WorldWideScience

Sample records for malaria control measures

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

    Science.gov (United States)

    Omumbo, Judy A; Noor, Abdisalan M; Fall, Ibrahima S; Snow, Robert W

    2013-01-01

    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. 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. 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. 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, strategic planning will be necessary to guide appropriate financing for malaria

  2. 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 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.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.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.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, strategic planning will be necessary to guide appropriate

  3. How Well Are Malaria Maps Used to Design and Finance Malaria Control in Africa?

    Science.gov (United States)

    Omumbo, Judy A.; Noor, Abdisalan M.; Fall, Ibrahima S.; Snow, Robert W.

    2013-01-01

    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, strategic planning will be

  4. The use of a GIS-based malaria information system for malaria research and control in South Africa.

    Science.gov (United States)

    Martin, Carrin; Curtis, Bronwyn; Fraser, Colleen; Sharp, Brian

    2002-12-01

    The paper aims to outline the innovative development and application of a Geographical Information System based Malaria Information System for malaria research and control in South Africa. This system is a product of collaboration between the Malaria Control Programmes and the Malaria Research Programme of the Medical Research Council of South Africa. The ability of such a system to process data timeously into a usable format is discussed, as well as its relevance to malaria research, appropriate malaria control measures, tourism, and social and economic development.

  5. Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures

    Science.gov (United States)

    Tseroni, Maria; Baka, Agoritsa; Kapizioni, Christina; Snounou, Georges; Tsiodras, Sotirios; Charvalakou, Maria; Georgitsou, Maria; Panoutsakou, Maria; Psinaki, Ioanna; Tsoromokou, Maria; Karakitsos, George; Pervanidou, Danai; Vakali, Annita; Mouchtouri, Varvara; Georgakopoulou, Theano; Mamuris, Zissis; Papadopoulos, Nikos; Koliopoulos, George; Badieritakis, Evangelos; Diamantopoulos, Vasilis; Tsakris, Athanasios; Kremastinou, Jenny; Hadjichristodoulou, Christos

    2015-01-01

    Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011–2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013–2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3% coverage of the target population. A total of 688 adverse events were recorded in 397 (36.2%, 95% C.I.: 33.4–39.1) persons, the vast majority minor, predominantly dizziness and headache for chloroquine (284 events) and abdominal pain (85 events) for primaquine. A single case of primaquine-induced hemolysis was recorded in a person whose initial G6PD test proved incorrect. No malaria cases were recorded in Evrotas, Laconia, in 2013 and 2014, though three locally acquired malaria cases were recorded in other regions of Greece in 2013. Preventive antimalarial MDA to a high-risk population in a low transmission setting appears to have synergized with the usual antimalarial activities to achieve malaria elimination. This study suggests that judicious use of

  6. Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures.

    Science.gov (United States)

    Tseroni, Maria; Baka, Agoritsa; Kapizioni, Christina; Snounou, Georges; Tsiodras, Sotirios; Charvalakou, Maria; Georgitsou, Maria; Panoutsakou, Maria; Psinaki, Ioanna; Tsoromokou, Maria; Karakitsos, George; Pervanidou, Danai; Vakali, Annita; Mouchtouri, Varvara; Georgakopoulou, Theano; Mamuris, Zissis; Papadopoulos, Nikos; Koliopoulos, George; Badieritakis, Evangelos; Diamantopoulos, Vasilis; Tsakris, Athanasios; Kremastinou, Jenny; Hadjichristodoulou, Christos

    2015-11-01

    Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011-2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013-2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3% coverage of the target population. A total of 688 adverse events were recorded in 397 (36.2%, 95% C.I.: 33.4-39.1) persons, the vast majority minor, predominantly dizziness and headache for chloroquine (284 events) and abdominal pain (85 events) for primaquine. A single case of primaquine-induced hemolysis was recorded in a person whose initial G6PD test proved incorrect. No malaria cases were recorded in Evrotas, Laconia, in 2013 and 2014, though three locally acquired malaria cases were recorded in other regions of Greece in 2013. Preventive antimalarial MDA to a high-risk population in a low transmission setting appears to have synergized with the usual antimalarial activities to achieve malaria elimination. This study suggests that judicious use of MDA can

  7. 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...... ¼ 3.20, 95% CI 1.26–8.16; p ¼ 0.015). Conclusions: The results suggest that educational attainment need not be very advanced to affect practices of malaria prevention and treatment. Primary school attendance was a stronger predictor for use of malaria risk reduction measures than any of the other...... selected background characteristics. Educational attainment, information and communication about malaria prevention and control play a pivotal role in increasing and improving use of malaria risk reduction measures....

  8. Exploration of different methods for measuring DDT exposure among malaria vector-control workers in Limpopo Province, South Africa

    International Nuclear Information System (INIS)

    Dalvie, M.A.; Myers, J.E.; Thompson, M.L.; Robins, T.G.; Omar, Shaheed; Riebow, John

    2004-01-01

    DDT compounds are used in many developing countries, including South Africa, for the control of malaria vectors. This study investigated biological exposures among workers in relation to job history. A cross-sectional study of 59 workers at the Malaria Control Centre (MCC) in Tzaneen, South Africa, was performed. Tests included a job history questionnaire and the measurement of serum o'p' and p'p' isomers of DDE, DDT, and DDD, corrected for serum total lipids. Forty-seven (80%) workers donated a blood sample for the determination of serum DDT. The mean number of years worked at the MCC (malaria years) was 15.8±7.8 years and the mean serum DDT was 94.3±57.1 μg/g of lipid. There were no significant associations between short-to-medium-term serum DDT exposure measures (o'p'-DDE and o'p' and p'p' isomers of DDD and DDT) and malaria years. The long-term exposure measure, p'p'-DDE, was significantly associated with malaria years (β-circumflex=3.0±1.2 μg/g lipid/year; P=0.001; n=47; adjusted for age), but only 27% variance of p'p'-DDE was explained. Blood total DDT uncorrected for lipid content was strongly related to corrected levels (β-circumflex=0.74±0.48, P=0.00, R 2 =0.77), but uncorrected p'p'-DDE had a weaker association (β-circumflex=0.0024±0.0013, P=0.074; R 2 =0.53) with malaria years than did corrected levels (β-circumflex=0.042±0.017; P=0.016; R 2 =0.56). The results show that serum DDT levels for malaria vector-control workers in South Africa with a long-term spraying history are high. Job history information on DDT exposures must be very detailed in order to provide valid estimates of exposure

  9. The effects of zooprophylaxis and other mosquito control measures against malaria in Nouna, Burkina Faso

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    Sié Ali

    2009-12-01

    Full Text Available Abstract Background In the absence of large scale, organized vector control programmes, individual protective measures against mosquitoes are essential for reducing the transmission of diseases like malaria. Knowledge of the types and effectiveness of mosquito control methods used by households can aid in the development and promotion of preventive measures. Methods A matched, population-based case control study was carried out in the semi-urban region of Nouna, Burkina Faso. Surveys and mosquito captures were conducted for each participating household. Data were analysed using conditional logistic regression and Pearson's product-moment correlations. Results In Nouna, Burkina Faso, the main types of reported mosquito control measures used included sleeping under bed nets (insecticide-treated and untreated and burning mosquito coils. Most of the study households kept animals within the compound or house at night. Insecticide house sprays, donkeys, rabbits and pigs were significantly associated with a reduced risk of malaria only in univariate analyses. Conclusion Given the conflicting results of the effects of zooprophylaxis from previous studies, other community-based preventive measures, such as bed nets, coils and insecticide house-spraying, may be of more benefit.

  10. Assessment of Control Measures and Trends of Malaria in Burie-Zuria District, West Gojjam Zone, Amhara Region, North West Ethiopia

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    Addisu Workineh Kassa

    2015-01-01

    Full Text Available Introduction. Malaria is caused by the protozoan parasite Plasmodium and transmitted by the bite of Anopheles mosquitoes. The aim of this study was to assess control measures and trends of malaria and guide intervention measures at Burie-Zuria district, Amhara region. Methods. Descriptive cross-sectional assessment of control measures was undertaken. We used health facility records of malaria data. We surveyed households for clinical malaria cases and utilization of Long Lasting Impregnated Nets (LLINs and its status; the condition of Indore Residual Spraying (IRS operation at household level was observed. Results. In Zelma-Shenbekuma kebele (village the prevalence rate of confirmed malaria cases in the 2nd week of September was 1.2 per 1000 (17 of population and increased to 11.5 per 1000 (163 of population in the 3rd week of September 2012 and reached 16.6 per 1000 (236 of population in the 1st week of November 2012. The attack rate was the highest in 1-<5 years 120.3 per 1000 (1920 of population. LLINs were distributed four years back and only five of the fifteen respondents knew about the use of LLINs and used it regularly. Four of the fifteen households were not sprayed with IRS. Conclusion. Vector control interventions were not carried out timely.

  11. 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.

  12. Integrated vector management for malaria control

    Directory of Open Access Journals (Sweden)

    Impoinvil Daniel E

    2008-12-01

    Full Text Available Abstract Integrated vector management (IVM is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1 evidence-based decision-making, 2 integrated approaches 3, collaboration within the health sector and with other sectors, 4 advocacy, social mobilization, and legislation, and 5 capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN and/or indoor residual spraying (IRS coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with

  13. Malaria control in Malawi: are the poor being served? | Mathanga ...

    African Journals Online (AJOL)

    Background: In Africa, national governments and international organizations are focusing on rapidly “scaling up” malaria control interventions to at least 60 percent of vulnerable populations. The potential health and economic benefits of “scaling up” will depend on the equitable access to malaria control measures by the ...

  14. Ranking malaria risk factors to guide malaria control efforts in African highlands.

    Science.gov (United States)

    Protopopoff, Natacha; Van Bortel, Wim; Speybroeck, Niko; Van Geertruyden, Jean-Pierre; Baza, Dismas; D'Alessandro, Umberto; Coosemans, Marc

    2009-11-25

    Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

  15. Ranking malaria risk factors to guide malaria control efforts in African highlands.

    Directory of Open Access Journals (Sweden)

    Natacha Protopopoff

    Full Text Available INTRODUCTION: Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. METHODS AND FINDINGS: A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. CONCLUSIONS: In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

  16. Challenges and prospects for dengue and malaria control in Thailand, Southeast Asia.

    Science.gov (United States)

    Corbel, Vincent; Nosten, Francois; Thanispong, Kanutcharee; Luxemburger, Christine; Kongmee, Monthathip; Chareonviriyaphap, Theeraphap

    2013-12-01

    Despite significant advances in the search for potential dengue vaccines and new therapeutic schemes for malaria, the control of these diseases remains difficult. In Thailand, malaria incidence is falling whereas that of dengue is rising, with an increase in the proportion of reported severe cases. In the absence of antiviral therapeutic options for acute dengue, appropriate case management reduces mortality. However, the interruption of transmission still relies on vector control measures that are currently insufficient to curtail the cycle of epidemics. Drug resistance in malaria parasites is increasing, compromising malaria control and elimination. Deficiencies in our knowledge of vector biology and vectorial capacity also hinder public health efforts for vector control. Challenges to dengue and malaria control are discussed, and research priorities identified. Copyright © 2013. Published by Elsevier Ltd.

  17. Comparative effectiveness of malaria preventive measures on ...

    African Journals Online (AJOL)

    The burden of malaria and its associated problems in pregnancy can be reduced by the use of different malaria preventive measures. This study was conducted to determine the comparative effectiveness of three different malaria preventive measures on populations of parturient in Abeokuta, Ogun State, Nigeria.

  18. Optimal control for Malaria disease through vaccination

    Science.gov (United States)

    Munzir, Said; Nasir, Muhammad; Ramli, Marwan

    2018-01-01

    Malaria is a disease caused by an amoeba (single-celled animal) type of plasmodium where anopheles mosquito serves as the carrier. This study examines the optimal control problem of malaria disease spread based on Aron and May (1982) SIR type models and seeks the optimal solution by minimizing the prevention of the spreading of malaria by vaccine. The aim is to investigate optimal control strategies on preventing the spread of malaria by vaccination. The problem in this research is solved using analytical approach. The analytical method uses the Pontryagin Minimum Principle with the symbolic help of MATLAB software to obtain optimal control result and to analyse the spread of malaria with vaccination control.

  19. Sustainable malaria control: transdisciplinary approaches for translational applications

    Directory of Open Access Journals (Sweden)

    Birkholtz Lyn-Marie

    2012-12-01

    Full Text Available Abstract With the adoption of the Global Malaria Action Plan, several countries are moving from malaria control towards elimination and eradication. However, the sustainability of some of the approaches taken may be questionable. Here, an overview of malaria control and elimination strategies is provided and the sustainability of each in context of vector- and parasite control is assessed. From this, it can be concluded that transdisciplinary approaches are essential for sustained malaria control and elimination in malaria-endemic communities.

  20. Sustainable malaria control: transdisciplinary approaches for translational applications

    Science.gov (United States)

    2012-01-01

    With the adoption of the Global Malaria Action Plan, several countries are moving from malaria control towards elimination and eradication. However, the sustainability of some of the approaches taken may be questionable. Here, an overview of malaria control and elimination strategies is provided and the sustainability of each in context of vector- and parasite control is assessed. From this, it can be concluded that transdisciplinary approaches are essential for sustained malaria control and elimination in malaria-endemic communities. PMID:23268712

  1. Measuring the economic cost of malaria to households in Sri Lanka

    DEFF Research Database (Denmark)

    Konradsen, F; Hoek, Wim van der; Amerasinghe, P H

    1997-01-01

    . In estimating the socioeconomic impact of malaria and in measuring cost-benefits of malaria control interventions, these costs have to be considered together with direct expenditures incurred by households such as on treatment and travel and with costs for the service providers.......The economic cost at the household level of labor days lost due to malaria and other illnesses was estimated in a rural community in Sri Lanka. Over a one-year period, 223 episodes of malaria were recorded from the 298 inhabitants of the village. Based on daily activity records, the economically...

  2. Prevention measures and socio-economic development result in a decrease in malaria in Hainan, China.

    Science.gov (United States)

    Wang, Shan-Qing; Li, Yu-Chun; Zhang, Zhi-Ming; Wang, Guang-Ze; Hu, Xi-Min; Qualls, Whitney A; Xue, Rui-De

    2014-09-15

    Historically, the incidence of malaria in the Hainan Province, China has been high. However, since 2001 the malaria incidence in Hainan has decreased due to large-scale, public educational, promotional campaigns and the adoption of preventative measures against malaria following the fast growth of socio-economic development. The present study analysed the correlation between prevention measures and social economic development on the incidence of malaria in Hainan from 2001 to 2013. The data of malaria preventative measures and socio-economic development were collected from various cities and counties in Hainan Province from 2001 to 2013 and analysed by the grey correlation analysis system. Seasonal preventive medication and local fiscal revenue increases are significantly related to the reduction of malaria incidence from 2001 to 2013 (R1 = 0.751677; R5 = 0.764795). Malaria prevention and control measures and local economic development in Hainan decreased malaria incidence from 2001 to 2013.

  3. Transmission Dynamics and Optimal Control of Malaria in Kenya

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    Gabriel Otieno

    2016-01-01

    Full Text Available This paper proposes and analyses a mathematical model for the transmission dynamics of malaria with four-time dependent control measures in Kenya: insecticide treated bed nets (ITNs, treatment, indoor residual spray (IRS, and intermittent preventive treatment of malaria in pregnancy (IPTp. We first considered constant control parameters and calculate the basic reproduction number and investigate existence and stability of equilibria as well as stability analysis. We proved that if R0≤1, the disease-free equilibrium is globally asymptotically stable in D. If R0>1, the unique endemic equilibrium exists and is globally asymptotically stable. The model also exhibits backward bifurcation at R0=1. If R0>1, the model admits a unique endemic equilibrium which is globally asymptotically stable in the interior of feasible region D. The sensitivity results showed that the most sensitive parameters are mosquito death rate and mosquito biting rates. We then consider the time-dependent control case and use Pontryagin’s Maximum Principle to derive the necessary conditions for the optimal control of the disease using the proposed model. The existence of optimal control problem is proved. Numerical simulations of the optimal control problem using a set of reasonable parameter values suggest that the optimal control strategy for malaria control in endemic areas is the combined use of treatment and IRS; for epidemic prone areas is the use of treatment and IRS; for seasonal areas is the use of treatment; and for low risk areas is the use of ITNs and treatment. Control programs that follow these strategies can effectively reduce the spread of malaria disease in different malaria transmission settings in Kenya.

  4. Economic burden of malaria on businesses in Ghana: a case for private sector investment in malaria control.

    Science.gov (United States)

    Nonvignon, Justice; Aryeetey, Genevieve Cecilia; Malm, Keziah L; Agyemang, Samuel Agyei; Aubyn, Vivian N A; Peprah, Nana Yaw; Bart-Plange, Constance N; Aikins, Moses

    2016-09-06

    Despite the significant gains made globally in reducing the burden of malaria, the disease remains a major public health challenge, especially in sub-Saharan Africa (SSA) including Ghana. There is a significant gap in financing malaria control globally. The private sector could become a significant source of financing malaria control. To get the private sector to appreciate the need to invest in malaria control, it is important to provide evidence of the economic burden of malaria on businesses. The objective of this study, therefore, was to estimate the economic burden on malaria on businesses in Ghana, so as to stimulate the sector's investment in malaria control. Data covering 2012-2014 were collected from 62 businesses sampled from Greater Accra, Ashanti and Western Regions of Ghana, which have the highest concentration of businesses in the country. Data on the cost of businesses' spending on treatment and prevention of malaria in staff and their dependants as well as staff absenteeism due to malaria and expenditure on other health-related activities were collected. Views of business leaders on the effect of malaria on their businesses were also compiled. The analysis was extrapolated to cover 5828 businesses across the country. The results show that businesses in Ghana lost about US$6.58 million to malaria in 2014, 90 % of which were direct costs. A total of 3913 workdays were lost due to malaria in firms in the study sample during the period 2012-2014. Businesses in the study sample spent an average of 0.5 % of the annual corporate returns on treatment of malaria in employees and their dependants, 0.3 % on malaria prevention, and 0.5 % on other health-related corporate social responsibilities. Again business leaders affirmed that malaria affects their businesses' efficiency, employee attendance and productivity and expenses. Finally, about 93 % of business leaders expressed the need private sector investment in malaria control. The economic burden of

  5. Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination.

    Science.gov (United States)

    Recht, Judith; Siqueira, André M; Monteiro, Wuelton M; Herrera, Sonia M; Herrera, Sócrates; Lacerda, Marcus V G

    2017-07-04

    In spite of significant progress towards malaria control and elimination achieved in South America in the 2000s, this mosquito-transmitted tropical disease remains an important public health concern in the region. Most malaria cases in South America come from Amazon rain forest areas in northern countries, where more than half of malaria is caused by Plasmodium vivax, while Plasmodium falciparum malaria incidence has decreased in recent years. This review discusses current malaria data, policies and challenges in four South American Amazon countries: Brazil, Colombia, Peru and the Bolivarian Republic of Venezuela. Challenges to continuing efforts to further decrease malaria incidence in this region include: a significant increase in malaria cases in recent years in Venezuela, evidence of submicroscopic and asymptomatic infections, peri-urban malaria, gold mining-related malaria, malaria in pregnancy, glucose-6-phosphate dehydrogenase (G6PD) deficiency and primaquine use, and possible under-detection of Plasmodium malariae. Some of these challenges underscore the need to implement appropriate tools and procedures in specific regions, such as a field-compatible molecular malaria test, a P. malariae-specific test, malaria diagnosis and appropriate treatment as part of regular antenatal care visits, G6PD test before primaquine administration for P. vivax cases (with weekly primaquine regimen for G6PD deficient individuals), single low dose of primaquine for P. falciparum malaria in Colombia, and national and regional efforts to contain malaria spread in Venezuela urgently needed especially in mining areas. Joint efforts and commitment towards malaria control and elimination should be strategized based on examples of successful regional malaria fighting initiatives, such as PAMAFRO and RAVREDA/AMI.

  6. Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

    Science.gov (United States)

    Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad

    2017-11-01

    Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.

  7. Malaria Vector Control Still Matters despite Insecticide Resistance.

    Science.gov (United States)

    Alout, Haoues; Labbé, Pierrick; Chandre, Fabrice; Cohuet, Anna

    2017-08-01

    Mosquito vectors' resistance to insecticides is usually considered a major threat to the recent progresses in malaria control. However, studies measuring the impact of interventions and insecticide resistance reveal inconsistencies when using entomological versus epidemiological indices. First, evaluation tests that do not reflect the susceptibility of mosquitoes when they are infectious may underestimate insecticide efficacy. Moreover, interactions between insecticide resistance and vectorial capacity reveal nonintuitive outcomes of interventions. Therefore, considering ecological interactions between vector, parasite, and environment highlights that the impact of insecticide resistance on the malaria burden is not straightforward and we suggest that vector control still matters despite insecticide resistance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Effectiveness of malaria control interventions in Madagascar: a nationwide case-control survey.

    Science.gov (United States)

    Kesteman, Thomas; Randrianarivelojosia, Milijaona; Raharimanga, Vaomalala; Randrianasolo, Laurence; Piola, Patrice; Rogier, Christophe

    2016-02-11

    Madagascar, as other malaria endemic countries, depends mainly on international funding for the implementation of malaria control interventions (MCI). As these funds no longer increase, policy makers need to know whether these MCI actually provide the expected protection. This study aimed at measuring the effectiveness of MCI deployed in all transmission patterns of Madagascar in 2012-2013 against the occurrence of clinical malaria cases. From September 2012 to August 2013, patients consulting for non-complicated malaria in 31 sentinel health centres (SHC) were asked to answer a short questionnaire about long-lasting insecticidal nets (LLIN) use, indoor residual spraying (IRS) in the household and intermittent preventive treatment of pregnant women (IPTp) intake. Controls were healthy all-ages individuals sampled from a concurrent cross-sectional survey conducted in areas surrounding the SHC. Cases and controls were retained in the database if they were resident of the same communes. The association between Plasmodium infection and exposure to MCI was calculated by multivariate multilevel models, and the protective effectiveness (PE) of an intervention was defined as 1 minus the odds ratio of this association. Data about 841 cases (out of 6760 cases observed in SHC) and 8284 controls was collected. The regular use of LLIN provided a significant 51 % PE (95 % CI [16-71]) in multivariate analysis, excluding in one transmission pattern where PE was -11 % (95 % CI [-251 to 65]) in univariate analysis. The PE of IRS was 51 % (95 % CI [31-65]), and the PE of exposure to both regular use of LLIN and IRS was 72 % (95 % CI [28-89]) in multivariate analyses. Vector control interventions avoided yearly over 100,000 clinical cases of malaria in Madagascar. The maternal PE of IPTp was 73 %. In Madagascar, LLIN and IRS had good PE against clinical malaria. These results may apply to other countries with similar transmission profiles, but such case-control surveys could be

  9. Factoring quality laboratory diagnosis into the malaria control agenda for sub-Saharan Africa.

    Science.gov (United States)

    Aidoo, Michael

    2013-09-01

    Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

  10. Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia

    Directory of Open Access Journals (Sweden)

    Ly Po

    2010-04-01

    Full Text Available Abstract Background Malaria continues to be a major public health problem in remote forested areas in Cambodia. As a national strategy to strengthen community-based malaria control, the Cambodian government has been running the Village Malaria Worker (VMW project since 2001. This study sought to examine the nature and quality of the VMWs' services. Methods Data collection was carried out in February and March 2008 through interviews with one of the two VMWs who takes the lead in malaria control activities in each of the 315 VMW villages (n = 251. The questionnaire addressed 1 the sociodemographic characteristics of VMWs, 2 service quality, 3 actions for malaria prevention and vector control, and 4 knowledge of malaria epidemiology and vector ecology. Results VMWs were effective in conducting diagnosis with Rapid Diagnostic Tests (RDTs and prescribing anti-malarials to those who had positive RDT results, skills that they had acquired through their training programmes. However, most other services, such as active detection, explanations about compliance, and follow-up of patients, were carried out by only a small proportion of VMWs. The variety of actions that VMWs took for malaria prevention and vector control was small (average action index score 12.8/23, and their knowledge was very limited with less than 20% of the VMWs giving correct answers to six out of seven questions on malaria epidemiology and vector ecology. Knowledge of vector breeding places and malaria transmission were significant determinants of both the quality of VMWs' services and the variety of their actions for malaria prevention and vector control. Conclusions VMWs' services focused primarily on diagnosis and treatment. Their focus needs to be broadened to cover other aspects of malaria control in order to further strengthen community-based malaria control. VMWs' actions and knowledge also need substantial improvement. Strengthening training programmes can help achieve better

  11. Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

    Science.gov (United States)

    Elyazar, Iqbal R.F.; Hay, Simon I.; Baird, J. Kevin

    2011-01-01

    Approximately 230 million people live in Indonesia. The country is also home to over 20 anopheline vectors of malaria which transmit all four of the species of Plasmodium that routinely infect humans. A complex mosaic of risk of infection across this 5000-km-long archipelago of thousands of islands and distinctive habitats seriously challenges efforts to control malaria. Social, economic and political dimensions contribute to these complexities. This chapter examines malaria and its control in Indonesia, from the earliest efforts by malariologists of the colonial Netherlands East Indies, through the Global Malaria Eradication Campaign of the 1950s, the tumult following the coup d’état of 1965, the global resurgence of malaria through the 1980s and 1990s and finally through to the decentralization of government authority following the fall of the authoritarian Soeharto regime in 1998. We detail important methods of control and their impact in the context of the political systems that supported them. We examine prospects for malaria control in contemporary decentralized and democratized Indonesia with multidrug-resistant malaria and greatly diminished capacities for integrated malaria control management programs. PMID:21295677

  12. Factors Influencing Prevention and Control of Malaria among ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    investigate factors that influence malaria prevention and control practices among pregnant ... treatment of clinical cases and the promotion of ... influence their decision regarding malaria ..... have the ability to purchase anti-malaria drugs that.

