity due to prolonged suitable periods, especially in the central part of the country. Conclusion Adequate and effective surveillance-response strategies for NMEP should be designed to achieve the goal of malaria elimination in P.R. China by 2020, especially in the zones predicted to be the most vulnerable for climate change.

  19. Epidemiology: Malaria in a warmer West Africa

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    Caminade, C.; Jones, A. E.

    2016-11-01

    Malaria risk in West Africa is expected to fall (western region) or remain the same (eastern region) in response to climate change over the twenty-first century. This is primarily due to extreme temperature conditions projected under a high greenhouse gas emissions scenario.

  20. Immunochromatographic antigen testing alone is sufficient to identify asymptomatic refugees at risk of severe malaria presenting to a single health service in Victoria.

    Science.gov (United States)

    Fedele, Pasquale L; Wheeler, Michael; Lemoh, Christopher; Chunilal, Sanjeev

    2014-10-01

    Current screening guidelines for malaria in new refugees include a combination of thick and thin film examination and immunochromatographic antigen test (ICT). However, as the prevalence of malaria in our population has decreased due to changing refugee demographics, we sought to determine if an ICT alone can reliably exclude malaria in our asymptomatic refugee population.A retrospective analysis was conducted of all investigations for malaria performed from 1 August 2011 to 31 July 2013, including thick and thin blood film examination, BinaxNOW ICT, and external morphological and polymerase chain reaction (PCR) validation where applicable.Malaria was diagnosed in 45 of 1248 (3.6%) patients investigated, all of whom were symptomatic and the majority (71.1%) returned travellers. All 599 asymptomatic refugees screened were negative. Overall, 42 of 45 malaria cases were detected by the ICT; sensitivity 93.3% (95% CI 80.7-98.3%) and negative predictive value (NPV) 99.8% (99.2-99.9%). All 21 cases of Plasmodium falciparum and 20 of 22 cases of Plasmodium vivax were detected, giving a sensitivity of 100% (80.8-100%) and 90.9% (69.4-98.4%) respectively. Too few cases of Plasmodium malariae and no cases of Plasmodium ovale or Plasmodium knowlesi were diagnosed for adequate assessment to be carried out.These data suggest that full malaria screening in all asymptomatic refugees with the combination of thick and thin blood films and rapid antigen test may not be warranted. Alternative screening approaches should be considered, including the use of ICT alone, or limiting screening of asymptomatic refugees to only those originating from countries with high incidence of malaria.

  1. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India

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    Mohammad Sohail

    2015-01-01

    Full Text Available The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85% at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU, whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome.

  2. Falciparum malaria and climate change in the northwest frontier province of Pakistan.

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    Bouma, M J; Dye, C; van der Kaay, H J

    1996-08-01

    Following a striking increase in the severity of autumnal outbreaks of Plasmodium falciparum during the last decade in the Northwest Frontier Province (NWFP) of Pakistan, the role of climatologic variables was investigated. A multivariate analysis showed that during the transmission season of P. falciparum, the amount of rainfall in September and October, the temperature in November and December, and the humidity in December were all correlated (r2 = 0.82) with two measures of P. falciparum, the falciparum rate (percent of slides examined positive for P. falciparum) since 1981 and the annual P. falciparum proportion (percent of all malaria infections diagnosed as P. falciparum) since 1978. Climatologic records since 1876 show an increase in mean November and December temperatures by 2 degrees C and 1.5 degrees C, respectively, and in October rainfall. Mean humidity in December has also been increasing since 1950. These climatologic changes in the area appear to have made conditions for transmission of P. falciparum more favorable, and may account for the increase in incidence observed in the NWFP in recent years.

  3. Time series analysis of trends in malaria cases and deaths at hospitals and the effect of antimalarial interventions, 2001-2011, Ethiopia.

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    Maru Aregawi

    Full Text Available BACKGROUND: The Government of Ethiopia and its partners have deployed artemisinin-based combination therapies (ACT since 2004 and long-lasting insecticidal nets (LLINs since 2005. Malaria interventions and trends in malaria cases and deaths were assessed at hospitals in malaria transmission areas during 2001-2011. METHODS: Regional LLINs distribution records were used to estimate the proportion of the population-at-risk protected by LLINs. Hospital records were reviewed to estimate ACT availability. Time-series analysis was applied to data from 41 hospitals in malaria risk areas to assess trends of malaria cases and deaths during pre-intervention (2001-2005 and post-interventions (2006-2011 periods. FINDINGS: The proportion of the population-at-risk potentially protected by LLINs increased to 51% in 2011. The proportion of facilities with ACTs in stock exceeded 87% during 2006-2011. Among all ages, confirmed malaria cases in 2011 declined by 66% (95% confidence interval [CI], 44-79% and SPR by 37% (CI, 20%-51% compared to the level predicted by pre-intervention trends. In children under 5 years of age, malaria admissions and deaths fell by 81% (CI, 47%-94% and 73% (CI, 48%-86% respectively. Optimal breakpoint of the trendlines occurred between January and June 2006, consistent with the timing of malaria interventions. Over the same period, non-malaria cases and deaths either increased or remained unchanged, the number of malaria diagnostic tests performed reflected the decline in malaria cases, and rainfall remained at levels supportive of malaria transmission. CONCLUSIONS: Malaria cases and deaths in Ethiopian hospitals decreased substantially during 2006-2011 in conjunction with scale-up of malaria interventions. The decrease could not be accounted for by changes in hospital visits, malaria diagnostic testing or rainfall. However, given the history of variable malaria transmission in Ethiopia, more data would be required to exclude the

  4. Assessing reservoir operations risk under climate change

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    Brekke, L.D.; Maurer, E.P.; Anderson, J.D.; Dettinger, M.D.; Townsley, E.S.; Harrison, A.; Pruitt, T.

    2009-01-01

    Risk-based planning offers a robust way to identify strategies that permit adaptive water resources management under climate change. This paper presents a flexible methodology for conducting climate change risk assessments involving reservoir operations. Decision makers can apply this methodology to their systems by selecting future periods and risk metrics relevant to their planning questions and by collectively evaluating system impacts relative to an ensemble of climate projection scenarios (weighted or not). This paper shows multiple applications of this methodology in a case study involving California's Central Valley Project and State Water Project systems. Multiple applications were conducted to show how choices made in conducting the risk assessment, choices known as analytical design decisions, can affect assessed risk. Specifically, risk was reanalyzed for every choice combination of two design decisions: (1) whether to assume climate change will influence flood-control constraints on water supply operations (and how), and (2) whether to weight climate change scenarios (and how). Results show that assessed risk would motivate different planning pathways depending on decision-maker attitudes toward risk (e.g., risk neutral versus risk averse). Results also show that assessed risk at a given risk attitude is sensitive to the analytical design choices listed above, with the choice of whether to adjust flood-control rules under climate change having considerably more influence than the choice on whether to weight climate scenarios. Copyright 2009 by the American Geophysical Union.

  5. Fats & Fakes : Towards improved control of malaria

    NARCIS (Netherlands)

    Visser, B.J.

    2017-01-01

    Effective malaria control reduced the malaria burden worldwide tremendously. Simultaneously, the epidemiology of malaria is changing and has become more complex. To continue the progress of the last decade, this thesis addressed several areas of importance in the field of malaria. Since effective ma

  6. Declining incidence of malaria imported into the UK from West Africa

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    Smith Valerie

    2008-11-01

    Full Text Available Abstract Background Two thirds of all falciparum malaria cases reported in the United Kingdom (UK are acquired in West Africa (WA. To ensure recommendations and guidelines for malaria prophylaxis in travellers to West Africa correlate to the risk of infection, a study was undertaken to examine recent trends and predict future patterns of imported malaria acquired by UK residents visiting West Africa and West African visitors to the UK between 1993 and 2006. Methods and Results Using passenger numbers and malaria surveillance reports, the data revealed a 2.3-fold increase in travel to West Africa with a five-fold increase in travelers visiting friends and relatives (VFR. Malaria incidence fell through the study period, the greatest decline noted in VFR with a fall from 196 cases/1,000 person-years to 52 cases/1,000 person-years, 9.8% per year p Discussion The reduction in incidence among all three groups of travellers may be explained by several factors; changing chemoprophylaxis usage and/or increased travel in urban areas where malaria risk has declined over the past decade, or widespread reduction in malaria transmission in West Africa. Conclusion With the reduction in malaria incidence seen in both visitors to and from West Africa, the most rational explanation for these findings is a fall in malaria transmission in West Africa, which may require a change in chemoprophylaxis policy for UK travelers over the next 5–10 years.

  7. The role of ENSO in understanding changes in Colombia's annual malaria burden by region, 1960–2006

    OpenAIRE

    Oliveros Hugo; Barnston Anthony G; Mantilla Gilma

    2009-01-01

    Abstract Background Malaria remains a serious problem in Colombia. The number of malaria cases is governed by multiple climatic and non-climatic factors. Malaria control policies, and climate controls such as rainfall and temperature variations associated with the El Niño/Southern Oscillation (ENSO), have been associated with malaria case numbers. Using historical climate data and annual malaria case number data from 1960 to 2006, statistical models are developed to isolate the effects of cli...

  8. MIGRATION AND MALARIA IN EUROPE

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    Begoña Monge-Maillo

    2012-03-01

    Full Text Available The proportion of imported malaria cases due to immigrants in Europe has increased during the lasts decades, being the higher rates for those settled immigrants who travel to visit friends and relatives (VFRs at their country of origin. Cases are mainly due to P. falciparum and Sub-Saharan Africa is the most common origin. Clinically, malaria in immigrants is characterized by a mild clinical presentation with even asymptomatic o delayed malaria cases and low parasitemic level. These characteristics may be explained by a semi-immunity acquired after long periods of time exposed to stable transmission of malaria. Malaria cases among immigrants, even those asymptomatic patients with sub-microscopic parasitemia, could increase the risk of transmission and reintroduction of malaria in certain areas with the adequate vectors and climate conditions. Moreover imported malaria cases by immigrants can also play an important role in the non-vectorial transmission out of endemic area, by blood transfusions, organ transplantation or congenital or occupational exposures. Probably, out of endemic areas, screening of malaria among recent arrived immigrants coming from malaria endemic countries should be performed. These aim to reduce the risk of clinical malaria in the individual as well as to prevent autochthonous transmission of malaria in areas where it had been eradicated.

  9. [The malaria situation in the WHO European region].

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    Sabatinelli, G

    2000-01-01

    The number of indigenous malaria cases in European region peaked in 1997, when 77,985 cases were officially reported. These were caused almost exclusively by P. vivax, P. falciparum being restricted to a rather limited number of cases in Tajikistan only. Another important problem in the European Region is the importation of malaria associated with a high fatality rate from tropical endemic countries. There were 841 cases of malaria in Armenia, 567 of which were locally transmitted, 30 out of 81 districts recorded malaria cases. 89% of the indigenous cases were registered in Masis district, in the Ararat valley. In 1998, total number of cases increased to 1156. Of the 542 indigenous cases registered, 376 were in Masis district. 9911 cases were officially reported in 1997 in Azerbaijan and 5175 cases in 1998. Approximately half of malaria cases were reported from seven districts: Nakhichivan (10.4%), Imishli (14.6%), Fizuli (8.1%), Sabirabad (6.8%), Saatly (6%), Bejlagan (5.6%) and Bilasuvar (4.8%). Local transmission is also reported from the periurban areas of Baku, where many displaced people are living in temporary shelters. In 1997, a total of 30,054 malaria cases were officially registered in Tajikistan, of which 85.3% occurred in the Khatlon region, 10.5% in Dushanbe region, 3.5% in Gorno-Badakhshan region and 0.7% in Leninabad region. Following implementation of malaria control activities with WHO assistance, the number of malaria cases officially registered in 1998 dropped to 19,361 (187 were cases of falciparum malaria). A dramatic change occurred in malaria situation in Turkmenistan in 1998, when 115 indigenous cases were registered. The majority of malaria cases (104) were registered in the Kushka district, in south-east of Turkmenistan, among military service personnel. In recent years, the Government of Turkey has renewed its efforts to fight malaria, incorporating them into GAP with support from UNDP and WHO. In 1998, 36,451 cases were reported, 87

  10. Identification and Categorization of Climate Change Risks

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yuehong; WU Shaohong; DAI Erfu; LIU Dengwei; YIN Yunhe

    2008-01-01

    The scientific evidence that climate is changing due to greenhouse gas emission is now incontestable,which may put many social,biological,and geophysical systems in the world at risk.In this paper,we first identified main risks induced from or aggravated by climate change.Then we categorized them applying a new risk categorization system brought forward by Renn in a framework of International Risk Governance Council.We proposed that "uncertainty" could be treated as the classification criteria.Based on this,we established a quantitative method with fuzzy set theory,in which "confidence" and "likelihood",the main quantitative terms for expressing uncertainties in IPCC,were used as the feature parameters to construct the fuzzy membership functions of four risk types.According to the maximum principle,most climate change risks identified were classified into the appropriate risk types.In the mean time,given that not all the quantitative terms are available,a qualitative approach was also adopted as a complementary classification method.Finally,we get the preliminary results of climate change risk categorization,which might lay the foundation for the future integrated risk management of climate change.

  11. Effects of environmental change on malaria in the Amazon region of Brazil

    NARCIS (Netherlands)

    Takken, W.; Tarso Vilarinhos, de P.; Schneider, P.; Santos, dos F.

    2003-01-01

    Malaria is endemic in Brazil, affecting mostly the Amazon states. Whereas 50 years ago good progress was made towards its control, since the opening up of the Amazon region for forestry, agriculture and livestock activities, the disease has rapidly increased in incidence, peaking to >500,000 case

  12. Risk communication on climate change

    Energy Technology Data Exchange (ETDEWEB)

    Wardekker, J.A.

    2004-10-01

    For the title study use has been made of available scientific literature, results of new surveys and interviews. In the first part of the study attention is paid to the exchange of information between parties involved in climate change and differences in supply and demand of information. In the second part citizens' views on climate change, problems with communication on climate change, and the resulting consequences and options for communication are dealt with. In this second part also barriers to action that are related or influenced by communication are taken into consideration.

  13. High prevalence of malaria in Zambezia, Mozambique: the protective effect of IRS versus increased risks due to pig-keeping and house construction.

    Directory of Open Access Journals (Sweden)

    Emmanuel A Temu

    Full Text Available BACKGROUND: African countries are scaling up malaria interventions, especially insecticide treated nets (ITN and indoor residual spraying (IRS, for which ambitious coverage targets have been set. In spite of these efforts infection prevalence remains high in many parts of the continent. This study investigated risk factors for malaria infection in children using three malaria indicator surveys from Zambezia province, Mozambique. The impact of IRS and ITNs, the effects of keeping farm animals and of the construction material of roofs of houses and other potential risk factors associated with malaria infection in children were assessed. METHODS: Cross-sectional community-based surveys were conducted in October of 2006, 2007 and 2008. A total of 8338 children (ages 1-15 years from 2748 households were included in the study. All children were screened for malaria by rapid diagnostic tests. Caregiver interviews were used to assess household demographic and wealth characteristics and ITN and IRS coverage. Associations between malaria infection, vector control interventions and potential risk factors were assessed. RESULTS: Overall, the prevalence of malaria infection was 47.8% (95%CI: 38.7%-57.1% in children 1-15 years of age, less than a quarter of children (23.1%, 95%CI: 19.1%-27.6% were sleeping under ITN and almost two thirds were living in IRS treated houses (coverage 65.4%, 95%CI: 51.5%-77.0%. Protective factors that were independently associated with malaria infection were: sleeping in an IRS house without sleeping under ITN (Odds Ratio (OR= 0.6; 95%CI: 0.4-0.9; additional protection due to sleeping under ITN in an IRS treated house (OR = 0.5; 95%CI: 0.3-0.7 versus sleeping in an unsprayed house without a ITN; and parental education (primary/secondary: OR = 0.6; 95%CI: 0.5-0.7 versus parents with no education. Increased risk of infection was associated with: current fever (OR = 1.2; 95%CI: 1.0-1.5 versus no fever; pig keeping (OR

  14. MALARIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Richard-Fabian Schumacher

    2012-01-01

    Full Text Available

    This review is focused on childhood specific aspects of malaria, especially in resource-poor settings. We summarise the actual knowledge in the field of epidemiology, clinical presentation, diagnosis, management and prevention.

    These aspects are important as malaria is responsible for almost a quarter of all child death in sub-Saharan Africa. Malaria control is thus one key intervention to reduce childhood mortality, especially as malaria is also an important risk factor for other severe infections, namely bacteraemia.

    In children symptoms are more varied and often mimic other common childhood illness, particularly gastroenteritis, meningitis/encephalitis, or pneumonia. Fever is the key symptom, but the characteristic regular tertian and quartan patterns are rarely observed. There are no pathognomonic features for severe malaria in this age group. The well known clinical (fever, impaired consciousness, seizures, vomiting, respiratory distress and laboratory (severe anaemia, thrombocytopenia, hypoglycaemia, metabolic acidosis, and hyperlactataemia features of severe falciparum malaria in children, are equally typical for severe sepsis.

    Appropriate therapy (considering species, resistance patterns and individual patient factors – possibly a drug combination of an artemisinin derivative with a long-acting antimalarial drug - reduces treatment duration to only three days and should be urgently started.

    While waiting for the results of ongoing vaccine trials, all effort should be made to better implement other malaria-control measures like the use of treated bed-nets and new chemoprophylaxis regimens.

  15. MALARIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Richard-Fabian Schumacher

    2012-11-01

    Full Text Available This review is focused on childhood specific aspects of malaria, especially in resource-poor settings. We summarise the actual knowledge in the field of epidemiology, clinical presentation, diagnosis, management and prevention. These aspects are important as malaria is responsible for almost a quarter of all child death in sub-Saharan Africa. Malaria control is thus one key intervention to reduce childhood mortality, especially as malaria is also an important risk factor for other severe infections, namely bacteraemia. In children symptoms are more varied and often mimic other common childhood illness, particularly gastroenteritis, meningitis/encephalitis, or pneumonia. Fever is the key symptom, but the characteristic regular tertian and quartan patterns are rarely observed. There are no pathognomonic features for severe malaria in this age group. The well known clinical (fever, impaired consciousness, seizures, vomiting, respiratory distress and laboratory (severe anaemia, thrombocytopenia, hypoglycaemia, metabolic acidosis, and hyperlactataemia features of severe falciparum malaria in children, are equally typical for severe sepsis. Appropriate therapy (considering species, resistance patterns and individual patient factors – possibly a drug combination of an artemisinin derivative with a long-acting antimalarial drug - reduces treatment duration to only three days and should be urgently started. While waiting for the results of ongoing vaccine trials, all effort should be made to better implement other malaria-control measures like the use of treated bed-nets and new chemoprophylaxis regimens.

  16. High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali

    Science.gov (United States)

    Adomako-Ankomah, Yaw; Chenoweth, Matthew S.; Durfee, Katelyn; Doumbia, Saibou; Konate, Drissa; Doumbouya, Mory; Keita, Abdoul S.; Nikolaeva, Daria; Tullo, Gregory S.; Anderson, Jennifer M.; Fairhurst, Rick M.; Daniels, Rachel; Volkman, Sarah K.; Diakite, Mahamadou; Long, Carole A.

    2017-01-01

    The effects of persistent Plasmodium falciparum (Pf) infection and multiclonality on subsequent risk of clinical malaria have been reported, but the relationship between these 2 parameters and their relative impacts on the clinical outcome of infection are not understood. A longitudinal cohort study was conducted in a seasonal and high-transmission area of Mali, in which 500 subjects aged 1–65 years were followed for 1 year. Blood samples were collected every 2 weeks, and incident malaria cases were diagnosed and treated. Pf infection in each individual at each time point was assessed by species-specific nested-PCR, and Pf longitudinal prevalence per person (PfLP, proportion of Pf-positive samples over 1 year) was calculated. Multiclonality of Pf infection was measured using a 24-SNP DNA barcoding assay at 4 time-points (two in wet season, and two in dry season) over one year. PfLP was positively correlated with multiclonality at each time point (all r≥0.36; all P≤0.011). When host factors (e.g., age, gender), PfLP, and multiclonality (at the beginning of the transmission season) were analyzed together, only increasing age and high PfLP were associated with reduced clinical malaria occurrence or reduced number of malaria episodes (for both outcomes, P<0.001 for age, and P = 0.005 for PfLP). When age, PfLP and baseline Pf positivity were analyzed together, the effect of high PfLP remained significant even after adjusting for the other two factors (P = 0.001 for malaria occurrence and P<0.001 for number of episodes). In addition to host age and baseline Pf positivity, both of which have been reported as important modifiers of clinical malaria risk, our results demonstrate that persistent parasite carriage, but not baseline multiclonality, is associated with reduced risk of clinical disease in this population. Our study emphasizes the importance of considering repeated parasite exposure in future studies that evaluate clinical malaria risk. PMID:28158202

  17. Iron, anemia and hepcidin in malaria

    Directory of Open Access Journals (Sweden)

    Natasha eSpottiswoode

    2014-05-01

    Full Text Available Malaria and iron have a complex but important relationship. Plasmodium proliferation requires iron, both during the clinically silent liver stage of growth and in the disease-associated phase of erythrocyte infection. Precisely how the protozoan acquires its iron from its mammalian host remains unclear, but iron chelators can inhibit pathogen growth in vitro and in animal models. In humans, iron deficiency appears to protect against severe malaria, while iron supplementation increases risks of infection and disease. Malaria itself causes profound disturbances in physiological iron distribution and utilization, through mechanisms that include hemolysis, release of heme, dyserythropoiesis, anemia, deposition of iron in macrophages, and inhibition of dietary iron absorption. These effects have significant consequences. Malarial anemia is a major global health problem, especially in children, that remains incompletely understood and is not straightforward to treat. Furthermore, the changes in iron metabolism during a malaria infection may modulate susceptibility to coinfections. The release of heme and accumulation of iron in granulocytes may explain increased vulnerability to non-typhoidal Salmonella during malaria. The redistribution of iron away from hepatocytes and into macrophages may confer host resistance to superinfection, whereby blood-stage parasitemia prevents the development of a second liver-stage Plasmodium infection in the same organism. Key to understanding the pathophysiology of iron metabolism in malaria is the activity of the iron regulatory hormone hepcidin. Hepcidin is upregulated during blood-stage parasitemia and likely mediates much of the iron redistribution that accompanies disease. Understanding the regulation and role of hepcidin may offer new opportunities to combat malaria and formulate better approaches to treat anemia in the developing world.

  18. Oceanic influence on seasonal malaria outbreaks over Senegal and Sahel

    Science.gov (United States)

    Diouf, Ibrahima; Rodríguez de Fonseca, Belen; Deme, Abdoulaye; Cisse Cisse, Moustapha; Ndione Ndione, Jaques-Andre; Gaye, Amadou T.; Suarez, Roberto

    2015-04-01

    Beyond assessment and analysis of observed and simulated malaria parameters, this study is furthermore undertaken in the framework of predictability of malaria outbreaks in Senegal and remote regions in Sahel, which are found to take place two months after the rainy season. The predictors are the sea surface temperature anomalous patterns at different ocean basins mainly over the Pacific and Atlantic as they are related to changes in air temperature, humidity, rainfall and wind. A relationship between El Niño and anomalous malaria parameters is found. The malaria parameters are calculated with the Liverpool Malaria Model (LMM) using meteorological datasets from different reanalysis products. A hindcast of these parameters is performed using the Sea Surface temperature based Statistical Seasonal ForeCAST (S4CAST) model developed at UCM in order to predict malaria parameters some months in advance. The results of this work will be useful for decision makers to better access to climate forecasts and application on malaria transmission risk.

  19. Mission Risk Reduction Regulatory Change Management

    Science.gov (United States)

    Scroggins, Sharon

    2007-01-01

    NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated

  20. Incorporating Agency Into Climate Change Risk Assessments

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R.N. [CSIRO Atmospheric Research, Aspendale, Victoria, 3195 (Australia)

    2004-11-01

    Human agency has been viewed as a problem for climate change assessments because of its contribution to uncertainty. In this editorial, I outline the advantages of agency in managing climate change risks, describing how those advantages can be placed within a probabilistic framework.

  1. Coastal Risk Management in a Changing Climate

    DEFF Research Database (Denmark)

    Existing coastal management and defense approaches are not well suited to meet the challenges of climate change and related uncertanities. Professionals in this field need a more dynamic, systematic and multidisciplinary approach. Written by an international group of experts, "Coastal Risk...... Management in a Changing Climate" provides innovative, multidisciplinary best practices for mitigating the effects of climate change on coastal structures. Based on the Theseus program, the book includes eight study sites across Europe, with specific attention to the most vulnerable coastal environments...

  2. Malaria in Pregnancy

    OpenAIRE

    Apuzzio, Joseph J.; Abdulla Al-Khan; Jesus R. Alvarez

    2005-01-01

    Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be aler...

  3. Malaria in pregnancy.

    OpenAIRE

    Jesus R. Alvarez; Al-Khan, Abdulla; Apuzzio, Joseph J.

    2005-01-01

    Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be aler...

  4. Malaria in pregnancy.

    Science.gov (United States)

    Alvarez, Jesus R; Al-Khan, Abdulla; Apuzzio, Joseph J

    2005-12-01

    Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be alert of the disease and its effects on pregnancy.

  5. Malaria in Pregnancy

    Directory of Open Access Journals (Sweden)

    Jesus R. Alvarez

    2005-01-01

    Full Text Available Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be alert of the disease and its effects on pregnancy.

  6. Carriage of chloroquine-resistant parasites and delay of effective treatment increase the risk of severe malaria in Gambian children.

    NARCIS (Netherlands)

    Meerman, L.; Ord, R.; Bousema, T.; Niekerk, M. van; Osman, E.; Hallett, R.; Pinder, M.; Walraven, G.E.; Sutherland, C.J.

    2005-01-01

    Two hundred thirty-four Gambian children with severe falciparum malaria who were admitted to the pediatric ward of a rural district hospital each were matched for age with a same-sex control subject presenting as an outpatient with uncomplicated falciparum malaria. Severe malarial anemia (SMA) was t

  7. Assessment of volume depletion in children with malaria.

    Directory of Open Access Journals (Sweden)

    Timothy Planche

    2004-10-01

    Full Text Available BACKGROUND: The degree of volume depletion in severe malaria is currently unknown, although knowledge of fluid compartment volumes can guide therapy. To assist management of severely ill children, and to test the hypothesis that volume changes in fluid compartments reflect disease severity, we measured body compartment volumes in Gabonese children with malaria. METHODS AND FINDINGS: Total body water volume (TBW and extracellular water volume (ECW were estimated in children with severe or moderate malaria and in convalescence by tracer dilution with heavy water and bromide, respectively. Intracellular water volume (ICW was derived from these parameters. Bioelectrical impedance analysis estimates of TBW and ECW were calibrated against dilution methods, and bioelectrical impedance analysis measurements were taken daily until discharge. Sixteen children had severe and 19 moderate malaria. Severe childhood malaria was associated with depletion of TBW (mean [SD] of 37 [33] ml/kg, or 6.7% [6.0%] relative to measurement at discharge. This is defined as mild dehydration in other conditions. ECW measurements were normal on admission in children with severe malaria and did not rise in the first few days of admission. Volumes in different compartments (TBW, ECW, and ICW were not related to hyperlactataemia or other clinical and laboratory markers of disease severity. Moderate malaria was not associated with a depletion of TBW. CONCLUSIONS: Significant hypovolaemia does not exacerbate complications of severe or moderate malaria. As rapid rehydration of children with malaria may have risks, we suggest that fluid replacement regimens should aim to correct fluid losses over 12-24 h.

  8. Malaria (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Malaria KidsHealth > For Parents > Malaria A A A What's ... Prevention Diagnosis and Treatment en español Malaria About Malaria Malaria is a common infection in hot, tropical ...

  9. The Pattern of Variation between Diarrhea and Malaria Coexistence with Corresponding Risk Factors in, Chikhwawa, Malawi: A Bivariate Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Salule Masangwi

    2015-07-01

    Full Text Available Developing countries face a huge burden of infectious diseases, a number of which co-exist. This paper estimates the pattern and variation of malaria and diarrhea coexistence in Chikhwawa, a district in Southern Malawi using bivariate multilevel modelling with Bayesian estimation. A probit link was employed to examine hierarchically built data from a survey of individuals (n = 6,727 nested within households (n = 1,380 nested within communities (n = 33. Results show significant malaria [ ] and diarrhea [ ] variations with a strong correlation between them [ ] at household level. There are significant malaria [ ] and diarrhea [   ] variations at community level but with a small correlation [ ] between them. There is also significant correlation between malaria and diarrhea at individual level [ 0.241]. These results suggest a close association between reported malaria-like illness and diarrheal illness especially at household and individual levels in Southern Malawi.

  10. Use of integrated malaria management reduces malaria in Kenya.

    Directory of Open Access Journals (Sweden)

    Bernard A Okech

    Full Text Available BACKGROUND: During an entomological survey in preparation for malaria control interventions in Mwea division, the number of malaria cases at the Kimbimbi sub-district hospital was in a steady decline. The underlying factors for this reduction were unknown and needed to be identified before any malaria intervention tools were deployed in the area. We therefore set out to investigate the potential factors that could have contributed to the decline of malaria cases in the hospital by analyzing the malaria control knowledge, attitudes and practices (KAP that the residents in Mwea applied in an integrated fashion, also known as integrated malaria management (IMM. METHODS: Integrated Malaria Management was assessed among community members of Mwea division, central Kenya using KAP survey. The KAP study evaluated community members' malaria disease management practices at the home and hospitals, personal protection measures used at the household level and malaria transmission prevention methods relating to vector control. Concurrently, we also passively examined the prevalence of malaria parasite infection via outpatient admission records at the major referral hospital in the area. In addition we studied the mosquito vector population dynamics, the malaria sporozoite infection status and entomological inoculation rates (EIR over an 8 month period in 6 villages to determine the risk of malaria transmission in the entire division. RESULTS: A total of 389 households in Mwea division were interviewed in the KAP study while 90 houses were surveyed in the entomological study. Ninety eight percent of the households knew about malaria disease while approximately 70% of households knew its symptoms and methods to manage it. Ninety seven percent of the interviewed households went to a health center for malaria diagnosis and treatment. Similarly a higher proportion (81% used anti-malarial medicines bought from local pharmacies. Almost 90% of households reported

  11. Malaria in pregnancy.

    Science.gov (United States)

    Seal, Subrata Lall; Mukhopadhay, Sima; Ganguly, Rajendra Prasad

    2010-08-01

    Malaria during pregnancy is a recognised risk factor for maternal and foetal complications and it is endemic in certain areas of our country. Pregnancy also enhances the severity of malaria particularly with P falciparum infestation. The outcome of effects of malaria in pregnancy on the mother and foetus is studied here. This is a prospective observational study conducted in the department of obstetrics and gynaecology of RG Kar Medical College during the period from 1st January 2001 to 31st December 2006. Forty pregnant women with malaria in pregnancy were studied. Another 40 non- pregnant women during the same period were served as control. The maternal complications were compared with the controls and the outcome of pregnancy was studied. There was statistically significant (p renal failure, hepatic failure, hypoglycaemia, hypotension and death in the pregnant women in comparison to non-pregnant women. P falciparum infection was also more during pregnancy. There was also increased incidence of abqrtion, preterm labour, intra-uterine growth restriction and intra-uterine foetal death. Treatment with antimalarial drugs particularly in cerebral malaria does not give good results as there were 12 maternal deaths in this series. Every attempt should be made to prevent malaria during pregnancy by various measures as it is associated with high maternal morbidity and mortality and adversely affects the neonatal outcome.

  12. A mathematical model for malaria transmission relating global warming and local socioeconomic conditions

    Directory of Open Access Journals (Sweden)

    Hyun M Yang

    2001-06-01

    Full Text Available OBJECTIVE: Sensitivity analysis was applied to a mathematical model describing malaria transmission relating global warming and local socioeconomic conditions. METHODS: A previous compartment model was proposed to describe the overall transmission of malaria. This model was built up on several parameters and the prevalence of malaria in a community was characterized by the values assigned to them. To assess the control efforts, the model parameters can vary on broad intervals. RESULTS: By performing the sensitivity analysis on equilibrium points, which represent the level of malaria infection in a community, the different possible scenarios are obtained when the parameters are changed. CONCLUSIONS: Depending on malaria risk, the efforts to control its transmission can be guided by a subset of parameters used in the mathematical model.

  13. Assessing the future threat from vivax malaria in the United Kingdom using two markedly different modelling approaches

    Directory of Open Access Journals (Sweden)

    Richards Shane A

    2010-03-01

    Full Text Available Abstract Background The world is facing an increased threat from new and emerging diseases, and there is concern that climate change will expand areas suitable for transmission of vector borne diseases. The likelihood of vivax malaria returning to the UK was explored using two markedly different modelling approaches. First, a simple temperature-dependent, process-based model of malaria growth transmitted by Anopheles atroparvus, the historical vector of malaria in the UK. Second, a statistical model using logistic-regression was used to predict historical malaria incidence between 1917 and 1918 in the UK, based on environmental and demographic data. Using findings from these models and saltmarsh distributions, future risk maps for malaria in the UK were produced based on UKCIP02 climate change scenarios. Results The process-based model of climate suitability showed good correspondence with historical records of malaria cases. An analysis of the statistical models showed that mean temperature of the warmest month of the year was the major factor explaining the distribution of malaria, further supporting the use of the temperature-driven processed-based model. The risk maps indicate that large areas of central and southern England could support malaria transmission today and could increase in extent in the future. Confidence in these predictions is increased by the concordance between the processed-based and statistical models. Conclusion Although the future climate in the UK is favourable for the transmission of vivax malaria, the future risk of locally transmitted malaria is considered low because of low vector biting rates and the low probability of vectors feeding on a malaria-infected person.

  14. Coastal Risk Management in a Changing Climate

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Zanuttigh, Barbara; Andersen, Thomas Lykke

    2014-01-01

    Existing coastal management and defense approaches are not well suited to meet the challenges of climate change and related uncertanities. Professionals in this field need a more dynamic, systematic and multidisciplinary approach. Written by an international group of experts, Coastal Risk Managem...

  15. Climate change and drought risks for agriculture

    NARCIS (Netherlands)

    Verhagen, J.; Put, M.; Zaal, F.; Keulen, van H.

    2004-01-01

    Changes in rainfall patterns and risk of crop failure are discussed in this chapter. Agriculture is by far the most important economic activity in the region. The success of this economic activity relies heavily on water availability during the growing season. For rainfed production systems timing a

  16. [Malaria websites].

    Science.gov (United States)

    Genton, B

    2007-05-16

    One click on google.com, key-word "Malaria", 24,900,000 entries. How to choose among this jungle of websites? Ten sites are proposed to meet the needs of the general practitioner They are categorized by focus of interest, namely 1) detailed information on pre- and post-travel advice and management of travelers with illness upon return, 2) the essential on the parasite, the diagnosis and the treatment, 3) the malaria problem worldwide and 4) malaria maps.

  17. A 20-year longitudinal study of Plasmodium ovale and Plasmodium malariae prevalence and morbidity in a West African population.

    Directory of Open Access Journals (Sweden)

    Clémentine Roucher

    Full Text Available BACKGROUND: Plasmodium ovale and Plasmodium malariae have long been reported to be widely distributed in tropical Africa and in other major malaria-endemic areas of the world. However, little is known about the burden caused by these two malaria species. METHODS AND FINDINGS: We did a longitudinal study of the inhabitants of Dielmo village, Senegal, between June, 1990, and December, 2010. We monitored the inhabitants for fever during this period and performed quarterly measurements of parasitemia. We analyzed parasitological and clinical data in a random-effect logistic regression model to investigate the relationship between the level of parasitemia and the risk of fever and to establish diagnostic criteria for P. ovale and P. malariae clinical attacks. The prevalence of P. ovale and P. malariae infections in asymptomatic individuals were high during the first years of the project but decreased after 2004 and almost disappeared in 2010 in relation to changes in malaria control policies. The average incidence densities of P. ovale and P. malariae clinical attacks were 0.053 and 0.093 attacks per person per year in children <15 years and 0.024 and 0.009 attacks per person per year in adults ≥ 15 years, respectively. These two malaria species represented together 5.9% of the malaria burden. CONCLUSIONS: P. ovale and P. malariae were a common cause of morbidity in Dielmo villagers until the recent dramatic decrease of malaria that followed the introduction of new malaria control policies. P. ovale and P. malariae may constitute an important cause of morbidity in many areas of tropical Africa.

  18. Reduced risk of malaria parasitemia following household screening and treatment: a cross-sectional and longitudinal cohort study.