  13. Hemozoin Inhibition and Control of Clinical Malaria

    Directory of Open Access Journals (Sweden)

    Chibueze Peter Ihekwereme

    2014-01-01

    Full Text Available Malaria has a negative impact on health and social and economic life of residents of endemic countries. The ultimate goals of designing new treatment for malaria are to prevent clinical infection, reduce morbidity, and decrease mortality. There are great advances in the understanding of the parasite-host interaction through studies by various scientists. In some of these studies, attempts were made to evaluate the roles of malaria pigment or toxins in the pathogenesis of malaria. Hemozoin is a key metabolite associated with severe malaria anemia (SMA, immunosuppression, and cytokine dysfunction. Targeting of this pigment may be necessary in the design of new therapeutic products against malaria. In this review, the roles of hemozoin in the morbidity and mortality of malaria are highlighted as an essential target in the quest for effective control of clinical malaria.

  14. Mothers' perceptions and knowledge on childhood malaria in the holendemic Kibaha district, Tanzania: implications for malaria control and the IMCI strategy

    DEFF Research Database (Denmark)

    Tarimo, D S; Lwihula, G K; Minjas, J N

    2000-01-01

    Prior to an intervention on improving the quality of malaria case management, we assessed mothers' abilities to recognize nonsevere and severe/complicated malaria in children when a child has fever with other physiological and behavioural symptoms associated with malaria. Malaria was mentioned...... and treatment (89.4%). Poor outcome of treatment was ascribed to incorrect diagnosis and prescription, noncompliance at home and ineffective drugs (62.1%). Most mothers (86.6%) would take antipyretic measures first when a child has fever, and subsequently the majority (92.9%) would seek care at a modern health...... of these findings for chemotherapeutic malaria control in holoendemic areas within the context of the Integrated Management of Childhood Illnesses (IMCI) strategy are discussed....

  15. Mass mosquito trapping for malaria control in western Kenya

    NARCIS (Netherlands)

    Hiscox, Alexandra; Homan, Tobias; Mweresa, Collins K.; Maire, Nicolas; Pasquale, Di Aurelio; Masiga, Daniel; Oria, Prisca A.; Alaii, Jane; Leeuwis, Cees; Mukabana, Wolfgang R.; Takken, Willem; Smith, Thomas A.

    2016-01-01

    Background: Increasing levels of insecticide resistance as well as outdoor, residual transmission of malaria threaten the efficacy of existing vector control tools used against malaria mosquitoes. The development of odour-baited mosquito traps has led to the possibility of controlling malaria

  16. History of malaria control in Tajikistan and rapid malaria appraisal in an agro-ecological setting.

    Science.gov (United States)

    Matthys, Barbara; Sherkanov, Tohir; Karimov, Saifudin S; Khabirov, Zamonidin; Mostowlansky, Till; Utzinger, Jürg; Wyss, Kaspar

    2008-10-26

    Reported malaria cases in rice growing areas in western Tajikistan were at the root of a rapid appraisal of the local malaria situation in a selected agro-ecological setting where only scarce information was available. The rapid appraisal was complemented by a review of the epidemiology and control of malaria in Tajikistan and Central Asia from 1920 until today. Following a resurgence in the 1990s, malaria transmission has been reduced considerably in Tajikistan as a result of concerted efforts by the government and international agencies. The goal for 2015 is transmission interruption, with control interventions and surveillance currently concentrated in the South, where foci of Plasmodium vivax and Plasmodium falciparum persist. The rapid malaria appraisal was carried out in six communities of irrigated rice cultivation during the peak of malaria transmission (August/September 2007) in western Tajikistan. In a cross-sectional survey, blood samples were taken from 363 schoolchildren and examined for Plasmodium under a light microscope. A total of 56 farmers were interviewed about agricultural activities and malaria. Potential Anopheles breeding sites were characterized using standardized procedures. A literature review on the epidemiology and control of malaria in Tajikistan was conducted. One case of P. vivax was detected among the 363 schoolchildren examined (0.28%). The interviewees reported to protect themselves against mosquito bites and used their own concepts on fever conditions, which do not distinguish between malaria and other diseases. Three potential malaria vectors were identified, i.e. Anopheles superpictus, Anopheles pulcherrimus and Anopheles hyrcanus in 58 of the 73 breeding sites examined (79.5%). Rice paddies, natural creeks and man-made ponds were the most important Anopheles habitats. The presence of malaria vectors and parasite reservoirs, low awareness of, and protection against malaria in the face of population movements and inadequate

  17. History of malaria control in Tajikistan and rapid malaria appraisal in an agro-ecological setting

    Directory of Open Access Journals (Sweden)

    Utzinger Jürg

    2008-10-01

    Full Text Available Abstract Background Reported malaria cases in rice growing areas in western Tajikistan were at the root of a rapid appraisal of the local malaria situation in a selected agro-ecological setting where only scarce information was available. The rapid appraisal was complemented by a review of the epidemiology and control of malaria in Tajikistan and Central Asia from 1920 until today. Following a resurgence in the 1990s, malaria transmission has been reduced considerably in Tajikistan as a result of concerted efforts by the government and international agencies. The goal for 2015 is transmission interruption, with control interventions and surveillance currently concentrated in the South, where foci of Plasmodium vivax and Plasmodium falciparum persist. Methods The rapid malaria appraisal was carried out in six communities of irrigated rice cultivation during the peak of malaria transmission (August/September 2007 in western Tajikistan. In a cross-sectional survey, blood samples were taken from 363 schoolchildren and examined for Plasmodium under a light microscope. A total of 56 farmers were interviewed about agricultural activities and malaria. Potential Anopheles breeding sites were characterized using standardized procedures. A literature review on the epidemiology and control of malaria in Tajikistan was conducted. Results One case of P. vivax was detected among the 363 schoolchildren examined (0.28%. The interviewees reported to protect themselves against mosquito bites and used their own concepts on fever conditions, which do not distinguish between malaria and other diseases. Three potential malaria vectors were identified, i.e. Anopheles superpictus, Anopheles pulcherrimus and Anopheles hyrcanus in 58 of the 73 breeding sites examined (79.5%. Rice paddies, natural creeks and man-made ponds were the most important Anopheles habitats. Conclusion The presence of malaria vectors and parasite reservoirs, low awareness of, and protection against

  18. Current vector control challenges in the fight against malaria.

    Science.gov (United States)

    Benelli, Giovanni; Beier, John C

    2017-10-01

    The effective and eco-friendly control of Anopheles vectors plays a key role in any malaria management program. Integrated Vector Management (IVM) suggests making use of the full range of vector control tools available. The strategies for IVM require novel technologies to control outdoor transmission of malaria. Despite the wide number of promising control tools tested against mosquitoes, current strategies for malaria vector control used in most African countries are not sufficient to achieve successful malaria control. The majority of National Malaria Control Programs in Africa still rely on indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). These methods reduce malaria incidence but generally have little impact on malaria prevalence. In addition to outdoor transmission, growing levels of insecticide resistance in targeted vectors threaten the efficacy of LLINs and IRS. Larvicidal treatments can be useful, but are not recommended for rural areas. The research needed to improve the quality and delivery of mosquito vector control should focus on (i) optimization of processes and methods for vector control delivery; (ii) monitoring of vector populations and biting activity with reliable techniques; (iii) the development of effective and eco-friendly tools to reduce the burden or locally eliminate malaria and other mosquito-borne diseases; (iv) the careful evaluation of field suitability and efficacy of new mosquito control tools to prove their epidemiological impact; (v) the continuous monitoring of environmental changes which potentially affect malaria vector populations; (vi) the cooperation among different disciplines, with main emphasis on parasitology, tropical medicine, ecology, entomology, and ecotoxicology. A better understanding of behavioral ecology of malaria vectors is required. Key ecological obstacles that limit the effectiveness of vector control include the variation in mosquito behavior, development of insecticide resistance

  19. 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.

  20. The economics of malaria control and elimination: a systematic review.

    Science.gov (United States)

    Shretta, Rima; Avanceña, Anton L V; Hatefi, Arian

    2016-12-12

    Declining donor funding and competing health priorities threaten the sustainability of malaria programmes. Elucidating the cost and benefits of continued investments in malaria could encourage sustained political and financial commitments. The evidence, although available, remains disparate. This paper reviews the existing literature on the economic and financial cost and return of malaria control, elimination and eradication. A review of articles that were published on or before September 2014 on the cost and benefits of malaria control and elimination was performed. Studies were classified based on their scope and were analysed according to two major categories: cost of malaria control and elimination to a health system, and cost-benefit studies. Only studies involving more than two control or elimination interventions were included. Outcomes of interest were total programmatic cost, cost per capita, and benefit-cost ratios (BCRs). All costs were converted to 2013 US$ for standardization. Of the 6425 articles identified, 54 studies were included in this review. Twenty-two were focused on elimination or eradication while 32 focused on intensive control. Forty-eight per cent of studies included in this review were published on or after 2000. Overall, the annual per capita cost of malaria control to a health system ranged from $0.11 to $39.06 (median: $2.21) while that for malaria elimination ranged from $0.18 to $27 (median: $3.00). BCRs of investing in malaria control and elimination ranged from 2.4 to over 145. Overall, investments needed for malaria control and elimination varied greatly amongst the various countries and contexts. In most cases, the cost of elimination was greater than the cost of control. At the same time, the benefits of investing in malaria greatly outweighed the costs. While the cost of elimination in most cases was greater than the cost of control, the benefits greatly outweighed the cost. Information from this review provides guidance to

  1. Combining malaria control with rural electrification

    NARCIS (Netherlands)

    Oria, Prisca A.

    2016-01-01

    Chapter 1 presents the background information relevant to the subject matter and methods of this thesis. These include the application of social and behavioural sciences in malaria control, the SolarMal project and malaria in Kenya. It also presents the research objective, question and design

  2. Simulation of malaria epidemiology and control in the highlands of western Kenya

    Directory of Open Access Journals (Sweden)

    Stuckey Erin M

    2012-10-01

    malaria control in this low transmission setting. In this setting and for these scenarios, results were highly sensitive to transmission, vector exophagy, exophily and susceptibility to IRS, and the detection method used for surveillance. The level of accuracy of the results will thus depend upon the precision of estimates for each. New methods for analysing and evaluating uncertainty in simulation results will enhance the usefulness of simulations for malaria control decision-making. Improved measurement tools and increased primary data collection will enhance model parameterization and epidemiological monitoring. Further research is needed on the relationship between malaria indices to identify the best way to quantify transmission in low transmission settings. Measuring EIR through mosquito collection may not be the optimal way to estimate transmission intensity in areas with low, unstable transmission.

  3. Serological markers suggest heterogeneity of effectiveness of malaria control interventions on Bioko Island, equatorial Guinea.

    Directory of Open Access Journals (Sweden)

    Jackie Cook

    Full Text Available In order to control and eliminate malaria, areas of on-going transmission need to be identified and targeted for malaria control interventions. Immediately following intense interventions, malaria transmission can become more heterogeneous if interventions are more successful in some areas than others. Bioko Island, Equatorial Guinea, has been subject to comprehensive malaria control interventions since 2004. This has resulted in substantial reductions in the parasite burden, although this drop has not been uniform across the island.In 2008, filter paper blood samples were collected from 7387 people in a cross-sectional study incorporating 18 sentinel sites across Bioko, Equatorial Guinea. Antibodies were measured to P. falciparum Apical Membrane Antigen-1 (AMA-1 by Enzyme Linked Immunosorbent Assay (ELISA. Age-specific seropositivity rates were used to estimate seroconversion rates (SCR. Analysis indicated there had been at least a 60% decline in SCR in four out of five regions on the island. Changes in SCR showed a high degree of congruence with changes in parasite rate (PR and with regional reductions in all cause child mortality. The mean age adjusted concentration of anti-AMA-1 antibodies was mapped to identify areas where individual antibody responses were higher than expected. This approach confirmed the North West of the island as a major focus of continuing infection and an area where control interventions need to be concentrated or re-evaluated.Both SCR and PR revealed heterogeneity in malaria transmission and demonstrated the variable effectiveness of malaria control measures. This work confirms the utility of serological analysis as an adjunct measure for monitoring transmission. Age-specific seroprevalence based evidence of changes in transmission over time will be of particular value when no baseline data are available. Importantly, SCR data provide additional evidence to link malaria control activities to contemporaneous

  4. Malaria control. generating evidence from local to global level

    OpenAIRE

    Plüss, Bianca

    2009-01-01

    In addition of the provision of effective treatment to each case, malaria control is heavily relying on vector control with either insecticide treated mosquito nets (ITNs) or indoor residual spraying (IRS). The effectiveness of ITNs in controlling malaria in many different settings has already been comprehensively documented. On the other hand, while IRS has a long and distinguished history in malaria control, its health effects have never been properly quantified. The present thesis aimed...

  5. Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia

    Science.gov (United States)

    William, Timothy; Rahman, Hasan A.; Jelip, Jenarun; Ibrahim, Mohammad Y.; Menon, Jayaram; Grigg, Matthew J.; Yeo, Tsin W.; Anstey, Nicholas M.; Barber, Bridget E.

    2013-01-01

    Background The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time. Methods Reporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity. Results From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly. Conclusions A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence. PMID:23359830

  6. Forty Years of Malaria Control and Zululand In Natal

    African Journals Online (AJOL)

    when it became necessary to extend control measures over the whole area. ... field staff, are necessary to ensure that new or renovated dwellings ... and by 1956 malaria infection had been reduced to negli- ... There are 7 mission hospitals in.

  7. Successfully controlling malaria in South Africa | Blumberg | South ...

    African Journals Online (AJOL)

    Following major successes in malaria control over the past 75 years, South Africa is now embarking on a malaria elimination campaign with the goal of zero local transmission by the year 2018. The key control elements have been intensive vector control, primarily through indoor residual spraying, case management based ...

  8. Stable malaria incidence despite scaling up control strategies in a malaria vaccine-testing site in Mali.

    Science.gov (United States)

    Coulibaly, Drissa; Travassos, Mark A; Kone, Abdoulaye K; Tolo, Youssouf; Laurens, Matthew B; Traore, Karim; Diarra, Issa; Niangaly, Amadou; Daou, Modibo; Dembele, Ahmadou; Sissoko, Mody; Guindo, Bouréima; Douyon, Raymond; Guindo, Aldiouma; Kouriba, Bourema; Sissoko, Mahamadou S; Sagara, Issaka; Plowe, Christopher V; Doumbo, Ogobara K; Thera, Mahamadou A

    2014-09-19

    The recent decline in malaria incidence in many African countries has been attributed to the provision of prompt and effective anti-malarial treatment using artemisinin-based combination therapy (ACT) and to the widespread distribution of long-lasting, insecticide-treated bed nets (LLINs). At a malaria vaccine-testing site in Bandiagara, Mali, ACT was introduced in 2004, and LLINs have been distributed free of charge since 2007 to infants after they complete the Expanded Programme of Immunization (EPI) schedule and to pregnant women receiving antenatal care. These strategies may have an impact on malaria incidence. To document malaria incidence, a cohort of 400 children aged 0 to 14 years was followed for three to four years up to July 2013. Monthly cross-sectional surveys were done to measure the prevalence of malaria infection and anaemia. Clinical disease was measured both actively and passively through continuous availability of primary medical care. Measured outcomes included asymptomatic Plasmodium infection, anaemia and clinical malaria episodes. The incidence rate of clinical malaria varied significantly from June 2009 to July 2013 without a clear downward trend. A sharp seasonality in malaria illness incidence was observed with higher clinical malaria incidence rates during the rainy season. Parasite and anaemia point prevalence also showed seasonal variation with much higher prevalence rates during rainy seasons compared to dry seasons. Despite the scaling up of malaria prevention and treatment, including the widespread use of bed nets, better diagnosis and wider availability of ACT, malaria incidence did not decrease in Bandiagara during the study period.

  9. Controlled Human Malaria Infection: Applications, Advances, and Challenges.

    Science.gov (United States)

    Stanisic, Danielle I; McCarthy, James S; Good, Michael F

    2018-01-01

    Controlled human malaria infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or by direct injection of sporozoites or parasitized erythrocytes. When required, the resulting blood-stage infection is curtailed by the administration of antimalarial drugs. Inducing a malaria infection via inoculation with infected blood was first used as a treatment (malariotherapy) for neurosyphilis in Europe and the United States in the early 1900s. More recently, CHMI has been applied to the fields of malaria vaccine and drug development, where it is used to evaluate products in well-controlled early-phase proof-of-concept clinical studies, thus facilitating progression of only the most promising candidates for further evaluation in areas where malaria is endemic. Controlled infections have also been used to immunize against malaria infection. Historically, CHMI studies have been restricted by the need for access to insectaries housing infected mosquitoes or suitable malaria-infected individuals. Evaluation of vaccine and drug candidates has been constrained in these studies by the availability of a limited number of Plasmodium falciparum isolates. Recent advances have included cryopreservation of sporozoites, the manufacture of well-characterized and genetically distinct cultured malaria cell banks for blood-stage infection, and the availability of Plasmodium vivax -specific reagents. These advances will help to accelerate malaria vaccine and drug development by making the reagents for CHMI more widely accessible and also enabling a more rigorous evaluation with multiple parasite strains and species. Here we discuss the different applications of CHMI, recent advances in the use of CHMI, and ongoing challenges for consideration. Copyright © 2017 American Society for Microbiology.

  10. 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.

  11. Malaria in South Asia: Prevalence and control

    Science.gov (United States)

    Kumar, Ashwani; Chery, Laura; Biswas, Chinmoy; Dubhashi, Nagesh; Dutta, Prafulla; Dua, Virendra Kumar; Kacchap, Mridula; Kakati, Sanjeeb; Khandeparkar, Anar; Kour, Dalip; Mahajanj, Satish N.; Maji, Ardhendu; Majumder, Partha; Mohanta, Jagadish; Mohapatra, Pradyumna K.; Narayanasamy, Krishnamoorthy; Roy, Krishnangshu; Shastri, Jayanthi; Valecha, Neena; Vikash, Rana; Wani, Reena; White, John; Rathod, Pradipsinh K

    2013-01-01

    The “Malaria Evolution in South Asia” (MESA) program project is an International Center of Excellence for Malaria Research (ICEMR) sponsored by the US National Institutes of Health. This US–India collaborative program will study the origin of genetic diversity of malaria parasites and their selection on the Indian subcontinent. This knowledge should contribute to a better understanding of unexpected disease outbreaks and unpredictable disease presentations from Plasmodium falciparum and Plasmodium vivax infections. In this first of two reviews, we highlight malaria prevalence in India. In particular, we draw attention to variations in distribution of different human-parasites and different vectors, variation in drug resistance traits, and multiple forms of clinical presentations. Uneven malaria severity in India is often attributed to large discrepancies in health care accessibility as well as human migrations within the country and across neighboring borders. Poor access to health care goes hand in hand with poor reporting from some of the same areas, combining to possibly distort disease prevalence and death from malaria in some parts of India. Corrections are underway in the form of increased resources for disease control, greater engagement of village-level health workers for early diagnosis and treatment, and possibly new public–private partnerships activities accompanying traditional national malaria control programs in the most severely affected areas. A second accompanying review raises the possibility that, beyond uneven health care, evolutionary pressures may alter malaria parasites in ways that contribute to severe disease in India, particularly in the NE corridor of India bordering Myanmar Narayanasamy et al., 2012. PMID:22248528

  12. MALARIA VACCINE: MYTH OR REALITY?

    African Journals Online (AJOL)

    Femi Olaleye

    Malaria currently remains the highest killer disease nationwide despite existing control measures. Malaria vaccine ... that malaria could be eliminated or at least controlled. However, because of changes in vector behaviour, drug resistance, manpower constraints for public ..... Although animal host models are different from ...

  13. The history of 20th century malaria control in Peru.

    Science.gov (United States)

    Griffing, Sean M; Gamboa, Dionicia; Udhayakumar, Venkatachalam

    2013-08-30

    Malaria has been part of Peruvian life since at least the 1500s. While Peru gave the world quinine, one of the first treatments for malaria, its history is pockmarked with endemic malaria and occasional epidemics. In this review, major increases in Peruvian malaria incidence over the past hundred years are described, as well as the human factors that have facilitated these events, and concerted private and governmental efforts to control malaria. Political support for malaria control has varied and unexpected events like vector and parasite resistance have adversely impacted morbidity and mortality. Though the ready availability of novel insecticides like DDT and efficacious medications reduced malaria to very low levels for a decade after the post eradication era, malaria reemerged as an important modern day challenge to Peruvian public health. Its reemergence sparked collaboration between domestic and international partners towards the elimination of malaria in Peru.

  14. Malaria control in the African Region: perceptions and viewspoints on proceedings of the Africa Leaders Malaria Alliance (ALMA

    Directory of Open Access Journals (Sweden)

    Sambo Luis

    2011-06-01

    Full Text Available Abstract Background In 2009 a total of 153,408 malaria deaths were reported in Africa. Eleven countries showed a reduction of more than 50% in either confirmed malaria cases or malaria admissions and deaths in recent years. However, many African countries are not on track to achieve the malaria component of the Millennium Development Goal (MDG 6. The African Leaders Malaria Alliance (ALMA working session at the 15th African Union Summit discussed the bottlenecks to achieving MDG 6 (specifically halting and beginning to reverse the incidence of malaria by 2015, success factors, and what countries needed to do to accelerate achievement of the MDG. The purpose of this article is to reflect on the proceedings of the ALMA working session. Methods Working methods of the session included speeches and statements by invited speakers and high-level panel discussions. Discussion The main bottlenecks identified related to the capacity of the health systems to deliver quality care and accessibility issues; need for strong, decentralized malaria-control programmes with linkages with other health and development sectors, the civil society and private sector entities; benefits of co-implementation of malaria control programmes with child survival or other public health interventions; systematic application of integrated promotive, preventive, diagnostic and case management interventions with full community participation; adapting approaches to local political, socio-cultural and administrative environments. The following prerequisites for success were identified: a clear vision and effective leadership of national malaria control programmes; high level political commitment to ensure adequate capacity in expertise, skill mix and number of managers, technicians and service providers; national ownership, intersectoral collaboration and accountability, as well as strong civil society and private sector involvement; functional epidemiological surveillance systems

  15. 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.

  16. Malaria control and elimination, Venezuela, 1800s –1970s.

    Science.gov (United States)

    Griffing, Sean M; Villegas, Leopoldo; Udhayakumar, Venkatachalam

    2014-10-01

    Venezuela had the highest number of human malaria cases in Latin American before 1936. During 1891–1920,malaria was endemic to >600,000 km2 of this country; malaria death rates led to major population decreases during 1891–1920. No pathogen, including the influenza virus that caused the 1918 pandemic, caused more deaths than malaria during 1905–1945. Early reports of malaria eradication in Venezuela helped spark the world's interest in global eradication. We describe early approaches to malaria epidemiology in Venezuela and how this country developed an efficient control program and an approach to eradication.Arnoldo Gabaldón was a key policy maker during this development process. He directed malaria control in Venezuela from the late 1930s to the end of the 1970s and contributed to malaria program planning of the World Health Organization.We discuss how his efforts helped reduce the incidence of malaria in Venezuela and how his approach diverged from World Health Organization guidelines.

  17. Malaria Control and Elimination,1 Venezuela, 1800s–1970s

    Science.gov (United States)

    Villegas, Leopoldo; Udhayakumar, Venkatachalam

    2014-01-01

    Venezuela had the highest number of human malaria cases in Latin American before 1936. During 1891–1920, malaria was endemic to >600,000 km2 of this country; malaria death rates led to major population decreases during 1891–1920. No pathogen, including the influenza virus that caused the 1918 pandemic, caused more deaths than malaria during 1905–1945. Early reports of malaria eradication in Venezuela helped spark the world’s interest in global eradication. We describe early approaches to malaria epidemiology in Venezuela and how this country developed an efficient control program and an approach to eradication. Arnoldo Gabaldón was a key policy maker during this development process. He directed malaria control in Venezuela from the late 1930s to the end of the 1970s and contributed to malaria program planning of the World Health Organization. We discuss how his efforts helped reduce the incidence of malaria in Venezuela and how his approach diverged from World Health Organization guidelines.

  18. Malaria vector control: current and future strategies

    NARCIS (Netherlands)

    Takken, W.; Knols, B.G.J.

    2009-01-01

    The recently announced call for malaria eradication represents a new page in the history of this disease. This has been triggered by remarkable reductions in malaria resulting from combined application of effective drugs and vector control. However, this strategy is threatened by development of

  19. Insecticide Resistance Reducing Effectiveness of Malaria Control

    Centers for Disease Control (CDC) Podcasts

    Malaria prevention is increasingly insecticide based. Dr. John Gimnig, an entomologist with the Division of Parasitic Diseases, CDC, discusses evidence that mosquito resistance to insecticides, which is measured in the laboratory, could compromise malaria prevention in the field.

  20. Presentation of Malaria Epidemics Using Multiple Optimal Controls

    Directory of Open Access Journals (Sweden)

    Abid Ali Lashari

    2012-01-01

    Full Text Available An existing model is extended to assess the impact of some antimalaria control measures, by re-formulating the model as an optimal control problem. This paper investigates the fundamental role of three type of controls, personal protection, treatment, and mosquito reduction strategies in controlling the malaria. We work in the nonlinear optimal control framework. The existence and the uniqueness results of the solution are discussed. A characterization of the optimal control via adjoint variables is established. The optimality system is solved numerically by a competitive Gauss-Seidel-like implicit difference method. Finally, numerical simulations of the optimal control problem, using a set of reasonable parameter values, are carried out to investigate the effectiveness of the proposed control measures.

  1. Earth observation in support of malaria control and epidemiology: MALAREO monitoring approaches.

    Science.gov (United States)

    Franke, Jonas; Gebreslasie, Michael; Bauwens, Ides; Deleu, Julie; Siegert, Florian

    2015-06-03

    Malaria affects about half of the world's population, with the vast majority of cases occuring in Africa. National malaria control programmes aim to reduce the burden of malaria and its negative, socioeconomic effects by using various control strategies (e.g. vector control, environmental management and case tracking). Vector control is the most effective transmission prevention strategy, while environmental factors are the key parameters affecting transmission. Geographic information systems (GIS), earth observation (EO) and spatial modelling are increasingly being recognised as valuable tools for effective management and malaria vector control. Issues previously inhibiting the use of EO in epidemiology and malaria control such as poor satellite sensor performance, high costs and long turnaround times, have since been resolved through modern technology. The core goal of this study was to develop and implement the capabilities of EO data for national malaria control programmes in South Africa, Swaziland and Mozambique. High- and very high resolution (HR and VHR) land cover and wetland maps were generated for the identification of potential vector habitats and human activities, as well as geoinformation on distance to wetlands for malaria risk modelling, population density maps, habitat foci maps and VHR household maps. These products were further used for modelling malaria incidence and the analysis of environmental factors that favour vector breeding. Geoproducts were also transferred to the staff of national malaria control programmes in seven African countries to demonstrate how EO data and GIS can support vector control strategy planning and monitoring. The transferred EO products support better epidemiological understanding of environmental factors related to malaria transmission, and allow for spatio-temporal targeting of malaria control interventions, thereby improving the cost-effectiveness of interventions.

  2. Efficacy and cost-effectiveness of environmental management for malaria control.

    Science.gov (United States)

    Utzinger, J; Tozan, Y; Singer, B H

    2001-09-01

    Roll back malaria (RBM) aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa, and it is proposed to implement efficacious and cost-effective control strategies. But the evidence base of such information is scarce, and a notable missing element is the discussion of the potential of environmental management. We reviewed the literature and identified multiple malaria control programmes that incorporated environmental management as the central feature. Prominent among them are programmes launched in 1929 and implemented for two decades at copper mining communities in Zambia. The full package of control measures consisted of vegetation clearance, modification of river boundaries, draining swamps, oil application to open water bodies and house screening. Part of the population also was given quinine and was sleeping under mosquito nets. Monthly malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3-5 years, malaria-related mortality, morbidity and incidence rates were reduced by 70-95%. Over the entire 20 years of implementation, the programme had averted an estimated 4173 deaths and 161,205 malaria attacks. The estimated costs per death and malaria attack averted were US$ 858 and US$ 22.20, respectively. Over the initial 3-5 years start-up period, analogous to the short-duration of cost-effectiveness analyses of current studies, we estimated that the costs per disability adjusted life year (DALY) averted were US$ 524-591. However, the strategy has a track record of becoming cost-effective in the longer term, as maintenance costs were much lower: US$ 22-92 per DALY averted. In view of fewer adverse ecological effects, increased sustainability and better uses of local resources and knowledge, environmental management--integrated with pharmacological, insecticidal and bednet interventions

  3. Use of proxy measures in estimating socioeconomic inequalities in malaria prevalence.

    Science.gov (United States)

    Somi, Masha F; Butler, James R; Vahid, Farshid; Njau, Joseph D; Kachur, S P; Abdulla, Salim

    2008-03-01

    To present and compare socioeconomic status (SES) rankings of households using consumption and an asset-based index as two alternative measures of SES; and to compare and evaluate the performance of these two measures in multivariate analyses of the socioeconomic gradient in malaria prevalence. Data for the study come from a survey of 557 households in 25 study villages in Tanzania in 2004. Household SES was determined using consumption and an asset-based index calculated using Principal Components Analysis on a set of household variables. In multivariate analyses of malaria prevalence, we also used two other measures of disease prevalence: parasitaemia and self-report of malaria or fever in the 2 weeks before interview. Household rankings based on the two measures of SES differ substantially. In multivariate analyses, there was a statistically significant negative association between both measures of SES and parasitaemia but not between either measure of SES and self-reported malaria. Age of individual, use of a mosquito net, and wall construction were negatively and significantly associated with parasitaemia, whilst roof construction was positively associated with parasitaemia. Only age remained significant when malaria self-report was used as the measure of disease prevalence. An asset index is an effective alternative to consumption in measuring the socioeconomic gradient in malaria parasitaemia, but self-report may be an unreliable measure of malaria prevalence for this purpose.

  4. Mosquito larval source management for controlling malaria

    Science.gov (United States)

    Tusting, Lucy S; Thwing, Julie; Sinclair, David; Fillinger, Ulrike; Gimnig, John; Bonner, Kimberly E; Bottomley, Christian; Lindsay, Steven W

    2015-01-01

    Background Malaria is an important cause of illness and death in people living in many parts of the world, especially sub-Saharan Africa. Long-lasting insecticide treated bed nets (LLINs) and indoor residual spraying (IRS) reduce malaria transmission by targeting the adult mosquito vector and are key components of malaria control programmes. However, mosquito numbers may also be reduced by larval source management (LSM), which targets mosquito larvae as they mature in aquatic habitats. This is conducted by permanently or temporarily reducing the availability of larval habitats (habitat modification and habitat manipulation), or by adding substances to standing water that either kill or inhibit the development of larvae (larviciding). Objectives To evaluate the effectiveness of mosquito LSM for preventing malaria. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CABS Abstracts; and LILACS up to 24 October 2012. We handsearched the Tropical Diseases Bulletin from 1900 to 2010, the archives of the World Health Organization (up to 11 February 2011), and the literature database of the Armed Forces Pest Management Board (up to 2 March 2011). We also contacted colleagues in the field for relevant articles. Selection criteria We included cluster randomized controlled trials (cluster-RCTs), controlled before-and-after trials with at least one year of baseline data, and randomized cross-over trials that compared LSM with no LSM for malaria control. We excluded trials that evaluated biological control of anopheline mosquitoes with larvivorous fish. Data collection and analysis At least two authors assessed each trial for eligibility. We extracted data and at least two authors independently determined the risk of bias in the included studies. We resolved all disagreements through discussion with a third author. We analyzed the data using Review Manager 5 software

  5. Earth observation in support of malaria control and epidemiology: MALAREO monitoring approaches

    Directory of Open Access Journals (Sweden)

    Jonas Franke

    2015-06-01

    Full Text Available Malaria affects about half of the world’s population, with the vast majority of cases occuring in Africa. National malaria control programmes aim to reduce the burden of malaria and its negative, socioeconomic effects by using various control strategies (e.g. vector control, environmental management and case tracking. Vector control is the most effective transmission prevention strategy, while environmental factors are the key parameters affecting transmission. Geographic information systems (GIS, earth observation (EO and spatial modelling are increasingly being recognised as valuable tools for effective management and malaria vector control. Issues previously inhibiting the use of EO in epidemiology and malaria control such as poor satellite sensor performance, high costs and long turnaround times, have since been resolved through modern technology. The core goal of this study was to develop and implement the capabilities of EO data for national malaria control programmes in South Africa, Swaziland and Mozambique. High- and very high resolution (HR and VHR land cover and wetland maps were generated for the identification of potential vector habitats and human activities, as well as geoinformation on distance to wetlands for malaria risk modelling, population density maps, habitat foci maps and VHR household maps. These products were further used for modelling malaria incidence and the analysis of environmental factors that favour vector breeding. Geoproducts were also transferred to the staff of national malaria control programmes in seven African countries to demonstrate how EO data and GIS can support vector control strategy planning and monitoring. The transferred EO products support better epidemiological understanding of environmental factors related to malaria transmission, and allow for spatio-temporal targeting of malaria control interventions, thereby improving the cost-effectiveness of interventions.

  6. Knowledge and beliefs about malaria transmission and practices for vector control in Southern Mexico

    Directory of Open Access Journals (Sweden)

    Rodríguez Américo David

    2003-01-01

    Full Text Available OBJECTIVE: To investigate the knowledge and beliefs about malaria transmission and practices for vector control in eight villages on the coastal plain of Chiapas, Mexico. MATERIAL AND METHODS: A cross-sectional survey was conducted during May and June 1995 in Chiapas, Mexico. A questionnaire to investigate family structure, knowledge on malaria transmission, preventive measures and attitudes towards seeking treatment was applied to both family heads of a sample of households. Associations were analyzed by estimating odds ratios with confidence intervals and p values, using bivariate and multivariate logistic regression methods. RESULTS: Malaria knowledge was poor and only 48% associated malaria with mosquito bites. The perceived benefit of indoor residual spraying was associated to a reduction of mosquitoes, a reduction in the numbers of cockroaches and rats, but only 3% associated it directly with the prevention of malaria transmission. Most villagers (97.6% agreed with the indoor residual spraying of insecticides. Ninety nine percent of villagers had mosquito bednets, 75.7% used them all year round. Other measures used by villagers to prevent mosquito bites were smoke and mosquito coils. Above 40% of villagers self-medicated when any member of the family had a fever episode, but 51% attended proper health services (community dispensary, private physician, health worker. About 61% used pesticides for agricultural or livestock purposes and 55% applied them themselves. Women had a greater participation as family health promoters, with 70% of the housewives being in charge of the application of self-protection preventive measures. CONCLUSIONS: Educational programs aimed at increasing awareness on the participation of mosquitoes on malaria transmission could promote community participation in malaria control in the region.

  7. Simplified models of vector control impact upon malaria transmission by zoophagic mosquitoes.

    Directory of Open Access Journals (Sweden)

    Samson S Kiware

    Full Text Available BACKGROUND: High coverage of personal protection measures that kill mosquitoes dramatically reduce malaria transmission where vector populations depend upon human blood. However, most primary malaria vectors outside of sub-Saharan Africa can be classified as "very zoophagic," meaning they feed occasionally (<10% of blood meals upon humans, so personal protection interventions have negligible impact upon their survival. METHODS AND FINDINGS: We extended a published malaria transmission model to examine the relationship between transmission, control, and the baseline proportion of bloodmeals obtained from humans (human blood index. The lower limit of the human blood index enables derivation of simplified models for zoophagic vectors that (1 Rely on only three field-measurable parameters. (2 Predict immediate and delayed (with and without assuming reduced human infectivity, respectively impacts of personal protection measures upon transmission. (3 Illustrate how appreciable indirect communal-level protection for non-users can be accrued through direct personal protection of users. (4 Suggest the coverage and efficacy thresholds required to attain epidemiological impact. The findings suggest that immediate, indirect, community-wide protection of users and non-users alike may linearly relate to the efficacy of a user's direct personal protection, regardless of whether that is achieved by killing or repelling mosquitoes. High protective coverage and efficacy (≥80% are important to achieve epidemiologically meaningful impact. Non-users are indirectly protected because the two most common species of human malaria are strict anthroponoses. Therefore, the small proportion of mosquitoes that are killed or diverted while attacking humans can represent a large proportion of those actually transmitting malaria. CONCLUSIONS: Simplified models of malaria transmission by very zoophagic vectors may be used by control practitioners to predict intervention impact

  8. Mapping the receptivity of malaria risk to plan the future of control in Somalia

    Science.gov (United States)

    Alegana, Victor Adagi; Patil, Anand Prabhakar; Moloney, Grainne; Borle, Mohammed; Yusuf, Fahmi; Amran, Jamal; Snow, Robert William

    2012-01-01

    Objectives To measure the receptive risks of malaria in Somalia and compare decisions on intervention scale-up based on this map and the more widely used contemporary risk maps. Design Cross-sectional community Plasmodium falciparum parasite rate (PfPR) data for the period 2007–2010 corrected to a standard age range of 2 to Somalia. Participants Randomly sampled individuals of all ages. Main outcome measure Cartographic descriptions of malaria receptivity and contemporary risks in Somalia at the district level. Results The contemporary annual PfPR2–10 map estimated that all districts (n=74) and population (n=8.4 million) in Somalia were under hypoendemic transmission (≤10% PfPR2–10). Of these, 23% of the districts, home to 13% of the population, were under transmission of 10%–50% PfPR2–10) and the rest as hypoendemic. Conclusion Compared with maps of receptive risks, contemporary maps of transmission mask disparities of malaria risk necessary to prioritise and sustain future control. As malaria risk declines across Africa, efforts must be invested in measuring receptivity for efficient control planning. PMID:22855625

  9. Cost of malaria control in Sri Lanka

    DEFF Research Database (Denmark)

    Konradsen, F; Steele, P; Perera, D

    1999-01-01

    The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated...... to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs...

  10. Combining malaria control with rural electrification

    OpenAIRE

    Oria, Prisca A.

    2016-01-01

    Chapter 1 presents the background information relevant to the subject matter and methods of this thesis. These include the application of social and behavioural sciences in malaria control, the SolarMal project and malaria in Kenya. It also presents the research objective, question and design that informed this thesis. Chapter 2 systematically documented and analysed how the mosquito trapping technology and related social contexts mutually shaped each other and how this mutual shaping impacte...

  11. [Application of health education of house-to-house visit in malaria prevention and control].

    Science.gov (United States)

    Zhou, Wen-gang; Qu, Yan; Wang, Wen-guang; Tang, Song-yuan

    2014-10-01

    To evaluate the effects of health education of house-to-house visit in malaria prevention and control in the border and minority areas. A health education of house-to-house visit in malaria prevention and control was carried out, and baseline and follow up surveys were conducted by qualitative and quantitative methods to document the changes of local villagers' knowledge, attitudes and behaviors (KAP) of malaria prevention and control in 2 counties of Yunnan Province, and the results before and after the interventions were analyzed and compared. After the intervention, the cognition rates about malaria symptoms and signs, transmission mode, preventive measures and health-seeking behaviors were 99.3%, 98.9%, 79.9% and 99.3% respectively in the local residents, and those were 39.2%, 8.2%, 47.0% and 49.9% respectively before the intervention, and all the differences were statistically significant (P all house-to-house visit is an effective community-based health education approach.

  12. Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

    Science.gov (United States)

    Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

    2013-08-23

    Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are

  13. Malaria survey and malaria control detachments in the South-West Pacific Area in World War 2.

    Science.gov (United States)

    Crocker, Denton W

    2009-01-01

    Malaria among troops in the South-West Pacific Area (SWPA) in World War 2 affected the military effort to the degree that special units were formed to combat it. These malaria survey detachments (MSDs) and malaria control detachments (MCDs) were self-contained and so could move quickly to wherever their services were needed. In SWPA by 25 September 1944 there were 32 MSDs and 65 MCDs. Tables of organization called for 11 enlisted men in MSDs and MCDs, two officers in MSDs and one in MCDs. Detachments served throughout the SWPA. Detailed records of the 31st MSD show that in addition to antimalarial efforts it worked at control of scrub typhus, dengue and venereal disease, at reduction of rat populations and in experimental work involving DDT and schistosomiasis. Specific locations of the 31st MSD were New Guinea (3 sites), Morotai, Leyte, Mindoro, Okinawa and Japan. The detachment served overseas for 21 months. Experience in combating malaria in SWPA in World War 2 points to the need for better and continuous training of both medical and line officers in malaria prevention and control.

  14. Molecular biological approaches to the study of vectors in relation to malaria control

    Directory of Open Access Journals (Sweden)

    J. M. Crampton

    1992-01-01

    Full Text Available To a large extent, control of malaria vectors relies on the elimination of breeding sites and the application of chemical agents. There are increasing problems associated with the use of synthetic insecticides for vector control, including the evolution of resistance, the high cost of developing and registering new insecticides and an awareness of pollution from insecticide residues. These factors have stimulated interest in the application of molecular biology to the study of mosquito vectors of malaria; focussing primarily on two aspects. First, the improvement of existing control measures through the development of simplified DNA probe systems suitable for identification of vectors of malaria. The development of synthetic, non-radioactive DNA probes suitable for identification of species in the Anopheles gambiae complex is described with the aim of defining a simplified methodology wich is suitable for entomologist in the field. The second aspect to be considered is the development of completely novel strategies through the development of completely novel strategies through the genetic manipulation of insect vectors of malaria in order to alter their ability to transmit the disease. The major requirements for producing transgenic mosquitoes are outlined together with the progress wich has been made to date and discussed in relation to the prospects which this type of approach has for the future control of malaria.

  15. Funding for malaria control 2006–2010: A comprehensive global assessment

    Directory of Open Access Journals (Sweden)

    Pigott David M

    2012-07-01

    Full Text Available Abstract Background The last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world. As the ongoing climate of financial uncertainty places strains on investment in global health, there is an increasing need to audit the origin, recipients and geographical distribution of funding for malaria control relative to populations at risk of the disease. Methods A comprehensive review of malaria control funding from international donors, bilateral sources and national governments was undertaken to reconstruct total funding by country for each year 2006 to 2010. Regions at risk from Plasmodium falciparum and/or Plasmodium vivax transmission were identified using global risk maps for 2010 and funding was assessed relative to populations at risk. Those nations with unequal funding relative to a regional average were identified and potential explanations highlighted, such as differences in national policies, government inaction or donor neglect. Results US$8.9 billion was disbursed for malaria control and elimination programmes over the study period. Africa had the largest levels of funding per capita-at-risk, with most nations supported primarily by international aid. Countries of the Americas, in contrast, were supported typically through national government funding. Disbursements and government funding in Asia were far lower with a large variation in funding patterns. Nations with relatively high and low levels of funding are discussed. Conclusions Global funding for malaria control is substantially less than required. Inequity in funding is pronounced in some regions particularly when considering the distinct goals of malaria control and malaria elimination. Efforts to sustain and increase international investment in malaria control should be informed by evidence-based assessment of funding equity.

  16. Integrated urban malaria control: a case study in dar es salaam, Tanzania.

    Science.gov (United States)

    Caldas de Castro, Marcia; Yamagata, Yoichi; Mtasiwa, Deo; Tanner, Marcel; Utzinger, Jurg; Keiser, Jennifer; Singer, Burton H

    2004-08-01

    The rapid growth of cities in sub-Saharan Africa, much of it driven by rural-urban migration, is associated with complex transformations of these ecosystems and an intricate set of challenges for malaria control. Urban malaria transmission is substantially less intense and much more focal than in rural and peri-urban settings. However, the danger of epidemics is higher and the presence of substantial non-immune populations places people of all ages at comparable levels of risk. The limited number of breeding sites in urban centers suggests that prevention strategies based on vector control, with emphasis on environmental management, should be a central feature of urban malaria control programs. We focus on malaria in the city of Dar es Salaam, Tanzania. Following a brief review of the 100-year history of malaria control in this urban center, we describe and evaluate a control program that operated from 1988 to 1996 as a consequence of a bilateral agreement between the governments of Tanzania and Japan. We present an innovative urban malaria risk mapping methodology based on high-resolution aerial photography with ground-based validation. This strategy clarifies that remote sensing technology at a level of resolution of one meter is essential if this kind of information is to play a role in guiding the detailed specification of intervention strategies for urban malaria control. The Tanzania-Japan multiple-intervention malaria control program, adaptively implemented over time, is described and evaluated with implications for urban malaria control in sub-Saharan Africa more generally. Copyright 2004 The American Society of Tropical Medicine and Hygiene

  17. Tools and Strategies for Malaria Control and Elimination: What Do We Need to Achieve a Grand Convergence in Malaria?

    Directory of Open Access Journals (Sweden)

    Janet Hemingway

    2016-03-01

    Full Text Available Progress made in malaria control during the past decade has prompted increasing global dialogue on malaria elimination and eradication. The product development pipeline for malaria has never been stronger, with promising new tools to detect, treat, and prevent malaria, including innovative diagnostics, medicines, vaccines, vector control products, and improved mechanisms for surveillance and response. There are at least 25 projects in the global malaria vaccine pipeline, as well as 47 medicines and 13 vector control products. In addition, there are several next-generation diagnostic tools and reference methods currently in development, with many expected to be introduced in the next decade. The development and adoption of these tools, bolstered by strategies that ensure rapid uptake in target populations, intensified mechanisms for information management, surveillance, and response, and continued financial and political commitment are all essential to achieving global eradication.

  18. Insecticide Resistance Reducing Effectiveness of Malaria Control

    Centers for Disease Control (CDC) Podcasts

    2007-01-24

    Malaria prevention is increasingly insecticide based. Dr. John Gimnig, an entomologist with the Division of Parasitic Diseases, CDC, discusses evidence that mosquito resistance to insecticides, which is measured in the laboratory, could compromise malaria prevention in the field.  Created: 1/24/2007 by Emerging Infectious Diseases.   Date Released: 3/13/2007.

  19. Controlling imported malaria cases in the United States of America.

    Science.gov (United States)

    Dembele, Bassidy; Yakubu, Abdul-Aziz

    2017-02-01

    We extend the mathematical malaria epidemic model framework of Dembele et al. and use it to ``capture" the 2013 Centers for Disease Control and Prevention (CDC) reported data on the 2011 number of imported malaria cases in the USA. Furthermore, we use our ``fitted" malaria models for the top 20 countries of malaria acquisition by USA residents to study the impact of protecting USA residents from malaria infection when they travel to malaria endemic areas, the impact of protecting residents of malaria endemic regions from mosquito bites and the impact of killing mosquitoes in those endemic areas on the CDC number of imported malaria cases in USA. To significantly reduce the number of imported malaria cases in USA, for each top 20 country of malaria acquisition by USA travelers, we compute the optimal proportion of USA international travelers that must be protected against malaria infection and the optimal proportion of mosquitoes that must be killed.

  20. Effect of sulfadoxine-pyrimethamine resistance on the efficacy of intermittent preventive therapy for malaria control during pregnancy: a systematic review

    NARCIS (Netherlands)

    ter Kuile, Feiko O.; van Eijk, Annemieke M.; Filler, Scott J.

    2007-01-01

    In malaria-endemic regions, strategies to control malaria during pregnancy rely on case management of malaria illness and anemia, and preventive measures such as insecticide-treated nets and intermittent preventive therapy (IPT). To determine the effect of increasing resistance to

  1. Utility of health facility-based malaria data for malaria surveillance.

    Directory of Open Access Journals (Sweden)

    Yaw A Afrane

    Full Text Available Currently, intensive malaria control programs are being implemented in Africa to reduce the malaria burden. Clinical malaria data from hospitals are valuable for monitoring trends in malaria morbidity and for evaluating the impacts of these interventions. However, the reliability of hospital-based data for true malaria incidence is often questioned because of diagnosis accuracy issues and variation in access to healthcare facilities among sub-groups of the population. This study investigated how diagnosis and treatment practices of malaria cases in hospitals affect reliability of hospital malaria data.The study was undertaken in health facilities in western Kenya. A total of 3,569 blood smears were analyzed after being collected from patients who were requested by clinicians to go to the hospital's laboratory for malaria testing. We applied several quality control measures for clinical malaria diagnosis. We compared our slide reading results with those from the hospital technicians. Among the 3,390 patients whose diagnoses were analyzed, only 36% had clinical malaria defined as presence of any level of parasitaemia and fever. Sensitivity and specificity of clinicians' diagnoses were 60.1% (95% CI: 61.1-67.5 and 75.0% (95% CI: 30.8-35.7, respectively. Among the 980 patients presumptively treated with an anti-malarial by the clinicians without laboratory diagnosis, only 47% had clinical malaria.These findings revealed substantial over-prescription of anti-malarials and misdiagnosis of clinical malaria. More than half of the febrile cases were not truly clinical malaria, but were wrongly diagnosed and treated as such. Deficiency in malaria diagnosis makes health facility data unreliable for monitoring trends in malaria morbidity and for evaluating impacts of malaria interventions. Improving malaria diagnosis should be a top priority in rural African health centers.

  2. mSpray: a mobile phone technology to improve malaria control efforts and monitor human exposure to malaria control pesticides in Limpopo, South Africa.