    Directory of Open Access Journals (Sweden)

    Catherine G Sutcliffe

    Full Text Available BACKGROUND: In regions of declining malaria transmission, new strategies for control are needed to reduce transmission and achieve elimination. Artemisinin-combination therapy (ACT is active against immature gametocytes and can reduce the risk of transmission. We sought to determine whether household screening and treatment of infected individuals provides protection against infection for household members. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted in two areas in Southern Province, Zambia in 2007 and 2008/2009. To determine the impact of proactive case detection, households were randomly selected either to join a longitudinal cohort, in which participants were repeatedly screened throughout the year and those infected treated with artemether-lumefantrine, or a cross-sectional survey, in which participants were visited only once. Cross-sectional surveys were conducted throughout the year. The prevalence of RDT positivity was compared between the longitudinal and cross-sectional households at baseline and during follow-up using multilevel logistic regression. In the 2007 study area, 174 and 156 participants enrolled in the cross-sectional and longitudinal groups, respectively. In the 2008/2009 study area, 917 and 234 participants enrolled in the cross-sectional and longitudinal groups, respectively. In both study areas, participants and households in the longitudinal and cross-sectional groups were similar on demographic characteristics and prevalence of RDT positivity at baseline (2007: OR = 0.97; 95% CI:0.46, 2.03 | 2008/2009: OR = 1.28; 95% CI:0.44, 3.79. After baseline, the prevalence of RDT positivity was significantly lower in longitudinal compared to cross-sectional households in both study areas (2007: OR = 0.44; 95% CI:0.20, 0.96 | 2008/2009: OR = 0.16; 95% CI:0.05, 0.55. CONCLUSIONS/SIGNIFICANCE: Proactive case detection, consisting of screening household members with an RDT and treating those positive with

  19. Handling Interdependencies in Climate Change Risk Assessment

    Directory of Open Access Journals (Sweden)

    Richard J. Dawson

    2015-12-01

    Full Text Available Typically, a climate change risk assessment focuses on individual sectors or hazards. However, interdependencies between climate risks manifest themselves via functional, physical, geographical, economic, policy and social mechanisms. These can occur over a range of spatial or temporal scales and with different strengths of coupling. Three case studies are used to demonstrate how interdependencies can significantly alter the nature and magnitude of risk, and, consequently, investment priorities for adaptation. The three examples explore interdependencies that arise from (1 climate loading dependence; (2 mediation of two climate impacts by physical processes operating over large spatial extents; and, (3 multiple risks that are influenced by shared climatic and socio-economic drivers. Drawing upon learning from these case studies, and other work, a framework for the analysis and consideration of interdependencies in climate change risk assessment has been developed. This is an iterative learning loop that involves defining the system, scoping interaction mechanisms, applying appropriate modelling tools, identifying vulnerabilities and opportunities, and assessing the performance of adaptation interventions.

  20. Response to diazepam in children with malaria-induced seizures.

    Science.gov (United States)

    Ikumi, M L; Muchohi, S N; Ohuma, E O; Kokwaro, G O; Newton, C R J C

    2008-12-01

    Malaria infection reduces the binding capacity of benzodiazepine receptors in mice. We studied the efficacy of diazepam terminating seizures in children with falciparum malaria. Diazepam stopped seizures in fewer patients with malaria parasitaemia (chi(2)=3.93, P=0.047) and those with clinical diagnosis of malaria (chi(2)=9.84, P=0.002) compared to those without. However malaria was not identified as an independent risk factor for diazepam's failure to stop seizures in children.

  1. [The ABCD of malaria prevention in pediatric travelers].

    Science.gov (United States)

    Berberian, Griselda; Rosanova, M Teresa; Torroija, Cecilia; Praino, M Laura

    2014-10-01

    The development and spread of drug resistant malaria parasites, population and travelers movements to malaria zones have led to the resurgence of malaria as a global health problem. Estimates suggest that 660,000 deaths occur annually, mainly in infants, children and pregnant woman. Disease knowledge and protection against mosquito bites are the first line of defense against malaria. Malaria chemoprophylaxis adds to these measures, it must be evaluated based on the individual risk.

  2. Metabolite Signatures of Metabolic Risk Factors and their Longitudinal Changes

    NARCIS (Netherlands)

    Yin, X.; Subramanian, S.; Willinger, C.M.; Chen, G.; Juhasz, P.; Courchesne, P.; Chen, B.H.; Li, X.; Hwang, S.J.; Fox, C.S.; O'Donnell, C.J.; Muntendam, P.; Fuster, V.; Bobeldijk-Pastorova, I.; Sookoian, S.C.; Pirola, C.J.; Gordon, N.; Adourian, A.; Larson, M.G.; Levy, D.

    2016-01-01

    Context: Metabolic dysregulation underlies key metabolic risk factors—obesity, dyslipidemia, and dysglycemia. Objective: To uncover mechanistic links between metabolomic dysregulation and metabolic risk by testing metabolite associations with risk factors cross-sectionally and with risk factor chang

  3. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  4. Malaria Matters

    Centers for Disease Control (CDC) Podcasts

    2008-04-18

    This podcast gives an overview of malaria, including prevention and treatment, and what CDC is doing to help control and prevent malaria globally.  Created: 4/18/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/18/2008.

  5. UK malaria treatment guidelines.

    Science.gov (United States)

    Lalloo, David G; Shingadia, Delane; Pasvol, Geoffrey; Chiodini, Peter L; Whitty, Christopher J; Beeching, Nicholas J; Hill, David R; Warrell, David A; Bannister, Barbara A

    2007-02-01

    Malaria is the tropical disease most commonly imported into the UK, with 1500-2000 cases reported each year, and 10-20 deaths. Approximately three-quarters of reported malaria cases in the UK are caused by Plasmodium falciparum, which is capable of invading a high proportion of red blood cells and rapidly leading to severe or life-threatening multi-organ disease. Most non-falciparum malaria cases are caused by Plasmodium vivax; a few cases are caused by the other two species of Plasmodium: Plasmodium ovale or Plasmodium malariae. Mixed infections with more than 1 species of parasite can occur; they commonly involve P. falciparum with the attendant risks of severe malaria. Management of malaria depends on awareness of the diagnosis and on performing the correct diagnostic tests: the diagnosis cannot be excluded until 3 blood specimens have been examined by an experienced microscopist. There are no typical clinical features of malaria, even fever is not invariably present. The optimum diagnostic procedure is examination of thick and thin blood films by an expert to detect and speciate the malarial parasites; P. falciparum malaria can be diagnosed almost as accurately using rapid diagnostic tests (RDTs) which detect plasmodial antigens or enzymes, although RDTs for other Plasmodium species are not as reliable. The treatment of choice for non-falciparum malaria is a 3-day course of oral chloroquine, to which only a limited proportion of P. vivax strains have gained resistance. Dormant parasites (hypnozoites) persist in the liver after treatment of P. vivax or P. ovale infection: the only currently effective drug for eradication of hypnozoites is primaquine. This must be avoided or given with caution under expert supervision in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD), in whom it may cause severe haemolysis. Uncomplicated P. falciparum malaria can be treated orally with quinine, atovaquone plus proguanil (Malarone) or co-artemether (Riamet

  6. Does the Use of Dihydroartemisinin-Piperaquine in Treating Patients with Uncomplicated falciparum Malaria Reduce the Risk for Recurrent New falciparum Infection More Than Artemether-Lumefantrine?

    Directory of Open Access Journals (Sweden)

    Wisdom Akpaloo

    2014-01-01

    Full Text Available Malaria contributes significantly to the global disease burden. The World Health Organization recommended the use of artemisinin-based combination therapies (ACTs for treatment of uncomplicated falciparum malaria a decade ago in response to problems of drug resistance. This review compared two of the ACTs—Dihydroartemisinin-Piperaquine (DP and Artemether-Lumefantrine (AL to provide evidence which one has the ability to offer superior posttreatment prophylaxis at 28 and 42 days posttreatment. Four databases (MEDLINE, EMBASE, Cochrane Database and Global Health were searched on June 2, 2013 and a total of seven randomized controlled trials conducted in sub-Sahara Africa were included. Results involving 2, 340 participants indicates that reduction in risk for recurrent new falciparum infections (RNIs was 79% at day 28 in favour of DP [RR, 0.21; 95% CI: 0.14 to 0.32, P<0.001], and at day 42 was 44% favouring DP [RR, 0.56; 95% CI: 0.34 to 0.90; P=0.02]. No significant difference was seen in treatment failure rates between the two drugs at days 28 and 42. It is concluded that use of DP offers superior posttreatment prophylaxis compared to AL in the study areas. Hence DP can help reduce malaria cases in such areas more than AL.

  7. Psychosocial risk factors, weight changes and risk of obesity

    DEFF Research Database (Denmark)

    Iversen, Louise Bagger; Strandberg-Larsen, Katrine; Prescott, Eva

    2012-01-01

    the participants were asked comprehensive questions on major life events, work stress, vital exhaustion, social network, economic hardship, and intake of sleep medication. Weight and height were measured by health professionals. Weight changes and incident obesity was used as outcome measures. The participants......The aim of the study was to establish the effects of a range of psychosocial factors on weight changes and risk of obesity. The study population consisted of the 4,753 participants in the third (1991-1994) and fourth wave (2001-2003) of the Copenhagen City Heart Study, Denmark. At baseline...... on average gained 2 kg of weight and 8% became obese during follow-up. The experience of major life events in childhood, work life and adult life was associated with weight gain and obesity in women, but not in men. Vital exhaustion was associated with weight gain in a dose-response manner in men (P = 0...

  8. Malaria Treatment (United States)

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  9. Immunity to malaria in an era of declining malaria transmission.

    Science.gov (United States)

    Fowkes, Freya J I; Boeuf, Philippe; Beeson, James G

    2016-02-01

    With increasing malaria control and goals of malaria elimination, many endemic areas are transitioning from high-to-low-to-no malaria transmission. Reductions in transmission will impact on the development of naturally acquired immunity to malaria, which develops after repeated exposure to Plasmodium spp. However, it is currently unclear how declining transmission and malaria exposure will affect the development and maintenance of naturally acquired immunity. Here we review the key processes which underpin this knowledge; the amount of Plasmodium spp. exposure required to generate effective immune responses, the longevity of antibody responses and the ability to mount an effective response upon re-exposure through memory responses. Lastly we identify research priorities which will increase our understanding of how changing transmission will impact on malarial immunity.

  10. How well are malaria maps used to design and finance malaria control in Africa?

    Directory of Open Access Journals (Sweden)

    Judy A Omumbo

    Full Text Available INTRODUCTION: Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. MATERIALS AND METHODS: An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. RESULTS: 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. CONCLUSION: The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes

  11. Climate Change - Global Risks, Challenges & Decisions

    DEFF Research Database (Denmark)

    Richardson, Katherine; Steffen, Will; Schellnhuber, Hans J.

    negotiations is the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC), published in 2007. The IPCC report has already been instrumental in increasing both public and political awareness of the societal risks associated with unchecked emission of greenhouse gases. Since...... and environment, and the many tools and approaches available to deal effectively with the challenge of climate change. The report has been produced by a writing team comprised of members of the Scientific Steering Committee for the IARU Congress and individuals invited to give the writing team academic...... of this volume. The writing team has, in addition to presentations at the Congress, drawn upon recent publications in the scientific literature to create this synthesis. This report has been critically reviewed by representatives of the Earth System Science Partnership (ESSP), by the parallel session chairs...

  12. Study of clinical presentation of malaria and the associated liver profile changes in various species of plasmodia

    Directory of Open Access Journals (Sweden)

    Siddanagouda M. Biradar

    2016-12-01

    Conclusions: Malaria is a potential cause of morbidity and mortality in the tropical countries. Jaundice is one of the common presentations of falciparum malaria. The raised serum bilirubin could be due to both hemolysis and hepatocellular dysfunction. Early diagnosis and treatment will help in reducing further complications like severe anaemia, hepatic encephalopathy, acute renal failure and disseminated intravascular coagulation. [Int J Res Med Sci 2016; 4(12.000: 5447-5451

  13. Towards A Malaria Vaccine?

    Directory of Open Access Journals (Sweden)

    B S GARG

    1990-12-01

    Full Text Available The last few years have seen a marked change in the understanding of malaria mmunology.We have very little knowledge on immunity of Malaria based on experiments in humanbeings due to ethical reasons. Whatsoever our knowledge exists at present is based onexperimentas in mice and monkey. However it is clear that it is sporzoite or merozoitewhich is directly exposed to our immune system in the life cycle of Malaria parasite. On thebasis of human experiments we can draw inference that immunity to malaria is species.specific (on cross immunity, stage specific and strain specific as well acquired in the response to surface antigen and relapsed antigen although the parasite also demonstrates escape machanism to immune system.So the host system kills or elimi nate the parasite by means of (a Antbody to extracell~ular form of parasite with the help of mechanism of Block invasion, Agglutination or opsonization and/or (b Cellular machanism-either by phago-cytosis of parasite or by antibody dependent cellular cytotoxicity ABCC (? or by effects of mediators like tumor necrosis fJ.ctor (TNF in cerebaral malaria or crisis forming factor as found in sudan or by possible role of lysis mechanism.However, inspite of all these theories the parasite has been able to invade the immunesystem by virtue of its intracellular development stage specificity, sequestration in capillaries and also by its unusual characteristics of antigenic diversity and antigenic variation.

  14. DEVELOPMENT OF A PROTOTYPE OF MALARIA CLINICAL DIAGNOSTIC DECISION SUPPORT SYSTEM

    OpenAIRE

    Harefa, Sudarta Yabesman; Lazuardi, Lutfan; Fuad, Anis

    2014-01-01

    Introduction : Malaria is a public health problem that still causes mortality, particularly in high risk population. Kabupaten Nias is one of the malaria endemic areas. Malaria diagnosis is mainly determined according to physical examination, despite the fact that laboratory examination is the gold standard of malaria diagnosis. To help health workers in diagnosing malaria accurately, it is necessary to develop a decision support system for malaria diagnosis.Objectives: To develop a prototype...

  15. A refined estimate of the malaria burden in Niger

    Directory of Open Access Journals (Sweden)

    Doudou Maimouna

    2012-03-01

    malaria cases by biological diagnosis methods, to increase the accuracy of the malaria indicators used in monitoring and evaluation processes and to improve patient care in the more remote areas of Niger. This country extends over a large range of latitudes, resulting in the existence of three major bioclimatic zones determining vector distribution and endemicity. Conclusion This survey showed that the number of cases of presumed malaria reported in health centres in Niger is largely overestimated. The results highlight inadequacies in the description of the malaria situation and disease risk in Niger, due to the over-diagnosis of malaria in patients with simple febrile illness. They point out the necessity of confirming all cases of suspected malaria by biological diagnosis methods and the need to take geographic constraints into account more effectively, to improve malaria control and to adapt the choice of diagnostic method to the epidemiological situation in the area concerned. Case confirmation will thus also require a change in behaviour, through the training of healthcare staff, the introduction of quality control, greater supervision of the integrated health centres, the implementation of good clinical practice and a general optimization of the use of available diagnostic methods.

  16. Changing trends in prevalence of different Plasmodium species with dominance of Plasmodium falciparum malaria infection in Aligarh (India)

    Institute of Scientific and Technical Information of China (English)

    Haris M Khan; Fatima Shujatullah; Mohammad Ashfaq; Adil Raza

    2011-01-01

    Objective: To determine the prevalence of malaria in Aligarh and analyze species dominance in different years over a decade. Methods: Diagnosis of malaria was done using microscopy as gold standard, rapid antigen detection assays and quantitative buffy coat (QBC) assays. Giemsa stained blood smear examination was done, thick and thin films were examined for presence of different Plasmodium spp. Rapid antigen detection assays employing detection of HRP-2 and parasite lactate dehydrogenase antigen (pLDH) by immunochromatography was done in patients whose blood smear found to be negative by conventional Giemsa slide examination. QBC was done in cases where there is strong clinical suspicion of malaria with blood smear negative, in patients with chronic malaria, splenomegaly, or in those patients who had inadequate treatment and for post-treatment follow up. Results: Plasmodium vivax and Plasmodium falciparum were only species detected in our hospital. Overall prevalence of malaria in Aligarh was found to be 8.8%. The maximum prevalence of 20.1% was observed in year 2008 and lowest 2.3% in 2002.Conclusions:High prevalence of malaria is observed in this part of country with dominance of both species particularly Plasmodium falciparum should be monitored and factors accounting for occurrence should be studied to employ effective control measures.

  17. RiskChanges Spatial Decision Support system for the analysis of changing multi-hazard risk

    Science.gov (United States)

    van Westen, Cees; Zhang, Kaixi; Bakker, Wim; Andrejchenko, Vera; Berlin, Julian; Olyazadeh, Roya; Cristal, Irina

    2015-04-01

    Within the framework of the EU FP7 Marie Curie Project CHANGES and the EU FP7 Copernicus project INCREO a spatial decision support system was developed with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. Central to the SDSS are the stakeholders. The envisaged users of the system are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analyzing spatial data at a municipal scale. The SDSS should be able to function in different countries with different legal frameworks and with organizations with different mandates. These could be subdivided into Civil protection organization with the mandate to design disaster response plans, Expert organizations with the mandate to design structural risk reduction measures (e.g. dams, dikes, check-dams etc), and planning organizations with the mandate to make land development plans. The SDSS can be used in different ways: analyzing the current level of risk, analyzing the best alternatives for risk reduction, the evaluation of the consequences of possible future scenarios to the risk levels, and the evaluation how different risk reduction alternatives will lead to risk reduction under different future scenarios. The SDSS is developed based on open source software and following open standards, for code as well as for data formats and service interfaces. Code development was based upon open source software as well. The architecture of the system is modular. The various parts of the system are loosely coupled, extensible, using standards for interoperability, flexible and web-based. The Spatial Decision Support System is composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to

  18. Review: Malaria chemoprophylaxis for travelers to Latin America.

    Science.gov (United States)

    Steinhardt, Laura C; Magill, Alan J; Arguin, Paul M

    2011-12-01

    Because of recent declining malaria transmission in Latin America, some authorities have recommended against chemoprophylaxis for most travelers to this region. However, the predominant parasite species in Latin America, Plasmodium vivax, can form hypnozoites sequestered in the liver, causing malaria relapses. Additionally, new evidence shows the potential severity of vivax infections, warranting continued consideration of prophylaxis for travel to Latin America. Individualized travel risk assessments are recommended and should consider travel locations, type, length, and season, as well as probability of itinerary changes. Travel recommendations might include no precautions, mosquito avoidance only, or mosquito avoidance and chemoprophylaxis. There are a range of good options for chemoprophylaxis in Latin America, including atovaquone-proguanil, doxycycline, mefloquine, and--in selected areas--chloroquine. Primaquine should be strongly considered for nonpregnant, G6PD-nondeficient patients traveling to vivax-endemic areas of Latin America, and it has the added benefit of being the only drug to protect against malaria relapses.

  19. Risk factors for Plasmodium falciparum and Plasmodium vivax gametocyte carriage in Papua New Guinean children with uncomplicated malaria.

    Science.gov (United States)

    Karl, Stephan; Laman, Moses; Moore, Brioni R; Benjamin, John M; Salib, Mary; Lorry, Lina; Maripal, Samuel; Siba, Peter; Robinson, Leanne J; Mueller, Ivo; Davis, Timothy M E

    2016-08-01

    There are limited data on gametocytaemia risk factors before/after treatment with artemisinin combination therapy in children from areas with transmission of multiple Plasmodium species. We utilised data from a randomised trial comparing artemether-lumefantrine (AL) and artemisinin-naphthoquine (AN) in 230 Papua New Guinean children aged 0.5-5 years with uncomplicated malaria in whom determinants of gametocytaemia by light microscopy were assessed at baseline using logistic regression and during follow-up using multilevel mixed effects modelling. Seventy-four (32%) and 18 (8%) children presented with P. falciparum and P. vivax gametocytaemia, respectively. Baseline P. falciparum gametocytaemia was associated with Hackett spleen grade 1 (odds ratio (95% CI) 4.01 (1.60-10.05) vs grade 0; P<0.001) and haemoglobin (0.95 (0.92-0.97) per 1g/L increase; P<0.001), and P. falciparum asexual parasitaemia in slide-positive cases (0.36 (0.19-0.68) for a 10-fold increase; P=0.002). Baseline P. vivax gametocytaemia was associated with Hackett grade 2 (12.66 (1.31-122.56); P=0.028), mixed P. falciparum/vivax infection (0.16 (0.03-1.00); P=0.050), P. vivax asexual parasitaemia (5.68 (0.98-33.04); P=0.053) and haemoglobin (0.94 (0.88-1.00); P=0.056). For post-treatment P. falciparum gametocytaemia, independent predictors were AN vs AL treatment (4.09 (1.43-11.65)), haemoglobin (0.95 (0.93-0.97)), presence/absence of P. falciparum asexual forms (3.40 (1.66-0.68)) and day post-treatment (0.086 (0.82-0.90)) (P<0.001). Post-treatment P. vivax gametocytaemia was predicted by presence of P. vivax asexual forms (596 (12-28,433); P<0.001). Consistent with slow P. falciparum gametocyte maturation, low haemoglobin, low asexual parasite density and higher spleen grading, markers of increased prior infection exposure/immunity, were strong associates of pre-treatment gametocyte positivity. The persistent inverse association between P. falciparum gametocytaemia and haemoglobin during follow

  20. Malaria successes and challenges in Asia.

    Science.gov (United States)

    Bhatia, Rajesh; Rastogi, Rakesh Mani; Ortega, Leonard

    2013-12-01

    Asia ranks second to Africa in terms of malaria burden. In 19 countries of Asia, malaria is endemic and 2.31 billion people or 62% of the total population in these countries are at risk of malaria. In 2010, WHO estimated around 34.8 million cases and 45,600 deaths due to malaria in Asia. In 2011, 2.7 million cases and > 2000 deaths were reported. India, Indonesia, Myanmar and Pakistan are responsible for >85% of the reported cases (confirmed) and deaths in Asia. In last 10 yr, due to availability of donor's fund specially from Global fund, significant progress has been made by the countries in Asia in scaling-up malaria control interventions which were instrumental in reducing malaria morbidity and mortality significantly. There is a large heterogeneity in malaria epidemiology in Asia. As a result, the success in malaria control/elimination is also diverse. As compared to the data of the year 2000, out of 19 malaria endemic countries, 12 countries were able to reduce malaria incidence (microscopically confirmed cases only) by 75%. Two countries, namely Bangladesh and Malaysia are projected to reach 75% reduction by 2015 while India is projected to reach 50-75% only by 2015. The trend could not be assessed in four countries, namely Indonesia, Myanmar, Pakistan and Timor-Leste due to insufficient consistent data. Numerous key challenges need to be addressed to sustain the gains and eliminate malaria in most parts of Asia. Some of these are to control the spread of resistance in Plasmodium falciparum to artemisinin, control of outdoor transmission, control of vivax malaria and ensuring universal coverage of key interventions. Asia has the potential to influence the malaria epidemiology all over the world as well as to support the global efforts in controlling and eliminating malaria through production of quality-assured ACTs, RDTs and long-lasting insecticidal nets.

  1. Mapping the risk of anaemia in preschool-age children: the contribution of malnutrition, malaria, and helminth infections in West Africa.

    Directory of Open Access Journals (Sweden)

    Ricardo J Soares Magalhães

    2011-06-01

    Full Text Available BACKGROUND: Childhood anaemia is considered a severe public health problem in most countries of sub-Saharan Africa. We investigated the geographical distribution of prevalence of anaemia and mean haemoglobin concentration (Hb in children aged 1-4 y (preschool children in West Africa. The aim was to estimate the geographical risk profile of anaemia accounting for malnutrition, malaria, and helminth infections, the risk of anaemia attributable to these factors, and the number of anaemia cases in preschool children for 2011. METHODS AND FINDINGS: National cross-sectional household-based demographic health surveys were conducted in 7,147 children aged 1-4 y in Burkina Faso, Ghana, and Mali in 2003-2006. Bayesian geostatistical models were developed to predict the geographical distribution of mean Hb and anaemia risk, adjusting for the nutritional status of preschool children, the location of their residence, predicted Plasmodium falciparum parasite rate in the 2- to 10-y age group (Pf PR(2-10, and predicted prevalence of Schistosoma haematobium and hookworm infections. In the four countries, prevalence of mild, moderate, and severe anaemia was 21%, 66%, and 13% in Burkina Faso; 28%, 65%, and 7% in Ghana, and 26%, 62%, and 12% in Mali. The mean Hb was lowest in Burkina Faso (89 g/l, in males (93 g/l, and for children 1-2 y (88 g/l. In West Africa, severe malnutrition, Pf PR(2-10, and biological synergisms between S. haematobium and hookworm infections were significantly associated with anaemia risk; an estimated 36.8%, 14.9%, 3.7%, 4.2%, and 0.9% of anaemia cases could be averted by treating malnutrition, malaria, S. haematobium infections, hookworm infections, and S. haematobium/hookworm coinfections, respectively. A large spatial cluster of low mean Hb (95% was predicted for an area shared by Burkina Faso and Mali. We estimate that in 2011, approximately 6.7 million children aged 1-4 y are anaemic in the three study countries. CONCLUSIONS: By

  2. Risk, innovation and change : design propositions for implementing risk management in organizations

    NARCIS (Netherlands)

    Staveren, van Martinus Theodorus

    2009-01-01

    This Ph.D. research generated unique design propositions for implementing existing risk management methodologies in organizations. The resulting design propositions incorporate a synthesis of risk management, innovation management and change management. True implementation of risk management is defi

  3. Malaria vectors in the changing environment of the southern Punjab, Pakistan

    DEFF Research Database (Denmark)

    Klinkenberg, Eveline; Konradsen, Flemming; Herrel, Nathaly

    2004-01-01

    in the Pakistani Punjab may have been influenced by a change in vector species abundance or composition, possibly induced by environmental changes. To investigate this question, routinely-collected government entomological data for the period 1970 to 1999 for the district of Bahawalnagar, in the Indus Basin......, where irrigation-induced waterlogging of soil with related salinization has created an environment favourable for the more salt-tolerant A. stephensi. Some biotypes of A. stephensi are suspected of being less efficient vectors and, therefore, the shift in species dominance might have played a role...

  4. Maps of the Sri Lanka malaria situation preceding the tsunami and key aspects to be considered in the emergency phase and beyond

    Directory of Open Access Journals (Sweden)

    Konradsen Flemming

    2005-01-01

    Full Text Available Abstract Background Following the tsunami, a detailed overview of the area specific transmission levels is essential in assessing the risk of malaria in Sri Lanka. Recent information on vector insecticide resistance, parasite drug resistance, and insights into the national policy for malaria diagnosis and treatment are important in assisting national and international agencies in their control efforts. Methods Monthly records over the period January 1995 – October 2004 of confirmed malaria cases were used to perform an analysis of malaria distribution at district spatial resolution. Also, a focused review of published reports and routinely collected information was performed. Results The incidence of malaria was only 1 case per thousand population in the 10 months leading up to the disaster, in the districts with the highest transmission. Conclusion Although relocated people may be more exposed to mosquito bites, and their capacity to handle diseases affected, the environmental changes caused by the tsunami are unlikely to enhance breeding of the principal vector, and, given the present low parasite reservoir, the likelihood of a malaria outbreak is low. However, close monitoring of the situation is necessary, especially as December – February is normally the peak transmission season. Despite some losses, the Sri Lanka public health system is capable of dealing with the possible threat of a malaria outbreak after the tsunami. The influx of foreign medical assistance, drugs, and insecticides may interfere with malaria surveillance, and the long term malaria control strategy of Sri Lanka, if not in accordance with government policy.

  5. Climate change, uncertainty and investment in flood risk reduction

    NARCIS (Netherlands)

    Pol, van der T.D.

    2015-01-01

    Economic analysis of flood risk management strategies has become more complex due to climate change. This thesis investigates the impact of climate change on investment in flood risk reduction, and applies optimisation methods to support identification of optimal flood risk management strategies. Ch

  6. Short report: severe malaria associated with blood group.

    Science.gov (United States)

    Fischer, P R; Boone, P

    1998-01-01

    The ABO blood groups are not linked to the incidence of simple malaria infection but have been associated with rosette formation. In an effort to see if clinically severe malaria is associated with blood group, 489 patients were studied in Zimbabwe. Patients with malaria and group A blood had lower hemoglobin levels and more risk of coma than did infected patients with other blood groups. In this population, severe malaria is associated with blood group.

  7. Climate change and coastal aquaculture farmers’ risk perceptions

    DEFF Research Database (Denmark)

    Ahsan, Dewan; Brandt, Urs Steiner

    2015-01-01

    This paper addresses the issue of risk perception in relation to climate change threats, comparison of risk perceptions in two different regions, and derives general results of what affect peoples’ level of risk perceptions. Revelation of individual risk perception is essential for local acceptan...

  8. Vß profiles in African children with acute cerebral or uncomplicated malaria: very focused changes among a remarkable global stability

    DEFF Research Database (Denmark)

    Loizon, Séverine; Boeuf, Philippe; Tetteh, John K A

    2007-01-01

    T cells are thought to play a critical role in cerebral malaria pathogenesis. However, available evidences are restricted to rodent models in which V beta specific T cell expansion has been associated with neurological syndrome suggesting involvement of superantigens or dominant antigens. Using f...

  9. Climate change and coastal environmental risk perceptions in Florida.

    Science.gov (United States)

    Carlton, Stuart J; Jacobson, Susan K

    2013-11-30

    Understanding public perceptions of climate change risks is a prerequisite for effective climate communication and adaptation. Many studies of climate risk perceptions have either analyzed a general operationalization of climate change risk or employed a case-study approach of specific adaptive processes. This study takes a different approach, examining attitudes toward 17 specific, climate-related coastal risks and cognitive, affective, and risk-specific predictors of risk perception. A survey of 558 undergraduates revealed that risks to the physical environment were a greater concern than economic or biological risks. Perceptions of greater physical environment risks were significantly associated with having more pro-environmental attitudes, being female, and being more Democratic-leaning. Perceptions of greater economic risks were significantly associated with having more negative environmental attitudes, being female, and being more Republican-leaning. Perceptions of greater biological risks were significantly associated with more positive environmental attitudes. The findings suggest that focusing on physical environment risks maybe more salient to this audience than communications about general climate change adaptation. The results demonstrate that climate change beliefs and risk perceptions are multifactorial and complex and are shaped by individuals' attitudes and basic beliefs. Climate risk communications need to apply this knowledge to better target cognitive and affective processes of specific audiences, rather than providing simple characterizations of risks.

  10. Kompliceret malaria

    DEFF Research Database (Denmark)

    Rønn, A M; Bygbjerg, Ib Christian; Jacobsen, E

    1989-01-01

    An increasing number of cases of malaria, imported to Denmark, are caused by Plasmodium falciparum and severe and complicated cases are more often seen. In the Department of Infectious Diseases, Rigshospitalet, 23 out of 32 cases, hospitalized from 1.1-30.6.1988, i.e. 72%, were caused by P...

  11. ENVIRONMENTAL MANAGEMENT FOR MALARIA CONTROL

    Directory of Open Access Journals (Sweden)

    H. A. Rafatjah

    1976-09-01

    Full Text Available Environmental management for malaria control is defined as any planned physical activities that through transformation of land, water and vegetation will result in the prevention, reduction or elimination of malaria. In planning and implementing these activities, full consideration must be given to their long-term effects and benefits and to the preservation of the quality of environment and they need to be fully and closely coordinated with water, land and agricultural development projects. Environmental management activities for malaria control can be classified as source reduction, dealing mainly with physical alteration of the environment; environmental manipulation, introducing temporary environmental changes and the reduction, and prevention of man-vector contact by site selection, mosquito proofing of dwellings and personal protection. For anti-malaria programs to employ these activities they need to re-train the staff, re-orient the services and set up pilot operations for feasibility studies.

  12. The association between nutritional status and malaria in children from a rural community in the Amazonian region: a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Márcia Almeida Araújo Alexandre

    2015-04-01

    Full Text Available The relationship between malaria and undernutrition is controversial and complex. Synergistic associations between malnutrition and malaria morbidity and mortality have been suggested, as well as undernutrition being protective against infection, while other studies found no association. We sought to evaluate the relationship between the number of malaria episodes and nutritional statuses in a cohort of children below 15 years of age living in a rural community in the Brazilian Amazon.Following a baseline survey of clinical, malaria and nutritional assessment including anthropometry measurements and hemoglobin concentration, 202 children ranging from 1 month to 14 years of age were followed for one year through passive case detection for malaria episodes. After follow-up, all children were assessed again in order to detect changes in nutritional indicators associated with malaria infection. We also examined the risk of presenting malaria episodes during follow-up according to presence of stunting at baseline. Children who suffered malaria episodes during follow-up presented worse anthropometric parameters values during this period. The main change was a reduction of the linear growth velocity, associated with both the number of episodes and how close the last or only malaria episode and the second anthropometric assessment were. Changes were also observed for indices associated with chronic changes, such as weight-for-age and BMI-for-age, which conversely, were more frequently observed in children with the last or only episode occurring between 6 and 12 months preceding the second nutritional assessment survey. Children with inadequate height-for-age at baseline (Z-score < -2 presented lower risk of suffering malaria episodes during follow-up as assessed by both the log-rank test (p =0.057 and the multivariable Cox-proportional hazards regression (Hazard Ratio = 0.31, 95%CI [0.10; 0.99] p=0.049.Malaria was associated with impaired nutritional

  13. Determinan Kejadian Malaria di Wilayah Endemis

    Directory of Open Access Journals (Sweden)

    Hamzah Hasyim

    2014-02-01

    Full Text Available Kabupaten Lahat adalah salah satu wilayah endemis malaria di Sumatera Selatan dengan prevalensi 16,4% dan Annual Malaria Incidence 22,08. Tujuan penelitian ini untuk mengetahui faktor risiko lingkungan dengan kejadian malaria. Faktor risiko lingkungan genangan air (breeding place berhubungan dengan kejadian malaria dengan nilai p= 0,000. Analisis multivariat menemukan determinan utama kejadian malaria adalah breeding place di sekitar rumah responden dengan odds ratio (OR = 5,034 dan 95% CI = 2,65 _ 9,56. Responden yang tinggal di sekitar breeding place berisiko 5,03 kali lebih besar untuk menderita malaria dibandingkan dengan responden yang di sekitar rumah tidak terdapat breeding place setelah dikontrol variabel jarak rumah ke breeding place, ventilasi rumah, penggunaan kelambu, penggunaan obat anti nyamuk, dan kebiasaan keluar rumah pada malam hari. Lahat district is one of the malaria endemic area in South Sumatra Province with a prevalence of 16.4% and Annual Malaria Incidence of 22.08. The case control reports were carried out of 240 respondents. This study aimed to understand the relationship among of environmental risk factors with the incidence of malaria. After primary data collection followed by processing and data analysis in a multimedia laboratory. There was association between breeding place and malaria cases (p value= 0.000. The results of multivariate analysis of variables revealed the determinant risk was breeding place, with OR = 5.034 and CI 95%= 2.65 _ 9.56. Respondents who live around the breeding place has 5.034 times chance of affected malaria compared with respondents around the house there are no breeding place after the controlled distance to the breeding place house, use of mosquito nets, use of anti-mosquito, and habits out of the house at night variables.

  14. Malaria incidence in Myanmar 2005–2014: steady but fragile progress towards elimination

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    Thet Thet Mu

    2016-10-01

    Full Text Available Abstract Background There has been an impressive recent reduction in the global incidence of malaria, but the development of artemisinin resistance in the Greater Mekong Region threatens this progress. Increasing artemisinin resistance is particularly important in Myanmar, as it is the country in the Greater Mekong Region with the greatest malaria burden. If malaria is to be eliminated in the region, it is essential to define the spatial and temporal epidemiology of the disease in Myanmar to inform control strategies optimally. Results Between the years 2005 and 2014 there was an 81.1 % decline in the reported annual incidence of malaria in Myanmar (1341.8 cases per 100,000 population to 253.3 cases per 100,000 population. In the same period, there was a 93.5 % decline in reported annual mortality from malaria (3.79 deaths per 100,000 population to 0.25 deaths per 100,000 population and a 87.2 % decline in the proportion of hospitalizations due to malaria (7.8 to 1.0 %. Chin State had the highest reported malaria incidence and mortality at the end of the study period, although socio-economic and geographical factors appear a more likely explanation for this finding than artemisinin resistance. The reduced malaria burden coincided with significant upscaling of disease control measures by the national government with support from international partners. These programmes included the training and deployment of over 40,000 community health care workers, the coverage of over 60 % of the at-risk population with insecticide-treated bed nets and significant efforts to improve access to artemesinin-based combination treatment. Beyond these malaria-specific programmes, increased general investment in the health sector, changing population demographics and deforestation are also likely to have contributed to the decline in malaria incidence seen over this time. Conclusions There has been a dramatic fall in the burden of malaria in Myanmar since 2005

  15. Development of aptamer-nanoparticle conjugates as a new approach to malaria diagnosis

    OpenAIRE

    Cheung, Yee-wai; 張綺蕙

    2012-01-01

    Malaria is an infectious disease caused by eukaryotic protists in the genus Plasmodium. Approximately half of the world's population is at risk of malaria. The burden of Plasmodium falciparum malaria has increased in recent years due to the emergence of resistant strains, which have even been documented in regions previously reported as malaria-free. Although malaria vaccine research has been conducted and has showed recent positive results, there still remains no eff...

  16. Risk Communication, Moral Emotions and Climate Change.

    NARCIS (Netherlands)

    Roeser, Sabine

    2012-01-01

    This article discusses the potential role that emotions might play in enticing a lifestyle that diminishes climate change. Climate change is an important challenge for society. There is a growing consensus that climate change is due to our behavior, but few people are willing to significantly adapt

  17. The use of remotely sensed environmental data in the study of malaria

    Directory of Open Access Journals (Sweden)

    Vanessa Machault

    2011-05-01

    Full Text Available Mapping and anticipating risk is a major issue in the fight against malaria, a disease causing an estimated one million deaths each year. Approximately half the world’s population is at risk and it is of prime importance to evaluate the burden of malaria at the spatial as well as the temporal level. The role of the environment with regard to the determinants of transmission and burden of the disease are described followed by a discussion of special issues such as urban malaria, human population mapping and the detection of changes at the temporal scale. Risk maps at appropriate scales can provide valuable information for targeted control and the present review discusses the essentials of principles, methods, advantages and limitations of remote sensing along with a presentation of ecological, meteorological and climatologic data which rule the distribution of malaria. The panel of commonly used analytic methods is examined and the methodological limitations are highlighted. A review of the literature details the increasing interest in the use of remotely sensed data in the study of malaria, by mapping or modeling several malariometric indices such as prevalence, morbidity and mortality, which are discussed with reference to vector breeding, vector density and entomological inoculation rate, estimates of which constitute the foundation for understanding endemicity and epidemics.

  18. Extinction risks from climate change: macroecological and historical insights.

    Science.gov (United States)

    Jansson, Roland

    2009-06-09

    Human-induced climate change may threaten a large proportion of Earth's biota, but the uncertainties involved in projecting the future geographical distributions of species make quantitative predictions of extinction risk difficult to make. I discuss how insight from recent advances in macroecology and knowledge about species responses to past climate change can help predict extinction risks more accurately.

  19. Spatio-temporal analysis of malaria incidence in the Peruvian Amazon Region between 2002 and 2013

    Science.gov (United States)

    Soto-Calle, Veronica; Rosas-Aguirre, Angel; Llanos-Cuentas, Alejandro; Abatih, Emmanuel; DeDeken, Redgi; Rodriguez, Hugo; Rosanas-Urgell, Anna; Gamboa, Dionicia; D´Alessandro, Umberto; Erhart, Annette; Speybroeck, Niko

    2017-01-01

    Malaria remains a major public health problem in the Peruvian Amazon where the persistence of high-risk transmission areas (hotspots) challenges the current malaria control strategies. This study aimed at identifying significant space-time clusters of malaria incidence in Loreto region 2002–2013 and to determine significant changes across years in relation to the control measures applied. Poisson regression and purely temporal, spatial, and space-time analyses were conducted. Three significantly different periods in terms of annual incidence rates (AIR) were identified, overlapping respectively with the pre-, during, and post- implementation control activities supported by PAMAFRO project. The most likely space-time clusters of malaria incidence for P. vivax and P. falciparum corresponded to the pre- and first two years of the PAMAFRO project and were situated in the northern districts of Loreto, while secondary clusters were identified in eastern and southern districts with the latest onset and the shortest duration of PAMAFRO interventions. Malaria in Loreto was highly heterogeneous at geographical level and over time. Importantly, the excellent achievements obtained during 5 years of intensified control efforts totally vanished in only 2 to 3 years after the end of the program, calling for sustained political and financial commitment for the success of malaria elimination as ultimate goal. PMID:28091560

  20. Identification of hot spots of malaria transmission for targeted malaria control.

    NARCIS (Netherlands)

    Bousema, T.; Drakeley, C.; Gesase, S.; Hashim, R.; Magesa, S.; Mosha, F.; Otieno, S.; Carneiro, I.; Cox, J.; Msuya, E.; Kleinschmidt, I.; Maxwell, C.; Greenwood, B.; Riley, E.; Sauerwein, R.W.; Chandramohan, D.; Gosling, R.

    2010-01-01

    BACKGROUND: Variation in the risk of malaria within populations is a frequently described but poorly understood phenomenon. This heterogeneity creates opportunities for targeted interventions but only if hot spots of malaria transmission can be easily identified. METHODS: We determined spatial patte

  1. Improving Decision-Making Activities for Meningitis and Malaria

    Science.gov (United States)

    Ceccato, Pietro; Trzaska, Sylwia; Garcia-Pando, Carlos Perez; Kalashnikova, Olga; del Corral, John; Cousin, Remi; Blumenthal, M. Benno; Bell, Michael; Connor, Stephen J.; Thomson, Madeleine C.

    2013-01-01

    Public health professionals are increasingly concerned about the potential impact that climate variability and change can have on infectious disease. The International Research Institute for Climate and Society (IRI) is developing new products to increase the public health community's capacity to understand, use and demand the appropriate climate data and climate information to mitigate the public health impacts of climate on infectious disease, in particular meningitis and malaria. In this paper, we present the new and improved products that have been developed for: (i) estimating dust aerosol for forecasting risks of meningitis and (ii) for monitoring temperature and rainfall and integrating them into a vectorial capacity model for forecasting risks of malaria epidemics. We also present how the products have been integrated into a knowledge system (IRI Data Library Map Room, SERVIR) to support the use of climate and environmental information in climate-sensitive health decision-making.

  2. Risk Aversion, Intergenerational Equity and Climate Change

    Energy Technology Data Exchange (ETDEWEB)

    Ha-Duong, Minh [CNRS-CIRED, Paris (France); Treich, N. [LEERNA-INRA, University of Toulouse (France)

    2004-06-01

    The paper investigates a climate-economy model with an iso-elastic welfare function in which one parameter {gamma} measures relative risk-aversion and a distinct parameter {rho} measures resistance to intertemporal substitution. We show both theoretically and numerically that climate policy responds differently to variations in the two parameters. In particular, we show that higher {gamma} but lower {rho} leads to increase emissions control. We also argue that climate-economy models based on intertemporal expected utility maximization, i.e. models where {gamma} ={rho}, may misinterpret the sensitivity of the climate policy to risk-aversion.

  3. Response to diazepam in children with malaria induced seizures

    OpenAIRE

    2008-01-01

    Summary Malaria infection reduces the binding capacity of benzodiazepine receptors in mice. We studied the efficacy of diazepam terminating seizures in children with falciparum malaria. Diazepam stopped seizures in fewer patients with malaria parasitaemia (χ 2 = 3.93, P = 0.047) and those with clinical diagnosis of malaria (χ 2 = 9.84, P = 0.002) compared to those without. However malaria was not identified as an independent risk factor for diazepam's failure to stop seizures in children....

  4. Malaria Chemoprophylaxis in Military Aircrew

    Science.gov (United States)

    2001-06-01

    for WHO Group 1I endemic deficiency, including macrocytic anemia , areas. aphthous ulcers, and stomatitis. - Chemoprophylaxis for WHO Group III endemic...deficiency is an absolute contraindication because of the risk of -- docetaxel (Taxotere®) hemolytic anemia . This defect is known to affect...headache shown such a property. - accommodation disorders - agranulocytosis, anemia and CONCLUSION methemoglobinemia The choice of malaria

  5. Malaria infection has spatial, temporal, and spatiotemporal heterogeneity in unstable malaria transmission areas in northwest Ethiopia.

    Directory of Open Access Journals (Sweden)

    Kassahun Alemu

    Full Text Available BACKGROUND: Malaria elimination requires successful nationwide control efforts. Detecting the spatiotemporal distribution and mapping high-risk areas are useful to effectively target pockets of malaria endemic regions for interventions. OBJECTIVE: The aim of the study was to identify patterns of malaria distribution by space and time in unstable malaria transmission areas in northwest Ethiopia. METHODS: Data were retrieved from the monthly reports stored in the district malaria offices for the period between 2003 and 2012. Eighteen districts in the highland and fringe malaria areas were included and geo-coded for the purpose of this study. The spatial data were created in ArcGIS10 for each district. The Poisson model was used by applying Kulldorff methods using the SaTScan™ software to analyze the purely temporal, spatial and space-time clusters of malaria at a district levels. RESULTS: The study revealed that malaria case distribution has spatial, temporal, and spatiotemporal heterogeneity in unstable transmission areas. Most likely spatial malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR =197764.1, p<0.001. Significant spatiotemporal malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR=197764.1, p<0.001 between 2003/1/1 and 2012/12/31. A temporal scan statistics identified two high risk periods from 2009/1/1 to 2010/12/31 (LLR=72490.5, p<0.001 and from 2003/1/1 to 2005/12/31 (LLR=26988.7, p<0.001. CONCLUSION: In unstable malaria transmission areas, detecting and considering the spatiotemporal heterogeneity would be useful to strengthen malaria control efforts and ultimately achieve elimination.

  6. Climate Change: Global Risks, Challenges and Decisions

    NARCIS (Netherlands)

    Richardson, K.; Steffen, W.; Liverman, D.; Barker, T.; Jotzo, F.; Kammen, D.M.; Leemans, R.; Lenton, T.M.; Munasinghe, M.; Osman-Elasha, B.; Schellnhuber, H.J.; Stern, N.; Vogel, C.; Waever, O.

    2011-01-01

    Providing an up-to-date synthesis of knowledge relevant to the climate change issue, this book ranges from the basic science documenting the need for policy action to the technologies, economic instruments and political strategies that can be employed in response to climate change. Ethical and cultu

  7. Platelet profile is associated with clinical complications in patients with vivax and falciparum malaria in Colombia

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    Edgar Leonardo Martínez-Salazar

    2014-06-01

    Full Text Available Introduction Thrombocytopenia is a common complication in malaria patients. The relationship between abnormal platelet profile and clinical status in malaria patients is unclear. In low and unstable endemic regions where vivax malaria predominates, the hematologic profiles of malaria patients and their clinical utility are poorly understood. The aim of this study was to characterize the thrombograms of malaria patients from Colombia, where Plasmodium vivax infection is common, and to explore the relationship between thrombograms and clinical status. Methods Eight hundred sixty-two malaria patients were enrolled, including 533 (61.8% patients infected with Plasmodium falciparum, 311 (36.1% patients infected with Plasmodium vivax and 18 (2.1% patients with mixed infections. Results The most frequently observed changes were low platelet count (PC and high platelet distribution width (PDW, which were observed in 65% of patients; thrombocytopenia with <50,000 platelets/µL was identified in 11% of patients. Patients with complications had lower PC and plateletcrit (PT and higher PDW values. A higher risk of thrombocytopenia was identified in patients with severe anemia, neurologic complications, pulmonary complications, liver dysfunction, renal impairment and severe hypoglycemia. The presence of thrombocytopenia (<150,000 platelets/µL was associated with a higher probability of liver dysfunction. Conclusions Young age, longer duration of illness and higher parasitemia are associated with severe thrombocytopenia. Our study showed that thrombocytopenia is related to malaria complications, especially liver dysfunction. High PDW in patients with severe malaria may explain the mechanisms of thrombocytopenia that is common in this group of patients.

  8. [Current malaria situation in Turkey].

    Science.gov (United States)

    Gockchinar, T; Kalipsi, S

    2001-01-01

    Geographically, Turkey is situated in an area where malaria is very risky. The climatic conditions in the region are suitable for the malaria vector to proliferate. Due to agricultural infrastructural changes, GAP and other similar projects, insufficient environmental conditions, urbanization, national and international population moves, are a key to manage malaria control activities. It is estimated that malaria will be a potential danger for Turkey in the forthcoming years. The disease is located largely in south-eastern Anatolia. The Diyarbakir, Batman, Sanliurfa, Siirt, and Mardin districts are the most affected areas. In western districts, like Aydin and Manisa, an increase in the number of indigenous cases can be observed from time to time. This is due to workers moving from malaria districts to western parts to final work. Since these workers cannot be controlled, the population living in these regions get infected from indigenous cases. There were 84,345 malaria cases in 1994 and 82,096 in 1995, they decreased to 60,884 in 1996 and numbered 35,456 in 1997. They accounted for 36,842 and 20,963 in 1998 and 1999, respectively. In Turkey there are almost all cases of P. vivax malaria. There are also P. vivax and P. falciparum malaria cases coming from other countries: There were 321 P. vivax cases, including 2 P. falciparum ones, arriving to Turkey from Iraq in 1995. The P. vivax malaria cases accounted for 229 in 1996, and 67, cases P. vivax including 12 P. falciparum cases, in 1997, and 4 P. vivax cases in 1998 that came from that country. One P. vivax case entered Turkey from Georgia in 1998. The cause of higher incidence of P. vivax cases in 1995, it decreasing in 1999, is the lack of border controls over workers coming to Turkey. The other internationally imported cases are from Syria, Sudan, Pakistan, Afghanistan, Nigeria, India, Azerbaijan, Malaysia, Ghana, Indonesia, Yemen. Our examinations have shown that none of these internationally imported cases

  9. High Mortality Risk in Hypoglycemic and Dysglycemic Children Admitted at a Referral Hospital in a Non Malaria Tropical Setting of a Low Income Country

    Science.gov (United States)

    Barennes, Hubert; Sayavong, Eng; Pussard, Eric

    2016-01-01

    Introduction Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. Methods Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI). Blood glucose was assessed once on admission through a finger prick using a bedside glucometer. Glycemia levels: hypoglycemia: 8.3 mmol/L (≥150 mg⁄ dl), were related to the IMCI algorithm and case fatality using univariate and multivariate analysis. Results Of 350 children, 62.2% (n = 218) were severely ill and 49.1% (n = 172) had at least one IMCI danger sign. A total of 15 (4.2%, 95%CI: 2.4–6.9) had hypoglycemia, 99 (28.2%, 95%CI: 23.6–33.3) low glycemia, 201 (57.4%, 95% CI: 52.0–62.6) euglycemia and 35 (10.0%, 95% CI: 7.0–13.6) hyperglycemia. Hypoglycemia was associated with longer fasting (p = 0.001) and limited treatment before admission (p = 0.09). Hypoglycemia and hyperglycemia were associated with hypoxemia (SaO2) (p = 0.001). A total of 21 (6.0%) of the children died: 66.6% with hypoglycemic, 6.0% with low glycemic, 5.7% with hyperglycemic and 1.4% with euglycemic groups. A total of 9 (2.5%) deaths occurred during the first 24 hours of admission and 5 (1.7%) within 3 days of hospital discharge. Compared to euglycemic children, hypoglycemic and low glycemic children had a higher rate of early death (20%, p<0.001 and 5%, p = 0.008; respectively). They also had a higher risk of death (OR: 132; 95%CI: 29.0–596.5; p = 0.001; and OR: 4.2; 95%CI: 1.1–15.6; p = 0.02; respectively). In multivariate analyses

  10. No difference in the incidence of malaria in human-landing mosquito catch collectors and non-collectors in a Senegalese village with endemic malaria.

    Directory of Open Access Journals (Sweden)

    Amélé N Wotodjo

    Full Text Available The human landing catches is the gold standard method used to study the vectors of malaria and to estimate their aggressiveness. However, this method has raised safety concerns due to a possible increased risk of malaria or other mosquito-borne diseases among the mosquito collectors. The aim of this study was to evaluate the incidence of malaria attacks among mosquito collectors and to compare these results with those of non-collectors in a Senegalese village.From July 1990 to December 2011, a longitudinal malaria study involving mosquito collectors and non-collectors was performed in Dielmo village, Senegal. During the study period, 4 drugs were successively used to treat clinical malaria, and long-lasting insecticide-treated nets were offered to all villagers in July 2008. No malaria chemoprophylaxis was given to mosquito collectors. Incidence of uncomplicated clinical malaria and asymptomatic malaria infection were analyzed among these two groups while controlling for confounding factors associated with malaria risk in random effects negative binomial and logistic regression models, respectively.A total of 3,812 person-trimester observations of 199 adults at least 15 years of age were analyzed. Clinical malaria attacks accounted for 6.3% both in collectors and non-collectors, and asymptomatic malaria infections accounted for 21% and 20% in collectors and non-collectors, respectively. A non-significant lower risk of malaria was observed in the collector group in comparison with the non-collector group after adjusting for other risk factors of malaria and endemicity level (Clinical malaria: adjusted incidence rate ratio = 0.89; 95% confidence interval = 0.65-1.22; p= 0.47.Being a mosquito collector in Dielmo was not significantly associated with an increased risk of malaria both under holoendemic, mesoendemic and hypoendemic conditions of malaria epidemiology. This result supports the view that HLC, the most accurate method for evaluating

  11. Risks of non-linear climate change

    Energy Technology Data Exchange (ETDEWEB)

    Van Ham, J.; Van Beers, R.J.; Builtjes, P.J.H.; Koennen, G.P.; Oerlemans, J.; Roemer, M.G.M. [TNO-SCMO, Delft (Netherlands)

    1995-12-31

    Climate forcing as a result of increased concentrations of greenhouse gases has been primarily addressed as a problem of a possibly warmer climate. So far, such change has been obscured in observations, possibly as a result of natural climate variability and masking by aerosols. Consequently, projections of the effect of climate forcing have to be based on modelling, more specifically by applying Global Circulation Models GCMs. These GCMs do not cover all possible feedbacks; neither do they address all specific possible effects of climate forcing. The investigation reviews possible non-linear climate change which does not fall within the coverage of present GCMs. The review includes the potential relevance of changes in biogeochemical cycles, aerosol and cloud feedback, albedo instability, ice-flow instability, changes in the thermohaline circulation and changes resulting from stratospheric cooling. It is noted that these changes may have different time horizons. Three from the investigated issues provide indications for a possible non-linear change. On the decadal scale stratospheric cooling, which is the result of the enhanced greenhouse effect, in combination with a depleted ozone layer, could provide a positive feedback to further ozone depletion, in particular in the Arctic. Decreasing albedo on the Greenland ice sheet may enhance the runoff from this ice sheet significantly in case of warming on a timescale of a few centuries. Changes in ocean circulation in the North Atlantic could seasonally more than compensate a global warming of 3C in North-West Europe on a timescale of centuries to a millennium. 263 refs.

  12. IPCC reasons for concern regarding climate change risks

    Science.gov (United States)

    O'Neill, Brian C.; Oppenheimer, Michael; Warren, Rachel; Hallegatte, Stephane; Kopp, Robert E.; Pörtner, Hans O.; Scholes, Robert; Birkmann, Joern; Foden, Wendy; Licker, Rachel; Mach, Katharine J.; Marbaix, Phillippe; Mastrandrea, Michael D.; Price, Jeff; Takahashi, Kiyoshi; van Ypersele, Jean-Pascal; Yohe, Gary

    2017-01-01

    The reasons for concern framework communicates scientific understanding about risks in relation to varying levels of climate change. The framework, now a cornerstone of the IPCC assessments, aggregates global risks into five categories as a function of global mean temperature change. We review the framework's conceptual basis and the risk judgments made in the most recent IPCC report, confirming those judgments in most cases in the light of more recent literature and identifying their limitations. We point to extensions of the framework that offer complementary climate change metrics to global mean temperature change and better account for possible changes in social and ecological system vulnerability. Further research should systematically evaluate risks under alternative scenarios of future climatic and societal conditions.

  13. AID expression in peripheral blood of children living in a malaria endemic region is associated with changes in B cell subsets and Epstein-Barr virus

    Science.gov (United States)

    Wilmore, Joel R; Asito, Amolo S; Wei, Chungwen; Piriou, Erwan; Sumba, P. Odada; Sanz, Iñaki

    2015-01-01

    The development of endemic Burkitt's lymphoma (eBL) is closely associated with EBV infection and holoendemic malaria infections. The role of EBV in the development of malignancy has been studied in depth, but there is still little known about the mechanisms by which malaria affects Burkitt's lymphomagenesis. Activation induced cytidine deaminase (AID) expression is necessary for the introduction of c-myc translocations that are characteristic of BL, but a link between AID and EBV or malaria is unclear. To determine if frequency of malaria exposure leads to increased AID expression in peripheral blood mononuclear cells (PBMC) we examined two cohorts of children in western Kenya with endemic and sporadic malaria transmission dynamics. High frequency of malaria exposure led to increased expression of AID, which coincided with decreases in the IgM+ memory B cells. In the children from the malaria endemic region, the presence of a detectible EBV viral load was associated with higher AID expression compared to children with undetectable EBV, but this effect was not seen in children with sporadic exposure to malaria. This study demonstrates that intensity of malaria transmission correlates with AID expression levels in the presence of EBV suggesting that malaria and EBV infection have a synergistic effect on the development of c-myc translocations and BL. PMID:25099163

  14. AID expression in peripheral blood of children living in a malaria holoendemic region is associated with changes in B cell subsets and Epstein-Barr virus.

    Science.gov (United States)

    Wilmore, Joel R; Asito, Amolo S; Wei, Chungwen; Piriou, Erwan; Sumba, P Odada; Sanz, Iñaki; Rochford, Rosemary

    2015-03-15

    The development of endemic Burkitt's lymphoma (eBL) is closely associated with Epstein-Barr virus (EBV) infection and holoendemic malaria infections. The role of EBV in the development of malignancy has been studied in depth, but there is still little known about the mechanisms by which malaria affects Burkitt's lymphomagenesis. Activation induced cytidine deaminase (AID) expression is necessary for the introduction of c-myc translocations that are characteristic of BL, but a link between AID and EBV or malaria is unclear. To determine whether frequency of malaria exposure leads to increased AID expression in peripheral blood mononuclear cells (PBMC) we examined two cohorts of children in western Kenya with endemic and sporadic malaria transmission dynamics. High frequency of malaria exposure led to increased expression of AID, which coincided with decreases in the IgM(+) memory B cells. In the children from the malaria endemic region, the presence of a detectible EBV viral load was associated with higher AID expression compared to children with undetectable EBV, but this effect was not seen in children with sporadic exposure to malaria. This study demonstrates that intensity of malaria transmission correlates with AID expression levels in the presence of EBV suggesting that malaria and EBV infection have a synergistic effect on the development of c-myc translocations and BL.

  15. Climate change risk perception and communication: addressing a critical moment?

    Science.gov (United States)

    Pidgeon, Nick

    2012-06-01

    Climate change is an increasingly salient issue for societies and policy-makers worldwide. It now raises fundamental interdisciplinary issues of risk and uncertainty analysis and communication. The growing scientific consensus over the anthropogenic causes of climate change appears to sit at odds with the increasing use of risk discourses in policy: for example, to aid in climate adaptation decision making. All of this points to a need for a fundamental revision of our conceptualization of what it is to do climate risk communication. This Special Collection comprises seven papers stimulated by a workshop on "Climate Risk Perceptions and Communication" held at Cumberland Lodge Windsor in 2010. Topics addressed include climate uncertainties, images and the media, communication and public engagement, uncertainty transfer in climate communication, the role of emotions, localization of hazard impacts, and longitudinal analyses of climate perceptions. Climate change risk perceptions and communication work is critical for future climate policy and decisions.

  16. Incidence of malaria is clustered and buffers around plantations: a spatial analysis

    Directory of Open Access Journals (Sweden)

    Yudhi Wibowo

    2015-12-01

    Malaria incidence is clustered and buffers around plantations at <1000 m. Malaria hot spots are displayed as risk maps that are useful for monitoring and spatial targeting of prevention and control measures against the disease.

  17. Risk Communication: the connection between assessment and management of changing risks

    Science.gov (United States)

    Sprague, Teresa; Prenger-Berninghoff, Kathrin; Charrière, Marie

    2013-04-01

    Working toward effective risk mitigation strategies amidst ever-present and increasingly changing risks requires first effective communication between assessment and management spheres. This notion permeates the spectrum of what can be considered the physical changing risk inputs that feed into the risk governance processes of assessment, management and communication of risks. Close connections and overlaps between assessment and management requires communication to serve as the crux for the close collaboration necessary for encouraging preventative, long-term strategies for reducing disaster risks.1 More specifically, communication of risk information plays this connective role by informing and advising policy and decision making processes conducted by actors such as spatial planners who receive this information. In this way, those who assess the risks provide information to those who must manage these risks. When this one-directional communication pathway is reciprocated, risk managers provide information to risk assessors, enabling two-way communication amongst actors working toward risk reduction. This communication and exchange of information enables development of strategies and actions taken toward creating and improving risk mitigation measures within a given territory and community. Further, management actions taken (especially for mitigative measures) can alter the physical and social elements of the spatial context of their territory.2 This demands an adjustment of the previous risk assessment information and communication of the change in potential risk. These conceptual underpinnings are addressed and presented through explanation of an analytical framework encompassing changing risk inputs into risk governance processes. The framework elaborates the risk communication component and is supported by practical examples from stakeholder meetings and site visits in the Polish and Romania case study areas of the Marie Curie ITN, CHANGES.3 Specific examples

  18. The Evaluation of Climate Change Risks

    Directory of Open Access Journals (Sweden)

    Constantin POPESCU

    2012-11-01

    Full Text Available Nowadays, it is acknowledged that climatic changes represent a serious threat for the environment and, so, this problem has been approached at numerous conferences, conventions and summits. The climate is strongly influenced by the changes in the atmospheric concentrations of certain gases that hold the solar radiations on the Earth’s surface (the greenhouse effect. The water vapors and the carbon dioxide (CO2 present in the atmosphere have always generated a natural greenhouse effect, without which the Earth surface would be 33o C lower than it is today. Other greenhouse gases are: methane (CH4, nitrogen protoxide (N2O, and the halogenated compounds such as chlorofluorocarbons (CFCs. During the last hundred years, man’s activity has led to the increase of the atmospheric concentration of the greenhouse gases and of other pollutants, its consequence being the increase of the average global temperature. Although it has not been calculated exactly how much of this warming can be attributed to the greenhouse gases, there is evidence that human activity contributes to global warming. The main causes leading to the accentuation of the greenhouse effect are the burning of the fossil fuels, deforestations, cement production, waste disposal, refrigeration etc. The climatic changes triggered by the greenhouse gases will have consequences that have already made themselves visible, causing: the increase of the sea level and the possible flooding of the low areas; the melting of the icecap; the modification of the precipitations regime, with consequences like the increase of the floods and droughts frequency; changes in the occurrence of climatic extremes, especially in the occurrence of the high, extreme temperatures. All these will have a direct impact on ecosystems, health, some key economic sectors such as agriculture and on water resources.

  19. Change in abdominal obesity and risk of coronary calcification

    NARCIS (Netherlands)

    Sabour, S.; Grobbee, D.E.; Prokop, M.; Schouw, Y.T. van der; Bots, M.L.

    2011-01-01

    BACKGROUND: A prospective follow-up study was conducted to examine the relationship between 9 year change in abdominal obesity and risk of coronary artery calcification (CAC). METHODS: Data on coronary risk factors for 573 postmenopausal women were collected at baseline (1993-1997) and follow

  20. Climate Change and Children: Health Risks of Abatement Inaction, Health Gains from Action

    Directory of Open Access Journals (Sweden)

    Anthony J McMichael

    2014-08-01

    Full Text Available As human-driven climate change advances, many adults fret about the losses of livelihoods, houses and farms that may result. Children fret about their parents’ worries and about information they hear, but do not really understand about the world’s climate and perhaps about their own futures. In chronically worried or anxious children, blood cortisol levels rise and adverse changes accrue in various organ systems that prefigure adult-life diseases. Meanwhile, for many millions of children in poor countries who hear little news and live with day-to-day fatalism, climate change threatens the fundamentals of life—food sufficiency, safe drinking water and physical security—and heightens the risks of diarrhoeal disease, malaria and other climate-sensitive infections. Poor and disadvantaged populations, and especially their children, will bear the brunt of climate-related trauma, disease and premature death over the next few decades and, less directly, from social disruption, impoverishment and displacement. The recent droughts in Somalia as the Indian Ocean warmed and monsoonal rains failed, on top of chronic civil war, forced hundreds of thousands of Somali families into north-eastern Kenya’s vast Dadaab refugee camps, where, for children, shortages of food, water, hygiene and schooling has endangered physical, emotional and mental health. Children warrant special concern, both as children per se and as the coming generation likely to face ever more extreme climate conditions later this century. As children, they face diverse risks, from violent weather, proliferating aeroallergens, heat extremes and mobilised microbes, through to reduced recreational facilities, chronic anxieties about the future and health hazards of displacement and local resource conflict. Many will come to regard their parents’ generation and complacency as culpable.

  1. Flood risk and climate change: global and regional perspectives

    OpenAIRE

    Kundzewicz, Zbigniew W.; Kanae, Shinjiro; Seneviratne, Sonia I; Handmer, John; Nicholls, Neville; Peduzzi, Pascal; Mechler, Reinhard; Laurens M. Bouwer; Arnell, Nigel; Mach, Katharine; Muir-Wood, Robert; Brakenridge, G. Robert; Kron, Wolfgang; Benito, Gerardo; Honda, Yasushi

    2014-01-01

    A holistic perspective on changing rainfall-driven flood risk is provided for the late 20th and early 21st centuries. Economic losses from floods have greatly increased, principally driven by the expanding exposure of assets at risk. It has not been possible to attribute rain-generated peak streamflow trends to anthropogenic climate change over the past several decades. Projected increases in the frequency and intensity of heavy rainfall, based on climate models, should contribute to increase...

  2. Avoiding Drought Risks and Social Conflict Under Climate Change

    Science.gov (United States)

    Towler, E.; Lazrus, H.; Paimazumder, D.

    2014-12-01

    Traditional drought research has mainly focused on physical drought risks and less on the cultural processes that also contribute to how drought risks are perceived and managed. However, as society becomes more vulnerable to drought and climate change threatens to increase water scarcity, it is clear that drought research would benefit from a more interdisciplinary approach. To assess avoided drought impacts from reduced climate change, drought risks need to be assessed in the context of both climate prediction as well as improved understanding of socio-cultural processes. To this end, this study explores a risk-based framework to combine physical drought likelihoods with perceived risks from stakeholder interviews. Results are presented from a case study on how stakeholders in south-central Oklahoma perceive drought risks given diverse cultural beliefs, water uses, and uncertainties in future drought prediction. Stakeholder interviews (n=38) were conducted in 2012 to understand drought risks to various uses of water, as well as to measure worldviews from the cultural theory of risk - a theory that explains why people perceive risks differently, potentially leading to conflict over management decisions. For physical drought risk, drought projections are derived from a large ensemble of future climates generated from two RCPs that represent higher and lower emissions trajectories (i.e., RCP8.5 and RCP4.5). These are used to develop a Combined Drought Risk Matrix (CDRM) that characterizes drought risks for different water uses as the products of both physical likelihood (from the climate ensemble) and risk perception (from the interviews). We use the CRDM to explore the avoided drought risks posed to various water uses, as well as to investigate the potential for reduction of conflict over water management.

  3. Atypical lymphocytes in malaria mimicking dengue infection in Thailand

    Directory of Open Access Journals (Sweden)

    Polrat Wilairatana

    2010-09-01

    Full Text Available Polrat Wilairatana1, Noppadon Tangpukdee1, Sant Muangnoicharoen1, Srivicha Krudsood2, Shigeyuki Kano31Department of Clinical Tropical Medicine, 2Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 3Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, JapanAbstract: Patients with uncomplicated falciparum or vivax malaria usually present with acute febrile illness and thrombocytopenia similar to dengue infection. We retrospectively studied atypical lymphocytes (AL and atypical lymphocytosis (ALO, defined as AL > 5% of total white blood cells in 1310 uncomplicated malaria patients. In 718 falciparum malaria patients, AL and ALO on day 0 were found in 53.2% and 5.7% of the patients, respectively, with median AL on admission of 1% (range 0%–10%, whereas in 592 vivax malaria patients, AL and ALO on day 0 were found in 55.4% and 9.5% of the patients, respectively, with median AL on admission of 1% (range 0%–14%. After antimalarial treatment, AL and ALO declined in both falciparum and vivax malaria. However, AL and ALO remained in falciparum malaria on days 7, 14, and 21, whereas AL and ALO remained in vivax malaria on days 7, 14, 21, and 28. In both falciparum and vivax malaria patients, there was a positive correlation between AL and total lymphocytes, but a negative correlation between AL and highest fever on admission, white blood cells, and neutrophils, eosinophils, and platelets (P < 0.05. In conclusion, AL or ALO may be found in uncomplicated falciparum and vivax malaria mimicking dengue infection. In tropical countries where both dengue and malaria are endemic, presence of AL or ALO in any acute febrile patients with thrombocytopenia (similar to the findings in dengue malaria could not be excluded. Particularly if the patients have risk of malaria infection, confirmative microscopic examination for malaria should be carried out

  4. The historical distribution of main malaria foci in Spain as related to water bodies.

    Science.gov (United States)

    Sousa, Arturo; García-Barrón, Leoncio; Vetter, Mark; Morales, Julia

    2014-08-06

    The possible connectivity between the spatial distribution of water bodies suitable for vectors of malaria and endemic malaria foci in Southern Europe is still not well known. Spain was one of the last countries in Western Europe to be declared free of malaria by the World Health Organization (WHO) in 1964. This study combines, by means of a spatial-temporal analysis, the historical data of patients and deceased with the distribution of water bodies where the disease-transmitting mosquitos proliferate. Therefore, data from historical archives with a Geographic Information System (GIS), using the Inverse Distance Weighted (IDW) interpolation method, was analyzed with the aim of identifying regional differences in the distribution of malaria in Spain. The reasons, why the risk of transmission is concentrated in specific regions, are related to worse socioeconomic conditions (Extremadura), the presence of another vector (Anopheles labranchiae) besides A. atroparvus (Levante) or large areas of water bodies in conditions to reproduce theses vectors (La Mancha and Western Andalusia). In the particular case of Western Andalusia, in 1913, the relatively high percentage of 4.73% of the surface, equal to 202362 ha, corresponds to wetlands and other unhealthy water bodies. These wetlands have been reduced as a result of desiccation policies and climate change such as the Little Ice Age and Global Climate Change. The comprehension of the main factors of these wetland changes in the past can help us interpret accurately the future risk of malaria re-emergence in temperate latitudes, since it reveals the crucial role of unhealthy water bodies on the distribution, endemicity and eradication of malaria in southern Europe.

  5. The Historical Distribution of Main Malaria Foci in Spain as Related to Water Bodies

    Directory of Open Access Journals (Sweden)

    Arturo Sousa

    2014-08-01

    Full Text Available The possible connectivity between the spatial distribution of water bodies suitable for vectors of malaria and endemic malaria foci in Southern Europe is still not well known. Spain was one of the last countries in Western Europe to be declared free of malaria by the World Health Organization (WHO in 1964. This study combines, by means of a spatial-temporal analysis, the historical data of patients and deceased with the distribution of water bodies where the disease-transmitting mosquitos proliferate. Therefore, data from historical archives with a Geographic Information System (GIS, using the Inverse Distance Weighted (IDW interpolation method, was analyzed with the aim of identifying regional differences in the distribution of malaria in Spain. The reasons, why the risk of transmission is concentrated in specific regions, are related to worse socioeconomic conditions (Extremadura, the presence of another vector (Anopheles labranchiae besides A. atroparvus (Levante or large areas of water bodies in conditions to reproduce theses vectors (La Mancha and Western Andalusia. In the particular case of Western Andalusia, in 1913, the relatively high percentage of 4.73% of the surface, equal to 202362 ha, corresponds to wetlands and other unhealthy water bodies. These wetlands have been reduced as a result of desiccation policies and climate change such as the Little Ice Age and Global Climate Change. The comprehension of the main factors of these wetland changes in the past can help us interpret accurately the future risk of malaria re-emergence in temperate latitudes, since it reveals the crucial role of unhealthy water bodies on the distribution, endemicity and eradication of malaria in southern Europe.

  6. Climate Change - Global Risks, Challenges & Decisions

    DEFF Research Database (Denmark)

    Richardson, Katherine; Steffen, Will; Schellnhuber, Hans J.;

    and environment, and the many tools and approaches available to deal effectively with the challenge of climate change. The report has been produced by a writing team comprised of members of the Scientific Steering Committee for the IARU Congress and individuals invited to give the writing team academic...... and geographic breadth. It is based on the 16 plenary talks given at the Congress as well as input from over 80 chairs and cochairs of the 58 parallel sessions held at the Congress. The names of the plenary speakers and the chairs and co-chairs of the parallel sessions can be found on the inside cover...... of this volume. The writing team has, in addition to presentations at the Congress, drawn upon recent publications in the scientific literature to create this synthesis. This report has been critically reviewed by representatives of the Earth System Science Partnership (ESSP), by the parallel session chairs...

  7. Seasonal population changes and malaria transmission potential of Anopheles pharoensis and the minor anophelines in Mwea Irrigation Scheme, Kenya.

    Science.gov (United States)

    Mukiama, T K; Mwangi, R W

    1989-05-01

    A study in 1984 and 1985 showed that Anopheles gambiae s.l. and An. pharoensis were the major anophelines in Mwea Irrigation Scheme, Kenya, constituting 83.86% and 15.69% of the catch respectively. Four minor species made up the remaining 0.45%. The irrigation phase of the rice cultivation cycle in August, which linked the flooding effects of the two rainy seasons, resulted in major population increases of An. pharoensis and enabled continuous breeding for up to 9 months per year. The average of mean monthly proportions of unfed, bloodfed, and gravid females was 26.6, 58.8, and 14.6% respectively. The Plasmodium falciparum sporozoite rates for An. pharoensis were 1.3% by ELISA and 0.68% by dissection, while those for An. funestus were 1.7% by ELISA and 1.25% by dissection. An. pharoensis can contribute to the epidemiology of Malaria in the Mwea area.