    Science.gov (United States)

    Eskenazi, Brenda; Quirós-Alcalá, Lesliam; Lipsitt, Jonah M; Wu, Lemuel D; Kruger, Philip; Ntimbane, Tzundzukani; Nawn, John Burns; Bornman, M S Riana; Seto, Edmund

    2014-07-01

    Recent estimates indicate that malaria has led to over half a million deaths worldwide, mostly to African children. Indoor residual spraying (IRS) of insecticides is one of the primary vector control interventions. However, current reporting systems do not obtain precise location of IRS events in relation to malaria cases, which poses challenges for effective and efficient malaria control. This information is also critical to avoid unnecessary human exposure to IRS insecticides. We developed and piloted a mobile-based application (mSpray) to collect comprehensive information on IRS spray events. We assessed the utility, acceptability and feasibility of using mSpray to gather improved homestead- and chemical-level IRS coverage data. We installed mSpray on 10 cell phones with data bundles, and pilot tested it with 13 users in Limpopo, South Africa. Users completed basic information (number of rooms/shelters sprayed; chemical used, etc.) on spray events. Upon submission, this information as well as geographic positioning system coordinates and time/date stamp were uploaded to a Google Drive Spreadsheet to be viewed in real time. We administered questionnaires, conducted focus groups, and interviewed key informants to evaluate the utility of the app. The low-cost, cell phone-based "mSpray" app was learned quickly by users, well accepted and preferred to the current paper-based method. We recorded 2865 entries (99.1% had a GPS accuracy of 20 m or less) and identified areas of improvement including increased battery life. We also identified a number of logistic and user problems (e.g., cost of cell phones and cellular bundles, battery life, obtaining accurate GPS measures, user errors, etc.) that would need to be overcome before full deployment. Use of cell phone technology could increase the efficiency of IRS malaria control efforts by mapping spray events in relation to malaria cases, resulting in more judicious use of chemicals that are potentially harmful to humans

  3. Application of optimal control strategies to HIV-malaria co-infection dynamics

    Science.gov (United States)

    Fatmawati; Windarto; Hanif, Lathifah

    2018-03-01

    This paper presents a mathematical model of HIV and malaria co-infection transmission dynamics. Optimal control strategies such as malaria preventive, anti-malaria and antiretroviral (ARV) treatments are considered into the model to reduce the co-infection. First, we studied the existence and stability of equilibria of the presented model without control variables. The model has four equilibria, namely the disease-free equilibrium, the HIV endemic equilibrium, the malaria endemic equilibrium, and the co-infection equilibrium. We also obtain two basic reproduction ratios corresponding to the diseases. It was found that the disease-free equilibrium is locally asymptotically stable whenever their respective basic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. sic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. Then, the optimal control theory for the model was derived analytically by using Pontryagin Maximum Principle. Numerical simulations of the optimal control strategies are also performed to illustrate the results. From the numerical results, we conclude that the best strategy is to combine the malaria prevention and ARV treatments in order to reduce malaria and HIV co-infection populations.

  4. Evaluation of Commercial Agrochemicals as New Tools for Malaria Vector Control.

    Science.gov (United States)

    Hoppé, Mark; Hueter, Ottmar F; Bywater, Andy; Wege, Philip; Maienfisch, Peter

    2016-10-01

    Malaria is a vector-borne and life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. The vector control insecticide market represents a small fraction of the crop protection market and is estimated to be valued at up to $500 million at the active ingredient level. Insecticide resistance towards the current WHOPES-approved products urgently requires the development of new tools to protect communities against the transmission of malaria. The evaluation of commercial products for malaria vector control is a viable and cost effective strategy to identify new malaria vector control products. Several examples of such spin-offs from crop protection insecticides are already evidencing the success of this strategy, namely pirimiphos-methyl for indoor residual sprays and spinosad, diflubenzuron, novaluron, and pyriproxifen for mosquito larvae control, a supplementary technology for control of malaria vectors. In our study the adulticidal activities of 81 insecticides representing 23 insecticidal modes of action classes, 34 fungicides from 6 fungicidal mode of action classes and 15 herbicides from 2 herbicidal modes of action classes were tested in a newly developed screening system. WHOPES approved insecticides for malaria vector control consistently caused 80-100% mortality of adult Anopheles stephensi at application rates between 0.2 and 20 mg active ingradient (AI) litre -1 . Chlorfenapyr, fipronil, carbosulfan and endosulfan showed the expected good activity. Four new insecticides and three fungicides with promising activity against adult mosquitoes were identified, namely the insecticides acetamiprid, thiamethoxam, thiocyclam and metaflumizone and the fungicides diflumetorin, picoxystrobin, and fluazinam. Some of these compounds certainly deserve to be further evaluated for malaria vector control. This is the first report describing good activity of commercial fungicides against malaria

  5. Natural products for malaria vector control: flora, fish and fungi

    NARCIS (Netherlands)

    Howard, A.F.V.

    2010-01-01

    Introduction
    Despite international organisations providing much focus over the past 10 years, malaria is still killing vast numbers of Africans, especially children. It is agreed that malaria can only be successfully controlled by using different control tools simultaneously in the spirit of

  6. Malaria control in a forest camp in an oil exploration area of Upper Assam.

    Science.gov (United States)

    Prakash, Anil; Bhattacharyya, D R; Mohapatra, P K; Barua, U; Phukan, Anjan; Mahanta, J

    2003-01-01

    Assam, in north-east India, is extremely rich in hydrocarbon deposits and the oil industry is the major contributor to its economy. A large number of oil fields and related installations in Assam are located in forest areas or on their fringes where malaria is a serious problem among field staff and security personnel, adversely affecting oil production. We carried out an operational research study for one year in a forest-based industrial security camp of Dibrugarh district and developed an effective malaria control strategy for such areas. The specific strategy was formulated and implemented after taking into account the local epidemiology of malaria, vector's ecology and malaria risk behaviour of the camp inmates. The strategy was based on reducing the man-vector contact, using deltamethrin-treated mosquito nets in conjunction with mosquito repellent cream and weekly chemoprophylaxis with 300 mg chloroquine. The impact of the strategy was monitored entomologically and epidemiologically for one year after implementation. The mean landing rate of Anopheles dirus, the vector mosquito in the camp area, was 5.03 per person per night during the monitoring. In spite of such a high density of the vector, the man-vector contact was effectively checked by the intervention measures adopted. As a result, the incidence of malaria in the camp was reduced by > 90% as compared to previous years and the number of malaria cases came down from 6.7 per 1000 man-nights in 1998-99 to 0.06 in 2000-01. Mortality due to malaria was completely eliminated. Control of malaria should be based on the local determinants of transmission. The use of insecticide-treated mosquito nets in conjunction with a mosquito repellent cream is a good intervention for controlling Anopheles dirus-transmitted malaria in the forests of north-east India. The control module developed on the principle of reducing man-mosquito contact is easy to implement, cost-effective and replicable in similar forest

  7. SCIENTIFIC LETTER WHY MALARIA CONTROL IS FAILING IN ...

    African Journals Online (AJOL)

    hi-tech

    2004-02-01

    Feb 1, 2004 ... WHO launched Roll Back Malaria (RBM) during 1998 with the stated goal of halving malaria deaths worldwide by the year 2010(1). This was endorsed by the African heads of state on 25th April 2000, in the Abuja declaration, promising effective management, control and surveillance. This should be ...

  8. [Control of malaria transmission in a gold-mining area in Amapá State, Brazil, with participation by private enterprise].

    Science.gov (United States)

    Couto AA; Calvosa, V S; Lacerda, R; Castro, F; Santa Rosa, E; Nascimento, J M

    2001-01-01

    This paper reports on the epidemiological characterization of malaria following implementation of a program to control the endemic in a gold-mining area in northern Amapá State. The study focuses on total malaria cases in Amapá and the impact of the disease on the population, as represented by the Mineração Novo Astro S/A company and its employees as well as the community of Vila de Lourenço in the municipality of Calçoene, and adjacent gold miners. The effect of control measures in the program area is indicated by a significant reduction in malaria incidence and malaria-related morbidity and mortality. The importance of participation by private enterprise is emphasized, particularly in large projects for the control of endemic diseases (notably malaria) in the Amazon Region.

  9. Engineering and malaria control: learning from the past 100 years

    DEFF Research Database (Denmark)

    Konradsen, Flemming; van der Hoek, Wim; Amerasinghe, Felix P

    2004-01-01

    Traditionally, engineering and environment-based interventions have contributed to the prevention of malaria in Asia. However, with the introduction of DDT and other potent insecticides, chemical control became the dominating strategy. The renewed interest in environmental-management-based approa......Traditionally, engineering and environment-based interventions have contributed to the prevention of malaria in Asia. However, with the introduction of DDT and other potent insecticides, chemical control became the dominating strategy. The renewed interest in environmental......-management-based approaches for the control of malaria vectors follows the rapid development of resistance by mosquitoes to the widely used insecticides, the increasing cost of developing new chemicals, logistical constraints involved in the implementation of residual-spraying programs and the environmental concerns linked...... cases are discussed in the wider context of environment-based approaches for the control of malaria vectors, including current relevance. Clearly, some of the interventions piloted and implemented early in the last century still have relevance today but generally in a very site-specific manner...

  10. Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

  11. Controlling Malaria Using Livestock-Based Interventions: A One Health Approach

    Science.gov (United States)

    Franco, Ana O.; Gomes, M. Gabriela M.; Rowland, Mark; Coleman, Paul G.

    2014-01-01

    Where malaria is transmitted by zoophilic vectors, two types of malaria control strategies have been proposed based on animals: using livestock to divert vector biting from people (zooprophylaxis) or as baits to attract vectors to insecticide sources (insecticide-treated livestock). Opposing findings have been obtained on malaria zooprophylaxis, and despite the success of an insecticide-treated livestock trial in Pakistan, where malaria vectors are highly zoophilic, its effectiveness is yet to be formally tested in Africa where vectors are more anthropophilic. This study aims to clarify the different effects of livestock on malaria and to understand under what circumstances livestock-based interventions could play a role in malaria control programmes. This was explored by developing a mathematical model and combining it with data from Pakistan and Ethiopia. Consistent with previous work, a zooprophylactic effect of untreated livestock is predicted in two situations: if vector population density does not increase with livestock introduction, or if livestock numbers and availability to vectors are sufficiently high such that the increase in vector density is counteracted by the diversion of bites from humans to animals. Although, as expected, insecticide-treatment of livestock is predicted to be more beneficial in settings with highly zoophilic vectors, like South Asia, we find that the intervention could also considerably decrease malaria transmission in regions with more anthropophilic vectors, like Anopheles arabiensis in Africa, under specific circumstances: high treatment coverage of the livestock population, using a product with stronger or longer lasting insecticidal effect than in the Pakistan trial, and with small (ideally null) repellency effect, or if increasing the attractiveness of treated livestock to malaria vectors. The results suggest these are the most appropriate conditions for field testing insecticide-treated livestock in an Africa region with

  12. Domestic Larval Control Practices and Malaria Prevalence among Under-Five Children in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Souleymane Diabaté

    Full Text Available Larval source management has contributed to malaria decline over the past years. However, little is known about the impact of larval control practices undertaken at the household level on malaria transmission.The study was conducted in Kaya health district after the 2010 mass distribution of insecticide treated-nets and the initiation of malaria awareness campaigns in Burkina Faso. The aim was to (i estimate the level of domestic larval control practices (cleaning of the house and its surroundings, eradication of larval sources, and elimination of hollow objects that might collect water; (ii identify key determinants; and (iii explore the structural relationships between these practices, participation in awareness-raising activities and mothers' knowledge/attitudes/practices, and malaria prevalence among under-five children.Overall, 2004 households were surveyed and 1,705 under-five children were examined. Half of the mothers undertook at least one action to control larval proliferation. Mothers who had gone to school had better knowledge about malaria and were more likely to undertake domestic larval control practices. Living in highly exposed rural areas significantly decreased the odds of undertaking larval control actions. Mothers' participation in malaria information sessions increased the adoption of vector control actions and bednet use. Malaria prevalence was statistically lower among children in households where mothers had undertaken at least one vector control action or used bed-nets. There was a 0.16 standard deviation decrease in malaria prevalence for every standard deviation increase in vector control practices. The effect of bednet use on malaria prevalence was of the same magnitude.Cleaning the house and its surroundings, eradicating breeding sites, and eliminating hollow objects that might collect water play a substantial role in preventing malaria among under-five. There is a need for national malaria control programs to

  13. Renewed mobilization against malaria.

    Science.gov (United States)

    1991-01-01

    1 million people die in the world from malaria annually, 800,000 of whom are 5 year old children in Sub-Sahara Africa. Further it affects 270 million people. In fact, 110 million develop malaria, 90 million of whom are from Sub-Saharan Africa. Thus WHO has introduced a new world initiative for malaria control to reverse the worsening trend that began in the mid 1970s. In October 1991, 150 officials from 50 African, Asian, and Latin American countries and participants from UN cooperation and development agencies and bilateral agencies attended an interregional conference at the WHO Regional office for Africa in Brazzaville, Congo. It strove to evaluate malaria situations specific to Africa, to update the malaria control plan in Africa, and to contribute to the development of an implementable world strategy. This world strategy needs to consider the local situation and encourage participation of the government and people of affected countries. Further individuals, communities, and various sectors of the national economy including those involved in health, education, development, and agriculture need to participate in malaria control. In addition, for this strategy to work, most countries must strengthen the management and financing of health services to meet their needs. For example, local populations must share local operating costs such as those for essential drugs and mosquito control operations. Community participation must also include personal protection such as impregnated bed nets and environmental measures. Besides malaria control must be integrated into the existing health system at country, provincial, and peripheral levels. In sum, improved case management, control of malaria transmission, and prevention and control of epidemics form the basis for the new strategy.

  14. Mapping the receptivity of malaria risk to plan the future of control in Somalia.

    Science.gov (United States)

    Noor, Abdisalan Mohamed; Alegana, Victor Adagi; Patil, Anand Prabhakar; Moloney, Grainne; Borle, Mohammed; Yusuf, Fahmi; Amran, Jamal; Snow, Robert William

    2012-01-01

    To measure the receptive risks of malaria in Somalia and compare decisions on intervention scale-up based on this map and the more widely used contemporary risk maps. Cross-sectional community Plasmodium falciparum parasite rate (PfPR) data for the period 2007-2010 corrected to a standard age range of 2 to contemporary (2010) mean PfPR(2-10) and the maximum annual mean PfPR(2-10) (receptive) from the highest predicted PfPR(2-10) value over the study period as an estimate of receptivity. Randomly sampled communities in Somalia. Randomly sampled individuals of all ages. Cartographic descriptions of malaria receptivity and contemporary risks in Somalia at the district level. The contemporary annual PfPR(2-10) map estimated that all districts (n=74) and population (n=8.4 million) in Somalia were under hypoendemic transmission (≤10% PfPR(2-10)). Of these, 23% of the districts, home to 13% of the population, were under transmission of 10%-50% PfPR(2-10)) and the rest as hypoendemic. Compared with maps of receptive risks, contemporary maps of transmission mask disparities of malaria risk necessary to prioritise and sustain future control. As malaria risk declines across Africa, efforts must be invested in measuring receptivity for efficient control planning.

  15. Comparison of clinical and parasitological data from controlled human malaria infection trials.

    Directory of Open Access Journals (Sweden)

    Meta Roestenberg

    Full Text Available Exposing healthy human volunteers to Plasmodium falciparum-infected mosquitoes is an accepted tool to evaluate preliminary efficacy of malaria vaccines. To accommodate the demand of the malaria vaccine pipeline, controlled infections are carried out in an increasing number of centers worldwide. We assessed their safety and reproducibility.We reviewed safety and parasitological data from 128 malaria-naïve subjects participating in controlled malaria infection trials conducted at the University of Oxford, UK, and the Radboud University Nijmegen Medical Center, The Netherlands. Results were compared to a report from the US Military Malaria Vaccine Program.We show that controlled human malaria infection trials are safe and demonstrate a consistent safety profile with minor differences in the frequencies of arthralgia, fatigue, chills and fever between institutions. But prepatent periods show significant variation. Detailed analysis of Q-PCR data reveals highly synchronous blood stage parasite growth and multiplication rates.Procedural differences can lead to some variation in safety profile and parasite kinetics between institutions. Further harmonization and standardization of protocols will be useful for wider adoption of these cost-effective small-scale efficacy trials. Nevertheless, parasite growth rates are highly reproducible, illustrating the robustness of controlled infections as a valid tool for malaria vaccine development.

  16. Plasmodium vivax Malaria in Cambodia

    Science.gov (United States)

    Siv, Sovannaroth; Roca-Feltrer, Arantxa; Vinjamuri, Seshu Babu; Bouth, Denis Mey; Lek, Dysoley; Rashid, Mohammad Abdur; By, Ngau Peng; Popovici, Jean; Huy, Rekol; Menard, Didier

    2016-01-01

    The Cambodian National Strategic Plan for Elimination of Malaria aims to move step by step toward elimination of malaria across Cambodia with an initial focus on Plasmodium falciparum malaria before achieving elimination of all forms of malaria, including Plasmodium vivax in 2025. The emergence of artemisinin-resistant P. falciparum in western Cambodia over the last decade has drawn global attention to support the ultimate goal of P. falciparum elimination, whereas the control of P. vivax lags much behind, making the 2025 target gradually less achievable unless greater attention is given to P. vivax elimination in the country. The following review presents in detail the past and current situation regarding P. vivax malaria, activities of the National Malaria Control Program, and interventional measures applied. Constraints and obstacles that can jeopardize our efforts to eliminate this parasite species are discussed. PMID:27708187

  17. Are multilateral malaria research and control programs the most successful? Lessons from the past 100 years in Africa.

    Science.gov (United States)

    Alilio, Martin S; Bygbjerg, Ib C; Breman, Joel G

    2004-08-01

    Multilateral malaria research and control programs in Africa have regained prominence recently as bilateral assistance has diminished. The transnational nature of the threat and the need for inspired leadership, good coordination, and new discoveries to decrease the impact of the disease has led to the founding of the Multilateral Initiative on Malaria, the Roll Back Malaria Project, Global Fund for HIV, Tuberculosis and Malaria (Global Fund), the Medicines for Malaria Venture, and the Malaria Vaccine Initiative, among other groups. Historically, the most striking feature of malaria control and elimination activities was the connectedness and balance between malaria research and control especially, from 1892 to 1949. A combination of scientific originality, perseverance in research, integrated approaches, and social concern were the keys for success. The elimination of Anopheles gambiae from Upper Egypt in 1942 using integrated vector control methods is a prime example of malaria control during the first half of the 20th century where those factors were brought together. After 1949, there were three decades of great optimism. Four notable landmarks characterized this period: the Kampala Conference in 1950; the Global Malaria Eradication Program beginning in 1955; the primary health care strategies adopted by most African States after attaining their political independence in the 1960s, and accelerating in the 1980s; and creation of the Special Program in Training and Research in Tropical Diseases at the World Health Organization in 1975. The initial highly encouraging operational results, largely obtained in temperate or subtropical areas where transmission was unstable, engendered undue expectations for the success of identical antimalarial measures elsewhere. Many were convinced that the eradication was in sight, such that support for malaria research virtually ceased. Young, bright scientists were discouraged from seeking a career in a discipline that appeared

  18. Malaria Control In the Northern Transvaal

    African Journals Online (AJOL)

    epidemiology as it affects control operations in the Trans- vaal followed by an outline of .... every case of malaria is a danger and must be detected, given adequate .... mosquito-borne viruses, possibly Chikungunya virus. The Arbor virus unit of ...

  19. The potential impact of integrated malaria transmission control on entomologic inoculation rate in highly endemic areas.

    Science.gov (United States)

    Killeen, G F; McKenzie, F E; Foy, B D; Schieffelin, C; Billingsley, P F; Beier, J C

    2000-05-01

    We have used a relatively simple but accurate model for predicting the impact of integrated transmission control on the malaria entomologic inoculation rate (EIR) at four endemic sites from across sub-Saharan Africa and the southwest Pacific. The simulated campaign incorporated modestly effective vaccine coverage, bed net use, and larval control. The results indicate that such campaigns would reduce EIRs at all four sites by 30- to 50-fold. Even without the vaccine, 15- to 25-fold reductions of EIR were predicted, implying that integrated control with a few modestly effective tools can meaningfully reduce malaria transmission in a range of endemic settings. The model accurately predicts the effects of bed nets and indoor spraying and demonstrates that they are the most effective tools available for reducing EIR. However, the impact of domestic adult vector control is amplified by measures for reducing the rate of emergence of vectors or the level of infectiousness of the human reservoir. We conclude that available tools, including currently neglected methods for larval control, can reduce malaria transmission intensity enough to alleviate mortality. Integrated control programs should be implemented to the fullest extent possible, even in areas of intense transmission, using simple models as decision-making tools. However, we also conclude that to eliminate malaria in many areas of intense transmission is beyond the scope of methods which developing nations can currently afford. New, cost-effective, practical tools are needed if malaria is ever to be eliminated from highly endemic areas.

  20. [Malaria situation and evaluation on the control effect in Henan Province during 1990-2005].

    Science.gov (United States)

    Liu, Xue-zhou; Xu, Bian-li

    2006-06-01

    To analyze malaria situation and evaluate the effect of control program in Henan Province during 1990-2005. Data were collected and analyzed on the measures and effects of malaria control, vector surveillance, blood examination for cases with fever and serological surveillance in the province during 1990-2005. In the 16 years, a total of 802,700 people were given pre-transmission season treatment with chloroquine and primaquine for a radical cure of vivax malaria, chemoprophylaxis was given to 764,300 people at high risk during the transmission season, treatment or presumptive treatment was given to 43,891 cases. 11,216,100 cases with fever were tested and 11,213 (0.10%) were found positive accounting for 29.01% (11 213/338 654) of all malaria cases. A total of 1 332 800 bed nets were treated with insecticide and 1,999 300 people were protected in 1990-1992 and 1996-1999. 34,846 residents including pupils were tested with IFAT in 1990-2000 and 1149 (3.30%) were positive. The parasite rate amongst 71,234 local residents including pupils was 0.40% (286/71,234). The principal transmitting vectors were Anopheles sinensis and An. anthropophagus. The man-biting habit for An. sinensis and An. anthropophagus was 0.0608 and 0.3143 respectively, and the vectorial capacity of An. anthropophagus was 22.4 times higher than that of An. sinensis. In this period, 38,654 malaria cases were reported in the province and the annual malaria incidence was 2.62 per hundred thousand, the lowest annual incidence was in 1992 (0.37 per hundred thousand). 70.05% (27,076/38,654) of these malaria cases were from areas where An. anthropophagus was present. In general, the malaria control activities have been effective and the epidemiological situation kept stable in Henan Province, although in some areas the situation is unstable and outbreak spots or focal epidemics occur.

  1. Malaria control in the Colombian Pacific Coast El control de la malaria en la costa Pacífica colombiana

    Directory of Open Access Journals (Sweden)

    Lyda Osorio

    2011-05-01

    Full Text Available En el siglo XXI la malaria continúa siendo un importante problema de salud pública en 21 países de Centro y Suramérica, incluido Colombia. La incidencia de la malaria reportada al Ministerio de la Protección Social se ha duplicado en las últimas tres décadas, pasando de 2,2 casos/1.000 habitantes en 1975 a 4,5 casos/1.000 habitantes en el 2005. En este mismo año se reportaron un total de 107.866 casos de malaria, de los cuales 63% fueron causados por Plasmodium vivax, 35% por Plasmodium falciparum y 2% se clasificaron como infecciones mixtas (P. falciparum y P. vivax (1. Históricamente, P. falciparum, la especie que se asocia con las mayores complicaciones y mortalidad, es más frecuente en la región de la costa Pacífica, donde causa hasta 75% de las infecciones. De hecho, 54% del total de casos por esta especie en el 2005 y 82% de la mortalidad atribuible a malaria en Colombia se reportaron en los cuatro departamentos que comprenden esta región: Chocó, Cauca, Nariño y Valle del Cauca (1. Estas estadísticas adolecen de subregistro, por lo cual es probable que la magnitud del problema de la malaria y la mortalidad por su causa sean incluso mayores. Actualmente se adelantan esfuerzos para mejorar la notificación, pero la vigilancia (2 y el control de la malaria encuentran retos específicos en la región Pacífica.

    Uno de estos retos es la diversidad de escenarios epidemiológicos que se presentan: 1 malaria en áreas urbanas con más de 10.000 habitantes como Quibdó e Istmina en el Chocó, Buenaventura en el Valle del Cauca, Guapi en Cauca y Tumaco en Nariño; 2 áreas con transmisión inestable altamente influenciada por fenómenos climáticos como El Niño (3; 3 áreas con transmisión estable y presencia de portadores asintomáticos; 4 áreas receptoras donde ocurren brotes esporádicos de malaria introducida, y 5 áreas sin transmisión pero con morbilidad y mortalidad en viajeros que se desplazan a áreas end

  2. Aggressive active case detection: a malaria control strategy based on the Brazilian model.

    Science.gov (United States)

    Macauley, Cameron

    2005-02-01

    Since 1996, the Brazilian Ministry of Health has adopted a malaria control strategy known as aggressive active case detection (AACD) in which most or all members of every community are tested and treated for malaria on a monthly basis. The strategy attempts to identify and treat cases of asymptomatic malaria, which, if untreated, continue to transmit the infection. Malaria remains uncontrolled because almost all health care systems in the world rely on passive case detection: the treatment of only symptomatic cases of malaria. Research has shown conclusively that asymptomatic cases exist in any population where malaria transmission is stable and incidence is high: therefore passive case detection simply will not succeed in breaking the cycle of transmission. Numerous case studies show that malaria has been successfully controlled on a regional or national level by mass blood surveys. AACD is an effective malaria control strategy if used in conjunction with other methods, especially when (1) an effective treatment exists, (2) influx of potential carriers of the infection can be monitored, and (3) people are inclined to cooperate with monthly blood testing. AACD requires access to rapid diagnostic tests (RDTs), microscopy supplies, extensive human resources, and prompt, affordable, and effective treatment. AACD is compared to PCD in terms of clinical efficacy and cost effectiveness in a case study of malaria in the Brazilian Yanomami Indians. Where it is feasible, AACD could drastically reduce the incidence of malaria and should be an integral part of the World Health Organization's Roll Back Malaria strategy.