  8. Climate Change or Nuclear Power - Which Risk do we Prefer?

    Energy Technology Data Exchange (ETDEWEB)

    Bruce, Donald [Church of Scotland, Edinburgh (United Kingdom). Society, Religion and Technology Project

    2006-09-15

    Climate change and nuclear power provide two of the biggest technological risks of our times. Both involve widespread risks, long-term wastes and inter-generational equity, but in rather different ways. If it came to a choice, which is the worse set of risks to run? Serious doubts have been raised whether the implementation of renewable energies and energy saving are able in practice to deliver quickly enough the radical reductions of CO{sub 2} emissions that are needed to tackle climate change. Some countries may face a dilemma - to continue another generation of nuclear power or to accept that its CO{sub 2} emissions will rise when current nuclear stations finish their time? This paper compares the risks, and explores the ethical issues around which a society would have to weigh up such a choice, the role of the precautionary principle, and the place of expert and lay evaluations of risk (full text of contribution)

  9. Endogenous Risks and Learning in Climate Change Decision Analysis

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, B.C.; Ermoliev, Y.; Ermolieva, T.

    2005-10-05

    We analyze the effects of risks and learning on climate change decisions. A two-stage, dynamic, climate change stabilization problem is formulated. The explicit incorporation of ex-post learning induces risk aversion among ex-ante decisions, which is characterized in linear models by VaR- (Value at Risk) and CVaR-type risk (Conditional Value at Risk) measures. Combined with explicit introduction of 'safety' constraints, it creates a 'hit-or-miss' type decision making situation and shows that, even in linear models, learning may lead to either less or more restrictive ex-ante emission reductions. We analyze stylized elements of the model in order to identify the key factors driving outcomes, in particular, the critical role of quantiles of probability distributions characterizing key uncertainties.

  10. ABO phenotypes and malaria related outcomes in mothers and babies in The Gambia: a role for histo-blood groups in placental malaria?

    NARCIS (Netherlands)

    M.P. Loscertales; B.J. Brabin

    2006-01-01

    Background: Host susceptibility to P. falciparum is critical for understanding malaria in pregnancy, its consequences for the mother and baby, and for improving malaria control in pregnant women. Yet host genetic factors which could influence placental malaria risk are little studied and there are n

  11. Climate Change Influences Potential Distribution of Infected Aedes aegypti Co-Occurrence with Dengue Epidemics Risk Areas in Tanzania

    Science.gov (United States)

    Mweya, Clement N.; Kimera, Sharadhuli I.; Stanley, Grades; Misinzo, Gerald; Mboera, Leonard E. G.

    2016-01-01

    Background Dengue is the second most important vector-borne disease of humans globally after malaria. Incidence of dengue infections has dramatically increased recently, potentially due to changing climate. Climate projections models predict increases in average annual temperature, precipitation and extreme events in the future. The objective of this study was to assess the effect of changing climate on distribution of dengue vectors in relation to epidemic risk areas in Tanzania. Methods/Findings We used ecological niche models that incorporated presence-only infected Aedes aegypti data co-occurrence with dengue virus to estimate potential distribution of epidemic risk areas. Model input data on infected Ae. aegypti was collected during the May to June 2014 epidemic in Dar es Salaam. Bioclimatic predictors for current and future projections were also used as model inputs. Model predictions indicated that habitat suitability for infected Ae. aegypti co-occurrence with dengue virus in current scenarios is highly localized in the coastal areas, including Dar es Salaam, Pwani, Morogoro, Tanga and Zanzibar. Models indicate that areas of Kigoma, Ruvuma, Lindi, and those around Lake Victoria are also at risk. Projecting to 2020, we show that risk emerges in Mara, Arusha, Kagera and Manyara regions, but disappears in parts of Morogoro, Ruvuma and near Lake Nyasa. In 2050 climate scenario, the predicted habitat suitability of infected Ae. aegypti co-occurrence with dengue shifted towards the central and north-eastern parts with intensification in areas around all major lakes. Generally, model findings indicated that the coastal regions would remain at high risk for dengue epidemic through 2050. Conclusion/Significance Models incorporating climate change scenarios to predict emerging risk areas for dengue epidemics in Tanzania show that the anticipated risk is immense and results help guiding public health policy decisions on surveillance and control of dengue epidemics. A

  12. UK malaria treatment guidelines 2016.

    Science.gov (United States)

    Lalloo, David G; Shingadia, Delane; Bell, David J; Beeching, Nicholas J; Whitty, Christopher J M; Chiodini, Peter L

    2016-06-01

    1.Malaria is the tropical disease most commonly imported into the UK, with 1300-1800 cases reported each year, and 2-11 deaths. 2. Approximately three quarters of reported malaria cases in the UK are caused by Plasmodium falciparum, which is capable of invading a high proportion of red blood cells and rapidly leading to severe or life-threatening multi-organ disease. 3. Most non-falciparum malaria cases are caused by Plasmodium vivax; a few cases are caused by the other species of plasmodium: Plasmodium ovale, Plasmodium malariae or Plasmodium knowlesi. 4. Mixed infections with more than one species of parasite can occur; they commonly involve P. falciparum with the attendant risks of severe malaria. 5. There are no typical clinical features of malaria; even fever is not invariably present. Malaria in children (and sometimes in adults) may present with misleading symptoms such as gastrointestinal features, sore throat or lower respiratory complaints. 6. A diagnosis of malaria must always be sought in a feverish or sick child or adult who has visited malaria-endemic areas. Specific country information on malaria can be found at http://travelhealthpro.org.uk/. P. falciparum infection rarely presents more than six months after exposure but presentation of other species can occur more than a year after exposure. 7. Management of malaria depends on awareness of the diagnosis and on performing the correct diagnostic tests: the diagnosis cannot be excluded until more than one blood specimen has been examined. Other travel related infections, especially viral haemorrhagic fevers, should also be considered. 8. The optimum diagnostic procedure is examination of thick and thin blood films by an expert to detect and speciate the malarial parasites. P. falciparum and P. vivax (depending upon the product) malaria can be diagnosed almost as accurately using rapid diagnostic tests (RDTs) which detect plasmodial antigens. RDTs for other Plasmodium species are not as reliable. 9

  13. Malaria Modeling and Surveillance for the Greater Mekong Subregion

    Science.gov (United States)

    Kiang, Richard; Adimi, Farida; Soika, Valerii; Nigro, Joseph

    2005-01-01

    At 4,200 km, the Mekong River is the tenth longest river in the world. It directly and indirectly influences the lives of hundreds of millions of inhabitants in its basin. The riparian countries - Thailand, Myanmar, Cambodia, Laos, Vietnam, and a small part of China - form the Greater Mekong Subregion (GMS). This geographical region has the misfortune of being the world's epicenter of falciparum malaria, which is the most severe form of malaria caused by Plasmodium falciparum. Depending on the country, approximately 50 to 90% of all malaria cases are due to this species. In the Malaria Modeling and Surveillance Project, we have been developing techniques to enhance public health's decision capability for malaria risk assessments and controls. The main objectives are: 1) Identifying the potential breeding sites for major vector species; 2) Implementing a malaria transmission model to identify the key factors that sustain or intensify malaria transmission; and 3) Implementing a risk algorithm to predict the occurrence of malaria and its transmission intensity. The potential benefits are: 1) Increased warning time for public health organizations to respond to malaria outbreaks; 2) Optimized utilization of pesticide and chemoprophylaxis; 3) Reduced likelihood of pesticide and drug resistance; and 4) Reduced damage to environment. Environmental parameters important to malaria transmission include temperature, relative humidity, precipitation, and vegetation conditions. These parameters are extracted from NASA Earth science data sets. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records.

  14. Improving Decision-Making Activities for Meningitis and Malaria

    Science.gov (United States)

    Ceccato, P.; Trzaska, S.; Perez, C.; Kalashnikova, O. V.; del Corral, J.; Cousin, R.; Blumenthal, M. B.; Connor, S.; Thomson, M. C.

    2012-12-01

    Public health professionals are increasingly concerned about the potential impact that climate variability and change can have on infectious disease. The International Research Institute for Climate and Society (IRI) is developing new products to increase the public health community's capacity to understand, use, and demand the appropriate climate data and climate information to mitigate the public health impacts of climate on infectious disease, in particular Meningitis and Malaria. In this paper we present the new and improved products that have been developed for monitoring dust, temperature, rainfall and vectorial capacity model for monitoring and forecasting risks of Meningitis and Malaria epidemics. We also present how the products have been integrated into a knowledge system (IRI Data Library Map room, SERVIR) to support the use of climate and environmental information in climate-sensitive health decision-making.

  15. What would PCR assessment change in the management of fevers in a malaria endemic area? A school-based study in Benin in children with and without fever

    Directory of Open Access Journals (Sweden)

    Faucher Jean-François

    2010-08-01

    Full Text Available Abstract Background A recent school-based study in Benin showed that applying a policy of anti-malarial prescriptions restricted to parasitologically-confirmed cases on the management of fever is safe and feasible. Additional PCR data were analysed in order to touch patho-physiological issues, such as the usefulness of PCR in the management of malaria in an endemic area or the triggering of a malaria attack in children with submicroscopic malaria. Methods PCR data were prospectively collected in the setting of an exposed (with fever/non exposed (without fever study design. All children had a negative malaria rapid diagnostic test (RDT at baseline, were followed up to day 14 and did not receive drugs with anti-malarial activity. The index group was defined by children with fever at baseline and the control group by children without fever at baseline. Children with submicroscopic malaria in these two groups were defined by a positive PCR at baseline. Results PCR was positive in 66 (27% children of the index group and in 104 (44% children of the control group respectively. The only significant factor positively related to PCR positivity at baseline was the clinical status (control group. When definition of malaria attacks included PCR results, no difference of malaria incidence was observed between the index and control groups, neither in the whole cohort, nor in children with submicroscopic malaria. The rate of undiagnosed malaria at baseline was estimated to 3.7% at baseline in the index group. Conclusions Treating all children with fever and a positive PCR would have led to a significant increase of anti-malarial consumption, with few benefits in terms of clinical events. Non malarial fevers do not or do not frequently trigger malaria attacks in children with submicroscopic malaria.

  16. An affordable, quality-assured community-based system for high-resolution entomological surveillance of vector mosquitoes that reflects human malaria infection risk patterns

    Directory of Open Access Journals (Sweden)

    Chaki Prosper P

    2012-05-01

    Full Text Available Abstract Background More sensitive and scalable entomological surveillance tools are required to monitor low levels of transmission that are increasingly common across the tropics, particularly where vector control has been successful. A large-scale larviciding programme in urban Dar es Salaam, Tanzania is supported by a community-based (CB system for trapping adult mosquito densities to monitor programme performance. Methodology An intensive and extensive CB system for routine, longitudinal, programmatic surveillance of malaria vectors and other mosquitoes using the Ifakara Tent Trap (ITT-C was developed in Urban Dar es Salaam, Tanzania, and validated by comparison with quality assurance (QA surveys using either ITT-C or human landing catches (HLC, as well as a cross-sectional survey of malaria parasite prevalence in the same housing compounds. Results Community-based ITT-C had much lower sensitivity per person-night of sampling than HLC (Relative Rate (RR [95% Confidence Interval (CI] = 0.079 [0.051, 0.121], P Anopheles gambiae s.l. and 0.153 [0.137, 0.171], P An. gambiae or Culex respectively. Despite the poor sensitivity of the ITT per night of sampling, when CB-ITT was compared with QA-HLC, it proved at least comparably sensitive in absolute terms (171 versus 169 primary vectors caught and cost-effective (153US$ versus 187US$ per An. gambiae caught because it allowed more spatially extensive and temporally intensive sampling (4284 versus 335 trap nights distributed over 615 versus 240 locations with a mean number of samples per year of 143 versus 141. Despite the very low vectors densities (Annual estimate of about 170 An gambiae s.l bites per person per year, CB-ITT was the only entomological predictor of parasite infection risk (Odds Ratio [95% CI] = 4.43[3.027,7. 454] per An. gambiae or Anopheles funestus caught per night, P =0.0373. Discussion and conclusion CB trapping approaches could be improved with more sensitive traps

  17. Elimination of malaria due to Plasmodium vivax in central part of the People’s Republic of China: analysis and prediction based on modelling

    Directory of Open Access Journals (Sweden)

    Zhao Chen

    2014-11-01

    Full Text Available Five provinces in central People’s Republic of China (P.R. China have successfully reduced the burden of malaria due to Plasmodium vivax in the last 7 years. The results of the Action Plan of China Malaria Elimination (APCME that com- menced in 2010 are analysed against the background of the progress reached by the national malaria control programme (NMEP that was launched in 2006. We examined the epidemiological changes in the number of autochthonous cases over time and discuss the feasibility of achieving the goal of malaria elimination by 2020. There was a total decline of 34,320 malaria cases between 2006 and 2012 arriving at an average annual incidence of 0.04 per 10,000 people by 2012. At the same time, the number of counties reporting autochthonous cases declined from 290 to 19. Spatial autocorrelation and Bayesian modelling were used to evaluate the datasets and predict the spatio-temporal pattern in the near future. The former approach showed that spatial clusters of P. vivax malaria existed in the study region during the study period, while the risk prediction map generated by the Bayesian model indicates that only sporadic malaria cases will appear during in the future. The results suggest that the initial NMEP approach and the follow-up APCME strategy have played a key role in reducing the threat of malaria in central P.R. China. However, to achieve the goal of malaria elimination by the end of the current decade, interven- tion plans must be adjusted with attention paid to those endemic counties still at risk according to the prediction map.

  18. Malaria related knowledge, practices and behaviour of people in Nepal

    Directory of Open Access Journals (Sweden)

    A.B. Joshi

    2008-02-01

    Full Text Available Background & objectives: The information on malaria related knowledge, practices and behaviour of the people of Nepal living in malaria endemic areas are essential to develop behavioural change communication messages and for producing policy to prevent and control malaria in the country. The objective of this study was to assess knowledge, practices and behaviour of the people living in malaria endemic districts and relate with malaria control policy in Nepal. Methods: The paper utilizes data from a cross-sectional study of 1330 households conducted during December 2004 to April 2005 in rural areas of Jhapa, Kailali and Kanchanpur districts. The method used includes structured questionnaire and focus group discussions. Results: The results revealed that 40% respondents were illiterates. Eighty-six percent respondents have heard about malaria but only 50% responded fever with chills as the sign and symptom of malaria. Seventy-three percent responded that mosquito bite causes malaria transmission and 74% respondents considered that malaria is the fatal disease but very few have knowledge that the treatment of malaria in time can save life. More than 50% did not have information on availability of free treatment of malaria in Nepal. Still 16% were found consulting traditional healers for the treatment. The outside sleeping habit was found in almost one fourth of the population mainly in summer season indicating no knowledge about prevention of malaria. Although bednet use practice was higher, only 4% had knowledge on insecticide impregnated bednets and 23% of them practicing it. Issues regarding the proper and regular use of bednets, the quality of the bednet and use of free treatment provided by the government, since these districts are reporting high incidence of malaria.Interpretation & conclusion: Health education must be taken into account for communities in malaria endemic areas to produce desired outcomes in malaria control.

  19. Embedding climate change risk assessment within a governance context

    Energy Technology Data Exchange (ETDEWEB)

    Preston, Benjamin L [ORNL

    2011-01-01

    Climate change adaptation is increasingly being framed in the context of climate risk management. This has contributed to the proliferation of climate change vulnerability and/or risk assessments as means of supporting institutional decision-making regarding adaptation policies and measures. To date, however, little consideration has been given to how such assessment projects and programs interact with governance systems to facilitate or hinder the implementation of adaptive responses. An examination of recent case studies involving Australian local governments reveals two key linkages between risk assessment and the governance of adaptation. First, governance systems influence how risk assessment processes are conducted, by whom they are conducted, and whom they are meant to inform. Australia s governance system emphasizes evidence-based decision-making that reinforces a knowledge deficit model of decision support. Assessments are often carried out by external experts on behalf of local government, with limited participation by relevant stakeholders and/or civil society. Second, governance systems influence the extent to which the outputs from risk assessment activities are translated into adaptive responses and outcomes. Technical information regarding risk is often stranded by institutional barriers to adaptation including poor uptake of information, competition on the policy agenda, and lack of sufficient entitlements. Yet, risk assessments can assist in bringing such barriers to the surface, where they can be debated and resolved. In fact, well-designed risk assessments can contribute to multi-loop learning by institutions, and that reflexive problem orientation may be one of the more valuable benefits of assessment.

  20. Chronicle of malaria epidemics in Thailand, 1980-2000.

    Science.gov (United States)

    Konchom, Supawadee; Singhasivanon, Pratap; Kaewkungwal, Jaranit; Chuprapawan, Sirichai; Thimasarn, Krongthong; Kidson, Chev; Yimsamran, Surapon; Rojanawatsirivet, Chaiporn

    2005-01-01

    The occurrence of malaria epidemics in Thailand was reviewed from the malaria surveillance report of the National Malaria Control Program. The literature review revealed that the four epidemic periods recorded during 1980-2000 almost always occurred in the provinces and districts located along international borders. Malaria epidemics are caused by various factors such as: extensive population movement, multi-drug resistance development, low immune status of the population, lack of knowledge and appropriate personal protection against mosquito biting, and the re-emergence of malaria transmission in low malarious areas. Such factors can lead to changes in the parasite ratio and appearance of malaria epidemics throughout the country. Evidence related to the burden of malaria epidemics was also reviewed to identify causal factors that will be helpful in future research.

  1. Changes in CVD risk factors in the activity counseling trial

    Directory of Open Access Journals (Sweden)

    Meghan Baruth

    2011-01-01

    Full Text Available Meghan Baruth1, Sara Wilcox1, James F Sallis3, Abby C King4,5, Bess H Marcus6, Steven N Blair1,21Department of Exercise Science, 2Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Public Health Research Center, Columbia, SC, USA; 3Department of Psychology, San Diego State University, San Diego, CA, USA; 4Department of Health Research and Policy, 5Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; 6Behavioral and Social Sciences Section, Brown University Program in Public Health, Providence, RI, USAAbstract: Primary care facilities may be a natural setting for delivering interventions that focus on behaviors that improve cardiovascular disease (CVD risk factors. The purpose of this study was to examine the 24-month effects of the Activity Counseling Trial (ACT on CVD risk factors, to examine whether changes in CVD risk factors differed according to baseline risk factor status, and to examine whether changes in fitness were associated with changes in CVD risk factors. ACT was a 24-month multicenter randomized controlled trial to increase physical activity. Participants were 874 inactive men and women aged 35–74 years. Participants were randomly assigned to one of three arms that varied by level of counseling, intensity, and resource requirements. Because there were no significant differences in change over time between arms on any of the CVD risk factors examined, all arms were combined, and the effects of time, independent of arm, were examined separately for men and women. Time × Baseline risk factor status interactions examined whether changes in CVD risk factors differed according to baseline risk factor status. Significant improvements in total cholesterol, high-density lipoprotein cholesterol (HDL-C and low-density lipoprotein cholesterol, the ratio of total cholesterol to HDL-C, and triglycerides were seen in

  2. Multi-risk assessment: from natural hazards to climate change

    Science.gov (United States)

    Valentina, Gallina; Silvia, Torresan; Andrea, Critto; Antonio, Marcomini

    2014-05-01

    The World Bank report on the main hotspots of natural hazards highlights that million people in the world are relatively highly exposed to at least two hazards and additional impacts on natural and human systems can be posed by climate change. Therefore, a major challenge for natural hazard and climate impact research is to develop new methods and tools for the aggregation of cumulative effects expected from multiple impacts forced by natural and anthropogenic drivers across different regions and sectors, taking into account changing climate, exposure and vulnerability. So far, a hazard by hazard approach has been generally applied for evaluating the consequences of natural and climate change hazards on the analyzed region (e.g. heavy precipitations, floods, sea-level rise, coastal erosion, storm surges). However, different natural hazards and climate-related impacts affecting a region should be handled according to a multi-risk approach in order to aggregate, compare and rank different kinds of concurrent impacts caused by climate change. Several EU funded projects (e.g. ESPON-HAZARD, ARMONIA, MATRIX) were developed so far in order to provide sound scientific advancement towards the elaboration of multi-risk approaches. A full multi-risk approach entails both a multi-hazard and multi-vulnerability perspective. However, internationally, most of the work concerning multi-hazards focused especially on natural hazards (e.g. flooding, storm surges, landslides, seismicity, droughts) affecting the same area. Moreover, multi-risk approaches developed so far refer only to the assessment of different hazards and rely on the analysis of static vulnerability (i.e. no time-dependent vulnerabilities for different exposed elements), also called multi-hazard risk assessment. A relevant challenge is therefore to develop a comprehensive formal approach for the assessment of different natural and climate-induced hazards and risks at the regional scale. A critical review of existing

  3. Neuropsychiatric adverse events during prophylaxis against malaria by using mefloquine before traveling

    Directory of Open Access Journals (Sweden)

    Osama Al-Amer

    2015-01-01

    Full Text Available Malaria is one of the most common infectious diseases, resulting in the deaths of millions of children around the world. The disease causes approximately half a million to 2.5 million people to die annually. People can only get malaria by being bitten by an infective female Anopheles mosquito that transmits malaria from infected individuals. The increase in international travel and the spread of malaria around the world has resulted in an increased risk of malaria infection. Prophylactic drugs are used to prevent the spread of malaria and to protect individuals in endemic areas. The most efficacious drug for treatment and prophylaxis against malaria is mefloquine (MQ, an antimalarial drug used especially as a prophylaxis against Plasmodium falciparum and as a treatment for malaria. MQ is also used to prevent the treatment of chloroquine-resistant P. falciparum malaria. This review focuses on the advantages of MQ and its adverse events.

  4. [Physiopathology of cerebral malaria].

    Science.gov (United States)

    Ringwald, P

    1995-01-01

    Physiopathology of severe malaria is extremely complex and misappreciated. Sequestration of parasited red cells and role of cytokines are now accepted but we still have to discover why only a few people develop a severe malaria. A better knowledge of that physiopathology would allow the conception of new therapeutic strategies to reduce malaria mortality.

  5. Microfinance against malaria: impact of Freedom from Hunger's malaria education when delivered by rural banks in Ghana.

    Science.gov (United States)

    De La Cruz, Natalie; Crookston, Benjamin; Gray, Bobbi; Alder, Steve; Dearden, Kirk

    2009-12-01

    A community randomized pre-test/post-test design was used to compare the knowledge and behaviors of microfinance clients receiving malaria education (n=213) to those receiving diarrhea education (n=223) and to non-client controls (n=268). Comparisons assessed differences at follow-up as well as within-group changes over time. At follow-up, malaria clients had significantly better malaria knowledge than comparison groups: 48.4% of malaria clients were able to identify groups most vulnerable to malaria compared with 39.2% of diarrhea clients (P=0.044) and 37.7% of non-clients (P=0.024). Malaria clients were more likely than diarrhea clients (P=0.024) (Pmicrofinance institutions can effectively contribute to community and national malaria initiatives.

  6. Predicting impacts of climate change on Fasciola hepatica risk.

    Directory of Open Access Journals (Sweden)

    Naomi J Fox

    Full Text Available Fasciola hepatica (liver fluke is a physically and economically devastating parasitic trematode whose rise in recent years has been attributed to climate change. Climate has an impact on the free-living stages of the parasite and its intermediate host Lymnaea truncatula, with the interactions between rainfall and temperature having the greatest influence on transmission efficacy. There have been a number of short term climate driven forecasts developed to predict the following season's infection risk, with the Ollerenshaw index being the most widely used. Through the synthesis of a modified Ollerenshaw index with the UKCP09 fine scale climate projection data we have developed long term seasonal risk forecasts up to 2070 at a 25 km square resolution. Additionally UKCIP gridded datasets at 5 km square resolution from 1970-2006 were used to highlight the climate-driven increase to date. The maps show unprecedented levels of future fasciolosis risk in parts of the UK, with risk of serious epidemics in Wales by 2050. The seasonal risk maps demonstrate the possible change in the timing of disease outbreaks due to increased risk from overwintering larvae. Despite an overall long term increase in all regions of the UK, spatio-temporal variation in risk levels is expected. Infection risk will reduce in some areas and fluctuate greatly in others with a predicted decrease in summer infection for parts of the UK due to restricted water availability. This forecast is the first approximation of the potential impacts of climate change on fasciolosis risk in the UK. It can be used as a basis for indicating where active disease surveillance should be targeted and where the development of improved mitigation or adaptation measures is likely to bring the greatest benefits.

  7. Fisheries and Oceans Canada climate change risk assessment initiative

    Energy Technology Data Exchange (ETDEWEB)

    Dalpe, R. [Fisheries and Oceans, Ottawa, ON (Canada)

    2005-07-01

    This paper provided an overview of an initiative undertaken by the Department of Fisheries and Oceans (DFO) Canada to assess the risks associated with climate change on Canada's waterways and aquatic resources over the next 10 to 20 years. It discussed the risk associated with changes in water temperature and level in increasing the vulnerability of fish stocks and ecosystems. A decrease in water levels is also an issue as it will render current infrastructure ineffective. Storm surges can also have an impact on coastal community infrastructure. The purpose of the assessment was to provide DFO management with a structured understanding of the major climate change factors that pose risks to DFO's operations and to establish priorities in identifying appropriate risk mitigation responses. The presentation discussed the different stages of the initiative (planning, identification and evaluation of risk, validation, and reporting), its' challenges and benefits, as well as lessons learned from this exercises. Lessons learned from the project are as follows: get senior level buy-in from the outset; engage the right people; make it easy for others to be engaged; validate results and risk management response; be ready for surprises; and build in some flexibility to the process. figs.

  8. Spatial and temporal patterns of malaria incidence in Mozambique

    Directory of Open Access Journals (Sweden)

    Zacarias Orlando P

    2011-07-01

    Full Text Available Abstract Background The objective of this study is to analyze the spatial and temporal patterns of malaria incidence as to determine the means by which climatic factors such as temperature, rainfall and humidity affect its distribution in Maputo province, Mozambique. Methods This study presents a model of malaria that evolves in space and time in Maputo province-Mozambique, over a ten years period (1999-2008. The model incorporates malaria cases and their relation to environmental variables. Due to incompleteness of climatic data, a multiple imputation technique is employed. Additionally, the whole province is interpolated through a Gaussian process. This method overcomes the misalignment problem of environmental variables (available at meteorological stations - points and malaria cases (available as aggregates for every district - area. Markov Chain Monte Carlo (MCMC methods are used to obtain posterior inference and Deviance Information Criteria (DIC to perform model comparison. Results A Bayesian model with interaction terms was found to be the best fitted model. Malaria incidence was associated to humidity and maximum temperature. Malaria risk increased with maximum temperature over 28°C (relative risk (RR of 0.0060 and 95% Bayesian credible interval (CI of 0.00033-0.0095 and humidity (relative risk (RR of 0.00741 and 95% Bayesian CI 0.005141-0.0093. The results would suggest that additional non-climatic factors including socio-economic status, elevation, etc. also influence malaria transmission in Mozambique. Conclusions These results demonstrate the potential of climate predictors particularly, humidity and maximum temperature in explaining malaria incidence risk for the studied period in Maputo province. Smoothed maps obtained as monthly average of malaria incidence allowed to visualize months of initial and peak transmission. They also illustrate a variation on malaria incidence risk that might not be related to climatic factors

  9. Increased risks of malaria due to limited residual life of insecticide and outdoor biting versus protection by combined use of nets and indoor residual spraying on Bioko Island, Equatorial Guinea

    Directory of Open Access Journals (Sweden)

    Bradley John

    2012-07-01

    Full Text Available Abstract Background Malaria is endemic on Bioko Island, Equatorial Guinea, with year-round transmission. In 2004 an intensive malaria control strategy primarily based on indoor residual spraying (IRS was launched. The limited residual life of IRS poses particular challenges in a setting with year-round transmission, such as Bioko. Recent reports of outdoor biting by Anopheles gambiae are an additional cause for concern. In this study, the effect of the short residual life of bendiocarb insecticide and of children spending time outdoors at night, on malaria infection prevalence was examined. Methods Data from the 2011 annual malaria indicator survey and from standard WHO cone bioassays were used to examine the relationship between time since IRS, mosquito mortality and prevalence of infection in children. How often children spend time outside at night and the association of this behaviour with malaria infection were also examined. Results Prevalence of malaria infection in two to 14 year-olds in 2011 was 18.4%, 21.0% and 28.1% in communities with median time since IRS of three, four and five months respectively. After adjusting for confounders, each extra month since IRS corresponded to an odds ratio (OR of 1.44 (95% CI 1.15–1.81 for infection prevalence in two to 14 year-olds. Mosquito mortality was 100%, 96%, 81% and 78%, at month 2, 3, 4 and 5 respectively after spraying. Only 4.1% of children spent time outside the night before the survey between the hours of 22.00 and 06.00 and those who did were not at a higher risk of infection (OR 0.87, 95% CI 0.50–1.54. Sleeping under a mosquito net provided additive protection (OR 0.68, 95% CI 0.54–0.86. Conclusions The results demonstrate the epidemiological impact of reduced mosquito mortality with time since IRS. The study underscores that in settings of year-round transmission there is a compelling need for longer-lasting IRS insecticides, but that in the interim, high coverage of long

  10. Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2014-02-26

    This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians. The number of malaria cases reported in the United States in 2011 was the largest since 1971, representing a 14 percent increase from 2010 and a 48 percent increase from 2008. A CDC subject matter expert describes malaria prevention strategies aimed at reducing the risk of malaria in travelers, discusses the diagnosis of malaria in patients with suspect malaria, and explains the treatment options for confirmed malaria cases.  Created: 2/26/2014 by Center for Global Health (CGH); Malaria Branch; Emergency Risk Communication Branch (ERCB); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 2/26/2014.

  11. Empirical Analysis of Urban Residents’ Perceived Climatic Change Risks

    Institute of Scientific and Technical Information of China (English)

    Peihui; DAI; Lingling; HUANG

    2014-01-01

    The impact of climate change on human survival and security,urban development is even more profound,and receives more and more attention. To explore the perceived status of urban residents for the risks of climate change and put forward corresponding countermeasures and suggestions,taking Wuhan for example,from the microscopic point of urban residents,we use factor analysis to classify the perceived risks and recognized risk reduction measures,use cluster analysis to divide the urban residents into five groups,and use variance analysis to explore differences in the choice of measures between different cluster groups. We draw the following conclusions: the risk of deterioration of the ecological environment,the risk of economic damage,the risk of damage to the mental health,the risk of damage to the physical health and the risk of damage to the political harmony are the main risks of climate change for urban residents; individuals and families to develop good habits,businesses and governments to strengthen energy conservation,schools and other agencies to carry on the propaganda and education,carrying out multi-agent environment improvement,learn from the West are their recognized risk reduction measures. Depending on the perceived risk,the urban residents are clustered into five groups: those who are concerned about the body and politics,those who are concerned about the mental health,those who are concerned about the economic development,those who are concerned about the ecological safety,and those who ignore the climatic change. For the roles of individual and the family,business and government in the environmental protection,different groups have unanimous views,while for other measures,different groups have different understanding. It is concluded that individuals and families to develop environmentally friendly habits,government to strengthen regulation,businesses to take environmental responsibility,schools to strengthen publicity and education,and exploring

  12. An Overview of Occupational Risks From Climate Change.

    Science.gov (United States)

    Applebaum, Katie M; Graham, Jay; Gray, George M; LaPuma, Peter; McCormick, Sabrina A; Northcross, Amanda; Perry, Melissa J

    2016-03-01

    Changes in atmosphere and temperature are affecting multiple environmental indicators from extreme heat events to global air quality. Workers will be uniquely affected by climate change, and the occupational impacts of major shifts in atmospheric and weather conditions need greater attention. Climate change-related exposures most likely to differentially affect workers in the USA and globally include heat, ozone, polycyclic aromatic hydrocarbons, other chemicals, pathogenic microorganisms, vector-borne diseases, violence, and wildfires. Epidemiologic evidence documents a U-, J-, or V-shaped relationship between temperature and mortality. Whereas heat-related morbidity and mortality risks are most evident in agriculture, many other outdoor occupational sectors are also at risk, including construction, transportation, landscaping, firefighting, and other emergency response operations. The toxicity of chemicals change under hyperthermic conditions, particularly for pesticides and ozone. Combined with climate-related changes in chemical transport and distribution, these interactions represent unique health risks specifically to workers. Links between heat and interpersonal conflict including violence require attention because they pose threats to the safety of emergency medicine, peacekeeping and humanitarian relief, and public safety professionals. Recommendations for anticipating how US workers will be most susceptible to climate change include formal monitoring systems for agricultural workers; modeling scenarios focusing on occupational impacts of extreme climate events including floods, wildfires, and chemical spills; and national research agenda setting focusing on control and mitigation of occupational susceptibility to climate change.

  13. Malaria-related anaemia: a Latin American perspective

    Directory of Open Access Journals (Sweden)

    Juan Pablo Quintero

    2011-08-01

    Full Text Available Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA, malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria.

  14. Malaria og graviditet

    DEFF Research Database (Denmark)

    Hoffmann, A L; Rønn, A M; Langhoff-Roos, J

    1992-01-01

    In regions where malaria is endemism, the disease is a recognised cause of complications of pregnancy such as spontaneous abortion, premature delivery, intrauterine growth retardation and foetal death. Malaria is seldom seen in pregnant women in Denmark but, during the past two years, the authors...... the patients but also their practitioners were unaware that malaria can occur several years after exposure. Three out of the four patients had employed malaria prophylaxis. As resistance to malarial prophylactics in current use is increasing steadily, chemoprophylaxis should be supplemented by mechanical...... protection against malaria and insect repellents. As a rule, malaria is treated with chloroquine. In cases of Falciparum malaria in whom chloroquine resistance is suspected, treatment with mefloquine may be employed although this should only be employed in cases of dire necessity in pregnant patients during...

  15. An online operational rainfall-monitoring resource for epidemic malaria early warning systems in Africa

    Directory of Open Access Journals (Sweden)

    Ceccato Pietro

    2005-01-01

    Full Text Available Abstract Periodic epidemics of malaria are a major public health problem for many sub-Saharan African countries. Populations in epidemic prone areas have a poorly developed immunity to malaria and the disease remains life threatening to all age groups. The impact of epidemics could be minimized by prediction and improved prevention through timely vector control and deployment of appropriate drugs. Malaria Early Warning Systems are advocated as a means of improving the opportunity for preparedness and timely response. Rainfall is one of the major factors triggering epidemics in warm semi-arid and desert-fringe areas. Explosive epidemics often occur in these regions after excessive rains and, where these follow periods of drought and poor food security, can be especially severe. Consequently, rainfall monitoring forms one of the essential elements for the development of integrated Malaria Early Warning Systems for sub-Saharan Africa, as outlined by the World Health Organization. The Roll Back Malaria Technical Resource Network on Prevention and Control of Epidemics recommended that a simple indicator of changes in epidemic risk in regions of marginal transmission, consisting primarily of rainfall anomaly maps, could provide immediate benefit to early warning efforts. In response to these recommendations, the Famine Early Warning Systems Network produced maps that combine information about dekadal rainfall anomalies, and epidemic malaria risk, available via their Africa Data Dissemination Service. These maps were later made available in a format that is directly compatible with HealthMapper, the mapping and surveillance software developed by the WHO's Communicable Disease Surveillance and Response Department. A new monitoring interface has recently been developed at the International Research Institute for Climate Prediction (IRI that enables the user to gain a more contextual perspective of the current rainfall estimates by comparing them to

  16. Acute kidney injury in imported Plasmodium falciparum malaria

    NARCIS (Netherlands)

    L.C. Koopmans, L.C. (Liese); M.E. van Wolfswinkel (Marlies); D.A. Hesselink (Dennis); E.J. Hoorn (Ewout); R. Koelewijn (Rob); J.J. van Hellemond (Jaap); P.J. van Genderen (P.)

    2015-01-01

    textabstractBackground: Acute kidney injury (AKI) is a known complication of malaria, and is reported to occur in up to 40 % of adult patients with a severe Plasmodium falciparum infection in endemic regions. To gain insight in the incidence and risk factors of AKI in imported P. falciparum malaria,

  17. Multiple insecticide resistance mechanisms involving metabolic changes and insensitive target sites selected in anopheline vectors of malaria in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Karunaratne SHP Parakrama

    2008-08-01

    Full Text Available Abstract Background The current status of insecticide resistance and the underlying resistance mechanisms were studied in the major vector of malaria, Anopheles culicifacies, and the secondary vector, Anopheles subpictus in five districts (Anuradhapura, Kurunegala, Moneragala, Puttalam and Trincomalee of Sri Lanka. Eight other anophelines, Anopheles annularis, Anopheles barbirostris, Anopheles jamesii, Anopheles nigerrimus, Anopheles peditaeniatus, Anopheles tessellatus, Anopheles vagus and Anopheles varuna from Anuradhapura district were also tested. Methods Adult females were exposed to the WHO discriminating dosages of DDT, malathion, fenitrothion, propoxur, λ-cyhalothrin, cyfluthrin, cypermethrin, deltamethrin, permethrin and etofenprox. The presence of metabolic resistance by esterase, glutathione S-transferase (GST and monooxygenase-based mechanisms, and the sensitivity of the acetylcholinesterase target site were assessed using synergists, and biochemical, and metabolic techniques. Results All the anopheline species had high DDT resistance. All An. culicifacies and An. subpictus populations were resistant to malathion, except An. culicifacies from Kurunegala, where there was no malathion carboxylesterase activity. Kurunegala and Puttalam populations of An. culicifacies were susceptible to fenitrothion. All the An. culicifacies populations were susceptible to carbamates. Both species were susceptible to the discriminating dosages of cypermethrin and cyfluthrin, but had different levels of resistance to other pyrethroids. Of the 8 other anophelines, only An. nigerrimus and An. peditaeniatus were resistant to all the insecticides tested, probably due to their high exposure to the insecticides used in agriculture. An. vagus showed some resistance to permethrin. Esterases, GSTs and monooxygenases were elevated in both An. culicifacies and An. subpictus. AChE was most sensitive to insecticides in Kurunegala and Trincomalee An. culicifacies

  18. Climate Change and Risk Management Challenges in the Arctic

    DEFF Research Database (Denmark)

    Jakobsen, Uffe

    Climate change or global warming results in melting ice in the Arctic, both inland and sea ice. This opens up opportunities of natural ressource extraction and possibilities of new shipping routes, that opens up opportunities for increased maritime activities. However, with these opportunies come...... possibilies of transborder risk management and partnership building....

  19. The High-mountain Cryosphere: Environmental Changes and Human Risks

    Directory of Open Access Journals (Sweden)

    Maria Shahgedanova

    2016-08-01

    Full Text Available Reviewed: The High-mountain Cryosphere: Environmental Changes and Human Risks Edited by Christian Huggel, Mark Carey, John J. Clague, and Andreas Kääb. Cambridge, UK: Cambridge University Press, 2015. xii + 363 pp. Hardcover: US$ 140.00, ISBN 978-1-107-06584-0. E-book: US$ 112.00, ISBN 978-1-316-35515-2.

  20. Vitamin D status and changes in cardiovascular risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta;

    2012-01-01

    A low vitamin D level has been associated with increased cardiovascular disease risk but possible mechanisms remain unclear. We investigated the association between vitamin D levels and 5-year changes in blood pressure, lipid profile and incidence of the metabolic syndrome, hypertension...

  1. The case study of climate change : the nature of risk and the risk of nature

    Energy Technology Data Exchange (ETDEWEB)

    Good, J. [Cornell Univ., Ithaca, NY (United States). Dept. of Communication

    2000-06-01

    The science of climate change is complex, large-scale and uncertain. The challenges of communicating the risks of climate change were described with particular emphasis on working with communities to explain climate change with its complex, scientific and social realities. The greenhouse effect is a feature of the earth in which a carbon dioxide blanket absorbs the sun's heat as it radiates off the earth. The paper stated that the greenhouse effect is arguably the best accepted theory in climatology, but the question is whether the huge increase in carbon dioxide that the industrial revolution has brought forth has increased the efficiency of this blanket and set the earth on a warming trend. The ultimate question is whether the earth is warming in response to human activity. It could be claimed that apart from the risk of nuclear war, the risk of climate change is the largest scale risk facing today's society. Climate change pits the burning of fossil fuels against the climate and as a modern day risk, climate change is far removed from the historic roots of environmental risks. The paper argued, that in a world based on burning fossil fuels and where those who are involved with the supply of fossil fuels hold tremendous influence, it is difficult to accept that the burning might have to stop. This paper explored how and what people currently learn about the environment and climate change through the media. A three-step communication strategy based in the United States was then proposed. The first step is aimed at journalists with focus on improved accuracy of climate change information. The second step focuses on urban centres and has as its guiding concepts self-efficacy, reasoned action and the importance of reaching people in diverse communities. The final step is aimed at political leaders, beginning with municipalities, and relies on campaigns for alternative energy.

  2. History of malaria research and its contribution to the malaria control success in Suriname: a review

    Directory of Open Access Journals (Sweden)

    Breeveld Florence JV

    2012-03-01

    Full Text Available Abstract Suriname has cleared malaria from its capital city and coastal areas mainly through the successful use of chloroquine and DDT (dichloro-diphenyl-trichloroethane during the Global Malaria Eradication programme that started in 1955. Nonetheless, malaria transmission rates remained high in the interior of the country for a long time. An impressive decline in malaria cases was achieved in the past few years, from 14,403 registered cases in 2003 to 1,371 in 2009. The introduction of artemisinin-based combination therapy (ACT in 2004 has further fuelled the decrease in the number of infections with Plasmodium falciparum. The only population group still heavily burdened with malaria is gold mining industry workers. Interestingly, an important part of malaria cases diagnosed and treated in Suriname originate from border regions. Therefore, practical initiatives of combined efforts between neighbouring countries must be scaled up in order to effectively attack these specific areas. Furthermore, it is of vital importance to keep investing into the malaria control programme and public awareness campaigns. Especially the correct use of ACT must be promoted in order to prevent the emergence of resistance. However, effective preventive measures and adequate therapeutic options are on their own not enough to control, let alone eliminate malaria. Changing personal and social behaviour of people is particularly difficult, but crucial in making the current success sustainable. With this in mind, research on successfully implemented interventions, focusing on behavioural modifications and methods of measuring their effectiveness, must be expanded.

  3. History of malaria research and its contribution to the malaria control success in Suriname: a review.

    Science.gov (United States)

    Breeveld, Florence J V; Vreden, Stephen G S; Grobusch, Martin P

    2012-03-29

    Suriname has cleared malaria from its capital city and coastal areas mainly through the successful use of chloroquine and DDT (dichloro-diphenyl-trichloroethane) during the Global Malaria Eradication programme that started in 1955. Nonetheless, malaria transmission rates remained high in the interior of the country for a long time. An impressive decline in malaria cases was achieved in the past few years, from 14,403 registered cases in 2003 to 1,371 in 2009. The introduction of artemisinin-based combination therapy (ACT) in 2004 has further fuelled the decrease in the number of infections with Plasmodium falciparum. The only population group still heavily burdened with malaria is gold mining industry workers. Interestingly, an important part of malaria cases diagnosed and treated in Suriname originate from border regions. Therefore, practical initiatives of combined efforts between neighbouring countries must be scaled up in order to effectively attack these specific areas. Furthermore, it is of vital importance to keep investing into the malaria control programme and public awareness campaigns. Especially the correct use of ACT must be promoted in order to prevent the emergence of resistance. However, effective preventive measures and adequate therapeutic options are on their own not enough to control, let alone eliminate malaria. Changing personal and social behaviour of people is particularly difficult, but crucial in making the current success sustainable. With this in mind, research on successfully implemented interventions, focusing on behavioural modifications and methods of measuring their effectiveness, must be expanded.

  4. Plasma glutamine levels and falciparum malaria.

    Science.gov (United States)

    Cowan, G; Planche, T; Agbenyega, T; Bedu-Addo, G; Owusu-Ofori, A; Adebe-Appiah, J; Agranoff, D; Woodrow, C; Castell, L; Elford, B; Krishna, S

    1999-01-01

    Glutamine deficiency is associated with increased rates of sepsis and mortality, which can be prevented by glutamine supplementation. Changes in glutamine concentration were examined in Ghanaian children with acute falciparum malaria and control cases. The mean (SD) plasma glutamine concentration was lower in patients with acute malaria (401 (82) mumol/L, n = 50) than in control patients (623 (67) mumol/L, n = 7; P sepsis and dyserythropoeisis.

  5. Deforestation and malaria in Mâncio Lima County, Brazil.

    Science.gov (United States)

    Olson, Sarah H; Gangnon, Ronald; Silveira, Guilherme Abbad; Patz, Jonathan A

    2010-07-01

    Malaria is the most prevalent vector-borne disease in the Amazon. We used malaria reports for health districts collected in 2006 by the Programa Nacional de Controle da Malaria to determine whether deforestation is associated with malaria incidence in the county (municipio) of Mancio Lima, Acre State, Brazil. Cumulative percent deforestation was calculated for the spatial catchment area of each health district by using 60 x 60-meter, resolution-classified imagery. Statistical associations were identified with univariate and multivariate general additive negative binomial models adjusted for spatial effects. Our cross-sectional study shows malaria incidence across health districts in 2006 is positively associated with greater changes in percentage of cumulative deforestation within respective health districts. After adjusting for access to care, health district size, and spatial trends, we show that a 4.2%, or 1 SD, change in deforestation from August 1997 through August 2001 is associated with a 48% increase of malaria incidence.

  6. Can Knowledge Deficit Explain Societal Perception of Climate Change Risk?

    Science.gov (United States)

    Mitra, R.; McNeal, K.; Bondell, H.

    2014-12-01

    Climate change literacy efforts have had a rough journey in the past decade. Although scientists have become increasingly convinced about anthropological climate change, change in public opinion has been underwhelming. The unexplained gap between scientific consensus and public opinion has made this topic an important research area in the realm of public understanding of science. Recent research on climate change risk perception (CCRP) has advanced an intriguing hypothesis, namely, cultural cognition thesis (CCT), which posits that the public has adequate knowledge to understand climate change science but people tend to use this knowledge solely to promote their culturally motivated view-point of climate change. This talk provides evidence to demonstrate that despite culture playing a significant role in influencing CCRP, knowledge deficiency remains a persistent problem in our society and contributes to the aforementioned gap. However, such deficits can remain undiagnosed due to limitations of survey design.

  7. 恶性疟相关性心肌炎易患因素初步探讨%Preliminary study on the risk factors of myocarditis associated with falciparum malaria

    Institute of Scientific and Technical Information of China (English)

    潘红星; Julian Obiang Ngue

    2009-01-01

    Objective To investigate the risk factors of myocarditis associated with falciparum malaria. Methods From September 2008 to June 2009, at Regional Hospital of Bata in the Republic of Equatorial Guinea, all falciparum malaria patients were enrolled for a pair-matched case-contrel study to investigate if obesity and smok-ing could be considered as significant risks for the development of falciparum malaria-related myocarditis. Among them, forty-four pairs of patients with and without malaria-related myocarditis (patients without myocarditis as con-trois) were matched by gender, age (±3 years) and race. Data were analyzed with conditioned logistic regression. Results Obesity was significantly associated with the development of falciparum malaria-related myocarditis (P =0. 0271, OR = 3.5,95% CI 1.152-10.633). Conclusion Obesity might be considered as the risk factor for the de-velopment of falciparum malaria-related myocarditis. Early prevention and treatment should be taken. Anti-malaria drugs showing cardiovascular side effects should be used with caution in obese patients.%目的 探讨恶性疟相关性心肌炎的易患因素.方法 对赤道几内亚共和国巴塔地区2008年9月至2009年6月所有诊治的恶性疟患者病例资料进行病例-对照研究,并发恶性疟相关性心肌炎者作为并发心肌炎组,未并发心肌炎者作为对照组,按年龄、性别及种族以1:1相互配对(配对者年龄差≤3),调查分析肥胖与吸烟是否为恶性疟相关性心肌炎的易患因素.对所得数据用统计软件SAS9.1.3进行条件Logistic回归分析.结果 肥胖者患恶性疟时并发恶性疟相关性心肌炎的危险性比非肥胖者大(P=0.0271,比数比=3.5,95%可信区间1.152~10.633).吸烟者未被入选回归模型.结论 患恶性疟的肥胖患者易并发恶性疟相关性心肌炎,应及早采取干预性防治措施并慎用有心血管系统不良反应的抗疟药物.吸烟者与不吸烟者在患恶性疟时并发

  8. Is housing quality associated with malaria incidence among young children and mosquito vector numbers? Evidence from Korogwe, Tanzania.

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    Jenny X Liu

    Full Text Available BACKGROUND: Several studies conducted in Northeast Tanzania have documented declines in malaria transmission even before interventions were scaled up. One explanation for these reductions may be the changes in socio-environmental conditions associated with economic development, and in particular improvements in housing construction. OBJECTIVE: This analysis seeks to identify (1 risk factors for malaria incidence among young children and (2 household and environmental factors associated with mosquito vector numbers collected in the child's sleeping area. Both analyses focus on housing construction quality as a key determinant. METHODOLOGY: For 435 children enrolled in a larger trial of intermittent preventive treatment for malaria in infants in the Korogwe District in Tanga, Northeastern Tanzania, detailed information on their dwelling characteristics were collected in the last year of the trial. Principal components analysis was used to construct an index of housing structure quality and converted to quintile units for regression analysis. Univariate and multivariate random effects negative binomial regressions were used to predict risk factors for child malaria incidence and the mean total number of indoor female Anopheles gambiae and funestus mosquitoes collected per household across three occasions. FINDINGS: Building materials have substantially improved in Korogwe over time. Multivariate regressions showed that residing in rural areas (versus urban increased malaria incidence rates by over three-fold and mean indoor female A. gambiae and funestus numbers by nearly two-fold. Compared to those residing in the lowest quality houses, children residing in the highest quality houses had one-third lower malaria incidence rates, even when wealth and rural residence were controlled for. Living in the highest quality houses reduced vector numbers while having cattle near the house significantly increased them. CONCLUSIONS: Results corroborate

  9. Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia.

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    Tsige Ketema

    Full Text Available Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20 software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%. Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P0.05, IgG3 antibody was significantly higher (P<0.001 among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001 with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05 in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it can enhance induction of humoral immune response and CD4+ T-lymphocyte population during malaria infection. This calls for further investigation on the effect of khat on parasite or antigen-specifc protective malaria immunity and analysis of cytokines released upon malaria infection among khat chewers.

  10. Malaria transmission in Bissau, Guinea-Bissau between 1995 and 2012: malaria resurgence did not negatively affect mortality.

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    Johan Ursing

    Full Text Available As Plasmodium falciparum prevalence decreases in many parts of Sub-Saharan Africa, so does immunity resulting in larger at risk populations and increased risk of malaria resurgence. In Bissau, malaria prevalence decreased from ∼50% to 3% between 1995 and 2003. The epidemiological characteristics of P. falciparum malaria within Bandim health and demographic surveillance site (population ∼100,000 between 1995 and 2012 are described.The population was determined by census. 3603 children aged <15 years that were enrolled in clinical trials at the Bandim health centre (1995-2012 were considered incident cases. The mean annual malaria incidence per thousand children in 1995-1997, 1999-2003, 2007, 2011, 2012 were as follows; age <5 years 22→29→4→9→3, age 5-9 years 15→28→4→33→12, age 10-14 years 9→15→1→45→19. There were 4 campaigns (2003-2010 to increase use of insecticide treated bed nets (ITN amongst children <5 years. An efficacious high-dose chloroquine treatment regime was routinely used until artemisinin based combination therapy (ACT was introduced in 2008. Long lasting insecticide treated bed nets (LLIN were distributed in 2011. By 2012 there was 1 net per 2 people and 97% usage. All-cause mortality decreased from post-war peaks in 1999 until 2012 in all age groups and was not negatively affected by malaria resurgence.The cause of decreasing malaria incidence (1995-2007 was probably multifactorial and coincident with the use of an efficacious high-dose chloroquine treatment regime. Decreasing malaria prevalence created a susceptible group of older children in which malaria resurged, highlighting the need to include all age groups in malaria interventions. ACT did not hinder malaria resurgence. Mass distribution of LLINs probably curtailed malaria epidemics. All-cause mortality was not negatively affected by malaria resurgence.

  11. Future climate data from RCP 4.5 and occurrence of malaria in Korea.

    Science.gov (United States)

    Kwak, Jaewon; Noh, Huiseong; Kim, Soojun; Singh, Vijay P; Hong, Seung Jin; Kim, Duckgil; Lee, Keonhaeng; Kang, Narae; Kim, Hung Soo

    2014-10-15

    Since its reappearance at the Military Demarcation Line in 1993, malaria has been occurring annually in Korea. Malaria is regarded as a third grade nationally notifiable disease susceptible to climate change. The objective of this study is to quantify the effect of climatic factors on the occurrence of malaria in Korea and construct a malaria occurrence model for predicting the future trend of malaria under the influence of climate change. Using data from 2001-2011, the effect of time lag between malaria occurrence and mean temperature, relative humidity and total precipitation was investigated using spectral analysis. Also, a principal component regression model was constructed, considering multicollinearity. Future climate data, generated from RCP 4.5 climate change scenario and CNCM3 climate model, was applied to the constructed regression model to simulate future malaria occurrence and analyze the trend of occurrence. Results show an increase in the occurrence of malaria and the shortening of annual time of occurrence in the future.

  12. [New approaches of malaria prevention for travelers].

    Science.gov (United States)

    Voumard, Rachel; Berthod, Delphine; Rochat, Laurence; D'Acremont, Valérie; Genton, Blaise; De Vallière, Serge

    2016-05-01

    Malaria is declining in many tropical countries. This reduction challenges our usual preventive strategies. In moderate to low risk areas, the Swiss guidelines recommend a stand-by emergency treatment. Controversies between experts are numerous though. Professionals at the Travel Clinic in Lausanne has explored shared-decision making through three clinical studies. The first showed that travelers visiting moderate to low risk malaria areas prefer a standby emergency treatment rather than chemoprophylaxis. The second study investigates the use of rapid diagnostic tests by travelers. The third focuses on the prospects of tropical telemedicine. Involving the traveler into the debate is a priority, until a vaccine becomes available.

  13. Potential Serological Biomarkers of Cerebral Malaria

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    Naomi W. Lucchi

    2011-01-01

    Full Text Available Biomarkers have been used to diagnose and prognosticate the progress and outcome of many chronic diseases such as neoplastic and non communicable diseases. However, only recently did the field of malaria research move in the direction of actively identifying biomarkers that can accurately discriminate the severe forms of malaria. Malaria continues to be a deadly disease, killing close to a million people (mostly children every year. One life-threatening complication of malaria is cerebral malaria (CM. Studies carried out in Africa have demonstrated that even with the best treatment, as high as 15–30% of CM patients die and about 10–24% of CM survivors suffer short-or long-term neurological impairment. The transition from mild malaria to CM can be sudden and requires immediate intervention. Currently, there is no biological test available to confirm the diagnosis of CM and its complications. It is hoped that development of biomarkers to identify CM patients and potential risk for adverse outcomes would greatly enhance better intervention and clinical management to improve the outcomes. We review here what is currently known regarding biomarkers for CM outcomes.

  14. Cerebral malaria: gamma-interferon redux

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    Nicholas H Hunt

    2014-08-01

    Full Text Available There are two theories that seek to explain the pathogenesis of cerebral malaria, the mechanical obstruction hypothesis and the immunopathology hypothesis. Evidence consistent with both ideas has accumulated from studies of the human disease and experimental models. Thus some combination of these concepts seems necessary to explain the very complex pattern of changes seen in cerebral malaria. The interactions between malaria parasites, erythrocytes, the cerebral microvascular endothelium, brain parenchymal cells, platelets and microparticles need to be considered. One factor that seems able to knit together much of this complexity is the cytokine interferon-gamma. In this review we consider findings from the clinical disease, in vitro models and the murine counterpart of human cerebral malaria in order to evaluate the roles played by interferon-gamma in the pathogenesis of this often fatal and debilitating condition.

  15. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

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    Uzochukwu Benjamin SC

    2009-11-01

    Full Text Available Abstract Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. Methods A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. Results The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, Conclusion The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases.

  16. 1H NMR metabonomics indicates continued metabolic changes and sexual dimorphism post-parasite clearance in self-limiting murine malaria model.

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    Arjun Sengupta

    Full Text Available Malaria, a mosquito-borne disease caused by Plasmodium spp. is considered to be a global threat, specifically for the developing countries. In human subjects considerable information exists regarding post-malarial physiology. However, most murine malarial models are lethal, and most studies deal with acute phases occurring as disease progresses. Much less is known regarding physiological status post-parasite clearance. We have assessed the physiological changes at the organ levels using (1H NMR based metabonomics in a non lethal self-clearing murine malarial model of P. chabaudi parasites and Balb/C, far beyond the parasite clearance point. The results showed distinct metabolic states between uninfected and infected mice at the peak parasitemia, as well as three weeks post-parasite clearance. Our data also suggests that the response at the peak infection as well as recovery exhibited distinct sexual dimorphism. Specifically, we observed accumulation of acetylcholine in the brain metabolic profile of both the sexes. This might have important implication in understanding the pathophysiology of the post malarial neurological syndromes. In addition, the female liver showed high levels of glucose, dimethylglycine, methylacetoacetate and histidine after three weeks post-parasite clearance, while the males showed accumulation of branched chain amino acids, lysine, glutamine and bile acids.

  17. The robustness of flood insurance regimes given changing risk resulting from climate change

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    Jessica Lamond

    2014-01-01

    Full Text Available The changing risk of flooding associated with climate change presents different challenges for the different flood insurance market models in use around the world, which vary in respect of consumer structure and their risk transfer mechanism. A review of international models has been undertaken against three broad criteria for the functioning and sustainability of a flood insurance scheme: knowing the nature of the insurable risk; the availability of an insurable population; and the presence of a solvent insurer. The solvency of insurance markets appears strong, partly because insurers and reinsurers can choose to exclude markets which would give rise to insolvency or can diversify their portfolios to include offsetting perils. Changing risk may threaten solvency if increasing risk is not recognised and adjusted for but insurability of flood risk may be facilitated by the use of market based and hybrid schemes offering greater diversification and more flexibility. While encouragement of mitigation is in theory boosted by risk based pricing, availability and affordability of insurance may be negatively impacted. This threatens the sustainability of an insurable population, therefore the inclusion of the state in partnership is beneficial in ensuring continuity of cover, addressing equity issues and incentivising mitigation.

  18. Health risk in the context of climate change and adaptation - Concept and mapping as an integrated approach

    Science.gov (United States)

    Kienberger, S.; Notenbaert, A.; Zeil, P.; Bett, B.; Hagenlocher, M.; Omolo, A.

    2012-04-01

    Climate change has been stated as being one of the greatest challenges to global health in the current century. Climate change impacts on human health and the socio-economic and related poverty consequences are however still poorly understood. While epidemiological issues are strongly coupled with environmental and climatic parameters, the social and economic circumstances of populations might be of equal or even greater importance when trying to identify vulnerable populations and design appropriate and well-targeted adaptation measures. The inter-linkage between climate change, human health risk and socio-economic impacts remains an important - but largely outstanding - research field. We present an overview on how risk is traditionally being conceptualised in the human health domain and reflect critically on integrated approaches as being currently used in the climate change context. The presentation will also review existing approaches, and how they can be integrated towards adaptation tools. Following this review, an integrated risk concept is being presented, which has been currently adapted under the EC FP7 research project (HEALTHY FUTURES; http://www.healthyfutures.eu/). In this approach, health risk is not only defined through the disease itself (as hazard) but also by the inherent vulnerability of the system, population or region under study. It is in fact the interaction of environment and society that leads to the development of diseases and the subsequent risk of being negatively affected by it. In this conceptual framework vulnerability is being attributed to domains of lack of resilience as well as underlying preconditions determining susceptibilities. To fulfil a holistic picture vulnerability can be associated to social, economic, environmental, institutional, cultural and physical dimensions. The proposed framework also establishes the important nexus to adaptation and how different measures can be related to avoid disease outbreaks, reduce

  19. Changes in field workability and drought risk from projected climate change drive spatially variable risks in Illinois cropping systems

    Science.gov (United States)

    Tomasek, Bradley J.; Williams, Martin M.; Davis, Adam S.

    2017-01-01

    As weather patterns become more volatile and extreme, risks introduced by weather variability will become more critical to agricultural production. The availability of days suitable for field work is driven by soil temperature and moisture, both of which may be altered by climate change. We projected changes in Illinois season length, spring field workability, and summer drought risk under three different emissions scenarios (B1, A1B, and A2) down to the crop district scale. Across all scenarios, thermal time units increased in parallel with a longer frost-free season. An increase in late March and Early April field workability was consistent across scenarios, but a decline in overall April through May workable days was observed for many cases. In addition, summer drought metrics were projected to increase for most scenarios. These results highlight how the spatial and temporal variability in climate change may present unique challenges to mitigation and adaptation efforts. PMID:28231329

  20. Geographical patterns of malaria transmission based on serological markers for falciparum and vivax malaria in Ratanakiri, Cambodia

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    Karen Kerkhof

    2016-10-01

    Full Text Available Abstract Background Malaria transmission is highly heterogeneous, especially in low endemic countries, such as Cambodia. This results in geographical clusters of residual transmission in the dry, low transmission season, which can fuel the transmission to wider areas or populations during the wet season. A better understanding of spatial clustering of malaria can lead to a more efficient, targeted strategy to reduce malaria transmission. This study aims to evaluate the potential of the use of serological markers to define spatial patterns in malaria exposure. Methods Blood samples collected in a community-based randomized trial performed in 98 high endemic communities in Ratanakiri province, north-eastern Cambodia, were screened with a multiplex serological assay for five serological markers (three Plasmodium falciparum and two Plasmodium vivax. The antibody half-lives range from approximately six months until more than two years. Geographical heterogeneity in malaria transmission was examined using a spatial scan statistic on serology, PCR prevalence and malaria incidence rate data. Furthermore, to identify behavioural patterns or intrinsic factors associated with malaria exposure (antibody levels, risk factor analyses were performed by using multivariable random effect logistic regression models. The serological outcomes were then compared to PCR prevalence and malaria incidence data. Results A total of 6502 samples from two surveys were screened in an area where the average parasite prevalence estimated by PCR among the selected villages is 3.4 %. High-risk malaria pockets were observed adjacent to the ‘Tonle San River’ and neighbouring Vietnam for all three sets of data (serology, PCR prevalence and malaria incidence rates. The main risk factors for all P. falciparum antigens and P. vivax MSP1.19 are age, ethnicity and staying overnight at the plot hut. Conclusion It is possible to identify similar malaria pockets of higher malaria

  1. Changes in risk factor profile after ischemic stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete

    Background and aims. Adherence to preventive medication and to a healthy life style reduces stroke survivors’ risk of recurrent stroke. We investigated risk factor management in patients admitted to 3 Copenhagen hospitals with ischemic stroke (IS) Methods. 320 patients with acute IS were followed......-fatal recurrent stroke or myocardial infarction Conclusions. We suggest the organisation of secondary prevention clinics within the stroke units for life style modification and treatment to target of risk factors immediately after discharge, thus extending the success of TIA clinics to all stroke survivors...... a maximum score of 6 points. Mean baseline RFP-score was 1.6 Results. After 1 year we found a reduction in current smoking (p=0.008) and in excessive drinking (p=0.0001). There was no change in physical activity and in untreated hypertension. There was an increase in the proportion of patients on lipid...

  2. Environmental health risk assessment and management for global climate change

    Science.gov (United States)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  3. Indigenous malaria in a suburb of Ghent, Belgium.

    Science.gov (United States)

    Peleman, R; Benoit, D; Goossens, L; Bouttens, F; Puydt, H D; Vogelaers, D; Colardyn, F; Van de Woude, K

    2000-01-01

    We report here details of a patient with Plasmodium falciparum malaria which was acquired in the vicinity of Ghent (Evergem) in July 1997. Indigenous malaria disappeared from Belgium in 1938. Due to an increase in international travel, the influx of migrant labor and the changing environmental conditions, there has been an upsurge of imported malaria. Airport- and port-malaria is acquired through the bite of a tropical anophelline mosquito by people whose geographical history excludes exposure to this vector in its natural habitat. As far as we know, only two cases of port-malaria have been reported: in Marseille. We describe here another possible case of port-malaria due to infection with P. falciparum in a 42-year-old woman with an underlying non-Hodgkin lymphoma.

  4. Concurrent dengue and malaria in an area in Kolkata

    Institute of Scientific and Technical Information of China (English)

    Amiya Kumar Hati; Indranil Bhattacharjee; Hiranmoy Mukherjee; Bhaswati Bandyopadhayay; Deban Bandyopadhyay; Rajyasree De; Goutam Chandra

    2012-01-01

    ABSTRACT Objective:To establish the nature and extent of dual dengue and malaria infections in an endemic area through a longitudinal study.Methods: A prospective study was conducted from August2005to December2010to document the nature and extent of concurrent dengue and malaria infections in an area in central Kolkata, endemic both for dengue and malaria.Results:Of2 971 suspected cases of dengue fever, in605 (20.36%)persons dengue infection was detected, of whom46 (7.60%, 46/605)patients (40 and6suffered from secondary and primary dengue fever respectively) were simultaneously suffering from malaria (28 and18 were infected with Plasmodium vivax (P.vivax) andPlasmodium falciparum (P. falciparum) respectively, such dual infections of dengue and malaria were detected in all the years of the study period, except 2007, indicating intense transmission of both dengue and malaria in the study area, and the phenomenon was not an isolated one, the rate of concomitant infections ranged from25% in2009 to4.9% in 2005. Out of total population surveyed,1.54% (46/2 971)had concurrent dengue and malaria infection.Conclusions: These findings added a new dimension in diagnosis, treatment, epidemiology and control of dengue and malaria. The possible risk of concurrent dengue and malaria infections should always be kept in mind in endemic areas for early diagnosis employing modern technology and prompt and effective treatment to avoid serious complications.

  5. Socio-Demographics and the Development of Malaria Elimination Strategies in the Low Transmission Setting

    Science.gov (United States)

    Chuquiyauri, Raul; Paredes, Maribel; Peñataro, Pablo; Torres, Sonia; Marin, Silvia; Tenorio, Alexander; Brouwer, Kimberly C.; Abeles, Shira; Llanos-Cuentas, Alejandro; Gilman, Robert H.; Kosek, Margaret; Vinetz, Joseph M.

    2011-01-01

    This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9,000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis. PMID:22100446

  6. Socio-demographics and the development of malaria elimination strategies in the low transmission setting.

    Science.gov (United States)

    Chuquiyauri, Raul; Paredes, Maribel; Peñataro, Pablo; Torres, Sonia; Marin, Silvia; Tenorio, Alexander; Brouwer, Kimberly C; Abeles, Shira; Llanos-Cuentas, Alejandro; Gilman, Robert H; Kosek, Margaret; Vinetz, Joseph M

    2012-03-01

    This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis.

  7. Strategic risk assessment: A case study of climate change

    Energy Technology Data Exchange (ETDEWEB)

    Beer, T. [CSIRO, Mordialloc, Victoria (Australia). Div. of Atmospheric Research

    1996-12-31

    The philosophical basis for the on-going international and Australian action on climate change is the precautionary principle. The version of this relevant to Australia is that agreed to by the Australian States and by the Commonwealth of Australia as expressed in the Inter-Governmental Agreement on the Environment (IGAE). This study addresses the following questions: 1. What form of assessment of the risk-weighted consequences of climate change has been undertaken, as required under the precautionary principle? This paper claims that the IPCC process constitutes the risk-weighted assessment that is needed to justify the use of the precautionary principle. 2. Reducing the risk due to climate change requires actions on the basis of some combination of environmental integrity, equity, and economic efficiency as measured by cost-benefit analysis. Is the concept of intergenerational equity consistent with cost-benefit analysis? This paper claims that the problems of valuation over future time-scales, which may range from decades to centuries, make it difficult to apply cost-benefit analysis to the problem.

  8. Interactive Simulator for Teaching of Climate Change Risk

    Directory of Open Access Journals (Sweden)

    Antonio Torres Valle

    2015-12-01

    Full Text Available The use of simulators is good practice for teaching or training in the operation of complex processes. This is the case of climate change, the one associated with multiple phenomena that cannot be played as isolated laboratory practices. The experts themselves of the Intergovernmental Panel on Climate Change (IPCC have suggested qualitative indicators tomeasure the components of this risk (hazard, vulnerability and exposure and still, its complexity is remarkable for the multi, inter and transdisciplinary knowledge necessary for evaluation. One of the most important challenges of teaching these topics is the multiplicity of combinations that can occur for a variety of inputs of tax risk factors in each area of the world studied. Therefore, the presentation of an interdependent matrix system that maps the global and regional variables concerning the risks of climate change and a recursive system for evaluation are the basis of the simulator proposed in this paper. The same has been tested with global and regional scenarios, which have been incorporated into computercode developed for the preparation of prewritten didactic exercises and a recommendation for the implementation of new case studies.

  9. Glucose-6-phosphate dehydrogenase deficiency and the risk of malaria and other diseases in children in Kenya: a case-control and a cohort study

    Science.gov (United States)

    Uyoga, Sophie; Ndila, Carolyne M; Macharia, Alex W; Nyutu, Gideon; Shah, Shivang; Peshu, Norbert; Clarke, Geraldine M; Kwiatkowski, Dominic P; Rockett, Kirk A; Williams, Thomas N

    2015-01-01

    Summary Background The global prevalence of X-linked glucose-6-phosphate dehydrogenase (G6PD) deficiency is thought to be a result of selection by malaria, but epidemiological studies have yielded confusing results. We investigated the relationships between G6PD deficiency and both malaria and non-malarial illnesses among children in Kenya. Methods We did this study in Kilifi County, Kenya, where the G6PD c.202T allele is the only significant cause of G6PD deficiency. We tested the associations between G6PD deficiency and severe and complicated Plasmodium falciparum malaria through a case-control study of 2220 case and 3940 control children. Cases were children aged younger than 14 years, who visited the high dependency ward of Kilifi County Hospital with severe malaria between March 1, 1998, and Feb 28, 2010. Controls were children aged between 3–12 months who were born within the same study area between August 2006, and September 2010. We assessed the association between G6PD deficiency and both uncomplicated malaria and other common diseases of childhood in a cohort study of 752 children aged younger than 10 years. Participants of this study were recruited from a representative sample of households within the Ngerenya and Chonyi areas of Kilifi County between Aug 1, 1998, and July 31, 2001. The primary outcome measure for the case-control study was the odds ratio for hospital admission with severe malaria (computed by logistic regression) while for the cohort study it was the incidence rate ratio for uncomplicated malaria and non-malaria illnesses (computed by Poisson regression), by G6PD deficiency category. Findings 2863 (73%) children in the control group versus 1643 (74%) in the case group had the G6PD normal genotype, 639 (16%) versus 306 (14%) were girls heterozygous for G6PD c.202T, and 438 (11%) versus 271 (12%) children were either homozygous girls or hemizygous boys. Compared with boys and girls without G6PD deficiency, we found significant

  10. Comparative Risk Assessment to Inform Adaptation Priorities for the Natural Environment: Observations from the First UK Climate Change Risk Assessment

    OpenAIRE

    Iain Brown

    2015-01-01

    Risk assessment can potentially provide an objective framework to synthesise and prioritise climate change risks to inform adaptation policy. However, there are significant challenges in the application of comparative risk assessment procedures to climate change, particularly for the natural environment. These challenges are evaluated with particular reference to the first statutory Climate Change Risk Assessment (CCRA) and evidence review procedures used to guide policy for the UK government...

  11. Contribution of future urbanisation expansion to flood risk changes

    Science.gov (United States)

    Bruwier, Martin; Mustafa, Ahmed; Archambeau, Pierre; Erpicum, Sébastien; Pirotton, Michel; Teller, Jacques; Dewals, Benjamin

    2016-04-01

    The flood risk is expected to increase in the future due to climate change and urban development. Climate change modifies flood hazard and urban development influences exposure and vulnerability to floods. While the influence of climate change on flood risk has been studied widely, the impact of urban development also needs to be considered in a sustainable flood risk management approach. The main goal of this study is the determination of the sensitivity of future flood risk to different urban development scenarios at a relatively short-time horizon in the River Meuse basin in Wallonia (Belgium). From the different scenarios, the expected impact of urban development on flood risk is assessed. Three urban expansion scenarios are developed up to 2030 based on a coupled cellular automata (CA) and agent-based (AB) urban expansion model: (i) business-as-usual, (ii) restrictive and (iii) extreme expansion scenarios. The main factor controlling these scenarios is the future urban land demand. Each urban expansion scenario is developed by considering or not high and/or medium flood hazard zones as a constraint for urban development. To assess the model's performance, it is calibrated for the Meuse River valley (Belgium) to simulate urban expansion between 1990 and 2000. Calibration results are then assessed by comparing the 2000 simulated land-use map and the actual 2000 land-use map. The flood damage estimation for each urban expansion scenario is determined for five flood discharges by overlaying the inundation map resulting from a hydraulic computation and the urban expansion map and by using damage curves and specific prices. The hydraulic model Wolf2D has been extensively validated by comparisons between observations and computational results during flood event .This study focuses only on mobile and immobile prices for urban lands, which are associated to the most severe damages caused by floods along the River Meuse. These findings of this study offers tools to

  12. Human movement data for malaria control and elimination strategic planning

    Directory of Open Access Journals (Sweden)

    Pindolia Deepa K

    2012-06-01

    Full Text Available Abstract Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i discuss relevant types of HPM across spatial and temporal scales, (ii document where datasets exist to quantify HPM, (iii highlight where data gaps remain and (iv briefly put forward methods for integrating these datasets in a Geographic Information System (GIS framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  13. Human movement data for malaria control and elimination strategic planning.

    Science.gov (United States)

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-06-18

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  14. Bahamians and Climate Change: An Analysis of Risk Perception and Climate Change Literacy

    Science.gov (United States)

    Neely, R.; Owens, M. A.