  3. Malaria in the Greater Mekong Subregion: Heterogeneity and Complexity

    Science.gov (United States)

    Cui, Liwang; Yan, Guiyun; Sattabongkot, Jetsumon; Cao, Yaming; Chen, Bin; Chen, Xiaoguang; Fan, Qi; Fang, Qiang; Jongwutiwes, Somchai; Parker, Daniel; Sirichaisinthop, Jeeraphat; Kyaw, Myat Phone; Su, Xin-zhuan; Yang, Henglin; Yang, Zhaoqing; Wang, Baomin; Xu, Jianwei; Zheng, Bin; Zhong, Daibin; Zhou, Guofa

    2011-01-01

    The Greater Mekong Subregion (GMS), comprised of six countries including Cambodia, China's Yunnan Province, Lao PDR, Myanmar (Burma), Thailand and Vietnam, is one of the most threatening foci of malaria. Since the initiation of the WHO's Mekong Malaria Program a decade ago, malaria situation in the GMS has greatly improved, reflected in the continuous decline in annual malaria incidence and deaths. However, as many nations are moving towards malaria elimination, the GMS nations still face great challenges. Malaria epidemiology in this region exhibits enormous geographical heterogeneity with Myanmar and Cambodia remaining high-burden countries. Within each country, malaria distribution is also patchy, exemplified by ‘border malaria’ and ‘forest malaria’ with high transmission occurring along international borders and in forests or forest fringes, respectively. ‘Border malaria’ is extremely difficult to monitor, and frequent malaria introductions by migratory human populations constitute a major threat to neighboring, malaria-eliminating countries. Therefore, coordination between neighboring countries is essential for malaria elimination from the entire region. In addition to these operational difficulties, malaria control in the GMS also encounters several technological challenges. Contemporary malaria control measures rely heavily on effective chemotherapy and insecticide control of vector mosquitoes. However, the spread of multidrug resistance and potential emergence of artemisinin resistance in Plasmodium falciparum make resistance management a high priority in the GMS. This situation is further worsened by the circulation of counterfeit and substandard artemisinin-related drugs. In most endemic areas of the GMS, P. falciparum and P. vivax coexist, and in recent malaria control history, P. vivax has demonstrated remarkable resilience to control measures. Deployment of the only registered drug (primaquine) for the radical cure of vivax malaria is

  4. A simplified model for predicting malaria entomologic inoculation rates based on entomologic and parasitologic parameters relevant to control.

    Science.gov (United States)

    Killeen, G F; McKenzie, F E; Foy, B D; Schieffelin, C; Billingsley, P F; Beier, J C

    2000-05-01

    Malaria transmission intensity is modeled from the starting perspective of individual vector mosquitoes and is expressed directly as the entomologic inoculation rate (EIR). The potential of individual mosquitoes to transmit malaria during their lifetime is presented graphically as a function of their feeding cycle length and survival, human biting preferences, and the parasite sporogonic incubation period. The EIR is then calculated as the product of 1) the potential of individual vectors to transmit malaria during their lifetime, 2) vector emergence rate relative to human population size, and 3) the infectiousness of the human population to vectors. Thus, impacts on more than one of these parameters will amplify each other's effects. The EIRs transmitted by the dominant vector species at four malaria-endemic sites from Papua New Guinea, Tanzania, and Nigeria were predicted using field measurements of these characteristics together with human biting rate and human reservoir infectiousness. This model predicted EIRs (+/- SD) that are 1.13 +/- 0.37 (range = 0.84-1.59) times those measured in the field. For these four sites, mosquito emergence rate and lifetime transmission potential were more important determinants of the EIR than human reservoir infectiousness. This model and the input parameters from the four sites allow the potential impacts of various control measures on malaria transmission intensity to be tested under a range of endemic conditions. The model has potential applications for the development and implementation of transmission control measures and for public health education.

  5. Patent Medicine Sellers: How Can They Help Control Childhood Malaria?

    Directory of Open Access Journals (Sweden)

    Rosamund M. Akuse

    2010-01-01

    Full Text Available Roll Back Malaria Initiative encourages participation of private health providers in malaria control because mothers seek care for sick children from them. This study investigated Patent Medicine Sellers (PMS management of presumptive malaria in children in order to identify how they can assist malaria control. A cross-sectional survey of 491 PMS in Kaduna, Nigeria, was done using interviews and observation of shop activities. Most (80% customers bought drugs without prescriptions. Only 29.5% were given instructions about doses. Between 40–100% doses of recommended antimalarials were incorrect. Some (22% PMS did not ask questions about illness for which they were consulted. Most children treated in shops received injections. PMS facilitate homecare but have deficiencies in knowledge and practice. Interventions must focus on training them to accurately determine doses, give advice about drug administration, use oral medication, and ask about illness. Training should be made a prerequisite for registering and reregistering shops.

  6. Increased malaria transmission around irrigation schemes in Ethiopia and the potential of canal water management for malaria vector control

    OpenAIRE

    Kibret, Solomon; Wilson, G Glenn; Tekie, Habte; Petros, Beyene

    2014-01-01

    Background Irrigation schemes have been blamed for the increase in malaria in many parts of sub-Saharan Africa. However, proper water management could help mitigate malaria around irrigation schemes in this region. This study investigates the link between irrigation and malaria in Central Ethiopia. Methods Larval and adult mosquitoes were collected fortnightly between November 2009 and October 2010 from two irrigated and two non-irrigated (control) villages in the Ziway area, Central Ethiopia...

  7. Household Barriers to Effective Malaria Prevention and Control in a ...

    African Journals Online (AJOL)

    Background: Malaria is endemic throughout Nigeria. Majority of Nigerians live in rural areas where subsistence farming is their main occupation. Most of them live below poverty line, earning less than $1.25 a day. In rural communities, many household factors constitute barriers to effective malaria prevention and control.

  8. Malaria control in rural Malawi: implementing peer health education for behaviour change.

    Science.gov (United States)

    Malenga, Tumaini; Kabaghe, Alinune Nathanael; Manda-Taylor, Lucinda; Kadama, Asante; McCann, Robert S; Phiri, Kamija Samuel; van Vugt, Michèle; van den Berg, Henk

    2017-11-20

    Interventions to reduce malaria burden are effective if communities use them appropriately and consistently. Several tools have been suggested to promote uptake and use of malaria control interventions. Community workshops on malaria, using the 'Health Animator' approach, are a potential behaviour change strategy for malaria control. The strategy aims to influence a change in mind-set of vulnerable populations to encourage self-reliance, using community volunteers known as Health Animators. The aim of the paper is to describe the process of implementing community workshops on malaria by Health Animators to improve uptake and use of malaria control interventions in rural Malawi. This is a descriptive study reporting feasibility, acceptability, appropriateness and fidelity of using Health Animator-led community workshops for malaria control. Quantitative data were collected from self-reporting and researcher evaluation forms. Qualitative assessments were done with Health Animators, using three focus groups (October-December 2015) and seven in-depth interviews (October 2016-February 2017). Seventy seven health Animators were trained from 62 villages. A total of 2704 workshops were conducted, with consistent attendance from January 2015 to June 2017, representing 10-17% of the population. Attendance was affected by social responsibilities and activities, relationship of the village leaders and their community and involvement of Community Health Workers. Active discussion and participation were reported as main strengths of the workshops. Health Animators personally benefited from the mind-set change and were proactive peer influencers in the community. Although the information was comprehended and accepted, availability of adequate health services was a challenge for maintenance of behaviour change. Community workshops on malaria are a potential tool for influencing a positive change in behaviour towards malaria, and applicable for other health problems in rural

  9. Targeting the breeding sites of malaria mosquitoes: biological and physical control of malaria mosquito larvae

    OpenAIRE

    Bukhari, S.T.

    2011-01-01

    Malaria causes an estimated 225 million cases and 781,000 deaths every year. About 85% of the deaths are in children under five years of age. Malaria is caused by the Plasmodium parasite which is transmitted by the Anopheles mosquito vector. Mainly two methods of intervention are used for vector control, i.e. insecticide-treated bed nets and indoor residual spraying. Both involve the use of insecticides and target Anopheles adults indoors. A rising increase in resistance against these insec...

  10. The economic burden of malaria.

    Science.gov (United States)

    Gallup, J L; Sachs, J D

    2001-01-01

    Malaria and poverty are intimately connected. Controlling for factors such as tropical location, colonial history, and geographical isolation, countries with intensive malaria had income levels in 1995 of only 33% that of countries without malaria, whether or not the countries were in Africa. The high levels of malaria in poor countries are not mainly a consequence of poverty. Malaria is geographically specific. The ecological conditions that support the more efficient malaria mosquito vectors primarily determine the distribution and intensity of the disease. Intensive efforts to eliminate malaria in the most severely affected tropical countries have been largely ineffective. Countries that have eliminated malaria in the past half century have all been either subtropical or islands. These countries' economic growth in the 5 years after eliminating malaria has usually been substantially higher than growth in the neighboring countries. Cross-country regressions for the 1965-1990 period confirm the relationship between malaria and economic growth. Taking into account initial poverty, economic policy, tropical location, and life expectancy, among other factors, countries with intensive malaria grew 1.3% less per person per year, and a 10% reduction in malaria was associated with 0.3% higher growth. Controlling for many other tropical diseases does not change the correlation of malaria with economic growth, and these diseases are not themselves significantly negatively correlated with economic growth. A second independent measure of malaria has a slightly higher correlation with economic growth in the 1980-1996 period. We speculate about the mechanisms that could cause malaria to have such a large impact on the economy, such as foreign investment and economic networks within the country.

  11. The Summary Index of Malaria Surveillance (SIMS: a stable index of malaria within India

    Directory of Open Access Journals (Sweden)

    Sharma Vinod P

    2010-02-01

    Full Text Available Abstract Background Malaria in India has been difficult to measure. Mortality and morbidity are not comprehensively reported, impeding efforts to track changes in disease burden. However, a set of blood measures has been collected regularly by the National Malaria Control Program in most districts since 1958. Methods Here, we use principal components analysis to combine these measures into a single index, the Summary Index of Malaria Surveillance (SIMS, and then test its temporal and geographic stability using subsets of the data. Results The SIMS correlates positively with all its individual components and with external measures of mortality and morbidity. It is highly consistent and stable over time (1995-2005 and regions of India. It includes measures of both vivax and falciparum malaria, with vivax dominant at lower transmission levels and falciparum dominant at higher transmission levels, perhaps due to ecological specialization of the species. Conclusions This measure should provide a useful tool for researchers looking to summarize geographic or temporal trends in malaria in India, and can be readily applied by administrators with no mathematical or scientific background. We include a spreadsheet that allows simple calculation of the index for researchers and local administrators. Similar principles are likely applicable worldwide, though further validation is needed before using the SIMS outside India.

  12. [Analysis of overseas imported malaria situation and implication for control in Jiangsu Province, PR China].

    Science.gov (United States)

    Liu, Yao-Bao; Cao, Jun; Zhou, Hua-Yun; Wang, Wei-Ming; Cao, Yuan-Yuan; Gao, Qi

    2013-02-01

    To analyze the epidemiological characteristics of overseas imported malaria in Jiangsu Province and explore the strategies and priorities in prevention and control, so as to provide the evidence for improving the diagnosis, treatment and management of imported malaria. The data of overseas imported malaria as well as the case epidemiological investigation in Jiangsu Province from July 18, 2011 to June 30, 2012 were collected and analyzed descriptively for the species composition, original countries, population distribution, regional distribution, onset time, diagnosis and treatment, channels to go abroad, and counterparts returned together with the patients. A total of 233 overseas imported malaria cases were reported, and 226 cases (97.0%) were imported from African countries. A total of 208 cases (89.3%) were falciparum malaria, and 224 cases (96.1%) were laboratory-confirmed. The imported malaria cases were young adults who were mainly migrant farmer and skilled male workers. There was no significant seasonal variation for onset time. Totally 145 cases (62.2%) got malaria onset in 20 days after returning home. The median time from onset to seeing doctor was two days and the median time from seeing doctor to being diagnosed was one day. The first visit health facilities by the patients were relatively scattered and the diagnostic health facilities were mainly medical institutions and CDC at the county level and above (220 cases, accounting for 94.4%). The ratio of standard treatment after malaria diagnosis was 100%. A total of 205 cases (88.0%) were workers dispatched to abroad as labor export by the company, and 142 cases (60.9%) cases had counterparts returned together. The situation of overseas imported malaria in Jiangsu Province is severe. It is necessary to further strengthen the professional training and multi-sectoral cooperation, establish the collaborative investigation mechanism for high-risk groups, and take effective prevention and control measures

  13. Disrupting Mosquito Reproduction and Parasite Development for Malaria Control.

    Directory of Open Access Journals (Sweden)

    Lauren M Childs

    2016-12-01

    Full Text Available The control of mosquito populations with insecticide treated bed nets and indoor residual sprays remains the cornerstone of malaria reduction and elimination programs. In light of widespread insecticide resistance in mosquitoes, however, alternative strategies for reducing transmission by the mosquito vector are urgently needed, including the identification of safe compounds that affect vectorial capacity via mechanisms that differ from fast-acting insecticides. Here, we show that compounds targeting steroid hormone signaling disrupt multiple biological processes that are key to the ability of mosquitoes to transmit malaria. When an agonist of the steroid hormone 20-hydroxyecdysone (20E is applied to Anopheles gambiae females, which are the dominant malaria mosquito vector in Sub Saharan Africa, it substantially shortens lifespan, prevents insemination and egg production, and significantly blocks Plasmodium falciparum development, three components that are crucial to malaria transmission. Modeling the impact of these effects on Anopheles population dynamics and Plasmodium transmission predicts that disrupting steroid hormone signaling using 20E agonists would affect malaria transmission to a similar extent as insecticides. Manipulating 20E pathways therefore provides a powerful new approach to tackle malaria transmission by the mosquito vector, particularly in areas affected by the spread of insecticide resistance.

  14. Framework for Evaluating the Health Impact of the Scale-Up of Malaria Control Interventions on All-Cause Child Mortality in Sub-Saharan Africa

    Science.gov (United States)

    Yé, Yazoume; Eisele, Thomas P.; Eckert, Erin; Korenromp, Eline; Shah, Jui A.; Hershey, Christine L.; Ivanovich, Elizabeth; Newby, Holly; Carvajal-Velez, Liliana; Lynch, Michael; Komatsu, Ryuichi; Cibulskis, Richard E.; Moore, Zhuzhi; Bhattarai, Achuyt

    2017-01-01

    Abstract. Concerted efforts from national and international partners have scaled up malaria control interventions, including insecticide-treated nets, indoor residual spraying, diagnostics, prompt and effective treatment of malaria cases, and intermittent preventive treatment during pregnancy in sub-Saharan Africa (SSA). This scale-up warrants an assessment of its health impact to guide future efforts and investments; however, measuring malaria-specific mortality and the overall impact of malaria control interventions remains challenging. In 2007, Roll Back Malaria's Monitoring and Evaluation Reference Group proposed a theoretical framework for evaluating the impact of full-coverage malaria control interventions on morbidity and mortality in high-burden SSA countries. Recently, several evaluations have contributed new ideas and lessons to strengthen this plausibility design. This paper harnesses that new evaluation experience to expand the framework, with additional features, such as stratification, to examine subgroups most likely to experience improvement if control programs are working; the use of a national platform framework; and analysis of complete birth histories from national household surveys. The refined framework has shown that, despite persisting data challenges, combining multiple sources of data, considering potential contributions from both fundamental and proximate contextual factors, and conducting subnational analyses allows identification of the plausible contributions of malaria control interventions on malaria morbidity and mortality. PMID:28990923

  15. Border malaria in China: knowledge and use of personal protection by minority populations and implications for malaria control: a questionnaire-based survey

    Directory of Open Access Journals (Sweden)

    Hill Nigel

    2008-10-01

    Full Text Available Abstract Background Malaria control in remote, forested areas of the Mekong region relies on personal protection from mosquito bites. Uptake of these methods may be limited by knowledge of the link between mosquitoes and malaria as well as social and economic aspects. Understanding barriers to uptake will inform malaria control programmes on targets for improvement of delivery. Methods A total 748 key respondents: health providers and village heads, from 187 villages and 25 different ethnic groups, were interviewed using structured questionnaires. Differences in use of personal protection, and knowledge of malaria between groups were analysed using chi-square; and binary logistic regression used for multivariate analysis. Results Malaria knowledge was poor with 19.4% of women and 37.5% of men linking mosquitoes with malaria, although 95.6% knew one or more methods of mosquito control. Virtually all respondents used personal protection at some time during the year; and understanding of malaria transmission was strongly associated with bednet use. Those working in forest agriculture were significantly more likely to know that mosquitoes transmit malaria but this did not translate into a significantly greater likelihood of using bednets. Furthermore, use of personal protection while woing outdoors was rare, and less than 3% of respondents knew about the insecticide impregnation of bednets. The use of bednets, synthetic repellents and mosquito coils varied between ethnic groups, but was significantly more frequent among those with higher income, more years of education and permanent housing. The reported use of repellents and coils was also more common among women despite their low knowledge of malaria transmission, and low likelihood of having heard information on malaria within the last year. Conclusion The use of personal protection must be increased, particularly among outdoor workers that have higher malaria risk. However, personal protection

  16. Border malaria in China: knowledge and use of personal protection by minority populations and implications for malaria control: a questionnaire-based survey.

    Science.gov (United States)

    Moore, Sarah J; Min, Xia; Hill, Nigel; Jones, Caroline; Zaixing, Zhang; Cameron, Mary M

    2008-10-01

    Malaria control in remote, forested areas of the Mekong region relies on personal protection from mosquito bites. Uptake of these methods may be limited by knowledge of the link between mosquitoes and malaria as well as social and economic aspects. Understanding barriers to uptake will inform malaria control programmes on targets for improvement of delivery. A total 748 key respondents: health providers and village heads, from 187 villages and 25 different ethnic groups, were interviewed using structured questionnaires. Differences in use of personal protection, and knowledge of malaria between groups were analysed using chi-square; and binary logistic regression used for multivariate analysis. Malaria knowledge was poor with 19.4% of women and 37.5% of men linking mosquitoes with malaria, although 95.6% knew one or more methods of mosquito control. Virtually all respondents used personal protection at some time during the year; and understanding of malaria transmission was strongly associated with bednet use. Those working in forest agriculture were significantly more likely to know that mosquitoes transmit malaria but this did not translate into a significantly greater likelihood of using bednets. Furthermore, use of personal protection while woing outdoors was rare, and less than 3% of respondents knew about the insecticide impregnation of bednets. The use of bednets, synthetic repellents and mosquito coils varied between ethnic groups, but was significantly more frequent among those with higher income, more years of education and permanent housing. The reported use of repellents and coils was also more common among women despite their low knowledge of malaria transmission, and low likelihood of having heard information on malaria within the last year. The use of personal protection must be increased, particularly among outdoor workers that have higher malaria risk. However, personal protection is widely used and widely accepted to prevent nuisance biting

  17. A community-based health education programme for bio-environmental control of malaria through folk theatre (Kalajatha in rural India

    Directory of Open Access Journals (Sweden)

    Tiwari Satyanarayan

    2006-12-01

    Full Text Available Abstract Background Health education is an important component in disease control programme. Kalajatha is a popular, traditional art form of folk theatre depicting various life processes of a local socio-cultural setting. It is an effective medium of mass communication in the Indian sub-continent especially in rural areas. Using this medium, an operational feasibility health education programme was carried out for malaria control. Methods In December 2001, the Kalajatha events were performed in the evening hours for two weeks in a malaria-affected district in Karnataka State, south India. Thirty local artists including ten governmental and non-governmental organizations actively participated. Impact of this programme was assessed after two months on exposed vs. non-exposed respondents. Results The exposed respondents had significant increase in knowledge and change in attitude about malaria and its control strategies, especially on bio-environmental measures (p Conclusion This study was carried out under the primary health care system involving the local community and various potential partners. Kalajatha conveyed the important messages on malaria control and prevention to the rural community. Similar methods of communication in the health education programme should be intensified with suitable modifications to reach all sectors, if malaria needs to be controlled.

  18. Costs and cost-effectiveness of malaria control interventions - a systematic review

    Directory of Open Access Journals (Sweden)

    White Michael T

    2011-11-01

    Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

  19. malERA: An updated research agenda for diagnostics, drugs, vaccines, and vector control in malaria elimination and eradication.

    Science.gov (United States)

    2017-11-01

    Since the turn of the century, a remarkable expansion has been achieved in the range and effectiveness of products and strategies available to prevent, treat, and control malaria, including advances in diagnostics, drugs, vaccines, and vector control. These advances have once again put malaria elimination on the agenda. However, it is clear that even with the means available today, malaria control and elimination pose a formidable challenge in many settings. Thus, currently available resources must be used more effectively, and new products and approaches likely to achieve these goals must be developed. This paper considers tools (both those available and others that may be required) to achieve and maintain malaria elimination. New diagnostics are needed to direct treatment and detect transmission potential; new drugs and vaccines to overcome existing resistance and protect against clinical and severe disease, as well as block transmission and prevent relapses; and new vector control measures to overcome insecticide resistance and more powerfully interrupt transmission. It is also essential that strategies for combining new and existing approaches are developed for different settings to maximise their longevity and effectiveness in areas with continuing transmission and receptivity. For areas where local elimination has been recently achieved, understanding which measures are needed to maintain elimination is necessary to prevent rebound and the reestablishment of transmission. This becomes increasingly important as more countries move towards elimination.

  20. Contributions of Anopheles larval control to malaria suppression in tropical Africa: review of achievements and potential.

    Science.gov (United States)

    Walker, K; Lynch, M

    2007-03-01

    Malaria vector control targeting the larval stages of mosquitoes was applied successfully against many species of Anopheles (Diptera: Culicidae) in malarious countries until the mid-20th Century. Since the introduction of DDT in the 1940s and the associated development of indoor residual spraying (IRS), which usually has a more powerful impact than larval control on vectorial capacity, the focus of malaria prevention programmes has shifted to the control of adult vectors. In the Afrotropical Region, where malaria is transmitted mainly by Anopheles funestus Giles and members of the Anopheles gambiae Giles complex, gaps in information on larval ecology and the ability of An. gambiae sensu lato to exploit a wide variety of larval habitats have discouraged efforts to develop and implement larval control strategies. Opportunities to complement adulticiding with other components of integrated vector management, along with concerns about insecticide resistance, environmental impacts, rising costs of IRS and logistical constraints, have stimulated renewed interest in larval control of malaria vectors. Techniques include environmental management, involving the temporary or permanent removal of anopheline larval habitats, as well as larviciding with chemical or biological agents. This present review covers large-scale trials of anopheline larval control methods, focusing on field studies in Africa conducted within the past 15 years. Although such studies are limited in number and scope, their results suggest that targeting larvae, particularly in human-made habitats, can significantly reduce malaria transmission in appropriate settings. These approaches are especially suitable for urban areas, where larval habitats are limited, particularly when applied in conjunction with IRS and other adulticidal measures, such as the use of insecticide treated bednets.

  1. Integrated malaria vector control in different agro-ecosystems in western Kenya

    NARCIS (Netherlands)

    Imbahale, S.S.

    2009-01-01

    Malaria is a complex disease and its transmission is a function of the interaction between the Anopheles mosquito vector, the Plasmodium parasite, the hosts and the environment. Malaria control has mainly targeted the Plasmodium parasite or the adult anopheline mosquitoes. However, development of

  2. Working without a blindfold: the critical role of diagnostics in malaria control

    Directory of Open Access Journals (Sweden)

    Bell David R

    2008-12-01

    Full Text Available Abstract Diagnostic testing for malaria has for many years been eschewed, lest it be an obstacle to the delivery of rapid, life-saving treatment. The approach of treating malaria without confirmatory testing has been reinforced by the availability of inexpensive treatment with few side effects, by the great difficulty of establishing quality-assured microscopy in rural and resource-poor settings, and by the preeminence of malaria as a cause of important fever in endemic regions. Within the last decade, all three of these factors have changed. More expensive artemisinin combination therapy (ACT has been widely introduced, simple immunochromatographic tests for malaria have been developed that can be used as an alternative to microscopy by village health workers, and recognition of the health cost of mismanaging non-malarial fever is growing. In most of the world a small fraction of fever is due to malaria, and reflex treatment with ACT does not make medical or economic sense. Global malaria control efforts have been energized by the availability of new sources of funding, and by the rapid reduction in malaria prevalence in a number of settings where bed nets, indoor residual spraying with insecticides, and ACT have been systematically deployed. This momentum has been captured by a new call for malaria elimination. Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts.

  3. Challenges in malaria control in sub-Saharan Africa: the vaccine perspective

    DEFF Research Database (Denmark)

    Lusingu, John P A; Von Seidlein, Lorenz

    2008-01-01

    of these interventions. The emergence of resistance against drugs and insecticides requires in response a steady stream of new interventions. Up to the beginning of this millennium, most sub-Saharan African countries have been using chloroquine (CQ) as the first-line antimalarial drug, which had to be replaced...... malaria control measures have been applied such as environmental improvements, use of insecticide impregnated nets, residual indoor spraying, early case detection and treatment with effective antimalarial drugs. However, the adaptation of vector and parasite has so far limited the effect...... with sulphadoxine-pyrimethamine (SP) after resistant parasites had rendered CQ ineffective. Currently the first line treatment of malaria consists of combination therapy which includes an artemisinin derivative. The current approach appears robust but history has taught us to be alert and to expect resistance...

  4. Optimal control in a model of malaria with differential susceptibility

    Science.gov (United States)

    Hincapié, Doracelly; Ospina, Juan

    2014-06-01

    A malaria model with differential susceptibility is analyzed using the optimal control technique. In the model the human population is classified as susceptible, infected and recovered. Susceptibility is assumed dependent on genetic, physiological, or social characteristics that vary between individuals. The model is described by a system of differential equations that relate the human and vector populations, so that the infection is transmitted to humans by vectors, and the infection is transmitted to vectors by humans. The model considered is analyzed using the optimal control method when the control consists in using of insecticide-treated nets and educational campaigns; and the optimality criterion is to minimize the number of infected humans, while keeping the cost as low as is possible. One first goal is to determine the effects of differential susceptibility in the proposed control mechanism; and the second goal is to determine the algebraic form of the basic reproductive number of the model. All computations are performed using computer algebra, specifically Maple. It is claimed that the analytical results obtained are important for the design and implementation of control measures for malaria. It is suggested some future investigations such as the application of the method to other vector-borne diseases such as dengue or yellow fever; and also it is suggested the possible application of free software of computer algebra like Maxima.