    2011-12-01

    The Commonwealth of the Bahamas is forecasted to be adversely impacted by the effects of climate change. This presentation will present the results of an assessment of the risk perception toward climate change and climate change literacy among Bahamians. 499 Bahamians from the health care and hospitality industries participated in surveys and/or focus groups and three (3) areas of climate change literacy (attitude, behavior and knowledge) were analyzed as well as risk perception. In general, 1) Bahamians demonstrated an elementary understanding of the underlying causes of climate change, 2) possessed positive attitudes toward adopting new climate change policies, and 3) are already adjusting their behaviors in light of the current predictions. This research also resulted in the development of a model of the relationships between the climate literacy subscales (attitude, behavior and knowledge) and risk perception. This study also examined information sources and their impacts on climate change literacy. As the source of information is important in assessing the quality of the information, participants also identified the source(s) of most of their climate change information. The TV news was cited as the most common source for climate change information among Bahamians. As there is limited active research generating specific climate change information in the Bahamas, all the information Bahamians receive as it pertains to climate change is generated abroad. As a result, Bahamians must decipher through to make sense of it on an individual level. From the focus groups, many of the participants have been able to view possible changes through a cultural lens and are willing to make adjustments to maintain the uniqueness and viability of the Bahamas and to preserve it for generations. Continued study of Bahamians' climate change literacy will inform adaption and mitigation policy as well as individual action.

  15. Thrombocytopenia in pregnant women with Plasmodium falciparum malaria in an area of unstable malaria transmission in eastern Sudan

    Directory of Open Access Journals (Sweden)

    Adam Mayyada B

    2012-08-01

    Full Text Available Abstract Background Blood platelet levels are being evaluated as predictive and prognostic indicators of the severity of malaria infections in humans. However, there are few studies on platelets and Plasmodium falciparum malaria during pregnancy. Methods A case–control study was conducted at Gadarif Hospital in Eastern Sudan, an area characterized by unstable malaria transmission. The aim of the study was to investigate thrombocytopenia in pregnant women with P. falciparum malaria (cases and healthy pregnant women (controls. Results The median (interquartile platelet counts were significantly lower in patients with malaria (N = 60 than in the controls (N = 60, 61, 000 (43,000–85,000 vs. 249,000 (204,000–300,000/μL, respectively, p P. falciparum malaria (N = 12 compared with those patients with uncomplicated P. falciparum malaria (N = 48, 68, 000 (33,000-88,000/μL vs. 61, 000 (45,000–85,000/μL, respectively, p = 0.8. While none of the control group had thrombocytopenia (platelet count p P. falciparum malaria, compared with the pregnant healthy control group, were at higher risk (OR = 10.1, 95% CI = 4.1–25.18; p  Conclusion P. falciparum malaria is associated with thrombocytopenia in pregnant women in this setting. More research is needed.

  16. Sensing risk, fearing uncertainty: Systems science approach to change.

    Directory of Open Access Journals (Sweden)

    Ivo P Janecka

    2014-03-01

    Full Text Available BackgroundMedicine devotes its primary focus to understanding change, from cells to network relationships; observations of non-linearity are inescapable. Recent events provide extraordinary examples of major non-linear surprises within the societal system: human genome-from anticipated 100,000+ genes to only 20,000+; junk DNA-initially ignored but now proven to control genetic processes; economic reversals-bursting of bubbles in technology, housing, finance; foreign wars; relentless rise in obesity, neurodegenerative diseases.There are two attributes of systems science that are especially relevant to this research: One- it offers a method for creating a structural context with a guiding path to pragmatic knowledge; and, two- it gives pre-eminence to sensory input capable to register, evaluate, and react to change. Material / MethodPublic domain records of change, during the last fifty years, have been studied in the context of systems science, the dynamic systems model, and various cycles. Results / Conclusions Change is dynamic, ever-present, never isolated, and of variable impact; it reflects innumerable relationships among contextual systems; change can be perceived as risk or uncertainty depending upon how the assessment is made; risk is quantifiable by sensory input and generates a degree of rational optimism; uncertainty is not quantifiable and evokes fear; trust is key to sharing risk; the measurable financial credit can be a proxy for societal trust; expanding credit dilutes trust; when a credit bubble bursts, so will trust; absence of trust paralyzes systems’ relationships leading to disorganized complexity which prevents value creation and heightens the probability of random events; disappearance of value, accompanied by chaos, threatens all systems.From personal health to economic sustainability and collective rationality, most examined components of the societal system were found not to be optimized and trust was not in evidence.

  17. Erythrocyte Features for Malaria Parasite Detection in Microscopic Images of Thin Blood Smear: A Review

    Directory of Open Access Journals (Sweden)

    Salam Shuleenda Devi

    2016-12-01

    Full Text Available Microscopic image analysis of blood smear plays a very important role in characterization of erythrocytes in screening of malaria parasites. The characteristics feature of erythrocyte changes due to malaria parasite infection. The microscopic features of the erythrocyte include morphology, intensity and texture. In this paper, the different features used to differentiate the non- infected and malaria infected erythrocyte have been reviewed.

  18. Development of a malaria knowledge test for student travelers.

    Science.gov (United States)

    Hartjes, Laurie B; Baumann, Linda C

    2012-01-01

    This paper describes a malaria knowledge test (MKT) developed to evaluate a web-based game for students who increasingly travel to malaria-risk regions of the world. The 18-item MKT was structured according to the dimensions of the self-regulation model (SRM) to measure the accuracy of students' beliefs about malaria. An experimental design was used to compare three game versions. Students (N=482) participated in 2010 by completing a pre-test, playing a Web-based game simulating student travel to malaria-endemic destinations, and completing a post-test. Study data support the validity and reliability of the MKT for the evaluation of malaria education interventions and for student self-assessment. Use of the MKT to evaluate an educational game about malaria revealed a strong overall learning effect and discrimination by game version, travel experience, and SRM dimension. This 5-min test may also be adapted for educational outreach purposes among health care providers globally, residents of malaria-endemic regions, and other high risk travel groups (e.g., elderly, chronic health conditions, pregnant, or returning to malaria-endemic regions to visit friends/relatives).

  19. Asymptomatic Malaria among Blood Donors in Benin City Nigeria.

    Directory of Open Access Journals (Sweden)

    Bankole Henry Oladeinde

    2014-09-01

    Full Text Available This study aimed at determining the prevalence and associated risk factors for asymptomatic malaria parasitaemia and anemia among blood donors in a private medical laboratory in Benin City, Nigeria.Venous blood was collected from a total of 247 blood donors. Malaria status, ABO, Rhesus blood groups and hemoglobin concentration of all participants were determined using standard methods.The prevalence of asymptomatic malaria infection was higher among commercial blood donors than volunteer group (commercial vs volunteer donor: 27.5 %vs. 13.8%; OR = 2.373, 95% CI = 0.793, 7.107, P = 0.174. Asymptomatic malaria was not significantly affected by gender (P = 0.733, age (P = 0.581, ABO (P = 0.433 and rhesus blood groups (P = 0.806 of blood donors. Age was observed to significantly (P = 0.015 affect malaria parasite density with donors within the age group of 21-26 years having the highest risk. The prevalence of anemia was significantly higher among commercial donors (commercial vs volunteer donors: 23.4% vs 3.4%: OR = 8.551, 95% CI = 1.135, 64.437, P = 0.013 and donors of blood group O type (P = < 0.0001.Asymptomatic malaria parasitaemia and anemia was higher among commercial donors than voluntary donors. Mandatory screening of blood donors for malaria parasite is advocated to curb transfusion transmitted malaria and associated sequelae.

  20. Temporal constraints on predation risk assessment in a changing world

    Energy Technology Data Exchange (ETDEWEB)

    Chivers, Douglas P., E-mail: doug.chivers@usask.ca [Department of Biology, University of Saskatchewan, Saskatoon, SK S7N 5E2 (Canada); Ramasamy, Ryan A.; McCormick, Mark I.; Watson, Sue-Ann [ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville Qld4811 (Australia); School of Marine and Tropical Biology, James Cook University, Townsville Qld4811 (Australia); Siebeck, Ulrike E. [School of Biomedical Sciences, University of Queensland, Brisbane Qld4072 (Australia); Ferrari, Maud C.O. [Department of Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, SK S7W 5B4 (Canada)

    2014-12-01

    Habitat degradation takes various forms and likely represents the most significant threat to our global biodiversity. Recently, we have seen considerable attention paid to increasing global CO{sub 2} emissions which lead to ocean acidification (OA). Other stressors, such as changing levels of ultraviolet radiation (UVR), also impact biodiversity but have received much less attention in the recent past. Here we examine fundamental questions about temporal aspects of risk assessment by coral reef damselfish and provide critical insights into how OA and UVR influence this assessment. Chemical cues released during a predator attack provide a rich source of information that other prey animals use to mediate their risk of predation and are the basis of the majority of trait-mediated indirect interactions in aquatic communities. However, we have surprisingly limited information about temporal aspects of risk assessment because we lack knowledge about how long chemical cues persist after they are released into the environment. Here, we showed that under ambient CO{sub 2} conditions (∼ 385 μatm), alarm cues of ambon damselfish (Pomacentrus amboinensis) did not degrade within 30 min in the absence of ultraviolet radiation (UVR), but were degraded within 15 min when the CO{sub 2} was increased to ∼ 905 μatm. In experiments that used filters to eliminate UVR, we found minimal degradation of alarm cues within 30 min, whereas under ambient UVR conditions, alarm cues were completely degraded within 15 min. Moreover, in the presence of both UVR and elevated CO{sub 2}, alarm cues were broken down within 5 min. Our results highlight that alarm cues degrade surprisingly quickly under natural conditions and that anthropogenic changes have the potential to dramatically change rates of cue degradation in the wild. This has considerable implications for risk assessment and consequently the importance of trait-mediated indirect interactions in coral-reef communities. - Highlights:

  1. Attributing Climate Conditions for Stable Malaria Transmission to Human Activity in sub-Saharan Africa

    Science.gov (United States)

    Sheldrake, L.; Mitchell, D.; Allen, M. R.

    2015-12-01

    Temperature and precipitation limit areas of stable malaria transmission, but the effects of climate change on the disease remain controversial. Previously, studies have not separated the influence of anthropogenic climate change and natural variability, despite being an essential step in the attribution of climate change impacts. Ensembles of 2900 simulations of regional climate in sub-Saharan Africa for the year 2013, one representing realistic conditions and the other how climate might have been in the absence of human influence, were used to force a P.falciparium climate suitability model developed by the Mapping Malaria Risk in Africa project. Strongest signals were detected in areas of unstable transmission, indicating their heightened sensitivity to climatic factors. Evidently, impacts of human-induced climate change were unevenly distributed: the probability of conditions being suitable for stable malaria transmission were substantially reduced (increased) in the Sahel (Greater Horn of Africa (GHOA), particularly in the Ethiopian and Kenyan highlands). The length of the transmission season was correspondingly shortened in the Sahel and extended in the GHOA, by 1 to 2 months, including in Kericho (Kenya), where the role of climate change in driving recent malaria occurrence is hotly contested. Human-induced warming was primarily responsible for positive anomalies in the GHOA, while reduced rainfall caused negative anomalies in the Sahel. The latter was associated with anthropogenic impacts on the West African Monsoon, but uncertainty in the RCM's ability to reproduce precipitation trends in the region weakens confidence in the result. That said, outputs correspond well with broad-scale changes in observed endemicity, implying a potentially important contribution of anthropogenic climate change to the malaria burden during the past century. Results support the health-framing of climate risk and help indicate hotspots of climate vulnerability, providing

  2. Australia's dengue risk driven by human adaptation to climate change.

    Directory of Open Access Journals (Sweden)

    Nigel W Beebe

    Full Text Available BACKGROUND: The reduced rainfall in southeast Australia has placed this region's urban and rural communities on escalating water restrictions, with anthropogenic climate change forecasts suggesting that this drying trend will continue. To mitigate the stress this may place on domestic water supply, governments have encouraged the installation of large domestic water tanks in towns and cities throughout this region. These prospective stable mosquito larval sites create the possibility of the reintroduction of Ae. aegypti from Queensland, where it remains endemic, back into New South Wales and other populated centres in Australia, along with the associated emerging and re-emerging dengue risk if the virus was to be introduced. METHODOLOGY/PRINCIPAL FINDINGS: Having collated the known distribution of Ae. aegypti in Australia, we built distributional models using a genetic algorithm to project Ae. aegypti's distribution under today's climate and under climate change scenarios for 2030 and 2050 and compared the outputs to published theoretical temperature limits. Incongruence identified between the models and theoretical temperature limits highlighted the difficulty of using point occurrence data to study a species whose distribution is mediated more by human activity than by climate. Synthesis of this data with dengue transmission climate limits in Australia derived from historical dengue epidemics suggested that a proliferation of domestic water storage tanks in Australia could result in another range expansion of Ae. aegypti which would present a risk of dengue transmission in most major cities during their warm summer months. CONCLUSIONS/SIGNIFICANCE: In the debate of the role climate change will play in the future range of dengue in Australia, we conclude that the increased risk of an Ae. aegypti range expansion in Australia would be due not directly to climate change but rather to human adaptation to the current and forecasted regional drying

  3. Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Nabakooza Jane

    2010-07-01

    Full Text Available Abstract Background Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs are not readily available. With the introduction of artemisinin-based combination therapy (ACT for treatment of malaria in many low-resource settings, there is need to target treatment to patients with parasitologically confirmed malaria in order to improve quality of care, reduce over consumption of anti-malarials, reduce drug pressure and in turn delay development and spread of drug resistance. This study evaluated the effect of malaria RDTs on health workers' anti-malarial drug (AMD prescriptions among outpatients at low level health care facilities (LLHCF within different malaria epidemiological settings in Uganda. Methods All health workers (HWs in 21 selected intervention (where RDTs were deployed LLHF were invited for training on the use RDTs. All HWs were trained to use RDTs for parasitological diagnosis of all suspected malaria cases irrespective of age. Five LLHCFs with clinical diagnosis (CD only were included for comparison. Subsequently AMD prescriptions were compared using both a 'pre - post' and 'intervention - control' analysis designs. In-depth interviews of the HWs were conducted to explore any factors that influence AMD prescription practices. Results A total of 166,131 out-patient attendances (OPD were evaluated at 21 intervention LLHCFs. Overall use of RDTs resulted in a 38% point reduction in AMD prescriptions. There was a two-fold reduction (RR 0.62, 95% CI 0.55-0.70 in AMD prescription with the greatest reduction in the hypo-endemic setting (RR 0.46 95% CI 0.51-0.53 but no significant change in the urban setting (RR1.01, p-value = 0.820. Over 90% of all eligible OPD patients were offered a test. An average of 30% (range 25%-35% of the RDT-negative fever patients received

  4. Climate Change Risk Appraisal in the Austrian Ski Industry

    Science.gov (United States)

    Wolfsegger, C.

    2009-04-01

    Ski tourism is an economically and culturally important industry in many parts of Europe. A growing number of studies in Europe, North America, Japan, and Australia have concluded that climate change has potentially serious implications for the sustainability of ski operations by reducing the average length of ski seasons and, where applicable, increasing snowmaking costs. To date, however, the climate change risk awareness and adaptive responses of stakeholders in the ski industry have not been examined. A survey of managers at low elevation ski areas in Austria was undertaken to explore their perceptions of climate change (past and future), how climate change had/will affect their operations, and their adaptive responses (past and planned). The results indicate that climate change is not perceived to be a serious threat to ski operations and that with technological adaptation, principally snowmaking, ski area managers believe they will be able to effectively cope with climate change in the 21st century. The consequences of these perceptions for the future operation of these ski areas are discussed and conclusions drawn for the future of ski tourism in Austria.

  5. Global climate changes, natural disasters, and travel health risks.

    Science.gov (United States)

    Diaz, James H

    2006-01-01

    Whether the result of cyclical atmospheric changes, anthropogenic activities, or combinations of both, authorities now agree that the earth is warming from a variety of climatic effects, including the cascading effects of greenhouse gas emissions to support human activities. To date, most reports of the public health outcomes of global warming have been anecdotal and retrospective in design and have focused on heat stroke deaths following heat waves, drowning deaths in floods and tsunamis, and mosquito-borne infectious disease outbreaks following tropical storms and cyclones. Accurate predictions of the true public health outcomes of global climate change are confounded by several effect modifiers including human acclimatization and adaptation, the contributions of natural climatic changes, and many conflicting atmospheric models of climate change. Nevertheless, temporal relationships between environmental factors and human health outcomes have been identified and may be used as criteria to judge the causality of associations between the human health outcomes of climate changes and climate-driven natural disasters. Travel medicine physicians are obligated to educate their patients about the known public health outcomes of climate changes, about the disease and injury risk factors their patients may face from climate-spawned natural disasters, and about the best preventive measures to reduce infectious diseases and injuries following natural disasters throughout the world.

  6. Learning and Risk Exposure in a Changing Climate

    Science.gov (United States)

    Moore, F.

    2015-12-01

    Climate change is a gradual process most apparent over long time-scales and large spatial scales, but it is experienced by those affected as changes in local weather. Climate change will gradually push the weather people experience outside the bounds of historic norms, resulting in unprecedented and extreme weather events. However, people do have the ability to learn about and respond to a changing climate. Therefore, connecting the weather people experience with their perceptions of climate change requires understanding how people infer the current state of the climate given their observations of weather. This learning process constitutes a first-order constraint on the rate of adaptation and is an important determinant of the dynamic adjustment costs associated with climate change. In this paper I explore two learning models that describe how local weather observations are translated into perceptions of climate change: an efficient Bayesian learning model and a simpler rolling-mean heuristic. Both have a period during which the learner's beliefs about the state of the climate are different from its true state, meaning the learner is exposed to a different range of extreme weather outcomes then they are prepared for. Using the example of surface temperature trends, I quantify this additional exposure to extreme heat events under both learning models and both RCP 8.5 and 2.6. Risk exposure increases for both learning models, but by substantially more for the rolling-mean learner. Moreover, there is an interaction between the learning model and the rate of climate change: the inefficient rolling-mean learner benefits much more from the slower rates of change under RCP 2.6 then the Bayesian. Finally, I present results from an experiment that suggests people are able to learn about a trending climate in a manner consistent with the Bayesian model.

  7. Review of the malaria epidemiology and trends in Zambia

    Institute of Scientific and Technical Information of China (English)

    Freddie Masaninga; Mac Otten; Ibrahima Soce Fall; Olusegun Babaniyi; Emmanuel Chanda; Pascalina Chanda-Kapata; Busiku Hamainza; Hieronymo T Masendu; Mulakwa Kamuliwo; Wambinji Kapelwa; John Chimumbwa; John Govere

    2013-01-01

    A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control. This review considered data from the National Health Information Management System, Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages. Data showed three distinct epidemiological strata after a notable malaria reduction (66%) in in-patient cases and deaths, particularly between 2000-2008. These changes occurred following the (re-)introduction and expansion of indoor residual spraying up to 90%coverage, scale-up of coverage of long-lasting insecticide-treated nets in household from 50%to 70%, and artemisin-based combination therapy nationwide. However, malaria cases and deaths re-surged, increasing in 2009-2010 in the northern-eastern parts of Zambia. Delays in the disbursement of funds affected the implementation of interventions, which resulted in resurgence of cases and deaths. In spite of a decline in malaria disease burden over the past decade in Zambia, a reversal in impact is notable in the year 2009-2010, signifying that control gains are fragile and must be sustained toeliminate malaria.

  8. Review of the malaria epidemiology and trends in Zambia

    Directory of Open Access Journals (Sweden)

    Freddie Masaninga

    2013-02-01

    Full Text Available A comprehensive desk review of malaria trends was conducted between 2000–2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control. This review considered data from the National Health Information Management System, Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages. Data showed three distinct epidemiological strata after a notable malaria reduction (66% in in-patient cases and deaths, particularly between 2000–2008. These changes occurred following the (re-introduction and expansion of indoor residual spraying up to 90% coverage, scale-up of coverage of long-lasting insecticide-treated nets in household from 50% to 70%, and artemisin-based combination therapy nationwide. However, malaria cases and deaths re-surged, increasing in 2009–2010 in the northern-eastern parts of Zambia. Delays in the disbursement of funds affected the implementation of interventions, which resulted in resurgence of cases and deaths. In spite of a decline in malaria disease burden over the past decade in Zambia, a reversal in impact is notable in the year 2009–2010, signifying that control gains are fragile and must be sustained toeliminate malaria.

  9. Rapid Diagnosis of Malaria

    Directory of Open Access Journals (Sweden)

    Clinton K. Murray

    2009-01-01

    Full Text Available Malaria's global impact is expansive and includes the extremes of the healthcare system ranging from international travelers returning to nonendemic regions with tertiary referral medical care to residents in hyperendemic regions without access to medical care. Implementation of prompt and accurate diagnosis is needed to curb the expanding global impact of malaria associated with ever-increasing antimalarial drug resistance. Traditionally, malaria is diagnosed using clinical criteria and/or light microscopy even though both strategies are clearly inadequate in many healthcare settings. Hand held immunochromatographic rapid diagnostic tests (RDTs have been recognized as an ideal alternative method for diagnosing malaria. Numerous malaria RDTs have been developed and are widely available; however, an assortment of issues related to these products have become apparent. This review provides a summary of RDT including effectiveness and strategies to select the ideal RDT in varying healthcare settings.

  10. Antibody levels against GLURP R2, MSP1 block 2 hybrid and AS202.11 and the risk of malaria in children living in hyperendemic (Burkina Faso) and hypo-endemic (Ghana) areas

    DEFF Research Database (Denmark)

    Adu, Bright; Cherif, Mariama K; Bosomprah, Samuel;

    2016-01-01

    BACKGROUND: Differences in parasite transmission intensity influence the process of acquisition of host immunity to Plasmodium falciparum malaria and ultimately, the rate of malaria related morbidity and mortality. Potential vaccines being designed to complement current intervention efforts there...

  11. Flood risk changes over centuries in Rome: an empirical study

    Science.gov (United States)

    Di Baldassarre, Giuliano; Saccà, Smeralda; Tito Aronica, Giuseppe; Grimaldi, Salvatore; Crisci, Massimiliano

    2015-04-01

    Over centuries, the development of the historical city of Rome -close to one of the largest Italian rivers, the Tiber- has been intertwined with the magnitude and frequency of flooding events. The ancient Rome mostly developed on the (seven) hills, while the Tiber's floodplain was mainly exploited for agricultural purposes. A few small communities did settle in the riparian areas of the Tiber, but they had a relatively peaceful relationships with the frequent occurrence of flooding events. Nowadays, numerous people live in modern districts in the Tiber's floodplain, unaware of their exposure to potentially catastrophic flooding. The main goal of this research is to explore the dynamics of changing flood risk over the centuries between these two extreme pictures of the ancient and contemporary Rome. To this end, we carried out a socio-hydrological study by exploiting long time series of physical (flooding, river morphology) and social (urbanization, population dynamics) processes together with information about human interactions with the environment (flood defense structures). This empirical analysis showed how human and physical systems have been co-evolving over time, while being abruptly altered by the occurrence of extreme events. For instance, a large flooding event occurred in 1870 and contributed to the constructions of levees, which in turn facilitated the development of new urban areas in the Tiber's floodplain, while changed the societal memory of floods as well as the communities' perception of risk. This research work was also used to test the hypotheses of recent-developed models conceptualizing the interplay between floods and societies and simulating the long-term behavior of coupled human-water systems. The outcomes of this test provided interesting insights about the dynamics of flood risk, which are expected to support a better anticipation of future changes.

  12. HIPOGLIKEMIA PADA SEORANG PENDERITA MALARIA

    Directory of Open Access Journals (Sweden)

    P. N. Harianto

    2012-09-01

    Full Text Available Hypoglycemia is a serious and often fatal complication of severe malaria. This condition has been reported in many parts of the world including from Thailand (1983 and from Indonesia by Hoffman (1988 and Harianto (1990. Two main causes that can lead to development of this condition are quinine administration and the severity of the malaria condition itself. A case study is presented about development of prolonged hypoglycemia after quinine administration. A 41 years old male was hospitalized with 4 days history of fever, headache vomiting and icterus. On examination he was found to be in good mental status, had a normal blood pressure, and a body temperature of 40°C. He also had icterus and hepatomegaly. Laboratory examination on admission showed malaria slide positive forRfalciparum ring 30-40, with parasite count of 3% (+ on day I. CBC showed: WBC of 21,700/mm3 and platelet count of 40,000/mm3. Blood chemistry showed glucose level of 77 mm %, serum bilirubin of 29.34 mg % (direct 21.87 mg % SGOT 31 u/l, SGPT 20 u/l, serum ureum 167 mg %, creatinine of 3.36 mg %, serum Na 123 m Eq/L and K 3.99 Eq/L. Urinalysis was normal except for specific gravity of 1.07. After diagnosis of bilious malaria was confirmed, the patient was given i.v. quinine 500 mg diluted in 500 ml 5% dextrose, infused over 4 hours and repeated every 8 hours. On day IVi.v. quinine was switched to oral preparation of 600 mg given bid and the next day quinine was changed to oral chloroquine. The day after admission (30 hours after quinine administration, blood glucose dropped to 21 mg %, 16-46 mg % on day III, and to less than 10 mg % on day IV. It gradulty returned to normal afterwards. Administration of 10% dextrose and boluses of 40% glucose were able to keep the patient in good clinical condition and prevent death. Malaria slide improved on day III, became negative by day IV and serum bilirubin also decreased on follow up. Hypoglycemia should be expected in severe malaria

  13. Hotspots of Malaria Transmission in the Peruvian Amazon: Rapid Assessment through a Parasitological and Serological Survey.

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    Angel Rosas-Aguirre

    Full Text Available With low and markedly seasonal malaria transmission, increasingly sensitive tools for better stratifying the risk of infection and targeting control interventions are needed. A cross-sectional survey to characterize the current malaria transmission patterns, identify hotspots, and detect recent changes using parasitological and serological measures was conducted in three sites of the Peruvian Amazon.After full census of the study population, 651 participants were interviewed, clinically examined and had a blood sample taken for the detection of malaria parasites (microscopy and PCR and antibodies against P. vivax (PvMSP119, PvAMA1 and P. falciparum (PfGLURP, PfAMA1 antigens by ELISA. Risk factors for malaria infection (positive PCR and malaria exposure (seropositivity were assessed by multivariate survey logistic regression models. Age-specific seroprevalence was analyzed using a reversible catalytic conversion model based on maximum likelihood for generating seroconversion rates (SCR, λ. SaTScan was used to detect spatial clusters of serology-positive individuals within each site.The overall parasite prevalence by PCR was low, i.e. 3.9% for P. vivax and 6.7% for P. falciparum, while the seroprevalence was substantially higher, 33.6% for P. vivax and 22.0% for P. falciparum, with major differences between study sites. Age and location (site were significantly associated with P. vivax exposure; while location, age and outdoor occupation were associated with P. falciparum exposure. P. falciparum seroprevalence curves showed a stable transmission throughout time, while for P. vivax transmission was better described by a model with two SCRs. The spatial analysis identified well-defined clusters of P. falciparum seropositive individuals in two sites, while it detected only a very small cluster of P. vivax exposure.The use of a single parasitological and serological malaria survey has proven to be an efficient and accurate method to characterize the

  14. Hotspots of Malaria Transmission in the Peruvian Amazon: Rapid Assessment through a Parasitological and Serological Survey

    Science.gov (United States)

    Rosas-Aguirre, Angel; Speybroeck, Niko; Llanos-Cuentas, Alejandro; Rosanas-Urgell, Anna; Carrasco-Escobar, Gabriel; Rodriguez, Hugo; Gamboa, Dionicia; Contreras-Mancilla, Juan; Alava, Freddy; Soares, Irene S.; Remarque, Edmond; D´Alessandro, Umberto; Erhart, Annette

    2015-01-01

    Background With low and markedly seasonal malaria transmission, increasingly sensitive tools for better stratifying the risk of infection and targeting control interventions are needed. A cross-sectional survey to characterize the current malaria transmission patterns, identify hotspots, and detect recent changes using parasitological and serological measures was conducted in three sites of the Peruvian Amazon. Material and Methods After full census of the study population, 651 participants were interviewed, clinically examined and had a blood sample taken for the detection of malaria parasites (microscopy and PCR) and antibodies against P. vivax (PvMSP119, PvAMA1) and P. falciparum (PfGLURP, PfAMA1) antigens by ELISA. Risk factors for malaria infection (positive PCR) and malaria exposure (seropositivity) were assessed by multivariate survey logistic regression models. Age-specific seroprevalence was analyzed using a reversible catalytic conversion model based on maximum likelihood for generating seroconversion rates (SCR, λ). SaTScan was used to detect spatial clusters of serology-positive individuals within each site. Results The overall parasite prevalence by PCR was low, i.e. 3.9% for P. vivax and 6.7% for P. falciparum, while the seroprevalence was substantially higher, 33.6% for P. vivax and 22.0% for P. falciparum, with major differences between study sites. Age and location (site) were significantly associated with P. vivax exposure; while location, age and outdoor occupation were associated with P. falciparum exposure. P. falciparum seroprevalence curves showed a stable transmission throughout time, while for P. vivax transmission was better described by a model with two SCRs. The spatial analysis identified well-defined clusters of P. falciparum seropositive individuals in two sites, while it detected only a very small cluster of P. vivax exposure. Conclusion The use of a single parasitological and serological malaria survey has proven to be an efficient

  15. Mefloquine at the crossroads? Implications for malaria chemoprophylaxis in Europe.

    Science.gov (United States)

    Schlagenhauf, Patricia; Hatz, Christoph; Behrens, Ron; Visser, Leo; Funk, Maia; Holzer, Benedikt; Beck, Bernhard; Bourquin, Cathérine; Etter, Hermann; Furrer, Hansjakob; Genton, Blaise; Landry, Pierre; Chappuis, Francois; Loutan, Louis; Stössel, Ulrich; Jeschko, Eva; Rossanese, Andrea; Nothdurft, Hans Dieter

    2015-01-01

    Since its introduction to the market in 1985, mefloquine has been used for malaria chemoprophylaxis by more than 35 million travellers. In Europe, in 2014, the European Medicines Agency (EMA) issued recommendations on strengthened warnings, prescribing checklists and updates to the product information of mefloquine. Some malaria prevention advisors question the scientific basis for the restrictions and suggest that this cost-effective, anti-malarial drug will be displaced as a first-line anti-malaria medication with the result that vulnerable groups such as VFR and long-term travellers, pregnant travellers and young children are left without a suitable alternative chemoprophylaxis. This commentary looks at the current position of mefloquine prescribing and the rationale of the new EMA recommendations and restrictions. It also describes the new recommendations for malaria prophylaxis that have been adapted by Switzerland, Germany, Austria and Italy where chemoprophylaxis use is restricted to high-risk malaria-endemic areas.

  16. An ecosystem approach to malaria control in an urban setting

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    Carrasquilla Gabriel

    2001-01-01

    Full Text Available We conducted a research project aimed at strengthening local government and the community for a sustainable malaria control strategy. The project began with a baseline diagnosis of malaria prevalence, a KAP survey, entomology, and health services delivery, after which an epidemiological study was performed to identify risk factors associated with malaria, thereafter used to plan intervention measures. A program evaluation was conducted five years later. By using an ecosystem approach to reanalyze data, this paper discusses how malaria arises from a complex interaction of cultural, economic, ecological, social, and individual factors. Intervention measures require an intersectorial and transdisciplinary approach that does not exist at the moment. Health sector leadership is limited, and there is no true community participation. Implications for research, including the use of qualitative and quantitative methods, study design, and complexity of data analysis are discussed. Finally, implications for malaria control are discussed, stressing the differences between the ecosystem and integrated disease control approaches.

  17. Globalization at Risk: The Changing Preferences of States and Societies

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    James M. Quirk

    2008-12-01

    Full Text Available After long, wide trends toward freer and more integratedmarkets, peoples and ideas, reluctance to subordinate the ideals of globalization to state interests shows signs of serious erosion. Recent examples include the breakdown of international institutions, the rise in state control over energy resources and their use as diplomatic leverage, and US abandonment of the principles of globalization. The sources of these changing preferences are both ideological and utilitarian. The result is that key elements of globalization are at risk, but with unpredictable consequences.

  18. Against the tide: climate change and high-risk cities

    Energy Technology Data Exchange (ETDEWEB)

    Dodman, David

    2008-11-15

    In the world's poorest and most vulnerable nations, most cities and towns face a distinct dual pressure: rapidly growing population and high vulnerability to the impacts of climate change. Drought, storms, flooding and sea level rise are likely to hit hardest here. These in turn put water supplies, infrastructure, health and livelihoods at risk in the very cities already struggling to provide or safeguard such key needs. An effective response demands capable local and national government and support from strong international networks in building capacity to cope. Most of the Least Developed Countries lack both.

  19. Geographical mapping and Bayesian spatial modeling of malaria incidence in Sistan and Baluchistan province, Iran

    Institute of Scientific and Technical Information of China (English)

    Farid Zayeri; Masoud Salehi; Hasan Pirhosseini

    2011-01-01

    Objective:To present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran.Methods:We used the registered malaria data to compute the standard incidence rates (SIRs) of malaria in different areas of Sistan and Baluchistan province for a nine-year period (from 2001 to 2009). Statistical analyses consisted of two different parts: geographical mapping of malaria incidence rates, and modeling the environmental factors. The empirical Bayesian estimates of malaria SIRs were utilized for geographical mapping of malaria and a Poisson random effects model was used for assessing the effect of environmental factors on malaria SIRs.Results:In general, 64 926 new cases of malaria were registered in Sistan and Baluchistan Province from 2001 to 2009. Among them, 42 695 patients (65.8%) were male and 22 231 patients (34.2%) were female. Modeling the environmental factors showed that malaria incidence rates had positive relationship with humidity, elevation, average minimum temperature and average maximum temperature, while rainfall had negative effect on malaria SIRs in this province.Conclusions:The results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province, Iran. Geographical map and related environmental factors of malaria can help the health policy makers to intervene in high risk areas more efficiently and allocate the resources in a proper manner.

  20. A nation-wide malaria knowledge, attitudes and practices survey in Malawi: introduction.

    Science.gov (United States)

    Wirima, J J

    1994-03-01

    In Malawi malaria is the most frequent cause of morbidity and mortality in children and pertinent hospitalizations have been increasing annually since 1982. In 1990, malaria and malaria-associated anemia constituted the leading cause of outpatient visits for all age groups and the leading cause of pediatric hospitalizations, and pediatric inpatient deaths. The Ministry of Health in Malawi has had a National Malaria Control Plan since 1985. This plan calls for improvement in: 1) awareness of malaria in the population; 2) accurate diagnosis; (3) effective and affordable treatment nationwide; 4) effective prevention for high risk groups; 5) clarification of feasibility of alternative methods of vector control; 6) improved training in diagnosis and management; 7) accurate reporting; 8) effective management at national, regional, and district levels; 9) improved ability to monitor and evaluate progress; and 10) increased government and donor investment in malaria control. The Ministry of Health undertook a national baseline survey to explore deficiencies in current malaria control practices, and also included a cost assessment of household expenditure on malaria. A number of articles document the results of this effort highlighting characteristics of malaria in Malawi and current control methods by the population. These aspects include: 1) malaria is perceived as a very important health problem: 2) prompt treatment with a full dosage of the recommended antimalarials occurs in less than 10% of febrile children; 3) a malaria prevention program based in antenatal clinics could provide affordable malaria prevention for most pregnant women; 4) few households use measures to prevent malaria which is largely associated with poverty: and 5) a high proportion of available household income is spent on malaria treatment or is lost to malaria illness. The Malawian situation is similar to that of neighboring nations, and it is hoped that they also embark on malaria control in their

  1. Geographical and environmental approaches to urban malaria in Antananarivo (Madagascar

    Directory of Open Access Journals (Sweden)

    Rudant Jean-Paul

    2010-06-01

    Full Text Available Abstract Background Previous studies, conducted in the urban of Antananarivo, showed low rate of confirmed malaria cases. We used a geographical and environmental approach to investigate the contribution of environmental factors to urban malaria in Antananarivo. Methods Remote sensing data were used to locate rice fields, which were considered to be the principal mosquito breeding sites. We carried out supervised classification by the maximum likelihood method. Entomological study allowed vector species determination from collected larval and adult mosquitoes. Mosquito infectivity was studied, to assess the risk of transmission, and the type of mosquito breeding site was determined. Epidemiological data were collected from November 2006 to December 2007, from public health centres, to determine malaria incidence. Polymerase chain reaction was carried out on dried blood spots from patients, to detect cases of malaria. Rapid diagnostic tests were used to confirm malaria cases among febrile school children in a school survey. A geographical information system was constructed for data integration. Altitude, temperature, rainfall, population density and rice field surface area were analysed and the effects of these factors on the occurrence of confirmed malaria cases were studied. Results Polymerase chain reaction confirmed malaria in 5.1% of the presumed cases. Entomological studies showed An. arabiensis as potential vector. Rice fields remained to be the principal breeding sites. Travel report was considered as related to the occurrence of P. falciparum malaria cases. Conclusion Geographical and environmental factors did not show direct relationship with malaria incidence but they seem ensuring suitability of vector development. Absence of relationship may be due to a lack of statistical power. Despite the presence of An. arabiensis, scarce parasitic reservoir and rapid access to health care do not constitute optimal conditions to a threatening

  2. Arctic climate change and oil spill risk analysis

    Institute of Scientific and Technical Information of China (English)

    William B. Samuels; David E. Amstutz; Heather A. Crowley

    2011-01-01

    The purpose of this project was to:1) describe the effects of climate change in the Arctic and its impact on circulation,2) describe hindcast data used in the Ocean Energy Management,Regulation and Enforcement (BOEMRE) Oil Spill Risk Analysis (OSRA) model,3)evaluate alternatives such as using forecast results in the OSRA model,and 4) recommend future studies.Effects of climate change on winds,sea ice,ocean circulation and river discharge in the Arctic and impacts on surface circulation can be evaluated only through a series of specially designed numerical experiments using highresolution coupled ice-ocean models to elucidate the sensitivity of the models to various parameterizations or forcings.The results of these experiments will suggest what mechanisms are most important in controlling model response and guide inferences on how OSRA may respond to different climate change scenarios.Climatological change in the Arctic could lead to drastic alterations of wind,sea ice cover and concentration,and surface current fields all of which would influence hypothetical oil spill trajectories.Because of the pace at which conditions are changing,BOEMRE needs to assess whether forecast ice/ocean model results might contain useful information for the purposes of calculating hypothetical oil spill trajectories.

  3. Climate change impacts and risks for animal health in Asia.

    Science.gov (United States)

    Forman, S; Hungerford, N; Yamakawa, M; Yanase, T; Tsai, H-J; Joo, Y-S; Yang, D-K; Nha, J-J

    2008-08-01

    The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of climate variability on animal health. Animal health may be affected by climate change in four ways: heat-related diseases and stress, extreme weather events, adaptation of animal production systems to new environments, and emergence or re-emergence of infectious diseases, especially vector-borne diseases critically dependent on environmental and climatic conditions. To face these new menaces, the need for strong and efficient Veterinary Services is irrefutable, combined with good coordination of public health services, as many emerging human diseases are zoonoses. Asian developing countries have acute weaknesses in their Veterinary Services, which jeopardises the global surveillance network essential for early detection of hazards. Indeed, international cooperation within and outside Asia is vital to mitigating the risks of climate change to animal health in Asia.

  4. Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Grønbaek, M; Schnohr, P;

    2009-01-01

    in health behaviour (smoking, physical activity, alcohol consumption, overweight) and cardiac risk profile (cholesterol, HDL cholesterol, blood pressure, diabetes). RESULTS: Individuals with high levels of stress compared to those with low levels of stress were less likely to quit smoking (OR = 0.58; 95% CI......OBJECTIVE: The aim of this study was to evaluate the long-term effects of stress on changes in health behaviour and cardiac risk profile in men and women. DESIGN: A prospective cohort study. SETTING: The Copenhagen City Heart Study, Denmark. SUBJECTS: The analyses were based on 7066 women and men...... to use antihypertensive medication (1.94; 1.63-2.30), and stressed men were more than two times as likely to develop diabetes during follow-up (2.36; 1.22-4.59). CONCLUSION: This longitudinal study supports a causal relation between stress and cardiovascular diseases mediated through unfavourable changes...

  5. Time-of-day specific changes in metabolic detoxification and insecticide resistance in the malaria mosquito Anopheles gambiae.

    Science.gov (United States)

    Balmert, Nathaniel J; Rund, Samuel S C; Ghazi, John P; Zhou, Peng; Duffield, Giles E

    2014-05-01

    Mosquitoes exhibit ∼24 h rhythms in physiology and behavior, regulated by the cooperative action of an endogenous circadian clock and the environmental light:dark cycle. Here, we characterize diel (observed under light:dark conditions) time-of-day changes in metabolic detoxification and resistance to insecticide challenge in Anopheles gambiae mosquitoes. A better understanding of mosquito chronobiology will yield insights into developing novel control strategies for this important disease vector. We have previously identified >2000 rhythmically expressed An. gambiae genes. These include metabolic detoxification enzymes peaking at various times throughout the day. Especially interesting was the identification of rhythmic genes encoding enzymes capable of pyrethroid and/or DDT metabolism (CYP6M2, CYP6P3, CYP6Z1, and GSTE2). We hypothesized that these temporal changes in gene expression would confer time-of-day specific changes in metabolic detoxification and responses to insecticide challenge. An. gambiae mosquitoes (adult female Pimperena and Mali-NIH strains) were tested by gene expression analysis for diel rhythms in key genes associated with insecticidal resistance. Biochemical assays for total GST, esterase, and oxidase enzymatic activities were undertaken on time-specific mosquito head and body protein lysates. To determine for rhythmic susceptibility to insecticides by survivorship, mosquitoes were exposed to DDT or deltamethrin across the diel cycle. We report the occurrence of temporal changes in GST activity in samples extracted from the body and head with a single peak at late-night to dawn, but no rhythms were detected in oxidase or esterase activity. The Pimperena strain was found to be resistant to insecticidal challenge, and subsequent genomic analysis revealed the presence of the resistance-conferring kdr mutation. We observed diel rhythmicity in key insecticide detoxification genes in the Mali-NIH strain, with peak phases as previously reported in

  6. Estimating malaria burden in Nigeria: a geostatistical modelling approach

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    Nnadozie Onyiri

    2015-11-01

    Full Text Available This study has produced a map of malaria prevalence in Nigeria based on available data from the Mapping Malaria Risk in Africa (MARA database, including all malaria prevalence surveys in Nigeria that could be geolocated, as well as data collected during fieldwork in Nigeria between March and June 2007. Logistic regression was fitted to malaria prevalence to identify significant demographic (age and environmental covariates in STATA. The following environmental covariates were included in the spatial model: the normalized difference vegetation index, the enhanced vegetation index, the leaf area index, the land surface temperature for day and night, land use/landcover (LULC, distance to water bodies, and rainfall. The spatial model created suggests that the two main environmental covariates correlating with malaria presence were land surface temperature for day and rainfall. It was also found that malaria prevalence increased with distance to water bodies up to 4 km. The malaria risk map estimated from the spatial model shows that malaria prevalence in Nigeria varies from 20% in certain areas to 70% in others. The highest prevalence rates were found in the Niger Delta states of Rivers and Bayelsa, the areas surrounding the confluence of the rivers Niger and Benue, and also isolated parts of the north-eastern and north-western parts of the country. Isolated patches of low malaria prevalence were found to be scattered around the country with northern Nigeria having more such areas than the rest of the country. Nigeria’s belt of middle regions generally has malaria prevalence of 40% and above.

  7. Mortality changes after grants from the Global Fund to Fight AIDS, tuberculosis and malaria: An econometric analysis from 1995 to 2010

    NARCIS (Netherlands)

    I. Yan (Isabel); E.L. Korenromp (Eline); A. Bendavid (Avrom)

    2015-01-01

    textabstractBackground: Since its founding in 2002, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) has become the dominant multilateral health financier in low- and middle-income countries. The health impact of the Global Fund remains unknown because existing evaluations meas

  8. Soluble human leukocyte antigen -G during pregnancy and infancy in Benin: Mother/child resemblance and association with the risk of malaria infection and low birth weight

    Science.gov (United States)

    Milet, Jacqueline; Cottrell, Gilles; Mondière, Amandine; Avokpaho, Euripide; Gineau, Laure; Sabbagh, Audrey; Massougbodji, Achille; Moutairou, Kabirou; Donadi, Eduardo A.; Favier, Benoit; Carosella, Edgardo; Moreau, Philippe; Rouas-Freiss, Nathalie; Courtin, David; Garcia, André

    2017-01-01

    Human leukocyte antigen (HLA) G is a tolerogenic molecule involved in the maternal-fetal immune tolerance phenomenon. Its expression during some infectious diseases leading to immune evasion has been established. A first study conducted in Benin has shown that the production of soluble HLA-G (sHLA-G) during the first months of life is strongly correlated with the maternal level at delivery and associated with low birth weight and malaria. However sHLA-G measurements during pregnancy were not available for mothers and furthermore, to date the evolution of sHLA-G in pregnancy is not documented in African populations. To extend these previous findings, between January 2010 and June 2013, 400 pregnant women of a malaria preventive trial and their newborns were followed up in Benin until the age of 2 years. Soluble HLA-G was measured 3 times during pregnancy and repeatedly during the 2 years follow-up to explore how sHLA-G evolved and the factors associated. During pregnancy, plasma levels of sHLA-G remained stable and increased significantly at delivery (p<0.001). Multigravid women seemed to have the highest levels (p = 0.039). In infants, the level was highest in cord blood and decreased before stabilizing after 18 months (p<0.001). For children, a high level of sHLA-G was associated with malaria infection during the follow-up (p = 0.02) and low birth weight (p = 0.06). The mean level of sHLA-G during infancy was strongly correlated with the mother’s level during pregnancy (<0.001), and not only at delivery. Moreover, mothers with placental malaria infection had a higher probability of giving birth to a child with a high level of sHLA-g (p = 0.006). High sHLA-G levels during pregnancy might be associated with immune tolerance related to placental malaria. Further studies are needed but this study provides a first insight concerning the potential role of sHLA-G as a biomarker of weakness for newborns and infants. PMID:28166246

  9. EPIDEMIOLOGY OF MALARIA IN ENDEMIC AREAS

    Directory of Open Access Journals (Sweden)

    Beatrice Autino

    2012-01-01

    Full Text Available

    Malaria infection is still to be considered a major public health problem in those 106 countries where the risk of contracting the infection with one or more of the Plasmodium species exists. According to estimates from the World Health Organization, over 200 million cases and about 655.000 deaths have occurred in 2010. Estimating the real health and social burden of the disease is a difficult task, because many of the malaria endemic countries have limited diagnostic resources, especially in rural settings where conditions with similar clinical picture may coexist in the same geographical areas. Moreover, asymptomatic parasitaemia may occur in high transmission areas after childhood, when anti-malaria semi-immunity occurs. Malaria endemicity and control activities are very complex issues, that are influenced by factors related to the host, to the parasite, to the vector, to the environment and to the health system capacity to fully implement available anti-malaria weapons such as rapid diagnostic tests, artemisinin-based combination treatment, impregnated bed-nets and insecticide residual spraying while waiting for an effective vaccine to be made available.

  10. EPIDEMIOLOGY OF MALARIA IN ENDEMIC AREAS

    Directory of Open Access Journals (Sweden)

    Beatrice Autino

    2012-10-01

    Full Text Available Malaria infection is still to be considered a major public health problem in those 106 countries where the risk of contracting the infection with one or more of the Plasmodium species exists. According to estimates from the World Health Organization, over 200 million cases and about 655.000 deaths have occurred in 2010. Estimating the real health and social burden of the disease is a difficult task, because many of the malaria endemic countries have limited diagnostic resources, especially in rural settings where conditions with similar clinical picture may coexist in the same geographical areas. Moreover, asymptomatic parasitaemia may occur in high transmission areas after childhood, when anti-malaria semi-immunity occurs. Malaria endemicity and control activities are very complex issues, that are influenced by factors related to the host, to the parasite, to the vector, to the environment and to the health system capacity to fully implement available anti-malaria weapons such as rapid diagnostic tests, artemisinin-based combination treatment, impregnated bed-nets and insecticide residual spraying while waiting for an effective vaccine to be made available.

  11. EMIRA: Ecologic Malaria Reduction for Africa – innovative tools for integrated malaria control

    Directory of Open Access Journals (Sweden)

    Peter Dambach

    2014-11-01

    Full Text Available Background: Malaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticide treated nets (LLINs and to a much smaller extent on indoor residual spraying (IRS. A third pillar in the fight against the malaria vector, larval source management (LSM, has virtually not been used in Africa since the ban of DDT in the 1960s. Within the light of recent WHO recommendations for Bacillus thuringiensis israelensis (Bti use against malaria and other vector species, larval source management could see a revival in the upcoming years. In this project we analyze the ecologic and health impacts as well as the cost effectiveness of larval source management under different larviciding scenarios in a health district in Burkina Faso. Methods: The project is designed as prospective intervention study with duration of three years (2013–2015. Its spatial scale includes three arms of interventions and control, comprising a total of 127 villages and the district capital Nouna in the extended HDSS (Health Demographic Surveillance System of the Kossi province. Baseline data on mosquito abundance, parasitemia in U5 children, and malaria related morbidity and mortality are gathered over the project duration. Besides the outcome on ecologic and health parameters, the economic costs are seized and valued against the achieved health benefits. Conclusions: Risk map based, guided larvicide application might be a possibility to further decrease economic cost of LSM and facilitate its faster incorporation to integrated malaria control programs. Given the limited resources in many malaria endemic countries, it is of utmost importance to relate the costs of novel strategies for malaria prevention to their effect on the burden of the disease. Occurring costs and the impact on the health situation will be made comparable to other, existing intervention strategies, allowing

  12. Does malaria epidemiology project Cameroon as `Africa in miniature'?

    Indian Academy of Sciences (India)

    Huguette Gaelle Ngassa Mbenda; Gauri Awasthi; Poonam K Singh; Inocent Gouado; Aparup Das

    2014-09-01

    Cameroon, a west-central African country with a ∼20 million population, is commonly regarded as ‘Africa in miniature’ due to the extensive biological and cultural diversities of whole Africa being present in a single-country setting. This country is inhabited by ancestral human lineages in unique eco-climatic conditions and diverse topography. Over 90% Cameroonians are at risk of malaria infection, and ∼41% have at least one episode of malaria each year. Historically, the rate of malaria infection in Cameroon has fluctuated over the years; the number of cases was about 2 million in 2010 and 2011. The Cameroonian malaria control programme faces an uphill task due to high prevalence of multidrug-resistant parasites and insecticide-resistant malaria vectors. Above all, continued human migration from the rural to urban areas as well as population exchange with adjoining countries, high rate of ecological instabilities caused by deforestation, poor housing, lack of proper sanitation and drainage system might have resulted in the recent increase in incidences of malaria and other vector-borne diseases in Cameroon. The available data on eco-environmental variability and intricate malaria epidemiology in Cameroon reflect the situation in the whole of Africa, and warrant the need for in-depth study by using modern surveillance tools for meaningful basic understanding of the malaria triangle (host-parasite-vector-environment).

  13. Regional Risk Assessment for climate change impacts on coastal aquifers.

    Science.gov (United States)

    Iyalomhe, F; Rizzi, J; Pasini, S; Torresan, S; Critto, A; Marcomini, A

    2015-12-15

    Coastal aquifers have been identified as particularly vulnerable to impacts on water quantity and quality due to the high density of socio-economic activities and human assets in coastal regions and to the projected rising sea levels, contributing to the process of saltwater intrusion. This paper proposes a Regional Risk Assessment (RRA) methodology integrated with a chain of numerical models to evaluate potential climate change-related impacts on coastal aquifers and linked natural and human systems (i.e., wells, river, agricultural areas, lakes, forests and semi-natural environments). The RRA methodology employs Multi Criteria Decision Analysis methods and Geographic Information Systems functionalities to integrate heterogeneous spatial data on hazard, susceptibility and risk for saltwater intrusion and groundwater level variation. The proposed approach was applied on the Esino River basin (Italy) using future climate hazard scenarios based on a chain of climate, hydrological, hydraulic and groundwater system models running at different spatial scales. Models were forced with the IPCC SRES A1B emission scenario for the period 2071-2100 over four seasons (i.e., winter, spring, summer and autumn). Results indicate that in future seasons, climate change will cause few impacts on the lower Esino River valley. Groundwater level decrease will have limited effects: agricultural areas, forests and semi-natural environments will be at risk only in a region close to the coastline which covers less than 5% of the total surface of the considered receptors; less than 3.5% of the wells will be exposed in the worst scenario. Saltwater intrusion impact in future scenarios will be restricted to a narrow region close to the coastline (only few hundred meters), and thus it is expected to have very limited effects on the Esino coastal aquifer with no consequences on the considered natural and human systems.

  14. The efficiency of malaria chemoprophylaxis

    Directory of Open Access Journals (Sweden)

    Vasiliki Pappa

    2008-07-01

    Full Text Available Introduction: Malaria is a highly contagious disease. According to WHO, malaria cases are expected to increase due to climate changes. Despite the eradication efforts, malaria still remains one of the most significant causes of morbidity and mortality in tropical and subtropical regions. Many different antimalarial regimens are used , however resistance is emerging to many of themPurpose: This critical review was conducted, in order to respond to the following questions. A Which antimalarial regimen is most effective? B Which regimen is the safest for travelers in endemic regions? C Which regimen is best tolerated?Methodology: The literature research was conducted through the Internet. The Medline and Cinahl databases were used, as well as the search engines google, altavista and lycos. The research included articles that described clinical trials. The material was selected based on the aforementioned research questions and the chronological time limits.Results: Atovaquone/proguanil, tafenoquine, primaquine were the most effective regimens. Tafenoquine, as well as, primaquine have been related to hemolytic events in individuals with G6PD deficiency, gastrointestinal disorders, backache and flue-like syndrome. Doxycycline and mefloquine were related to gastrointestinal and neurological disorders. Those were the less tolerated regimens.Conclusions: Atovaquone/proguanil, tafenoquine, primaquine were the most effective regimens. As far as safety is concerned, tafenoquine and primaquine should not be prescribed to individuals with G6PD deficiency. All the regimens were considered well tolerated, however, in doxycycline and mefloquine trials were the most withdrawals due to adverse effects.

  15. [A history of malaria in modern Korea 1876-1945].

    Science.gov (United States)

    Yeo, Insok

    2011-06-30

    Japan had set out to colonize Taiwan as a result of Sino-Japanese war, malaria in Taiwan was a big obstacle to the colonization process. Therefore, a lot of medical scientists were asked to engage the malaria research in order to handle health problems in colonized countries caused by malaria. Unlike the situation in Taiwan, malaria in Korea did not cause a serious health problem as in Taiwan. However, its risk was not negligible. In 1933 there were almost 130,000 malaria patients in Korea and 1,800 patients among them died of malaria. The Japanese Government General took measures to control malaria especially during the 1930s and the number of patients decreased. However, as Japan engaged in the World War II, the general hygienic state of the society worsened and the number of malarial patients increased. The worsened situation remains the same after Liberation (1945) and during the Korean war (1950-53).

  16. Bioethics and the Framing of Climate Change's Health Risks.

    Science.gov (United States)

    Valles, Sean A

    2015-06-01

    Cheryl Cox MacPherson recently argued, in an article for this journal, that 'Climate Change is a Bioethics Problem'. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields.

  17. Climate change and human health: present and future risks.

    Science.gov (United States)

    McMichael, Anthony J; Woodruff, Rosalie E; Hales, Simon

    2006-03-11

    There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.

  18. Comparative Risk Assessment to Inform Adaptation Priorities for the Natural Environment: Observations from the First UK Climate Change Risk Assessment

    Directory of Open Access Journals (Sweden)

    Iain Brown

    2015-11-01

    Full Text Available Risk assessment can potentially provide an objective framework to synthesise and prioritise climate change risks to inform adaptation policy. However, there are significant challenges in the application of comparative risk assessment procedures to climate change, particularly for the natural environment. These challenges are evaluated with particular reference to the first statutory Climate Change Risk Assessment (CCRA and evidence review procedures used to guide policy for the UK government. More progress was achieved on risk identification, screening and prioritisation compared to risk quantification. This was due to the inherent complexity and interdependence of ecological risks and their interaction with socio-economic drivers as well as a climate change. Robust strategies to manage risk were identified as those that coordinate organisational resources to enhance ecosystem resilience, and to accommodate inevitable change, rather than to meet specific species or habitats targets. The assessment also highlighted subjective and contextual components of risk appraisal including ethical issues regarding the level of human intervention in the natural environment and the proposed outcomes of any intervention. This suggests that goals for risk assessment need to be more clearly explicated and assumptions on tolerable risk declared as a primer for further dialogue on expectations for managed outcomes. Ecosystem-based adaptation may mean that traditional habitats and species conservation goals and existing regulatory frameworks no longer provide the best guide for long-term risk management thereby challenging the viability of some existing practices.

  19. Changes in the Perceived Risk of Climate Change: Evidence from Sudden Climatic Events

    Science.gov (United States)

    Anttila-Hughes, J. K.

    2009-12-01

    In the course of the past two decades the threat of anthropogenic climate change has moved from a scientific concern of relative obscurity to become one of the largest environmental and public goods problems in history. During this period public understanding of the risk of climate change has shifted from negligible to quite large. In this paper I propose a means of quantifying this change by examining how sudden events supporting the theory of anthropogenic climate change have affected carbon intensive companies' stock prices. Using CAPM event study methodology for companies in several carbon-intensive industries, I find strong evidence that markets have been reacting to changes in the scientific evidence for climate change for some time. Specifically, the change in magnitude of response over time seems to indicate that investors believed climate change was a potentially serious risk to corporate profits as early as the mid 1990s. Moreover, market reaction dependence on event type indicates that investors are differentiating between different advances in the scientific knowledge. Announcements by NASA GISS that the previous year was a “record hot year” for the globe are associated with negative excess returns, while news of ice shelf collapses are associated with strong positive excess returns. These results imply that investors are aware of how different aspects of climate change will affect carbon intensive companies, specifically in terms of the link between warming in general and polar ice cover. This implies that policy choices based on observable public opinion have lagged actual private concern over climate change's potential threat.

  20. Malaria and Vascular Endothelium

    Energy Technology Data Exchange (ETDEWEB)

    Alencar, Aristóteles Comte Filho de, E-mail: aristoteles.caf@gmail.com [Universidade Federal do Amazonas, Manaus, AM (Brazil); Lacerda, Marcus Vinícius Guimarães de [Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, AM (Brazil); Okoshi, Katashi; Okoshi, Marina Politi [Faculdade de Medicina de Botucatu (Unesp), Botucatu, SP (Brazil)

    2014-08-15

    Involvement of the cardiovascular system in patients with infectious and parasitic diseases can result from both intrinsic mechanisms of the disease and drug intervention. Malaria is an example, considering that the endothelial injury by Plasmodium-infected erythrocytes can cause circulatory disorders. This is a literature review aimed at discussing the relationship between malaria and endothelial impairment, especially its effects on the cardiovascular system. We discuss the implications of endothelial aggression and the interdisciplinarity that should guide the malaria patient care, whose acute infection can contribute to precipitate or aggravate a preexisting heart disease.

  1. Malaria outbreak among French army troops returning from the Ivory Coast.

    Science.gov (United States)

    Mayet, Aurélie; Lacassagne, David; Juzan, Nicolas; Chaudier, Bernard; Haus-Cheymol, Rachel; Berger, Franck; Romand, Olivier; Ollivier, Lénaick; Verret, Catherine; Deparis, Xavier; Spiegel, André

    2010-01-01

    In 2006, a French Army unit reported 39 malaria cases among service persons returning from Ivory Coast. Thirty, including three serious forms, occurred after the return to France. The risk of post-return malaria was higher than the risk in Ivory Coast. Half of the imported cases had stopped post-return chemoprophylaxis early.

  2. Iron incorporation and post-malaria anaemia.

    Directory of Open Access Journals (Sweden)

    Conor P Doherty

    Full Text Available BACKGROUND: Iron supplementation is employed to treat post-malarial anaemia in environments where iron deficiency is common. Malaria induces an intense inflammatory reaction that stalls reticulo-endothelial macrophagal iron recycling from haemolysed red blood cells and inhibits oral iron absorption, but the magnitude and duration of these effects are unclear. METHODOLOGY/PRINCIPAL FINDINGS: We examined the red blood cell incorporation of oral administered stable isotopes of iron and compared incorporation between age matched 18 to 36 months old children with either anaemia post-malaria (n = 37 or presumed iron deficiency anaemia alone (n = 36. All children were supplemented for 30 days with 2 mg/kg elemental iron as liquid iron sulphate and administered (57Fe and (58Fe on days 1 and 15 of supplementation respectively. (57Fe and(58Fe incorporation were significantly reduced (8% vs. 28%: p<0.001 and 14% vs. 26%: p = 0.045 in the malaria vs. non-malaria groups. There was a significantly greater haemoglobin response in the malaria group at both day 15 (p = 0.001 and 30 (p<0.000 with a regression analysis estimated greater change in haemoglobin of 7.2 g/l (s.e. 2.0 and 10.1 g/l (s.e. 2.5 respectively. CONCLUSION/SIGNIFICANCE: Post-malaria anaemia is associated with a better haemoglobin recovery despite a significant depressant effect on oral iron incorporation which may indicate that early erythropoetic iron need is met by iron recycling rather than oral iron. Supplemental iron administration is of questionable utility within 2 weeks of clinical malaria in children with mild or moderate anaemia.

  3. Faktor Risiko yang Berhubungan dengan Kejadian Malaria di Indonesia (Analisis Lanjut Riskesdas 2013

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    Rika Mayasari

    2016-05-01

    Full Text Available Malaria is still endemic in most areas of Indonesia. Indonesia incluted the eastern part of the high malaria stratification, while Kalimantan, Sulawesi and Sumatra are being incluted in the medium stratification. Java and Bali are low endemic even though there are some villages of high endemic. Health status in an area is affected by four factors that are related and influenceach other, namely environmental, behavioral, health services and the off spring factors. Individual risk factors that contribute to the occurrence of malaria infection are age, gender, pregnancy, genetic, nutritional status, activities out of the house at night and contextual risk faktors (environment, seasons, social economy. The purpose of this research was to analyze the risk factors associated with the occurrence of malaria in Indonesia based on the data of basic health research (Riskesdas by 2013. There were 19 individual factors showed significantly with malaria risk. History of insecticide spraying (and use of household insecticides was not significantly associated with malaria risk. The greatest risk factor for malaria infection was the use of mosquito nets of nineteen individual factors there is one factors that was not a risk factor for the occurrence of malaria infection which is the factor home insect repellent/insecticide spraying. The greatest risk factor was the use of mosquito nets (OR = 2.30; 95% CI: 1.28-4.12 while the smallest was the travel time to the midwive services (OR = 0.32; 95% CI: 0.55-0,19.Keywords : Risk Faktors, Malaria, IndonesiaAbstrakMalaria masih endemis di sebagian besar wilayah Indonesia. Indonesia bagian timur masuk dalam stratifikasi malaria tinggi, sementara Kalimantan, Sulawesi dan Sumatera masuk dalam stratifikasi sedang. Daerah Jawa dan Bali masuk dalam stratifikasi rendah, namun masih terdapat desa dengan angka kasus malaria yang tinggi. Status kesehatan disuatu daerah dipengaruhi oleh empat faktor yang berhubungan dan saling

  4. An initial examination of the epidemiology of malaria in the State of Roraima, in the Brazilian Amazon Basin

    Directory of Open Access Journals (Sweden)

    CHAVES Sandra S.

    2000-01-01

    Full Text Available This study firstly describes the epidemiology of malaria in Roraima, Amazon Basin in Brazil, in the years from 1991 to 1993: the predominance of plasmodium species, distribution of the blood slides examined, the malaria risk and seasonality; and secondly investigates whether population growth from 1962 to 1993 was associated with increasing risk of malaria. Frequency of malaria varied significantly by municipality. Marginally more malaria cases were reported during the dry season (from October to April, even after controlling for by year and municipality. Vivax was the predominant type in all municipalities but the ratio of plasmodium types varied between municipalities. No direct association between population growth and increasing risk of malaria from 1962 to 1993 was detected. Malaria in Roraima is of the "frontier" epidemiological type with high epidemic potential.

  5. Costs of eliminating malaria and the impact of the global fund in 34 countries.

    Directory of Open Access Journals (Sweden)

    Brittany Zelman

    Full Text Available BACKGROUND: International financing for malaria increased more than 18-fold between 2000 and 2011; the largest source came from The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund. Countries have made substantial progress, but achieving elimination requires sustained finances to interrupt transmission and prevent reintroduction. Since 2011, global financing for malaria has declined, fueling concerns that further progress will be impeded, especially for current malaria-eliminating countries that may face resurgent malaria if programs are disrupted. OBJECTIVES: This study aims to 1 assess past total and Global Fund funding to the 34 current malaria-eliminating countries, and 2 estimate their future funding needs to achieve malaria elimination and prevent reintroduction through 2030. METHODS: Historical funding is assessed against trends in country-level malaria annual parasite incidences (APIs and income per capita. Following Kizewski et al. (2007, program costs to eliminate malaria and prevent reintroduction through 2030 are estimated using a deterministic model. The cost parameters are tailored to a package of interventions aimed at malaria elimination and prevention of reintroduction. RESULTS: The majority of Global Fund-supported countries experiencing increases in total funding from 2005 to 2010 coincided with reductions in malaria APIs and also overall GNI per capita average annual growth. The total amount of projected funding needed for the current malaria-eliminating countries to achieve elimination and prevent reintroduction through 2030 is approximately US$8.5 billion, or about $1.84 per person at risk per year (PPY (ranging from $2.51 PPY in 2014 to $1.43 PPY in 2030. CONCLUSIONS: Although external donor funding, particularly from the Global Fund, has been key for many malaria-eliminating countries, sustained and sufficient financing is critical for furthering global malaria elimination. Projected cost estimates for

  6. Malaria Early Warning: The MalarSat project

    Science.gov (United States)

    Roca, M.; Escorihuela, M. J.; Martínez, D.; Torrent, M.; Aponte, J.; Nunez, F.; Garcia, J.

    2009-04-01

    Malaria is one of the major public health challenges undermining development in the world. The aim of MalarSat Project is to provide a malaria risks infection maps at global scale using Earth Observation data to support and prevent epidemic episodes. The proposed service for creating malaria risk maps would be critically useful to improve the efficiency in insecticide programs, vaccine campaigns and the logistics epidemic treatment. Different teams have already carried out studies in order to exploit the use of Earth Observation (EO) data with epidemiology purposes. In the case of malaria risk maps, it has been shown that meteorological data is not sufficient to fulfill this objective. In particular being able to map the malaria mosquito habitat would increase the accuracy of risk maps. The malaria mosquitoes mainly reproduce in new water puddles of very reduced dimensions (about 1 meter wide). There is no instrument that could detect such small patches of water unless there are many of them spread in an area of several hundreds of meters. MalarSat aims at using the radar altimeter data from the EnviSat, RA-2, to try and build indicators of mosquitoes existence. This presentation will show the scientific objectives and principles of the MalarSat project.

  7. Of mice and women: rodent models of placental malaria

    DEFF Research Database (Denmark)

    Hviid, Lars; Marinho, Claudio R F; Staalsoe, Trine;

    2010-01-01

    Pregnant women are at increased malaria risk. The infections are characterized by placental accumulation of infected erythrocytes (IEs) with adverse consequences for mother and baby. Placental IE sequestration in the intervillous space is mediated by variant surface antigens (VSAs) selectively...... expressed in placental malaria (PM) and specific for chondroitin sulfate A (CSA). In Plasmodium falciparum, these VSA(PM) appear largely synonymous with the P. falciparum erythrocyte membrane protein 1 (PfEMP1) family variant VAR2CSA. As rodent malaria parasites do not possess PfEMP1 homologs...

  8. Cluster of Imported Vivax Malaria in Travelers Returning From Peru.

    Science.gov (United States)

    Weitzel, Thomas; Labarca, Jaime; Cortes, Claudia P; Rosas, Reinaldo; Balcells, M Elvira; Perret, Cecilia

    2015-01-01

    We report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis.

  9. [Severe malaria in Palmas, State of Tocantins: case report].

    Science.gov (United States)

    Parise, Eldi Vendrame

    2009-01-01

    Plasmodium falciparum causes the most severe clinical form of malaria. In this study, we report a severe case of malaria, through following up the patient and from notes in the medical files at the Palmas General Hospital. We discuss the outcome of this case and the complications caused by this infection, recognizing the potential risk of occurrences of severe malaria in not-endemic areas because of the delay in treatment, and the importance of intensifying surveillance measures involving all health unit employees, with emphasis on the reception areas for migrants from endemic regions.

  10. Exploring the relationship between malaria, rainfall intermittency, and spatial variation in rainfall seasonality

    Science.gov (United States)

    Merkord, C. L.; Wimberly, M. C.; Henebry, G. M.; Senay, G. B.

    2014-12-01

    Malaria is a major public health problem throughout tropical regions of the world. Successful prevention and treatment of malaria requires an understanding of the environmental factors that affect the life cycle of both the malaria pathogens, protozoan parasites, and its vectors, anopheline mosquitos. Because the egg, larval, and pupal stages of mosquito development occur in aquatic habitats, information about the spatial and temporal distribution of rainfall is critical for modeling malaria risk. Potential sources of hydrological data include satellite-derived rainfall estimates (TRMM and GPM), evapotranspiration derived from a simplified surface energy balance, and estimates of soil moisture and fractional water cover from passive microwave imagery. Previous studies have found links between malaria cases and total monthly or weekly rainfall in areas where both are highly seasonal. However it is far from clear that monthly or weekly summaries are the best metrics to use to explain malaria outbreaks. It is possible that particular temporal or spatial patterns of rainfall result in better mosquito habitat and thus higher malaria risk. We used malaria case data from the Amhara region of Ethiopia and satellite-derived rainfall estimates to explore the relationship between malaria outbreaks and rainfall with the goal of identifying the most useful rainfall metrics for modeling malaria occurrence. First, we explored spatial variation in the seasonal patterns of both rainfall and malaria cases in Amhara. Second, we assessed the relative importance of different metrics of rainfall intermittency, including alternation of wet and dry spells, the strength of intensity fluctuations, and spatial variability in these measures, in determining the length and severity of malaria outbreaks. We also explored the sensitivity of our results to the choice of method for describing rainfall intermittency and the spatial and temporal scale at which metrics were calculated. Results

  11. Climate change induced risk analysis of Addis Ababa city (Ethiopia)

    Science.gov (United States)

    Jalayer, Fatemeh; Herslund, Lise; Cavan, Gina; Printz, Andreas; Simonis, Ingo; Bucchignani, Edoardo; Jean-Baptiste, Nathalie; Hellevik, Siri; Fekade, Rebka; Nebebe, Alemu; Woldegerima, Tekle; Workalemahu, Liku; Workneh, Abraham; Yonas, Nebyou; Abebe Bekele, Essete; Yeshitela, Kumelachew

    2013-04-01

    CLUVA (CLimate change and Urban Vulnerability in Africa; http://www.cluva.eu/) is a 3 years project, funded by the European Commission in 2010. Its objective is to develop context-centered methods to assess vulnerability and increase knowledge on managing climate related risks and to estimate the impacts of climate changes in the next 40 years at urban scale in Africa. The project downscales IPCC climate projections to evaluate threats to selected African test cities; mainly floods, sea-level rise, droughts, heat waves, desertification. It also evaluates and links: social vulnerability; urban green structures and ecosystem services; urban-rural interfaces; vulnerability of urban built environment and lifelines; and related institutional and governance dimensions of adaptation. CLUVA combines assessment approaches to investigate how cities, communities and households can resist and cope with, as well as recover from climate induced hazards. This multi-scale and multi-disciplinary qualitative, quantitative and probabilistic approach of CLUVA is currently being applied to selected African test cities (Addis Ababa - Ethiopia; Dar es Salaam - Tanzania; Douala - Cameroun; Ouagadougou - Burkina Faso; St. Louis - Senegal). In particular, the poster will report on the progresses of the Addis Ababa case study. Addis Ababa, the largest city in Ethiopia, is exposed to heat waves, drought, and, more recently, to flash floods. Due to undulating topography, poor waste management and the absence of sustainable storm water management, Addis Ababa is prone to severe flood events during the rainy seasons. Metropolitan Addis Ababa is crossed by several small watercourses. Torrential rains, very common during the rainy season, cause a sudden rise in the flow of these water courses, inundating and damaging the settlements along their banks and affecting the livelihood of the local population. The combination of climate change and development pressures are expected to exacerbate the

  12. Malaria transmission in Bissau, Guinea-Bissau between 1995 and 2012

    DEFF Research Database (Denmark)

    Ursing, Johan; Rombo, Lars; Rodrigues, Amabelia;

    2014-01-01

    INTRODUCTION: As Plasmodium falciparum prevalence decreases in many parts of Sub-Saharan Africa, so does immunity resulting in larger at risk populations and increased risk of malaria resurgence. In Bissau, malaria prevalence decreased from ∼50% to 3% between 1995 and 2003. The epidemiological...... characteristics of P. falciparum malaria within Bandim health and demographic surveillance site (population ∼100,000) between 1995 and 2012 are described. METHODS AND FINDINGS: The population was determined by census. 3603 children aged ... (1995-2012) were considered incident cases. The mean annual malaria incidence per thousand children in 1995-1997, 1999-2003, 2007, 2011, 2012 were as follows; age

  13. Plasmodium falciparum malaria in children aged 0-2 years: the role of foetal haemoglobin and maternal antibodies to two asexual malaria vaccine candidates (MSP3 and GLURP.