  5. Long-Lasting Insecticidal Hammocks for controlling forest malaria: a community-based trial in a rural area of central Vietnam.

    Directory of Open Access Journals (Sweden)

    Ngo Duc Thang

    2009-10-01

    Full Text Available In Vietnam, malaria remains a problem in some remote areas located along its international borders and in the central highlands, partly due to the bionomics of the local vector, mainly found in forested areas and less vulnerable to standard control measures. Long Lasting Insecticidal Hammocks (LLIH, a tailored and user-friendly tool for forest workers, may further contribute in reducing the malaria burden. Their effectiveness was tested in a large community-based intervention trial carried out in Ninh Thuan province in Central Vietnam.Thirty villages (population 18,646 were assembled in 20 clusters (1,000 individuals per cluster that were randomly allocated to either the intervention or control group (no LLIH after stratification according to the pre-intervention P. falciparum antibody prevalence ( or =30%. LLIH were distributed to the intervention group in December 2004. For the following 2 years, the incidence of clinical malaria and the prevalence of infection were determined by passive case detection at community level and by bi-annual malariometric surveys. A 2-fold larger effect on malaria incidence in the intervention as compared to the control group was observed. Similarly, malaria prevalence decreased more substantially in the intervention (1.6-fold greater reduction than in the control group. Both for incidence and prevalence, a stronger and earlier effect of the intervention was observed in the high endemicity stratum. The number of malaria cases and infections averted by the intervention overall was estimated at 10.5 per 1,000 persons and 5.6/100 individuals, respectively, for the last half of 2006. In the high endemicity stratum, the impact was much higher, i.e. 29/1000 malaria cases and 15.7 infections/100 individuals averted.LLIH reduced malaria incidence and prevalence in this remote and forested area of Central Vietnam. As the targets of the newly-launched Global Malaria Action Plan include the 75% reduction of the global

  6. N-Acetylcysteine as adjunctive treatment in severe malaria: A randomized double blinded placebo controlled clinical trial

    Science.gov (United States)

    Charunwatthana, Prakaykaew; Faiz, M. Abul; Ruangveerayut, Ronnatrai; Maude, Richard; Rahman, M. Ridwanur; Roberts, L. Jackson; Moore, Kevin; Yunus, Emran Bin; Hoque, M. Gofranul; Hasan, Mahatab Uddin; Lee, Sue J.; Pukrittayakamee, Sasithon; Newton, Paul N.; White, Nicholas J.; Day, Nicholas P.J.; Dondorp, Arjen M.

    2009-01-01

    Objective Markers of oxidative stress are reported to be increased in severe malaria. It has been suggested that the antioxidant N-acetylcysteine (NAC) may be beneficial in treatment. We studied the efficacy and safety of parenteral N-acetylcysteine as an adjunct to artesunate treatment of severe falciparum malaria. Design A randomized double-blind placebo controlled trial on the use of high dose intravenous NAC as adjunctive treatment to artesunate. Setting A provincial hospital in Western Thailand and a tertiary referral hospital in Chittagong, Bangladesh. Patients One hundred and eight adult patients with severe falciparum malaria. Interventions Patients were randomized to receive N-acetylcysteine or placebo as adjunctive treatment to intravenous artesunate. Measurements and main results A total of 56 patients were treated with NAC and 52 received placebo. NAC had no significant effect on mortality, lactate clearance times (p=0.74) or coma recovery times (p=0.46). Parasite clearance time was increased from 30h (range 6h to 144h) to 36h (range 6h to 120h) (p=0.03), but this could be explained by differences in admission parasitemia. Urinary F2-isoprostane metabolites, measured as a marker of oxidative stress, were increased in severe malaria compared to patients with uncomplicated malaria and healthy volunteers. Admission red cell rigidity correlated with mortality, but did not improve with NAC. Conclusion Systemic oxidative stress is increased in severe malaria. Treatment with N-acetylcysteine had no effect on outcome in patients with severe falciparum malaria in this setting. PMID:19114891

  7. Modeling malaria control intervention effect in KwaZulu-Natal, South Africa using intervention time series analysis.

    Science.gov (United States)

    Ebhuoma, Osadolor; Gebreslasie, Michael; Magubane, Lethumusa

    The change of the malaria control intervention policy in South Africa (SA), re-introduction of dichlorodiphenyltrichloroethane (DDT), may be responsible for the low and sustained malaria transmission in KwaZulu-Natal (KZN). We evaluated the effect of the re-introduction of DDT on malaria in KZN and suggested practical ways the province can strengthen her already existing malaria control and elimination efforts, to achieve zero malaria transmission. We obtained confirmed monthly malaria cases in KZN from the malaria control program of KZN from 1998 to 2014. The seasonal autoregressive integrated moving average (SARIMA) intervention time series analysis (ITSA) was employed to model the effect of the re-introduction of DDT on confirmed monthly malaria cases. The result is an abrupt and permanent decline of monthly malaria cases (w 0 =-1174.781, p-value=0.003) following the implementation of the intervention policy. The sustained low malaria cases observed over a long period suggests that the continued usage of DDT did not result in insecticide resistance as earlier anticipated. It may be due to exophagic malaria vectors, which renders the indoor residual spraying not totally effective. Therefore, the feasibility of reducing malaria transmission to zero in KZN requires other reliable and complementary intervention resources to optimize the existing ones. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Prevalence of malaria, prevention measures, and main clinical features in febrile children admitted to the Franceville Regional Hospital, Gabon

    Directory of Open Access Journals (Sweden)

    Maghendji-Nzondo Sydney

    2016-01-01

    Full Text Available Recently, major progress has been made in controlling malaria in Africa. However, in Gabon, little information is available on the role of malaria in childhood febrile syndromes, the use and efficacy of preventive measures, and Plasmodium species distribution. Here, we characterized malaria in febrile children in Franceville, Gabon through a cross-sectional study at the pediatric unit of the Franceville Regional Hospital. We registered 940 febrile children. Their general condition was markedly altered in 11.7% of cases (n = 89/760; among them 19 (21.4% had a severely altered condition. Malaria was the second most frequent etiology (22.0%; n = 162/738, after respiratory tract infections (37.3%; n = 275/738. Children with malaria (63 ± 39 months were older than children without malaria (40 ± 37 months (p = 0.0013. Hemoglobin, red blood cell, white blood cell, and platelet values were lower in children with malaria than in those without malaria (p < 0.0001. Anemia was the most common feature of severe malaria (70.6%; n = 12/17, followed by neurological involvement (23.5%; n = 4/17. The prevalence of malaria was significantly higher in children older than 60 months than in younger children (40% vs. 15.5%; p < 0.0001. Plasmodium falciparum accounted for 97.5% of cases (158/162, followed by Plasmodium malariae (2.5%; n = 4/162. Bed net use was high (74.4%; n = 697/936 and contributed to malaria prevention (p = 0.001. Good basic knowledge of malaria also had a preventive effect (p < 0.0001. The prevalence of malaria in children in Franceville did not decrease significantly from 2009 to 2012, remaining at about 20%, highlighting that preventive measures should be reinforced.

  9. Taking malaria transmission out of the bottle: implications of mosquito dispersal for vector-control interventions

    NARCIS (Netherlands)

    Killeen, G.F.; Knols, B.G.J.; Gu, W.D.

    2003-01-01

    Most malaria transmission models assume enclosed systems of people, parasites, and vectors in which neither emigration nor immigration of mosquitoes is considered. This simplification has facilitated insightful analyses but has substantial limitations for evaluating control measures in the field.

  10. International funding for malaria control in relation to populations at risk of stable Plasmodium falciparum transmission.

    Directory of Open Access Journals (Sweden)

    Robert W Snow

    2008-07-01

    Full Text Available The international financing of malaria control has increased significantly in the last ten years in parallel with calls to halve the malaria burden by the year 2015. The allocation of funds to countries should reflect the size of the populations at risk of infection, disease, and death. To examine this relationship, we compare an audit of international commitments with an objective assessment of national need: the population at risk of stable Plasmodium falciparum malaria transmission in 2007.The national distributions of populations at risk of stable P. falciparum transmission were projected to the year 2007 for each of 87 P. falciparum-endemic countries. Systematic online- and literature-based searches were conducted to audit the international funding commitments made for malaria control by major donors between 2002 and 2007. These figures were used to generate annual malaria funding allocation (in US dollars per capita population at risk of stable P. falciparum in 2007. Almost US$1 billion are distributed each year to the 1.4 billion people exposed to stable P. falciparum malaria risk. This is less than US$1 per person at risk per year. Forty percent of this total comes from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Substantial regional and national variations in disbursements exist. While the distribution of funds is found to be broadly appropriate, specific high population density countries receive disproportionately less support to scale up malaria control. Additionally, an inadequacy of current financial commitments by the international community was found: under-funding could be from 50% to 450%, depending on which global assessment of the cost required to scale up malaria control is adopted.Without further increases in funding and appropriate targeting of global malaria control investment it is unlikely that international goals to halve disease burdens by 2015 will be achieved. Moreover, the additional financing

  11. Use of insecticide-impregnated mosquito nets and other impregnated materials for malaria control in the Americas Uso de mosquiteros y otros materiales impregnados para el control de la malaria en las Américas

    Directory of Open Access Journals (Sweden)

    R. H. Zimmerman

    1997-07-01

    Full Text Available This article reviews the current status of the use of insecticide-impregnated mosquito nets and other impregnated materials in the Americas. Studies from Brazil, Colombia, Ecuador, Guatemala, Peru, Suriname, and Venezuela are examined. It is concluded that most studies have suffered from experimental design errors, short duration problems, and/or inadequate measurement of health indicators. The review brings out the great difficulty of conducting scientific studies that attempt to measure the impact of insecticide-treated materials on malaria incidence. In particular, the low incidence of malaria in the Americas, the high prevalences of P. vivax and relapsing cases, and the relationship between human activity patterns and the crepuscular biting patterns of certain malaria vectors stand in the way of easy experimental design and execution. The utilization of impregnated mosquito nets or other impregnated materials as a major component of an integrated malaria control program would be premature at this time. However, it is recommended that well-conceived large-scale trials and interventions be considered when they are based on a thorough understanding of the dynamics of malaria transmission in the area of study.En este artículo se revisa el uso actual en las Américas de mosquiteros y otros materiales impregnados con insecticida. Se examinan diversos estudios efectuados en el Brasil, Colombia, Ecuador, Guatemala, Perú, Suriname y Venezuela y se llega a la conclusión de que en su mayor parte estos estudios adolecen de graves deficiencias de diseño, problemas de excesiva brevedad, o de una medición inadecuada de los indicadores de salud. La revisión resalta la gran dificultad de llevar a cabo estudios que buscan medir el impacto de los materiales tratados con insecticidas sobre la incidencia de malaria. En particular, la baja incidencia de malaria en las Américas, las altas prevalencias de Plasmodium vivax y de casos recurrentes y la relaci

  12. Using Rainfall and Temperature Data in the Evaluation of National Malaria Control Programs in Africa.

    Science.gov (United States)

    Thomson, Madeleine C; Ukawuba, Israel; Hershey, Christine L; Bennett, Adam; Ceccato, Pietro; Lyon, Bradfield; Dinku, Tufa

    2017-09-01

    Since 2010, the Roll Back Malaria (RBM) Partnership, including National Malaria Control Programs, donor agencies (e.g., President's Malaria Initiative and Global Fund), and other stakeholders have been evaluating the impact of scaling up malaria control interventions on all-cause under-five mortality in several countries in sub-Saharan Africa. The evaluation framework assesses whether the deployed interventions have had an impact on malaria morbidity and mortality and requires consideration of potential nonintervention influencers of transmission, such as drought/floods or higher temperatures. Herein, we assess the likely effect of climate on the assessment of the impact malaria interventions in 10 priority countries/regions in eastern, western, and southern Africa for the President's Malaria Initiative. We used newly available quality controlled Enhanced National Climate Services rainfall and temperature products as well as global climate products to investigate likely impacts of climate on malaria evaluations and test the assumption that changing the baseline period can significantly impact on the influence of climate in the assessment of interventions. Based on current baseline periods used in national malaria impact assessments, we identify three countries/regions where current evaluations may overestimate the impact of interventions (Tanzania, Zanzibar, Uganda) and three countries where current malaria evaluations may underestimate the impact of interventions (Mali, Senegal and Ethiopia). In four countries (Rwanda, Malawi, Mozambique, and Angola) there was no strong difference in climate suitability for malaria in the pre- and post-intervention period. In part, this may be due to data quality and analysis issues.

  13. [Current status of malaria control knowledge awareness of primary and sec- ondary school students in Xuzhou City].

    Science.gov (United States)

    Sun, Xing-sheng; Li, Li; Zhang, Kan-kan

    2015-12-01

    To understand the current status of malaria control knowledge awareness of primary and secondary school students and its influencing factors in Yunlong District, Xuzhou City, so as to provide the evidence for improving the malaria prevention work. A total of 800 students from 4 urban and rural primary and secondary schools were randomly selected and investigated with questionnaires. The total awareness rate of malaria control knowledge was 61.27%, and the awareness rates of symptoms of malaria and malaria prevention were only 38.99% and 57.59% respectively. The main approach of obtaining the malaria control knowledge was media (51.52%). The univariate analysis showed that sex, area and different education levels affected the awareness rates of malaria control knowledge (P knowledge of country students was lower than that of urban students (P knowledge of the secondary school students was higher than that of the primary school students (P knowledge of primary and secondary school students in Yunlong District is lower than that required by the national standard. Therefore, the health education of malaria control should be strengthened, especially in countryside school students and primary school students.

  14. Uso de mosquiteros y otros materiales impregnados con insecticida para el control de la malaria en las Américas Use of insecticide-impregnated mosquito nets and other impregnated materials for malaria control in the Americas

    Directory of Open Access Journals (Sweden)

    R. H. Zimmerman

    1997-01-01

    Full Text Available En el presente artículo se analiza el uso actual de mosquiteros y de otros materiales impregnados con insecticida en las Américas. Se examinan diversos estudios efectuados en Brasil, Colombia, Ecuador, Guatemala, Perú, Suriname y Venezuela y se llega a la conclusión de que, en su mayor parte, estos estudios adolecen de graves deficiencias de diseño experimental, problemas de excesiva brevedad, y medición inadecuada de indicadores de salud. En el análisis se resalta la gran dificultad de llevar a cabo estudios científicos que buscan determinar el efecto de los materiales tratados con insecticida en la incidencia de malaria. En particular, la baja incidencia de malaria en las Américas, la elevada prevalencia de Plasmodium vivax y de casos recurrentes, y la relación existente entre los patrones de actividad del ser humano y los hábitos de picadura crepusculares de ciertos vectores de la malaria impiden hacer experimentos de fácil diseño y ejecución. Por ahora sería prematuro usar mosquiteros u otros materiales impregnados con insecticida como componentes principales de un programa integral para el control de la malaria. No obstante, se recomienda que se considere la posibilidad de realizar ensayos e intervenciones bien diseñados a gran escala, siempre que se basen en un conocimiento profundo de la dinámica de la transmisión de la malaria en la zona en estudio.This article reviews the current status of insecticide-impregnated mosquito nets and other impregnated materials in the Americas. Studies from Brazil, Colombia, Ecuador, Guatemala, Peru, Suriname, and Venezuela are examined. It is concluded that most studies have suffered from experimental design errors, short duration problems, and/or inadequate measurement of health indicators. The review brings out the great difficulty of conducting scientific studies that attempt to measure the impact of insecticide-treated materials on malaria incidence. In particular, the low incidence

  15. Malaria control in Bhutan: case study of a country embarking on elimination

    Directory of Open Access Journals (Sweden)

    Yangzom Thinley

    2012-01-01

    Full Text Available Abstract Background Bhutan has achieved a major reduction in malaria incidence amid multiple challenges. This case study seeks to characterize the Bhutan malaria control programme over the last 10 years. Methods A review of the malaria epidemiology, control strategies, and elimination strategies employed in Bhutan was carried out through a literature review of peer-reviewed and grey national and international literature with the addition of reviewing the surveillance and vector control records of the Bhutan Vector-Borne Disease Control Programme (VDCP. Data triangulation was used to identify trends in epidemiology and key strategies and interventions through analysis of the VDCP surveillance and programme records and the literature review. Enabling and challenging factors were identified through analysis of socio-economic and health indicators, corroborated through a review of national and international reports and peer-review articles. Findings Confirmed malaria cases in Bhutan declined by 98.7% from 1994 to 2010. The majority of indigenous cases were due to Plasmodium vivax (59.9% and adult males are most at-risk of malaria. Imported cases, or those in foreign nationals, varied over the years, reaching 21.8% of all confirmed cases in 2006. Strategies implemented by the VDCP are likely to be related to the decline in cases over the last 10 years. Access to malaria diagnosis in treatment was expanded throughout the country and evidence-based case management, including the introduction of artemisinin-based combination therapy (ACT for P. falciparum, increasing coverage of high risk areas with Indoor Residual Spraying, insecticide-treated bed nets, and long-lasting insecticidal nets are likely to have contributed to the decline alongside enabling factors such as economic development and increasing access to health services. Conclusion Bhutan has made significant strides towards elimination and has adopted a goal of national elimination. A major

  16. Short report: entomologic inoculation rates and Plasmodium falciparum malaria prevalence in Africa.

    Science.gov (United States)

    Beier, J C; Killeen, G F; Githure, J I

    1999-07-01

    Epidemiologic patterns of malaria infection are governed by environmental parameters that regulate vector populations of Anopheles mosquitoes. The intensity of malaria parasite transmission is normally expressed as the entomologic inoculation rate (EIR), the product of the vector biting rate times the proportion of mosquitoes infected with sporozoite-stage malaria parasites. Malaria transmission intensity in Africa is highly variable with annual EIRs ranging from 1,000 infective bites per person per year. Malaria control programs often seek to reduce morbidity and mortality due to malaria by reducing or eliminating malaria parasite transmission by mosquitoes. This report evaluates data from 31 sites throughout Africa to establish fundamental relationships between annual EIRs and the prevalence of Plasmodium falciparum malaria infection. The majority of sites fitted a linear relationship (r2 = 0.71) between malaria prevalence and the logarithm of the annual EIR. Some sites with EIRs 80%. The basic relationship between EIR and P. falciparum prevalence, which likely holds in east and west Africa, and across different ecologic zones, shows convincingly that substantial reductions in malaria prevalence are likely to be achieved only when EIRs are reduced to levels less than 1 infective bite per person per year. The analysis also highlights that the EIR is a more direct measure of transmission intensity than traditional measures of malaria prevalence or hospital-based measures of infection or disease incidence. As such, malaria field programs need to consider both entomologic and clinical assessments of the efficacy of transmission control measures.

  17. Equity and adequacy of international donor assistance for global malaria control: an analysis of populations at risk and external funding commitments.

    Science.gov (United States)

    Snow, Robert W; Okiro, Emelda A; Gething, Peter W; Atun, Rifat; Hay, Simon I

    2010-10-23

    Financing for malaria control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide malaria-control ambitions. Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for malaria control was done for the period 2002-09 to compute overall and annualised per-person at-risk-funding commitments. Annualised malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010. International financing for malaria control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of malaria-including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for malaria control does not correlate with GDP. Funding for malaria control worldwide is 60% lower than the US$4·9 billion needed for comprehensive control in 2010; this includes

  18. Positive deviance as a novel tool in malaria control and elimination: methodology, qualitative assessment and future potential.

    Science.gov (United States)

    Shafique, Muhammad; Edwards, Hannah M; De Beyl, Celine Zegers; Thavrin, Bou Kheng; Min, Myo; Roca-Feltrer, Arantxa

    2016-02-16

    tool in malaria control and elimination settings. Work is ongoing to quantitatively measure impact of PD on behaviours and malaria transmission and once gathered, national malaria control programmes should be encouraged to look at including PD as part of their national strategies. Feasibility of scale-up, cost-effectiveness, and applicability to other settings and diseases is also currently being explored.

  19. Hari Malaria Sedunia 2013 Investasi Di Masa Depan. Taklukkan Malaria

    Directory of Open Access Journals (Sweden)

    Hotnida Sitorus

    2017-02-01

    Full Text Available Abstract Malaria is still the global health problems, World Health Organization estimates that malaria causes death of approximately 660.000 in 2010, most of the age of the children in the region of sub-Saharan Africa. World Malaria Day 2013 assigned the theme “Invest in the future. Defeat malaria”. It takes political will and collective action to jointly combat malaria through malaria elimination. Needed more new donors to be involved in global partnerships against malaria. These partnerships exist, one of which is support of funding or facility for malaria endemic countries which do not have sufficient resources to control malaria. A lot of effort has been done or is still in the development stage. The use of long-lasting insecticidal nets appropriately can reduce malaria cases. The use of rapid diagnostic test, especially in remote areas and health facility with no microscopy, is very beneficial for patients to get prompt treatment. The control of malaria through integrated vector management is a rational decision making process to optimize the use of resources in the control of vector. Sterile insect technique has a promising prospect and expected to replace the role of chemical insecticides that have negative impact both on the environment and target vector (resistance. Keywords: Malaria, long-lasting insecticidal nets, rapid diagnostic test Abstrak Malaria masih menjadi masalah kesehatan dunia, Organisasi Kesehatan Dunia (WHO memperkirakan malaria menyebabkan kurang lebih 660.000 kematian pada tahun 2010, kebanyakan usia anak-anak di wilayah Sub-Sahara Afrika. Pada peringatan hari malaria dunia tahun 2013 ditetapkan tema “Investasi di masa depan. Taklukkan malaria”. Dibutuhkan kemauan politik dan tindakan kolektif untuk bersama-sama memerangi malaria melalui gerakan eliminasi malaria. Diperlukan lebih banyak donor baru untuk turut terlibat dalam kemitraan global melawan malaria. Wujud kemitraan tersebut salah satunya adalah

  20. Combined measurement of soluble and cellular ICAM-1 among children with Plasmodium falciparum malaria in Uganda

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    Cserti-Gazdewich Christine M

    2010-08-01

    Full Text Available Abstract Background Intercellular adhesion molecule-1 (ICAM-1 is a cytoadhesion molecule implicated in the pathogenesis of Plasmodium falciparum malaria. Elevated levels of soluble ICAM-1 (sICAM-1 have previously been reported with increased malaria disease severity. However, studies have not yet examined both sICAM-1 concentrations and monocyte ICAM-1 expression in the same cohort of patients. To better understand the relationship of soluble and cellular ICAM-1 measurements in malaria, both monocyte ICAM-1 expression and sICAM-1 concentration were measured in children with P. falciparum infection exhibiting a spectrum of clinical severity. Methods Samples were analysed from 160 children, aged 0.5 to 10.8 years, with documented P. falciparum malaria in Kampala, Uganda. The patients belonged to one of three pre-study defined groups: uncomplicated malaria (UM, severe non-fatal malaria (SM-s, and fatal malaria (SM-f. Subset analysis was done on those with cerebral malaria (CM or severe malaria anaemia (SMA. Monocyte ICAM-1 was measured by flow cytometry. sICAM-1 was measured by enzyme immunoassay. Results Both sICAM-1 and monocyte cell-surface ICAM-1 followed a log-normal distribution. Median sICAM-1 concentrations increased with greater severity-of-illness: 279 ng/mL (UM, 462 ng/mL (SM-s, and 586 ng/mL (SM-f, p Conclusion In this cohort of children with P. falciparum malaria, sICAM-1 levels were associated with severity-of-illness. Patients with UM had higher monocyte ICAM-1 expression consistent with a role for monocyte ICAM-1 in immune clearance during non-severe malaria. Among the subsets of patients with either SMA or CM, monocyte ICAM-1 levels were higher in CM, consistent with the role of ICAM-1 as a marker of cytoadhesion. Categories of disease in pediatric malaria may exhibit specific combinations of soluble and cellular ICAM-1 expression.

  1. Malaria eradication: the economic, financial and institutional challenge.

    Science.gov (United States)

    Mills, Anne; Lubell, Yoel; Hanson, Kara

    2008-12-11

    Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices). More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities), the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between malaria control and economic

  2. Malaria eradication: the economic, financial and institutional challenge

    Directory of Open Access Journals (Sweden)

    Hanson Kara

    2008-12-01

    Full Text Available Abstract Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices. More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities, the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between

  3. Households' incidence on malaria and expenditures to treat malaria ...

    African Journals Online (AJOL)

    CONCLUSION: The relationship between expenditure and use of different vector control depends on the geographic location of respondents. People living in the rural areas spend more to have access to malaria control tools. Location of respondent has a positive effect on expenditures and use of malaria control tools.

  4. Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

    Science.gov (United States)

    Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F

    2015-04-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8-41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. © The American Society of Tropical Medicine and Hygiene.

  5. Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission across Seven Diverse ICEMR Network Sites

    Science.gov (United States)

    Wilson, Mark L.; Krogstad, Donald J.; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U.; Ndiaye, Daouda; Mathanga, Don P.; Eapen, Alex

    2015-01-01

    A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. PMID:26259941

  6. Successfully controlling malaria in South Africa

    African Journals Online (AJOL)

    regard to tourism, within an area of ~100 000 km2. ... Unfortunately, international funding for .... carriers, whether symptomatic or asymptomatic, to interrupt malaria ... education of healthcare workers on malaria diagnosis and treatment.

  7. TEAM 1 Integrated Research Partnerships for Malaria Control ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    TEAM 1 Integrated Research Partnerships for Malaria Control through an Ecohealth Approach in. East Africa. Abstract: Representing East Africa, the National Institute for Medical Research (NIMR, Tanzania), icipe, the. Kigali Health Institute (Rwanda) and the Kamuli local government district authority in Uganda form.

  8. Anopheline Reproductive Biology: Impacts on Vectorial Capacity and Potential Avenues for Malaria Control.

    Science.gov (United States)

    Mitchell, Sara N; Catteruccia, Flaminia

    2017-12-01

    Vectorial capacity is a mathematical approximation of the efficiency of vector-borne disease transmission, measured as the number of new infections disseminated per case per day by an insect vector. Multiple elements of mosquito biology govern their vectorial capacity, including survival, population densities, feeding preferences, and vector competence. Intriguingly, biological pathways essential to mosquito reproductive fitness directly or indirectly influence a number of these elements. Here, we explore this complex interaction, focusing on how the interplay between mating and blood feeding in female Anopheles not only shapes their reproductive success but also influences their ability to sustain Plasmodium parasite development. Central to malaria transmission, mosquito reproductive biology has recently become the focus of research strategies aimed at malaria control, and we discuss promising new methods based on the manipulation of key reproductive steps. In light of widespread resistance to all public health-approved insecticides targeting mosquito reproduction may prove crucial to the success of malaria-eradication campaigns. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

  9. Development and assessment of plant-based synthetic odor baits for surveillance and control of Malaria vectors

    Science.gov (United States)

    Recent malaria vector control measures have considerably reduced indoor biting mosquito populations. However, reducing the outdoor biting populations remains a challenge because of the unavailability of appropriate lures to achieve this. This study sought to test the efficacy of plant-based syntheti...

  10. Profile of seizures in adult falciparum malaria and the clinical efficacy of phenytoin sodium for control of seizures

    Directory of Open Access Journals (Sweden)

    Manoj Ku Mohapatra

    2012-10-01

    Full Text Available Objective: To study the profile of convulsion in adult severe falciparum malaria and efficacy of phenytoin sodium for its control. Methods: It comprised of two sub studies. Study-1 evaluated the pattern and risk factors of seizure in severe malaria and Study-2 investigated the efficacy of phenytoin sodium to control seizure in an open label trial. Patients of severe malaria were diagnosed as per WHO guideline. Clinical type and duration of convulsion were determined. Biochemical and haematological investigations including EEG and CT scan of brain were performed in all cases. All patients were treated with injection artesunate along with other supportive measures and patients with convulsions were treated with injection phenytoin sodium. Results: Out of 408 patients of severe malaria 118 (28.9% patients had seizure. Generalized tonic clonic seizure, partial seizure with secondary generalization, and status epilepticus was present in 89(75.4%, 25(21.2%, and 4(3.4% cases respectively. CT scan was abnormal in 16 (13.6% cases. EEG was abnormal in 108 (91.5% cases showing generalized seizure activity. Patients with convulsion (n=118 were treated with phenytoin sodium injection and convulsion was controlled within 12 hours [mean (6.2依2.1 hours] of treatment in 107 (90.6% patients. Recurrence of seizure occurred in 2 (1.7% patients and 11 (9.3% patients did not respond. The mortality and sequelae were more among patients with than without convulsion. Conclusions: Seizure is common in adult falciparum malaria and phenytoin is an effective drug for seizure control.

  11. Perspectives of people in Mali toward genetically-modified mosquitoes for malaria control

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    Famenini Shannon

    2010-05-01

    Full Text Available Abstract Background Genetically-modified (GM mosquitoes have been proposed as part of an integrated vector control strategy for malaria control. Public acceptance is essential prior to field trials, particularly since mosquitoes are a vector of human disease and genetically modified organisms (GMOs face strong scepticism in developed and developing nations. Despite this, in sub-Saharan Africa, where the GM mosquito effort is primarily directed, very little data is available on perspectives to GMOs. Here, results are presented of a qualitative survey of public attitudes to GM mosquitoes for malaria control in rural and urban areas of Mali, West Africa between the months of October 2008 and June 2009. Methods The sample consisted of 80 individuals - 30 living in rural communities, 30 living in urban suburbs of Bamako, and 20 Western-trained and traditional health professionals working in Bamako and Bandiagara. Questions were asked about the cause of malaria, heredity and selective breeding. This led to questions about genetic alterations, and acceptable conditions for a release of pest-resistant GM corn and malaria-refractory GM mosquitoes. Finally, participants were asked about the decision-making process in their community. Interviews were transcribed and responses were categorized according to general themes. Results Most participants cited mosquitoes as one of several causes of malaria. The concept of the gene was not widely understood; however selective breeding was understood, allowing limited communication of the concept of genetic modification. Participants were open to a release of pest-resistant GM corn, often wanting to conduct a trial themselves. The concept of a trial was reapplied to GM mosquitoes, although less frequently. Participants wanted to see evidence that GM mosquitoes can reduce malaria prevalence without negative consequences for human health and the environment. For several participants, a mosquito control programme was

  12. Control of malaria in the Comoro Islands over the past century.

    Science.gov (United States)

    Chakir, Ismaël; Said, Ali Ibrahim; Affane, Bacar; Jambou, Ronan

    2017-09-26

    The Comoros are an archipelago located in the Indian Ocean between the eastern coasts of Africa and north of Madagascar. Malaria transmission appeared late in the 19th century due to the intensification of human migration. The story of malaria transmission for the past century is depicted to provide useful lessons for the future. Currently, malaria transmission occurs differently on each island; thus, control strategies must be adapted for each particular island. Tentative malaria control in Comoros has a long history of success and failure. This study reviews the data available as a basis for recommendations for the future. There has been much effort to reach a pre-eradication state in Anjouan and Moheli, but only control steps have been taken in the Great Comoro. To date, the primary strategy used is mass treatment of the population using artemisinin-based combination therapy (ACT), which is similar to the strategy deployed during the 1950s in other countries. ACT appears efficient in two of the three islands; however, the sustainability of the strategy is unknown. This sustainability is compromised by (i) the huge level of uncontrolled exchange between the Comoro Islands and their neighbours, increasing the risk of introducing ACT-resistant strains, (ii) the use of large quantities of pesticides for agriculture usually associated with the resistance of mosquitoes, and (iii) the cost of the actions themselves. In view of the history of malaria in this area, the first recommendation is to enhance the training of health workers and the population. The second step is to establish a national strategy to assess malaria and related factors, which is currently lacking. A survey to assess the drug sensitivity of the parasites is particularly important in a context of low transmission associated with mass treatment of the population. The last point should be to secure financial support, which is not obvious in a context of pre-elimination. The Comoro Islands are thus a

  13. Financial management systems under decentralization and their effect on malaria control in Uganda.

    Science.gov (United States)

    Kivumbi, George W; Nangendo, Florence; Ndyabahika, Boniface Rutagira

    2004-01-01

    A descriptive case study with multiple sites and a single level of analysis was carried out in four purposefully selected administrative districts of Uganda to investigate the effect of financial management systems under decentralization on malaria control. Data were primarily collected from 36 interviews with district managers, staff at health units and local leaders. A review of records and documents related to decentralization at the central and district level was also used to generate data for the study. We found that a long, tedious, and bureaucratic process combined with lack of knowledge in working with new financial systems by several actors characterized financial flow under decentralization. This affected the timely use of financial resources for malaria control in that there were funds in the system that could not be accessed for use. We were also told that sometimes these funds were returned to the central government because of non-use due to difficulties in accessing them and/or stringent conditions not to divert them to other uses. Our data showed that a cocktail of bureaucratic control systems, corruption and incompetence make the financial management system under decentralization counter-productive for malaria control. The main conclusion is that good governance through appropriate and efficient financial management systems is very important for effective malaria control under decentralization.

  14. Epidemiologia de la malaria falciparum complicada: estudio de casos y controles en Tumaco y Turbo, Colombia, 2003 The epidemiology of complicated falciparum malaria: case and controls study in Tumaco and Turbo, Colombia, 2003

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    Alberto Tobón C.

    2006-09-01

    Full Text Available OBJETIVOS: Identificar aspectos del hospedero, del parásito y del ambiente asociados con ocurrencia de malaria por Plasmodium falciparum complicada. MÉTODOS: Estudio de casos y controles en pacientes de Tumaco y Turbo (Colombia aplicando los criterios de complicación de la Organización Mundial de la Salud. RESULTADOS: Entre noviembre 2002 y julio 2003 se captaron 64 casos (malaria complicada y 135 controles (malaria no complicada. Las complicaciones fueron: hiperparasitemia (40%, falla hepática (36%, síndrome dificultad respiratoria aguda (7%, falla renal (4%, trombocitopenia grave (3%, anemia grave (2%, malaria cerebral (2% e hipoglicemia grave (1%. Se encontraron como factores de riesgo para malaria falciparum complicada: a Los antecedentes de malaria falciparum durante el último año fueron menores en los casos (OR= 7.0 (1.2-43.6 P=0.019; b Mayor uso previo de antimaláricos en los casos (OR=2.2 (1.1-4.4 P=0.031 y c mayor uso de cloroquina en los casos (OR=7.4 (1.1-7.8 P=0.017. Se hallaron los alelos MAD-20 y K1 del gen msp1 y FC-27 e IC-1 del gen msp2, cuya distribución de frecuencias fue similar entre casos y controles, aunque el alelo K1 mostró una variación importante entre grupos (casos: 9.4%, controles: 3.5%. La frecuencia de "signos de peligro" fue significativamente mayor en los casos (OR= 3.3, (1.5-7.4 P=0.001. Los criterios de complicación malárica de la Organización Mundial de la Salud se comparan con otros y se discuten algunas implicaciones. CONCLUSIÓN: Se identificaron como factores de riesgo para malaria falciparum complicada, la ausencia de antecedentes de malaria falciparum en el último año y el uso de antimaláricos antes de llegar al hospital.OBJECTIVES: Aimed at identifying host and parasite aspects associated to the presence of Plasmodium falciparum complicated malaria. METHODS: Case and controls study in patients from Tumaco and Turbo (Colombia. We used the World Health Organization criteria to assess the

  15. Malaria risk in young male travellers but local transmission persists: a case-control study in low transmission Namibia.

    Science.gov (United States)

    Smith, Jennifer L; Auala, Joyce; Haindongo, Erastus; Uusiku, Petrina; Gosling, Roly; Kleinschmidt, Immo; Mumbengegwi, Davis; Sturrock, Hugh J W

    2017-02-10

    A key component of malaria elimination campaigns is the identification and targeting of high risk populations. To characterize high risk populations in north central Namibia, a prospective health facility-based case-control study was conducted from December 2012-July 2014. Cases (n = 107) were all patients presenting to any of the 46 health clinics located in the study districts with a confirmed Plasmodium infection by multi-species rapid diagnostic test (RDT). Population controls (n = 679) for each district were RDT negative individuals residing within a household that was randomly selected from a census listing using a two-stage sampling procedure. Demographic, travel, socio-economic, behavioural, climate and vegetation data were also collected. Spatial patterns of malaria risk were analysed. Multivariate logistic regression was used to identify risk factors for malaria. Malaria risk was observed to cluster along the border with Angola, and travel patterns among cases were comparatively restricted to northern Namibia and Angola. Travel to Angola was associated with excessive risk of malaria in males (OR 43.58 95% CI 2.12-896), but there was no corresponding risk associated with travel by females. This is the first study to reveal that gender can modify the effect of travel on risk of malaria. Amongst non-travellers, male gender was also associated with a higher risk of malaria compared with females (OR 1.95 95% CI 1.25-3.04). Other strong risk factors were sleeping away from the household the previous night, lower socioeconomic status, living in an area with moderate vegetation around their house, experiencing moderate rainfall in the month prior to diagnosis and living young male travellers, who have a disproportionate risk of malaria in northern Namibia, to coordinate cross-border regional malaria prevention initiatives and to scale up coverage of prevention measures such as indoor residual spraying and long-lasting insecticide nets in high risk areas if

  16. Malaria Risk Factors in Kaligesing, Purworejo District, Central Java Province, Indonesia: A Case-control Study.

    Science.gov (United States)

    Cahyaningrum, Pratiwi; Sulistyawati, Sulistyawati

    2018-05-01

    Malaria remains a public health concern worldwide, including Indonesia. Purworejo is a district in which endemic of malaria, they have re-setup to entering malaria elimination in 2021. Accordingly, actions must be taken to accelerate and guaranty that the goal will reach based on an understanding of the risk factors for malaria. Thus, we analysed malaria risk factors based on human and housing conditions in Kaligesing, Purworejo, Indonesia. A case-control study was carried out in Kaligesing subdistrict, Purworejo, Indonesia in July to August 2017. A structured questionnaire and checklist were used to collect data from 96 participants, who consisted of 48 controls and 48 cases. Univariate, bivariate, and multivariate analyses were performed. Bivariate analysis found that education level, the presence of a cattle cage within 100 m of the house, not sleeping under a bednet the previous night, and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly ( p ≤0.25) associated with malaria. Of these factors, only not sleeping under a bednet the previous night and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly associated with malaria. The findings of this study demonstrate that potential risk factor for Malaria should be paid of attention all the time, particularly for an area which is targeting Malaria elimination.

  17. Zinc and copper levels in children with severe plasmodium falciparum malaria in an area of unstable malaria transmission in eastern Sudan

    International Nuclear Information System (INIS)

    Doka, Y. A.

    2012-08-01

    The aim of this study is to measure the levels of zinc and copper in children suffering from plasmodium falciparum malaria in an area of unstable malaria transmission in Eastern Sudan. The importance of the study emanates from the fact that this type of malaria is prevalent in a serious manner and causes many fatalities and problems. In this study the analytic statistical methodology was adopted using Atomic Absorption Spectroscopy. Subject target groups, confirmed microscopically to be infected with malaria, (severe malaria 35 samples and two control groups: 35 samples of uncomplicated malaria and 35 samples of apparently healthy). The study revealed that there is a significant increase in the level of copper for both types of malaria ( the severe and the uncomplicated) while uncomplicated malaria decreased the level of zinc significantly. The study recommended that zinc supplement could be used for the patients suffering from severe malaria. (Author)

  18. Knowledge, attitudes and practices regarding malaria and mosquito ...

    African Journals Online (AJOL)

    To improve control measures against malaria, Tanzania has increased the distribution of free and subsidized insecticide-treated mosquito nets (ITNs) to pregnant women. However, data on knowledge, attitudes and practices of these women regarding malaria are scarce. This study was carried out to describe knowledge, ...

  19. Malaria burden and control in Bangladesh and prospects for elimination: an epidemiological and economic assessment.

    Science.gov (United States)

    Haque, Ubydul; Overgaard, Hans J; Clements, Archie C A; Norris, Douglas E; Islam, Nazrul; Karim, Jahirul; Roy, Shyamal; Haque, Waziul; Kabir, Moktadir; Smith, David L; Glass, Gregory E

    2014-02-01

    Malaria is endemic in 13 of 64 districts in Bangladesh. About 14 million people are at risk. Some evidence suggests that the prevalence of malaria in Bangladesh has decreased since the the Global Fund to Fight AIDS, Tuberculosis and Malaria started to support the National Malaria Control Program (NMCP) in 2007. We did an epidemiological and economic assessment of malaria control in Bangladesh. We obtained annually reported, district-level aggregated malaria case data and information about disbursed funds from the NMCP. We used a Poisson regression model to examine the associations between total malaria, severe malaria, malaria-attributable mortality, and insecticide-treated net coverage. We identified and mapped malaria hotspots using the Getis-Ord Gi* statistic. We estimated the cost-effectiveness of the NMCP by estimating the cost per confirmed case, cost per treated case, and cost per person of insecticide-treated net coverage. During the study period (from Jan 1, 2008, to Dec 31, 2012) there were 285,731 confirmed malaria cases. Malaria decreased from 6.2 cases per 1000 population in 2008, to 2.1 cases per 1000 population in 2012. Prevalence of all malaria decreased by 65% (95% CI 65-66), severe malaria decreased by 79% (78-80), and malaria-associated mortality decreased by 91% (83-95). By 2012, there was one insecticide-treated net for every 2.6 individuals (SD 0.20). Districts with more than 0.5 insecticide-treated nets per person had a decrease in prevalence of 21% (95% CI 19-23) for all malaria, 25% (17-32) for severe malaria, and 76% (35-91) for malaria-associated mortality among all age groups. Malaria hotspots remained in the highly endemic districts in the Chittagong Hill Tracts. The cost per diagnosed case was US$0.39 (SD 0.02) and per treated case was $0.51 (0.27); $0.05 (0.04) was invested per person per year for health education and $0.68 (0.30) was spent per person per year for insecticide-treated net coverage. Malaria elimination is an achievable

  20. A qualitative study of community perception and acceptance of biological larviciding for malaria mosquito control in rural Burkina Faso.

    Science.gov (United States)

    Dambach, Peter; Jorge, Margarida Mendes; Traoré, Issouf; Phalkey, Revati; Sawadogo, Hélène; Zabré, Pascal; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Becker, Norbert; Beiersmann, Claudia

    2018-03-23

    Vector and malaria parasite's rising resistance against pyrethroid-impregnated bed nets and antimalarial drugs highlight the need for additional control measures. Larviciding against malaria vectors is experiencing a renaissance with the availability of environmentally friendly and target species-specific larvicides. In this study, we analyse the perception and acceptability of spraying surface water collections with the biological larvicide Bacillus thuringiensis israelensis in a single health district in Burkina Faso. A total of 12 focus group discussions and 12 key informant interviews were performed in 10 rural villages provided with coverage of various larvicide treatments (all breeding sites treated, the most productive breeding sites treated, and untreated control). Respondents' knowledge about the major risk factors for malaria transmission was generally good. Most interviewees stated they performed personal protective measures against vector mosquitoes including the use of bed nets and sometimes mosquito coils and traditional repellents. The acceptance of larviciding in and around the villages was high and the majority of respondents reported a relief in mosquito nuisance and malarial episodes. There was high interest in the project and demand for future continuation. This study showed that larviciding interventions received positive resonance from the population. People showed a willingness to be involved and financially support the program. The positive environment with high acceptance for larviciding programs would facilitate routine implementation. An essential factor for the future success of such programs would be inclusion in regional or national malaria control guidelines.

  1. Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission Across Seven Diverse ICEMR Network Sites.

    Science.gov (United States)

    Wilson, Mark L; Krogstad, Donald J; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U; Ndiaye, Daouda; Mathanga, Don P; Eapen, Alex

    2015-09-01

    A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. © The American Society of Tropical Medicine and Hygiene.

  2. Cytokine response during non-cerebral and cerebral malaria: evidence of a failure to control inflammation as a cause of death in African adults

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    Yakhya Dieye

    2016-05-01

    Full Text Available Background. With 214 million cases and 438,000 deaths in 2015, malaria remains one of the deadliest infectious diseases in tropical countries. Several species of the protozoan Plasmodium cause malaria. However, almost all the fatalities are due to Plasmodium falciparum, a species responsible for the severest cases including cerebral malaria. Immune response to Plasmodium falciparum infection is mediated by the production of pro-inflammatory cytokines, chemokines and growth factors whose actions are crucial for the control of the parasites. Following this response, the induction of anti-inflammatory immune mediators downregulates the inflammation thus preventing its adverse effects such as damages to various organs and death. Methods. We performed a retrospective, nonprobability sampling study using clinical data and sera samples from patients, mainly adults, suffering of non-cerebral or cerebral malaria in Dakar, Sénégal. Healthy individuals residing in the same area were included as controls. We measured the serum levels of 29 biomarkers including growth factors, chemokines, inflammatory and anti-inflammatory cytokines. Results. We found an induction of both pro- and anti-inflammatory immune mediators during malaria. The levels of pro-inflammatory biomarkers were higher in the cerebral malaria than in the non-cerebral malaria patients. In contrast, the concentrations of anti-inflammatory cytokines were comparable in these two groups or lower in CM patients. Additionally, four pro-inflammatory biomarkers were significantly increased in the deceased of cerebral malaria compared to the survivors. Regarding organ damage, kidney failure was significantly associated with death in adults suffering of cerebral malaria. Conclusions. Our results suggest that a poorly controlled inflammatory response determines a bad outcome in African adults suffering of cerebral malaria.

  3. An entomopathogenic fungus for control of adult African malaria mosquitoes

    NARCIS (Netherlands)

    Scholte, E.J.; Ng'habi, K.R.N.; Kihonda, J.; Takken, W.; Paaijmans, K.P.; Abdulla, S.; Killeen, G.F.; Knols, B.G.J.

    2005-01-01

    Biological control of malaria mosquitoes in Africa has rarely been used in vector control programs. Recent developments in this field show that certain fungi are virulent to adult Anopheles mosquitoes. Practical delivery of an entomopathogenic fungus that infected and killed adult Anopheles gambiae,

  4. Modelling the influence of climate on malaria occurrence in Chimoio Municipality, Mozambique.

    Science.gov (United States)

    Ferrão, João Luís; Mendes, Jorge M; Painho, Marco

    2017-05-25

    Mozambique was recently ranked fifth in the African continent for the number of cases of malaria. In Chimoio municipality cases of malaria are increasing annually, contrary to the decreasing trend in Africa. As malaria transmission is influenced to a large extent by climatic conditions, modelling this relationship can provide useful insights for designing precision health measures for malaria control. There is a scarcity of information on the association between climatic variability and malaria transmission risk in Mozambique in general, and in Chimoio in particular. Therefore, the aim of this study is to model the association between climatic variables and malaria cases on a weekly basis, to help policy makers find adequate measures for malaria control and eradication. Time series analysis was conducted using data on weekly climatic variables and weekly malaria cases (counts) in Chimoio municipality, from 2006 to 2014. All data were analysed using SPSS-20, R 3.3.2 and BioEstat 5.0. Cross-correlation analysis, linear processes, namely ARIMA models and regression modelling, were used to develop the final model. Between 2006 and 2014, 490,561 cases of malaria were recorded in Chimoio. Both malaria and climatic data exhibit weekly and yearly systematic fluctuations. Cross-correlation analysis showed that mean temperature and precipitation present significantly lagged correlations with malaria cases. An ARIMA model (2,1,0) (2,1,1) 52 , and a regression model for a Box-Cox transformed number of malaria cases with lags 1, 2 and 3 of weekly malaria cases and lags 6 and 7 of weekly mean temperature and lags 12 of precipitation were fitted. Although, both produced similar widths for prediction intervals, the last was able to anticipate malaria outbreak more accurately. The Chimoio climate seems ideal for malaria occurrence. Malaria occurrence peaks during January to March in Chimoio. As the lag effect between climatic events and malaria occurrence is important for the

  5. A phase 2b randomized, controlled trial of the efficacy of the GMZ2 malaria vaccine in African children

    DEFF Research Database (Denmark)

    Sirima, Sodiomon B; Mordmüller, Benjamin; Milligan, Paul

    2016-01-01

    randomized to receive three injections of either 100μg GMZ2 adjuvanted with aluminum hydroxide or a control vaccine (rabies) four weeks apart and were followed up for six months to measure the incidence of malaria defined as fever or history of fever and a parasite density ⩾5000/μL. RESULTS: A cohort of 1849...... in the rabies vaccine group and 14 in the GMZ2 group), VE 27% (95% CI -44%, 63%). CONCLUSIONS: GMZ2 is the first blood-stage malaria vaccine to be evaluated in a large multicenter trial. GMZ2 was well tolerated and immunogenic, and reduced the incidence of malaria, but efficacy would need to be substantially...

  6. Community knowledge, attitudes and practices (KAP on malaria in Swaziland: A country earmarked for malaria elimination

    Directory of Open Access Journals (Sweden)

    Govender Dayanandan

    2009-02-01

    Full Text Available Abstract Background The potential contribution of knowledge, attitudes and practices (KAP studies to malaria research and control has not received much attention in most southern African countries. This study investigated the local communities' understanding of malaria transmission, recognition of signs and symptoms, perceptions of cause, treatment-seeking patterns, preventive measures and practices in order to inform the country's proposed malaria elimination programme in Swaziland. Methods A descriptive cross-sectional survey was undertaken in four Lubombo Spatial Development Initiative (LSDI sentinel sites in Swaziland. These sentinel sites share borders with Mozambique. A structured questionnaire was administered to 320 randomly selected households. Only one adult person was interviewed per household. The interviewees were the heads of households and in the absence of the heads of households responsible adults above 18 years were interviewed. Results A substantial number of research participants showed reasonable knowledge of malaria, including correct association between malaria and mosquito bites, its potential fatal consequences and correct treatment practices. Almost 90% (n = 320 of the respondents stated that they would seek treatment within 24 hours of onset of malaria symptoms, with health facilities as their first treatment option. Most people (78% perceived clinics and vector control practices as central to treating and preventing malaria disease. Indoor residual spraying (IRS coverage and bed net ownership were 87.2% and 38.8%, respectively. IRS coverage was in agreement with the World Health Organization's (WHO recommendation of more than 80% within the targeted communities. Conclusion Despite fair knowledge of malaria in Swaziland, there is a need for improving the availability of information through the preferred community channels, such as tinkhundlas (districts, as well as professional health routes. This recommendation

  7. 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.

  8. A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania

    Directory of Open Access Journals (Sweden)

    Randall A. Kramer

    2014-05-01

    Full Text Available The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1 a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2 vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding. The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.

  9. A randomized longitudinal factorial design to assess malaria vector control and disease management interventions in rural Tanzania.