    Directory of Open Access Journals (Sweden)

    David Tiga Kangoye

    Full Text Available Children below six months are reported to be less susceptible to clinical malaria. Maternally derived antibodies and foetal haemoglobin are important putative protective factors. We examined antibodies to Plasmodium falciparum merozoite surface protein 3 (MSP3 and glutamate-rich protein (GLURP, in children in their first two years of life in Burkina Faso and their risk of malaria.A cohort of 140 infants aged between four and six weeks was recruited in a stable transmission area of south-western Burkina Faso and monitored for 24 months by active and passive surveillance. Malaria infections were detected by examining blood smears using light microscopy. Enzyme-linked immunosorbent assay was used to quantify total Immunoglobulin G to Plasmodium falciparum antigens MSP3 and two regions of GLURP (R0 and R2 on blood samples collected at baseline, three, six, nine, 12, 18 and 24 months. Foetal haemoglobin and variant haemoglobin fractions were measured at the baseline visit using high pressure liquid chromatography.A total of 79.6% of children experienced one or more episodes of febrile malaria during monitoring. Antibody titres to MSP3 were prospectively associated with an increased risk of malaria while antibody responses to GLURP (R0 and R2 did not alter the risk. Antibody titres to MSP3 were higher among children in areas of high malaria risk. Foetal haemoglobin was associated with delayed first episode of febrile malaria and haemoglobin CC type was associated with reduced incidence of febrile malaria.We did not find any evidence of association between titres of antibodies to MSP3, GLURP-R0 or GLURP-R2 as measured by enzyme-linked immunosorbent assay and early protection against malaria, although anti-MSP3 antibody titres may reflect increased exposure to malaria and therefore greater risk. Foetal haemoglobin was associated with protection against febrile malaria despite the study limitations and its role is therefore worthy further investigation.

  14. Bioinformatics approaches to malaria

    DEFF Research Database (Denmark)

    Hansen, Daniel Aaen

    Malaria is a life threatening disease found in tropical and subtropical regions of the world. Each year it kills 781 000 individuals; most of them are children under the age of five in sub-Saharan Africa. The most severe form of malaria in humans is caused by the parasite Plasmodium falciparum......, which is the subject of the first part of this thesis. The PfEMP1 protein which is encoded by the highly variablevargene family is important in the pathogenesis and immune evasion of malaria parasites. We analyzed and classified these genes based on the upstream sequence in seven......Plasmodium falciparumclones. We show that the amount of nucleotide diversity is just as big within each clone as it is between the clones. DNA methylation is an important epigenetic mark in many eukaryotic species. We are studying DNA methylation in the malaria parasitePlasmodium falciparum. The work is still in progress...

  15. Fetal growth restriction is associated with malaria in pregnancy

    DEFF Research Database (Denmark)

    Briand, Valérie; Saal, Jessica; Ghafari, Caline

    2016-01-01

    BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography......-based follow-up study of Beninese women. METHODS: A total of 1016 women were followed up from gestational week 17 to delivery. Malaria was detected every month. Women underwent ultrasonography 4 times for gestational age determination and fetal biometry. We assessed the effect of malaria on birth weight......-for-gestational age z score (n = 735 women) and fetal growth velocity (n = 664), defined as a change in fetal weight z score over time. RESULTS: Malaria was detected in 43% of women. Fetal growth velocity was negative overall, decreasing further at the end of the third trimester. Women with ≥2 malarial parasite...

  16. SOCIAL IMPLICATIONS OF MALARIA AND THEIR RELATIONSHIPS WITH POVERTY

    Directory of Open Access Journals (Sweden)

    Francesco Ricci

    2012-08-01

    Full Text Available Having changed our understanding about issues related to poverty, even in the fight against malaria we must keep in mind a number of issues other than simple lack of economic resources. In this article we tried to discuss the various aspects that make malaria a disease closely related to poverty and the effects of malaria on the same poverty of patients who are affected. If you want the program to "Rool Back Malaria" to succeed, you must program interventions that improve the living conditions of populations in endemic area, individually and as communities. As has become clear that the discovery of an effective vaccine will not eradicate the disease, remains a fundamental understanding of mechanisms related to poverty that cause Malaria remains one of the major killers in the world, to help communities affected and individuals to prevent, cure properly and not being afraid of this ancient disease.

  17. Organizational change. Success factors and risks; Foeraendringsarbete. Framgaangsfaktorer och risker

    Energy Technology Data Exchange (ETDEWEB)

    Lundqvist, K. [Castor Analys AB, Stockholm (Sweden)

    2002-01-01

    possibilities of personal development. The phases of the change process are in practice iterative, they will be repeated when formulating stepwise goals, making action plans implementing, monitoring and reflecting over what has been achieved. This will develop organizational change competence. The phases are over-lapping. Not only one, but several processes are going on in different phases. The on-going change processes have to be coordinated and synchronized. The safety issues cannot be separated from other organizational issues. All organizational changes have to be synchronized. Issues of competence and staffing have to be continuously analyzed. The motivation of the staff will be effected in the beginning of a change process. Participation is a key to success. The work organization must be continuously developed. 'Just in time'- thinking can be in conflict with 'just in case'- thinking in high-risk environments. Under manning. Temporary staff. Outsourcing. (abstract truncated)

  18. Malaria and water resource development: the case of Gilgel-Gibe hydroelectric dam in Ethiopia

    Directory of Open Access Journals (Sweden)

    Kloos Helmut

    2009-01-01

    Full Text Available Abstract Background Ethiopia plans to increase its electricity power supply by five-fold over the next five years to fulfill the needs of its people and support the economic growth based on large hydropower dams. Building large dams for hydropower generation may increase the transmission of malaria since they transform ecosystems and create new vector breeding habitats. The aim of this study was to assess the effects of Gilgel-Gibe hydroelectric dam in Ethiopia on malaria transmission and changing levels of prevalence in children. Methods A cross-sectional, community-based study was carried out between October and December 2005 in Jimma Zone, south-western Ethiopia, among children under 10 years of age living in three 'at-risk' villages (within 3 km from dam and three 'control' villages (5 to 8 km from dam. The man-made Gilgel-Gibe dam is operating since 2004. Households with children less than 10 years of age were selected and children from the selected households were sampled from all the six villages. This included 1,081 children from 'at-risk' villages and 774 children from 'control' villages. Blood samples collected from children using finger prick were examined microscopically to determine malaria prevalence, density of parasitaemia and identify malarial parasite species. Results Overall 1,855 children (905 girls and 950 boys were surveyed. A total of 194 (10.5% children were positive for malaria, of which, 117 (60.3% for Plasmodium vivax, 76 (39.2% for Plasmodium falciparum and one (0.5% for both P. vivax and P. falciparum. A multivariate design-based analysis indicated that, while controlling for age, sex and time of data collection, children who resided in 'at-risk' villages close to the dam were more likely to have P. vivax infection than children who resided farther away (odds ratio (OR = 1.63, 95% CI = 1.15, 2.32 and showed a higher OR to have P. falciparum infection than children who resided in 'control' villages, but this was not

  19. Spatially explicit burden estimates of malaria in Tanzania: bayesian geostatistical modeling of the malaria indicator survey data.

    Directory of Open Access Journals (Sweden)

    Laura Gosoniu

    Full Text Available A national HIV/AIDS and malaria parasitological survey was carried out in Tanzania in 2007-2008. In this study the parasitological data were analyzed: i to identify climatic/environmental, socio-economic and interventions factors associated with child malaria risk and ii to produce a contemporary, high spatial resolution parasitaemia risk map of the country. Bayesian geostatistical models were fitted to assess the association between parasitaemia risk and its determinants. bayesian kriging was employed to predict malaria risk at unsampled locations across Tanzania and to obtain the uncertainty associated with the predictions. Markov chain Monte Carlo (MCMC simulation methods were employed for model fit and prediction. Parasitaemia risk estimates were linked to population data and the number of infected children at province level was calculated. Model validation indicated a high predictive ability of the geostatistical model, with 60.00% of the test locations within the 95% credible interval. The results indicate that older children are significantly more likely to test positive for malaria compared with younger children and living in urban areas and better-off households reduces the risk of infection. However, none of the environmental and climatic proxies or the intervention measures were significantly associated with the risk of parasitaemia. Low levels of malaria prevalence were estimated for Zanzibar island. The population-adjusted prevalence ranges from 0.29% in Kaskazini province (Zanzibar island to 18.65% in Mtwara region. The pattern of predicted malaria risk is similar with the previous maps based on historical data, although the estimates are lower. The predicted maps could be used by decision-makers to allocate resources and target interventions in the regions with highest burden of malaria in order to reduce the disease transmission in the country.

  20. Serum ferritin and hematological feature among malaria patients in Assam

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    Jitendra Sharma

    2014-01-01

    Full Text Available Introduction: Assam is considered as a vulnerable state for malarial infection. Malarial patient exhibit several divergent values in their blood cell parameter as well as changes in concentration of normal serum ferritin level. The study was intended to observe the concentration of serum ferritin level and estimation of hematological feature among malaria patients in Assam. Materials and Methods: During the period from August 2012 to January 2013, a total of 77 blood samples have been collected from 77 individuals suspected with malaria from different malaria endemic districts of Assam. Results: A total of 36 cases were found to be malaria positive of which 25 were symptomatic and 11 were asymptomatic. Overall the percentage of parasitaemia was found 0.1-15%. Distribution of malaria cases was observed in all age groups and both the sexes. Hematological values among the malaria positive patients revealed that about 89% were having anaemia, 66.67% with Thrombocytopenia and 47% Lymphocytopenia. Iron deficiency anaemia was recorded in 63.87% of the patients. Other haematological status includes 30.56% individual with Granulocytosis and 50.00% subjects with low Mean platelet volume etc. Results also showed that the serum ferritin level in the malaria positive population ranged in from 70 ng/ml to 300 ng/ml, with a mean value of 114 ng/ml. Conclusion: In our study, hematological abnormality and low serum ferritin level is observed as an imperative marker for identification of malaria patients.

  1. Credit Risk and the Change in Fair Value

    OpenAIRE

    Gudan Paulina; Oprea Margareta

    2011-01-01

    Users of financial statements need information about an entity’s exposure to risks and how those risks and managed. Such information can influence a user’s assessment of the financial position and financial performance of an entity or the amount, timing, and uncertainty of its future cash flows. Greater transparency regarding those risks allows users to make more informed judgments about risk and return. Entities should describe the nature and extent of risks arising from financial instrument...

  2. Comparison of infant malaria incidence in districts of Maputo province, Mozambique

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    Zacarias Orlando P

    2011-04-01

    Full Text Available Abstract Background Malaria is one of the principal health problems in Mozambique, representing 48% of total external consultations and 63% of paediatric hospital admissions in rural and general hospitals with 26.7% of total mortality. Plasmodium falciparum is responsible for 90% of all infections being also the species associated with most severe cases. The aim of this study was to identify zones of high malaria risk, showing their spatially and temporal pattern. Methods Space and time Poison model for the analysis of malaria data is proposed. This model allows for the inclusion of environmental factors: rainfall, temperature and humidity as predictor variables. Modelling and inference use the fully Bayesian approach via Markov Chain Monte Carlo (MCMC simulation techniques. The methodology is applied to analyse paediatric data arising from districts of Maputo province, Mozambique, between 2007 and 2008. Results Malaria incidence risk is greater for children in districts of Manhiça, Matola and Magude. Rainfall and humidity are significant predictors of malaria incidence. The risk increased with rainfall (relative risk - RR: .006761, 95% interval: .001874, .01304, and humidity (RR: .049, 95% interval: .03048, .06531. Malaria incidence was found to be independent of temperature. Conclusions The model revealed a spatial and temporal pattern of malaria incidence. These patterns were found to exhibit a stable malaria transmission in most non-coastal districts. The findings may be useful for malaria control, planning and management.

  3. Climate change risk analysis framework (CCRAF) a probabilistic tool for analyzing climate change uncertainties

    Science.gov (United States)

    Legget, J.; Pepper, W.; Sankovski, A.; Smith, J.; Tol, R.; Wigley, T.

    2003-04-01

    Potential risks of human-induced climate change are subject to a three-fold uncertainty associated with: the extent of future anthropogenic and natural GHG emissions; global and regional climatic responses to emissions; and impacts of climatic changes on economies and the biosphere. Long-term analyses are also subject to uncertainty regarding how humans will respond to actual or perceived changes, through adaptation or mitigation efforts. Explicitly addressing these uncertainties is a high priority in the scientific and policy communities Probabilistic modeling is gaining momentum as a technique to quantify uncertainties explicitly and use decision analysis techniques that take advantage of improved risk information. The Climate Change Risk Assessment Framework (CCRAF) presented here a new integrative tool that combines the probabilistic approaches developed in population, energy and economic sciences with empirical data and probabilistic results of climate and impact models. The main CCRAF objective is to assess global climate change as a risk management challenge and to provide insights regarding robust policies that address the risks, by mitigating greenhouse gas emissions and by adapting to climate change consequences. The CCRAF endogenously simulates to 2100 or beyond annual region-specific changes in population; GDP; primary (by fuel) and final energy (by type) use; a wide set of associated GHG emissions; GHG concentrations; global temperature change and sea level rise; economic, health, and biospheric impacts; costs of mitigation and adaptation measures and residual costs or benefits of climate change. Atmospheric and climate components of CCRAF are formulated based on the latest version of Wigley's and Raper's MAGICC model and impacts are simulated based on a modified version of Tol's FUND model. The CCRAF is based on series of log-linear equations with deterministic and random components and is implemented using a Monte-Carlo method with up to 5000

  4. Early detection and monitoring of Malaria

    Science.gov (United States)

    Rahman, Md Z.; Roytman, Leonid; Kadik, Abdelhamid; Miller, Howard; Rosy, Dilara A.

    2015-05-01

    Global Earth Observation Systems of Systems (GEOSS) are bringing vital societal benefits to people around the globe. In this research article, we engage undergraduate students in the exciting area of space exploration to improve the health of millions of people globally. The goal of the proposed research is to place students in a learning environment where they will develop their problem solving skills in the context of a world crisis (e.g., malaria). Malaria remains one of the greatest threats to public health, particularly in developing countries. The World Health Organization has estimated that over one million die of Malaria each year, with more than 80% of these found in Sub-Saharan Africa. The mosquitoes transmit malaria. They breed in the areas of shallow surface water that are suitable to the mosquito and parasite development. These environmental factors can be detected with satellite imagery, which provide high spatial and temporal coverage of the earth's surface. We investigate on moisture, thermal and vegetation stress indicators developed from NOAA operational environmental satellite data. Using these indicators and collected epidemiological data, it is possible to produce a forecast system that can predict the risk of malaria for a particular geographical area with up to four months lead time. This valuable lead time information provides an opportunity for decision makers to deploy the necessary preventive measures (spraying, treated net distribution, storing medications and etc) in threatened areas with maximum effectiveness. The main objective of the proposed research is to study the effect of ecology on human health and application of NOAA satellite data for early detection of malaria.

  5. Undernutrition and malaria in pregnancy – a dangerous dyad?

    OpenAIRE

    Unger, Holger W.; Ashorn, Per; Cates, Jordan E; Dewey, Kathryn G.; Rogerson, Stephen J.

    2016-01-01

    Background In low-resource settings, malaria and macronutrient undernutrition are major health problems in pregnancy, contributing significantly to adverse pregnancy outcomes such as preterm birth and fetal growth restriction. Affected pregnancies may result in stillbirth and neonatal death, and surviving children are at risk of poor growth and infection in infancy, and of non-communicable diseases in adulthood. Populations exposed to macronutrient undernutrition frequently reside in malaria-...

  6. A co-infection model of malaria and cholera diseases with optimal control.

    Science.gov (United States)

    Okosun, K O; Makinde, O D

    2014-12-01

    In this paper we formulate a mathematical model for malaria-cholera co-infection in order to investigate their synergistic relationship in the presence of treatments. We first analyze the single infection steady states, calculate the basic reproduction number and then investigate the existence and stability of equilibria. We then analyze the co-infection model, which is found to exhibit backward bifurcation. The impact of malaria and its treatment on the dynamics of cholera is further investigated. Secondly, we incorporate time dependent controls, using Pontryagin's Maximum Principle to derive necessary conditions for the optimal control of the disease. We found that malaria infection may be associated with an increased risk of cholera but however, cholera infection is not associated with an increased risk for malaria. Therefore, to effectively control malaria, the malaria intervention strategies by policy makers must at the same time also include cholera control.

  7. Malaria parasitaemia and disorders of plasma electrolytes

    Institute of Scientific and Technical Information of China (English)

    Idogun ES; Airauhi LU

    2009-01-01

    Objective:To assess the plasma electrolyte status of patients with diagnosis of malaria but without the symptoms of diarrhea,vomiting or altered sensorium and correlation of the plasma electrolyte changes and the degree of parasitae-mia.Methods:All the participants were adults,who met the clinical case definition of malaria but without the symptoms of diarrhea,vomiting or other medical illness.Blood slides were screened microscopically for malaria par-asite and the parasite positive patients were grouped into A (mild),B (moderate)and C (heavy)malaria parasite-amia,depending on the malaria parasite count per high power microscopic field.Plasma sodium,potassium and chloride were estimated using the ion selective electrode method,while bicarbonate ions were determined by simple titration method.Results:A total of 200 subjects were studied which comprised of 150 patients and 50 controls.The mean plasma sodium was significantly lower in patients with heavy parasitaemia[group C,(128.8 ±1.2)mmol /L] compared to those with mild and moderate parasitemia[(133.5 ±2.8)mmol /L and (133.5 ±3.5)mmol /L,P <0.0001].The mean plasma chloride was lowest in those patients with heavy parasitaemia (group C)than those pa-tients of group A and B (P <0.0001).Patients in group C also had significant hypokalaemia[(3.2 ±0.5)mmol /L]when compared to those in groups A and B[(3.6 ±0.3)mmol /L and (4.1 ±0.6)mmol /L respectively,P <0. 0001].Conclusion:A disorder of plasma electrolytes in malaria patients that had no symptoms of diarrhea and vom-iting was reported.And the severity of hyponatraemia and hypokalaemia correlate with the severity of the patients′malaria parasitaemia.This data should alert clinicians on the need to assess electrolytes status of patients with ma-laria even without the symptoms of fluid loss,especially when malaria parasitaemia is heavy.

  8. Farmers' Perceived Risks of Climate Change and Influencing Factors: A Study in the Mekong Delta, Vietnam

    Science.gov (United States)

    Le Dang, Hoa; Li, Elton; Nuberg, Ian; Bruwer, Johan

    2014-08-01

    Many countries are confronting climate change that threatens agricultural production and farmers' lives. Farmers' perceived risks of climate change and factors influencing those perceived risks are critical to their adaptive behavior and well-planned adaptation strategies. However, there is limited understanding of these issues. In this paper, we attempt to quantitatively measure farmers' perceived risks of climate change and explore the influences of risk experience, information, belief in climate change, and trust in public adaptation to those perceived risks. Data are from structured interviews with 598 farmers in the Mekong Delta. The study shows that perceived risks to production, physical health, and income dimensions receive greater priority while farmers pay less attention to risks to happiness and social relationships. Experiences of the events that can be attributed to climate change increase farmers' perceived risks. Information variables can increase or decrease perceived risks, depending on the sources of information. Farmers who believe that climate change is actually happening and influencing their family's lives, perceive higher risks in most dimensions. Farmers who think that climate change is not their concern but the government's, perceive lower risks to physical health, finance, and production. As to trust in public adaptation, farmers who believe that public adaptive measures are well co-ordinated, perceive lower risks to production and psychology. Interestingly, those who believe that the disaster warning system is working well, perceive higher risks to finance, production, and social relationships. Further attention is suggested for the quality, timing, and channels of information about climate change and adaptation.

  9. Changing trends of cardiovascular risk factors among Indians:a review of emerging risks

    Institute of Scientific and Technical Information of China (English)

    Arun; Kumar

    2014-01-01

    The global burden of disease due to cardiovascular diseases(CVDs) is escalating,and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition.Contributory causes include:growing population with demographic shifts and altered age profile,socio-economic factors,lifestyle changes due to urbanization.Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity.Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics,along with all form of tobacco use.The pace of health transition,however,varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs.A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial,primary and secondary prevention.Populations as well as individuals at risk must be protected through initiatives,enable nutritionbased preventive strategies to protect and promote cardiovascular health.

  10. Changing trends of cardiovascular risk factors among Indians:a review of emerging risks

    Institute of Scientific and Technical Information of China (English)

    Arun Kumar

    2014-01-01

    The global burden of disease due to cardiovascular diseases (CVDs) is escalating, and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition. Contributory causes include: growing population with demographic shifts and altered age profile, socio-economic factors, lifestyle changes due to urbanization. Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity. Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics, along with all form of tobacco use. The pace of health transition, however, varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives, enable nutrition-based preventive strategies to protect and promote cardiovascular health.

  11. Changing trends of cardiovascular risk factors among Indians: a review of emerging risks

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2014-12-01

    Full Text Available The global burden of disease due to cardiovascular diseases (CVDs is escalating, and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition. Contributory causes include: growing population with demographic shifts and altered age profile, socio-economic factors, lifestyle changes due to urbanization. Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity. Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics, along with all form of tobacco use. The pace of health transition, however, varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives, enable nutrition-based preventive strategies to protect and promote cardiovascular health.

  12. Overview of the risk management approach to adaptation to climate change in Canada

    Energy Technology Data Exchange (ETDEWEB)

    Noble, D.; Bruce, J.; Egener, M. [Global Change Strategies International, Ottawa, ON (Canada)

    2005-03-15

    Climate change poses risks related to frequent and extreme weather events, changes in water availability and changes in the performance of infrastructure systems. Risk management offers a decision-making framework to assist in the selection of optimal or cost-effective strategies using a systematic public process. Risks related to climate change are a new type of risk and are increasingly of concern for governments and citizens around the world. An introduction to risk-based approaches to climate change adaptation decision-making in Canada was presented in this paper. Steps in the risk management process were presented. Risk management approaches from various countries were reviewed, including the Canadian Standards Association's (CSA) national risk management guideline; the Government of Canada's Integrated Risk Management Framework; the Caribbean Risk Management Guideline; World Bank risk management strategies for adaptation to climate change; and the United Kingdom Climate Impacts Program. Details of a study conducted by the United Kingdom Department for Environment, Food, and Rural Affairs to explore the implications of climate change were also presented. Vulnerabilities of response mechanisms to climate change and the interrelations of public systems were reviewed. Issues concerning infrastructure renewal and development were examined, as well as emergency planning and management strategies. It was concluded that the development of training materials and tools for decision-makers in Canada is needed. A climate change risk management planning guidebook was proposed. refs., tabs., figs.

  13. Changes in vector species composition and current vector biology and behaviour will favour malaria elimination in Santa Isabel Province, Solomon Islands

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    Beebe Nigel W

    2011-09-01

    Full Text Available Abstract Background In 2009, Santa Isabel Province in the Solomon Islands embarked on a malaria elimination programme. However, very little is known in the Province about the anopheline fauna, which species are vectors, their bionomics and how they may respond to intensified intervention measures. The purpose of this study was to provide baseline data on the malaria vectors and to ascertain the possibility of successfully eliminating malaria using the existing conventional vector control measures, such as indoor residual spraying (IRS and long-lasting insecticidal nets (LLIN. Methods Entomological surveys were undertaken during October 2009. To determine species composition and distribution larval surveys were conducted across on the whole island. For malaria transmission studies, adult anophelines were sampled using human landing catches from two villages - one coastal and one inland. Results Five Anopheles species were found on Santa Isabel: Anopheles farauti, Anopheles hinesorum, Anopheles lungae, Anopheles solomonis, and Anopheles nataliae. Anopheles hinesorum was the most widespread species. Anopheles farauti was abundant, but found only on the coast. Anopheles punctulatus and Anopheles koliensis were not found. Anopheles farauti was the only species found biting in the coastal village, it was incriminated as a vector in this study; it fed early in the night but equally so indoors and outdoors, and had a low survival rate. Anopheles solomonis was the main species biting humans in the inland village, it was extremely exophagic, with low survival rates, and readily fed on pigs. Conclusion The disappearance of the two major vectors, An. punctulatus and An. koliensis, from Santa Isabel and the predominance of An. hinesorum, a non-vector species may facilitate malaria elimination measures. Anopheles farauti was identified as the main coastal vector with An. solomonis as a possible inland vector. The behaviour of An. solomonis is novel as it has

  14. Managing Climate Change Risk in China’s Agricultural Sector:The Potential for an Integrated Risk Management Framework

    Institute of Scientific and Technical Information of China (English)

    Kevin Z. Chen; Claire Hsu

    2014-01-01

    Climate change poses a serious threat to the future food security of China, which is among the most disaster-prone countries in the world. This paper discusses the implications of climate change for China’s agricultural sector. Its main objectives are to identify the agricultural risks associated with climate change, to introduce a conceptual framework for agricultural climate risk management and to enumerate key adaptation strategies, challenges, and recommendations.

  15. Variations in host genes encoding adhesion molecules and susceptibility to falciparum malaria in India

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    Tyagi Prajesh K

    2008-12-01

    Full Text Available Abstract Background Host adhesion molecules play a significant role in the pathogenesis of Plasmodium falciparum malaria and changes in their structure or levels in individuals can influence the outcome of infection. The aim of this study was to investigate the association of SNPs of three adhesion molecule genes, ICAM1, PECAM1 and CD36, with severity of falciparum malaria in a malaria-endemic and a non-endemic region of India. Methods The frequency distribution of seven selected SNPs of ICAM1, PECAM1 and CD36 was determined in 552 individuals drawn from 24 populations across India. SNP-disease association was analysed in a case-control study format. Genotyping of the population panel was performed by Sequenom mass spectroscopy and patient/control samples were genotyped by SNaPshot method. Haplotypes and linkage disequilibrium (LD plots were generated using PHASE and Haploview, respectively. Odds-ratio (OR for risk assessment was estimated using EpiInfo™ version 3.4. Results Association of the ICAM1 rs5498 (exon 6 G allele and the CD36 exon 1a A allele with increased risk of severe malaria was observed (severe versus control, OR = 1.91 and 2.66, P = 0.02 and 0.0012, respectively. The CD36 rs1334512 (-53 T allele as well as the TT genotype associated with protection from severe disease (severe versus control, TT versus GG, OR = 0.37, P = 0.004. Interestingly, a SNP of the PECAM1 gene (rs668, exon 3, C/G with low minor allele frequency in populations of the endemic region compared to the non-endemic region exhibited differential association with disease in these regions; the G allele was a risk factor for malaria in the endemic region, but exhibited significant association with protection from disease in the non-endemic region. Conclusion The data highlights the significance of variations in the ICAM1, PECAM1 and CD36 genes in the manifestation of falciparum malaria in India. The PECAM1 exon 3 SNP exhibits altered association with disease in the

  16. Pregnancy-induced changes in breast cancer risk.

    Science.gov (United States)

    Russo, Irma H; Russo, Jose

    2011-09-01

    Breast cancer is the malignant disease most frequently diagnosed in women of all races and nationalities. Since the 1970s the worldwide incidence of this disease has increased 30-40% in postmenopausal women, in whom, paradoxically, the risk of developing breast cancer is significantly reduced by an early first full term pregnancy (FTP) as compared to nulliparous and late parous women. Although the cause of breast cancer is not known, the mechanisms mediating the protection conferred by an early FTP have been identified to reside in the breast itself, and to be modulated by endogenous and environmental exposures that might negatively affect this organ during specific windows in its development that extend from prenatal life until the first pregnancy. Soon after conception the embryo initiates the production of human chorionic gonadotropin (hCG), the glycoprotein hormone that is diagnostic of pregnancy. HCG in conjunction with ovarian steroid hormones primes the hypothalamic neuroendocrine system for maintaining the pregnancy. Higher levels of hCG during the first trimester of pregnancy have been associated with a reduction in maternal breast cancer incidence after age 50. In preclinical studies it has been demonstrated that both FTP and hCG treatment of virgin rats prevent the development of chemically-induced mammary tumors, a phenomenon mediated by the differentiation of the mammary gland epithelial cells prior to carcinogen exposure. Complete differentiation proceeds through complex morphological, physiological and molecular changes that occur during pregnancy and lactation, that ultimately result in increased DNA repair capabilities of the mammary epithelium, activation of genes controlling differentiation and programmed cell death and imprinting in the breast epithelium a specific and permanent genomic signature of pregnancy. This signature is indicative of a reduced breast cancer risk and serves as a molecular biomarker of differentiation for evaluating the

  17. Ecology and Epidemiology of Integrated Malaria Vector Management in Dar es Salaam, Tanzania

    OpenAIRE

    Geissbühler, Yvonne

    2008-01-01

    Malaria remains one of the major contributors to the global burden of disease with approximately 70% of the clinical malaria attacks occurring in sub-Saharan Africa. Sub- Saharan Africa has the highest risk as ideal climatic conditions for transmission coincide with occurrence of some of the most efficient malaria vectors, namely Anopheles gambiae s.s., Anopheles arabiensis and Anopheles funestus.. Even though it is estimated that by the year 2030 more than 50% of the African p...

  18. Dystocia in dromedary camels: Prevalence, forms, risks and hematobiochemical changes.

    Science.gov (United States)

    Ali, Ahmed; Derar, Derar; Tharwat, Mohamed; Zeitoun, Moustafa M; Alsobyil, Fahd A

    2016-07-01

    The objectives of this study were to investigate the prevalence of dystocia in camel herds, its forms in primi- and multipara, the risks to fetus and dam, and the associated hematobiochemical changes. A total of 1890 calvings were surveyed for the prevalence of dystocia. Cases with dystocia (n=107) were examined for causes and treated with traction, fetotomy or Cesarean section. Logistic regression was performed to identify risk factors. The dependent variables were the fetal and maternal mortality, while the independent variables were parity, duration of dystocia, causes of dystocia, and method of treatment. Blood samples were collected from all dystocia camels and six controls for hematology and concentrations of serum amyloid A (SAA), haptoglobin (Hp), estradiol-17β (E2), progesterone (P4), total protein, albumin, calcium, phosphorus, magnesium, blood urea nitrogen (BUN), creatinine and aspartate aminotransferase (AST). The overall prevalence of dystocia was 8.6%. Risk of dystocia was higher in camels managed in an intensive system than in those in a free system (Odds ratio=1.9, P=0.0003) and higher in primipara than in multipara (Odds ratio 1.7, P=0.005). Abnormal posture was the most important cause of dystocia (51.4%). Uterine torsion was the second most important cause (23.4%) and was mainly observed in multipara (P=0.0006). Dystocia was linked to high fetal mortality (87.9%). A significant relationship was found between fetal death and duration of dystocia (Odds ratio=8.04, P=0.005). The percentage of dam mortality was 17.8%. Significant associations were detected between dam mortality rate and the duration of dystocia (Odds ratio=4.74, P=0.03) and fetal viability (Odds ratio=5.82, P=0.02). Increasing duration of dystocia was associated with significant increases in SAA, Hp, BUN and AST, but with decreases in E2 (Pdystocia in dromedary camels, and fetal and maternal deaths were mainly associated with the duration of dystocia.

  19. Malaria in Tunisian Military Personnel after Returning from External Operation

    Science.gov (United States)

    Ajili, Faïda; Battikh, Riadh; Laabidi, Janet; Abid, Rim; Bousetta, Najeh; Jemli, Bouthaina; Ben abdelhafidh, Nadia; Bassem, Louzir; Gargouri, Saadia; Othmani, Salah

    2013-01-01

    Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites. PMID:23766922

  20. Malaria in Tunisian Military Personnel after Returning from External Operation

    Directory of Open Access Journals (Sweden)

    Faïda Ajili

    2013-01-01

    Full Text Available Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51% of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites.

  1. The path of malaria vaccine development: challenges and perspectives.

    Science.gov (United States)

    Arama, C; Troye-Blomberg, M

    2014-05-01

    Malaria is a life-threatening disease caused by parasites of the Plasmodium genus. In many parts of the world, the parasites have developed resistance to a number of antimalarial agents. Key interventions to control malaria include prompt and effective treatment with artemisinin-based combination therapies, use of insecticidal nets by individuals at risk and active research into malaria vaccines. Protection against malaria through vaccination was demonstrated more than 30 years ago when individuals were vaccinated via repeated bites by Plasmodium falciparum-infected and irradiated but still metabolically active mosquitoes. However, vaccination with high doses of irradiated sporozoites injected into humans has long been considered impractical. Yet, following recent success using whole-organism vaccines, the approach has received renewed interest; it was recently reported that repeated injections of irradiated sporozoites increased protection in 80 vaccinated individuals. Other approaches include subunit malaria vaccines, such as the current leading candidate RTS,S (consisting of fusion between a portion of the P. falciparum-derived circumsporozoite protein and the hepatitis B surface antigen), which has been demonstrated to induce reasonably good protection. Although results have been encouraging, the level of protection is generally considered to be too low to achieve eradication of malaria. There is great interest in developing new and better formulations and stable delivery systems to improve immunogenicity. In this review, we will discuss recent strategies to develop efficient malaria vaccines.

  2. Urinary schistosomiasis and malaria associated anemia in Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Ketema Deribew; Zinaye Tekeste; Beyene Petros

    2013-01-01

    Objective: To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases. Methods: Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia. Results: The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53). Conclusions: The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.

  3. Asymptomatic malaria infections among foreign migrant workers in Thailand

    Institute of Scientific and Technical Information of China (English)

    Kanyanan Kritsiriwuthinan; Warunee Ngrenngarmlert

    2011-01-01

    Objective:To determine the prevalence of malaria infections among foreign migrant workers in Thailand. Methods:Giemsa-stained thin and thick blood films were prepared from blood samples of294 foreign migrant workers recruited in the study. Microscopic examination of these blood films was performed for malaria detection.Results: Blood film examination revealed 1.36%malaria infections in these294 subjects. All positive cases were male Myanmar workers in which their blood films only ring stage ofPlasmodium spp. was found at low parasite density (mean=144parasites/μL of blood). The prevalence of malaria infections was not significantly different among foreign migrant workers classified by age, gender, and resident province (P>0.05). Thin blood films of these workers also showed78.91%hypochromic erythrocytes and 61.9%relative Eosinophilia.Conclusions:These findings indicate a high risk of malaria transmission. Therefore active malaria surveillance by using molecular methods with more sensitive and specific than microscopy should be considered for malaria control in foreign migrant workers.

  4. Monkey malaria kills four humans.

    Science.gov (United States)

    Galinski, Mary R; Barnwell, John W

    2009-05-01

    Four human deaths caused by Plasmodium knowlesi, a simian malaria species, are stimulating a surge of public health interest and clinical vigilance in vulnerable areas of Southeast Asia. We, and other colleagues, emphasize that these cases, identified in Malaysia, are a clear warning that health facilities and clinicians must rethink the diagnosis and treatment of malaria cases presumed to be caused by a less virulent human malaria species, Plasmodium malariae.

  5. Re-Emerging Malaria Vectors in Rural Sahel (nouna, Burkina Faso): the Paluclim Project

    Science.gov (United States)

    Vignolles, Cécile; Sauerborn, Rainer; Dambach, Peter; Viel, Christian; Soubeyroux, Jean-Michel; Sié, Ali; Rogier, Christophe; Tourre, Yves M.

    2016-06-01

    The Paluclim project applied the tele-epidemiology approach, linking climate, environment and public health (CNES, 2008), to rural malaria in Nouna (Burkina Faso). It was to analyze the climate impact on vectorial risks, and its consequences on entomological risks forecast. The objectives were to: 1) produce entomological risks maps in the Nouna region, 2) produce dynamic maps on larvae sites and their productivity, 3) study the climate impact on malaria risks, and 4) evaluate the feasibility of strategic larviciding approach.

  6. Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

    DEFF Research Database (Denmark)

    Wiese, Lothar; Bruun, Brita; Baek, Leif

    2006-01-01

    a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy....... The rapid test used at the bedside had a sensitivity of 88% for the detection of P. falciparum compared to 95% when the test was performed in the microbiology laboratory. The risk of technical problems and invalid tests was highest when the test was used at the bedside. The rapid diagnostic test may...... be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis...

  7. Maps of the Sri Lanka malaria situation preceding the tsunami and key aspects to be considered in the emergency phase and beyond

    DEFF Research Database (Denmark)

    Briët, Olivier J T; Galappaththy, Gawrie N L; Konradsen, Flemming

    2005-01-01

    and treatment are important in assisting national and international agencies in their control efforts. METHODS: Monthly records over the period January 1995-October 2004 of confirmed malaria cases were used to perform an analysis of malaria distribution at district spatial resolution. Also, a focused review......BACKGROUND: Following the tsunami, a detailed overview of the area specific transmission levels is essential in assessing the risk of malaria in Sri Lanka. Recent information on vector insecticide resistance, parasite drug resistance, and insights into the national policy for malaria diagnosis...... with malaria surveillance, and the long term malaria control strategy of Sri Lanka, if not in accordance with government policy....

  8. Malaria Prevention Strategies: Adherence among Boston Area Travelers Visiting Malaria-Endemic Countries

    Science.gov (United States)

    Stoney, Rhett J.; Chen, Lin H.; Jentes, Emily S.; Wilson, Mary E.; Han, Pauline V.; Benoit, Christine M.; MacLeod, William B.; Hamer, Davidson H.; Barnett, Elizabeth D.

    2016-01-01

    We conducted a