    Science.gov (United States)

    Kramer, Randall A; Mboera, Leonard E G; Senkoro, Kesheni; Lesser, Adriane; Shayo, Elizabeth H; Paul, Christopher J; Miranda, Marie Lynn

    2014-05-16

    The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.

  10. PENGETAHUAN, SIKAP DAN PERILAKU (PSP MASYARAKAT TENTANG MALARIA DI DAERAH LOMBOK TIMUR, NUSA TENGGARA BARAT

    Directory of Open Access Journals (Sweden)

    Supratman Sukowati

    2012-11-01

    Full Text Available Malaria remains a major health problem in West Nusa Tenggara. The knowledge, attitude and practices (KAP of the community is one of the important factors for vector borne diseases control including malaria control. In order to provide basic data for malaria control measures, a study on the KAP of the people regarding malaria and its control were carried out in rural area of sub-district Labuhan Haji, East Lombok, West Nusa Tenggara in year of 1999. The valid questionnaire respondents were 99, with a 51% of male respondents and 52% of female respondents were not graduated from primary school. More than 80% respondents have ever heard about malaria, though only 46,6% of them know the characteristic of malaria clinical symptom, such as high fever, chill and sweating. The 77,8% of respondent have had experienced with malaria, so they know that malaria is dangerous. The KAP of community in East Lombok to malaria do not support the malaria control program, this due tothe low education as well as low social economic status.

  11. Strengthening tactical planning and operational frameworks for vector control: the roadmap for malaria elimination in Namibia.

    Science.gov (United States)

    Chanda, Emmanuel; Ameneshewa, Birkinesh; Angula, Hans A; Iitula, Iitula; Uusiku, Pentrina; Trune, Desta; Islam, Quazi M; Govere, John M

    2015-08-05

    Namibia has made tremendous gains in malaria control and the epidemiological trend of the disease has changed significantly over the past years. In 2010, the country reoriented from the objective of reducing disease morbidity and mortality to the goal of achieving malaria elimination by 2020. This manuscript outlines the processes undertaken in strengthening tactical planning and operational frameworks for vector control to facilitate expeditious malaria elimination in Namibia. The information sources for this study included all available data and accessible archived documentary records on malaria vector control in Namibia. A methodical assessment of published and unpublished documents was conducted via a literature search of online electronic databases, Google Scholar, PubMed and WHO, using a combination of search terms. To attain the goal of elimination in Namibia, systems are being strengthened to identify and clear all infections, and significantly reduce human-mosquito contact. Particularly, consolidating vector control for reducing transmission at the identified malaria foci will be critical for accelerated malaria elimination. Thus, guarding against potential challenges and the need for evidence-based and sustainable vector control instigated the strengthening of strategic frameworks by: adopting the integrated vector management (IVM) strategy; initiating implementation of the global plan for insecticide resistance management (GPIRM); intensifying malaria vector surveillance; improving data collection and reporting systems on DDT; updating the indoor residual spraying (IRS) data collection and reporting tool; and, improving geographical reconnaissance using geographical information system-based satellite imagery. Universal coverage with IRS and long-lasting insecticidal nets, supplemented by larval source management in the context of IVM and guided by vector surveillance coupled with rational operationalization of the GPIRM, will enable expeditious

  12. Can slide positivity rates predict malaria transmission?

    Directory of Open Access Journals (Sweden)

    Bi Yan

    2012-04-01

    Full Text Available Abstract Background Malaria is a significant threat to population health in the border areas of Yunnan Province, China. How to accurately measure malaria transmission is an important issue. This study aimed to examine the role of slide positivity rates (SPR in malaria transmission in Mengla County, Yunnan Province, China. Methods Data on annual malaria cases, SPR and socio-economic factors for the period of 1993 to 2008 were obtained from the Center for Disease Control and Prevention (CDC and the Bureau of Statistics, Mengla, China. Multiple linear regression models were conducted to evaluate the relationship between socio-ecologic factors and malaria incidence. Results The results show that SPR was significantly positively associated with the malaria incidence rates. The SPR (β = 1.244, p = 0.000 alone and combination (SPR, β = 1.326, p  Conclusion SPR is a strong predictor of malaria transmission, and can be used to improve the planning and implementation of malaria elimination programmes in Mengla and other similar locations. SPR might also be a useful indicator of malaria early warning systems in China.

  13. [Malaria in Guiana. II. The characteristics of different foci and antimalarial control].

    Science.gov (United States)

    Mouchet, J; Nadire-Galliot, M; Gay, F; Poman, J P; Lepelletier, L; Claustre, J; Bellony, S

    1989-01-01

    In French Guiana, the distribution of malaria in foci inhabited by quite different ethnic groups calls for specific studies. Along the Oyapock on the Brasilian border and along the Litani on the Surinam border, incidence among American Indians and Creoles ranges from 300 and 900 per thousand; Plasmodium falciparum accounts for 65% and P. vivax for 35%. Along the middle and lower Maroni on the Surinam border, the Boni and Ndjukas Negroes move freely through the frontier and since the civil strife Surinamese used to attend health centres of Guiana. Therefore it is difficult to find the sources of contamination and the incidence among French citizens; P. falciparum is the only parasite recorded in this focus. In 1987 a small outbreak mainly due to P. vivax, occurred in a Lao refugees village in the hinterland. The coastal foci harbour large communities of Haitian and Brazilian migrants. The vector is Anopheles darlingi and up to now there is no evidence that other species could be involved. The rise of malaria despite of control measures involves several factors: the house spraying is no more accepted by a large percentage of house holders and the alternative larviciding has only a limited efficacy; the houses of American Indians have no walls to be sprayed; there is a continuous introduction of parasites by migrants. It has been said that vectors have change their behaviour toward exophily but such a statement has not yet been supported by evidence. All these factors should be taken in account to improve malaria control.

  14. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2013-01-01

    Full Text Available Abstract Background While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS, data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO encourages the adoption of the integrated vector management (IVM strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  15. Malaria in the Republic of Djibouti, 1998-2009.

    Science.gov (United States)

    Ollivier, Lénaïck; Nevin, Remington L; Darar, Houssein Y; Bougère, Jacques; Saleh, Moustapha; Gidenne, Stéphane; Maslin, Jérôme; Anders, Dietmar; Decam, Christophe; Todesco, Alain; Khaireh, Bouh A; Ahmed, Ammar A

    2011-09-01

    Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention.

  16. Novel acetylcholinesterase target site for malaria mosquito control.

    Directory of Open Access Journals (Sweden)

    Yuan-Ping Pang

    2006-12-01

    Full Text Available Current anticholinesterase pesticides were developed during World War II and are toxic to mammals because they target a catalytic serine residue of acetylcholinesterases (AChEs in insects and in mammals. A sequence analysis of AChEs from 73 species and a three-dimensional model of a malaria-carrying mosquito (Anopheles gambiae AChE (AgAChE reported here show that C286 and R339 of AgAChE are conserved at the opening of the active site of AChEs in 17 invertebrate and four insect species, respectively. Both residues are absent in the active site of AChEs of human, monkey, dog, cat, cattle, rabbit, rat, and mouse. The 17 invertebrates include house mosquito, Japanese encephalitis mosquito, African malaria mosquito, German cockroach, Florida lancelet, rice leaf beetle, African bollworm, beet armyworm, codling moth, diamondback moth, domestic silkworm, honey bee, oat or wheat aphid, the greenbug, melon or cotton aphid, green peach aphid, and English grain aphid. The four insects are house mosquito, Japanese encephalitis mosquito, African malaria mosquito, and German cockroach. The discovery of the two invertebrate-specific residues enables the development of effective and safer pesticides that target the residues present only in mosquito AChEs rather than the ubiquitous serine residue, thus potentially offering an effective control of mosquito-borne malaria. Anti-AgAChE pesticides can be designed to interact with R339 and subsequently covalently bond to C286. Such pesticides would be toxic to mosquitoes but not to mammals.

  17. Combining fungal biopesticides and insecticide-treated bednets to enhance malaria control.

    Science.gov (United States)

    Hancock, Penelope A

    2009-10-01

    In developing strategies to control malaria vectors, there is increased interest in biological methods that do not cause instant vector mortality, but have sublethal and lethal effects at different ages and stages in the mosquito life cycle. These techniques, particularly if integrated with other vector control interventions, may produce substantial reductions in malaria transmission due to the total effect of alterations to multiple life history parameters at relevant points in the life-cycle and transmission-cycle of the vector. To quantify this effect, an analytically tractable gonotrophic cycle model of mosquito-malaria interactions is developed that unites existing continuous and discrete feeding cycle approaches. As a case study, the combined use of fungal biopesticides and insecticide treated bednets (ITNs) is considered. Low values of the equilibrium EIR and human prevalence were obtained when fungal biopesticides and ITNs were combined, even for scenarios where each intervention acting alone had relatively little impact. The effect of the combined interventions on the equilibrium EIR was at least as strong as the multiplicative effect of both interventions. For scenarios representing difficult conditions for malaria control, due to high transmission intensity and widespread insecticide resistance, the effect of the combined interventions on the equilibrium EIR was greater than the multiplicative effect, as a result of synergistic interactions between the interventions. Fungal biopesticide application was found to be most effective when ITN coverage was high, producing significant reductions in equilibrium prevalence for low levels of biopesticide coverage. By incorporating biological mechanisms relevant to vectorial capacity, continuous-time vector population models can increase their applicability to integrated vector management.

  18. Attacking the mosquito on multiple fronts: Insights from the Vector Control Optimization Model (VCOM for malaria elimination.

    Directory of Open Access Journals (Sweden)

    Samson S Kiware

    Full Text Available Despite great achievements by insecticide-treated nets (ITNs and indoor residual spraying (IRS in reducing malaria transmission, it is unlikely these tools will be sufficient to eliminate malaria transmission on their own in many settings today. Fortunately, field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources. The majority of these experiments were performed to test a single vector control intervention in isolation; however, there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions.We have developed a model of mosquito population dynamic to describe the mosquito life and feeding cycles and to optimize the impact of vector control intervention combinations at suppressing mosquito populations. The model simulations were performed for the main three malaria vectors in sub-Saharan Africa, Anopheles gambiae s.s, An. arabiensis and An. funestus. We considered areas having low, moderate and high malaria transmission, corresponding to entomological inoculation rates of 10, 50 and 100 infective bites per person per year, respectively. In all settings, we considered baseline ITN coverage of 50% or 80% in addition to a range of other vector control tools to interrupt malaria transmission. The model was used to sweep through parameters space to select the best optimal intervention packages. Sample model simulations indicate that, starting with ITNs at a coverage of 50% (An. gambiae s.s. and An. funestus or 80% (An. arabiensis and adding interventions that do not require human participation (e.g. larviciding at 80% coverage, endectocide treated cattle at 50% coverage and attractive toxic sugar baits at 50% coverage may be sufficient to suppress all the three species to an extent required to achieve local malaria

  19. Increased malaria transmission around irrigation schemes in Ethiopia and the potential of canal water management for malaria vector control.

    Science.gov (United States)

    Kibret, Solomon; Wilson, G Glenn; Tekie, Habte; Petros, Beyene

    2014-09-13

    Irrigation schemes have been blamed for the increase in malaria in many parts of sub-Saharan Africa. However, proper water management could help mitigate malaria around irrigation schemes in this region. This study investigates the link between irrigation and malaria in Central Ethiopia. Larval and adult mosquitoes were collected fortnightly between November 2009 and October 2010 from two irrigated and two non-irrigated (control) villages in the Ziway area, Central Ethiopia. Daily canal water releases were recorded during the study period and bi-weekly correlation analysis was done to determine relationships between canal water releases and larval/adult vector densities. Blood meal sources (bovine vs human) and malaria sporozoite infection were tested using enzyme-linked immunosorbent assay (ELISA). Monthly malaria data were also collected from central health centre of the study villages. Monthly malaria incidence was over six-fold higher in the irrigated villages than the non-irrigated villages. The number of anopheline breeding habitats was 3.6 times higher in the irrigated villages than the non-irrigated villages and the most common Anopheles mosquito breeding habitats were waterlogged field puddles, leakage pools from irrigation canals and poorly functioning irrigation canals. Larval and adult anopheline densities were seven- and nine-fold higher in the irrigated villages than in the non-irrigated villages, respectively, during the study period. Anopheles arabiensis was the predominant species in the study area. Plasmodium falciparum sporozoite rates of An. arabiensis and Anopheles pharoensis were significantly higher in the irrigated villages than the non-irrigated villages. The annual entomological inoculation rate (EIR) calculated for the irrigated and non-irrigated villages were 34.8 and 0.25 P. falciparum infective bites per person per year, respectively. A strong positive correlation was found between bi-weekly anopheline larval density and canal water

  20. Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme

    Directory of Open Access Journals (Sweden)

    Das Ashis

    2013-01-01

    factors, the availability of acceptable care can modulate the community perceptions and practices on malaria management. The current community awareness on symptoms of malaria and prevention is fair, yet the prevention and treatment practices are not optimal. Promoting active community involvement and ownership in malaria control and management through strengthening community based organizations would be relevant. Further, timely availability of drugs and commodities at the community level can improve their confidence in the public health system.

  1. Reduction in malaria prevalence and increase in malaria awareness in endemic districts of Bangladesh.

    Science.gov (United States)

    Alam, Mohammad Shafiul; Kabir, Mohammad Moktadir; Hossain, Mohammad Sharif; Naher, Shamsun; Ferdous, Nur E Naznin; Khan, Wasif Ali; Mondal, Dinesh; Karim, Jahirul; Shamsuzzaman, A K M; Ahmed, Be-Nazir; Islam, Akramul; Haque, Rashidul

    2016-11-11

    Malaria is endemic in 13 districts of Bangladesh. A baseline malaria prevalence survey across the endemic districts of Bangladesh was conducted in 2007, when the prevalence was reported around 39.7 per 1000 population. After two rounds of Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)-funded intervention by the National Malaria Control Programme (NMCP) and a BRAC-led NGO consortium, a follow-up survey was conducted across the malaria-endemic districts of Bangladesh to measure the change in prevalence rate and in people's knowledge of malaria. The survey was carried out from August to November 2013 in 70 upazilas (sub-districts) of 13 malaria-endemic districts of Bangladesh, following the same multi-stage cluster sampling design and the same number of households enrolled during the baseline prevalence survey in 2007, to collect 9750 randomly selected blood samples. For on-the-spot diagnosis of malaria, a rapid diagnostic test was used. The household head or eldest person available was interviewed using a pre-coded structured questionnaire to collect data on the knowledge and awareness of malaria in the household. Based on a weighted calculation, the overall malaria prevalence was found to be 1.41 per 1000 population. The proportion of Plasmodium falciparum mono-infection was 77.78% while both Plasmodium vivax mono-infection and mixed infection of the two species were found to be 11.11%. Bandarban had the highest prevalence (6.67 per 1000 population). Knowledge of malaria signs, symptoms and mode of transmission were higher in the follow-up survey (97.26%) than the baseline survey. Use of bed nets for prevention of malaria was found to be high (90.15%) at respondent level. People's knowledge of selected parameters increased significantly during the follow-up survey compared to the baseline survey conducted in 2007. A reduced prevalence rate of malaria and increased level of knowledge were observed in the present malaria prevalence survey in Bangladesh.

  2. Knowledge, Perception and Control Practices of Malaria Vector ...

    African Journals Online (AJOL)

    Malaria remains one of the most devastating public health scourges especially in the tropics. Several studies have documented the prevalence of malaria among different vulnerable groups; however, an understanding of the communities' knowledge, perceptions and practices relating to malaria is crucial to the success of ...

  3. Reduction in serum sphingosine 1-phosphate concentration in malaria.

    Directory of Open Access Journals (Sweden)

    Chuchard Punsawad

    Full Text Available Sphingosine 1-phosphate (S1P is a lipid mediator formed by the metabolism of sphingomyelin which is involved in the endothelial permeability and inflammation. Although the plasma S1P concentration is reportedly decreased in patients with cerebral malaria, the role of S1P in malaria is still unclear. The purpose of this study was to examine the impact of malaria on circulating S1P concentration and its relationship with clinical data in malaria patients. Serum S1P levels were measured in 29 patients with P. vivax, 30 patients with uncomplicated P. falciparum, and 13 patients with complicated P. falciparum malaria on admission and on day 7, compared with healthy subjects (n = 18 as control group. The lowest level of serum S1P concentration was found in the complicated P. falciparum malaria group, compared with P. vivax, uncomplicated P. falciparum patients and healthy controls (all p < 0.001. In addition, serum S1P level was positively correlated with platelet count, hemoglobin and hematocrit levels in malaria patients. In conclusions, low levels of S1P are associated with the severity of malaria, and are correlated with thrombocytopenia and anemia. These findings highlight a role of S1P in the severity of malaria and support the use of S1P and its analogue as a novel adjuvant therapy for malaria complications.

  4. The effect of holes in long-lasting insecticidal nets on malaria in Malawi: results from a case-control study.

    Science.gov (United States)

    Minta, Anna A; Landman, Keren Z; Mwandama, Dyson A; Shah, Monica P; Eng, Jodi L Vanden; Sutcliffe, James F; Chisaka, Joseph; Lindblade, Kim A; Mathanga, Don P; Steinhardt, Laura C

    2017-10-02

    Long-lasting insecticidal nets (LLINs) are a cornerstone of malaria prevention. Holes develop in LLINs over time and compromise their physical integrity, but how holes affect malaria transmission risk is not well known. After a nationwide mass LLIN distribution in July 2012, a study was conducted to assess the relationship between LLIN damage and malaria. From March to September 2013, febrile children ages 6-59 months who consistently slept under LLINs (every night for 2 weeks before illness onset) were enrolled in a case-control study at Machinga District Hospital outpatient department. Cases were positive for Plasmodium falciparum asexual parasites by microscopy while controls were negative. Digital photographs of participants' LLINs were analysed using an image-processing programme to measure holes. Total hole area was classified by quartiles and according to the World Health Organization's proportionate hole index (pHI) cut-offs [ 790 cm 2 (too torn)]. Number of holes by location and size, and total hole area, were compared between case and control LLINs using non-parametric analyses and logistic regression. Of 248 LLINs analysed, 97 (39%) were from cases. Overall, 86% of LLINs had at least one hole. The median number of holes of any size was 9 [interquartile range (IQR) 3, 22], and most holes were located in the lower halves of the nets [median 7 (IQR 2, 16)]. There were no differences in number or location of holes between LLINs used by cases and controls. The median total hole area was 10 cm 2 (IQR 2, 125) for control LLINs and 8 cm 2 (IQR 2, 47) for case LLINs (p = 0.10). Based on pHI, 109 (72%) control LLINs and 83 (86%) case LLINs were in "good" condition. Multivariable modeling showed no association between total hole area and malaria, controlling for child age, caregiver education, and iron versus thatched roof houses. LLIN holes were not associated with increased odds of malaria in this study. However, most of the LLINs were in relatively good

  5. Salivary Secretion and Composition in Malaria: A Case-control Study

    African Journals Online (AJOL)

    Summary: No previous studies have documented changes in salivary secretion in patients with malaria. This study aimed to compare salivary secretion and composition in malaria positive and malaria negative individuals. Ninety participants composed of 40 malaria parasite positive and 50 malaria parasite negative ...

  6. Assessment of humoral immune responses to blood-stage malaria antigens following ChAd63-MVA immunization, controlled human malaria infection and natural exposure.

    Science.gov (United States)

    Biswas, Sumi; Choudhary, Prateek; Elias, Sean C; Miura, Kazutoyo; Milne, Kathryn H; de Cassan, Simone C; Collins, Katharine A; Halstead, Fenella D; Bliss, Carly M; Ewer, Katie J; Osier, Faith H; Hodgson, Susanne H; Duncan, Christopher J A; O'Hara, Geraldine A; Long, Carole A; Hill, Adrian V S; Draper, Simon J

    2014-01-01

    The development of protective vaccines against many difficult infectious pathogens will necessitate the induction of effective antibody responses. Here we assess humoral immune responses against two antigens from the blood-stage merozoite of the Plasmodium falciparum human malaria parasite--MSP1 and AMA1. These antigens were delivered to healthy malaria-naïve adult volunteers in Phase Ia clinical trials using recombinant replication-deficient viral vectors--ChAd63 to prime the immune response and MVA to boost. In subsequent Phase IIa clinical trials, immunized volunteers underwent controlled human malaria infection (CHMI) with P. falciparum to assess vaccine efficacy, whereby all but one volunteer developed low-density blood-stage parasitemia. Here we assess serum antibody responses against both the MSP1 and AMA1 antigens following i) ChAd63-MVA immunization, ii) immunization and CHMI, and iii) primary malaria exposure in the context of CHMI in unimmunized control volunteers. Responses were also assessed in a cohort of naturally-immune Kenyan adults to provide comparison with those induced by a lifetime of natural malaria exposure. Serum antibody responses against MSP1 and AMA1 were characterized in terms of i) total IgG responses before and after CHMI, ii) responses to allelic variants of MSP1 and AMA1, iii) functional growth inhibitory activity (GIA), iv) IgG avidity, and v) isotype responses (IgG1-4, IgA and IgM). These data provide the first in-depth assessment of the quality of adenovirus-MVA vaccine-induced antibody responses in humans, along with assessment of how these responses are modulated by subsequent low-density parasite exposure. Notable differences were observed in qualitative aspects of the human antibody responses against these malaria antigens depending on the means of their induction and/or exposure of the host to the malaria parasite. Given the continued clinical development of viral vectored vaccines for malaria and a range of other diseases

  7. Assessment of humoral immune responses to blood-stage malaria antigens following ChAd63-MVA immunization, controlled human malaria infection and natural exposure.

    Directory of Open Access Journals (Sweden)

    Sumi Biswas

    Full Text Available The development of protective vaccines against many difficult infectious pathogens will necessitate the induction of effective antibody responses. Here we assess humoral immune responses against two antigens from the blood-stage merozoite of the Plasmodium falciparum human malaria parasite--MSP1 and AMA1. These antigens were delivered to healthy malaria-naïve adult volunteers in Phase Ia clinical trials using recombinant replication-deficient viral vectors--ChAd63 to prime the immune response and MVA to boost. In subsequent Phase IIa clinical trials, immunized volunteers underwent controlled human malaria infection (CHMI with P. falciparum to assess vaccine efficacy, whereby all but one volunteer developed low-density blood-stage parasitemia. Here we assess serum antibody responses against both the MSP1 and AMA1 antigens following i ChAd63-MVA immunization, ii immunization and CHMI, and iii primary malaria exposure in the context of CHMI in unimmunized control volunteers. Responses were also assessed in a cohort of naturally-immune Kenyan adults to provide comparison with those induced by a lifetime of natural malaria exposure. Serum antibody responses against MSP1 and AMA1 were characterized in terms of i total IgG responses before and after CHMI, ii responses to allelic variants of MSP1 and AMA1, iii functional growth inhibitory activity (GIA, iv IgG avidity, and v isotype responses (IgG1-4, IgA and IgM. These data provide the first in-depth assessment of the quality of adenovirus-MVA vaccine-induced antibody responses in humans, along with assessment of how these responses are modulated by subsequent low-density parasite exposure. Notable differences were observed in qualitative aspects of the human antibody responses against these malaria antigens depending on the means of their induction and/or exposure of the host to the malaria parasite. Given the continued clinical development of viral vectored vaccines for malaria and a range of other

  8. Can timely vector control interventions triggered by atypical environmental conditions prevent malaria epidemics? A case-study from Wajir County, Kenya.

    Directory of Open Access Journals (Sweden)

    Peter Maes

    Full Text Available Atypical environmental conditions with drought followed by heavy rainfall and flooding in arid areas in sub-Saharan Africa can lead to explosive epidemics of malaria, which might be prevented through timely vector-control interventions.Wajir County in Northeast Kenya is classified as having seasonal malaria transmission. The aim of this study was to describe in Wajir town the environmental conditions, the scope and timing of vector-control interventions and the associated resulting burden of malaria at two time periods (1996-1998 and 2005-2007.This is a cross-sectional descriptive and ecological study using data collected for routine program monitoring and evaluation.In both time periods, there were atypical environmental conditions with drought and malnutrition followed by massive monthly rainfall resulting in flooding and animal/human Rift Valley Fever. In 1998, this was associated with a large and explosive malaria epidemic (weekly incidence rates peaking at 54/1,000 population/week with vector-control interventions starting over six months after the massive rainfall and when the malaria epidemic was abating. In 2007, vector-control interventions started sooner within about three months after the massive rainfall and no malaria epidemic was recorded with weekly malaria incidence rates never exceeding 0.5 per 1,000 population per week.Did timely vector-control interventions in Wajir town prevent a malaria epidemic? In 2007, the neighboring county of Garissa experienced similar climatic events as Wajir, but vector-control interventions started six months after the heavy un-seasonal rainfall and large scale flooding resulted in a malaria epidemic with monthly incidence rates peaking at 40/1,000 population. In conclusion, this study suggests that atypical environmental conditions can herald a malaria outbreak in certain settings. In turn, this should alert responsible stakeholders about the need to act rapidly and preemptively with appropriate

  9. Morbidity from falciparum malaria in Natal/KwaZulu | Soni | South ...

    African Journals Online (AJOL)

    Haemoglobin and leucocyte counts were also measured in 37 control subjects without malaria. The commonest symptoms were persistent headache (100%), rigors (98%) and myalgia (93%). None of the patients presented with coma, pulmonary oedema, hypoglycaemia or algid malaria. Splenomegaly was found in 49%, ...

  10. An ecosystem approach to malaria control in an urban setting Uma abordagem ecossistêmica ao controle da malária em contexto urbano

    Directory of Open Access Journals (Sweden)

    Gabriel Carrasquilla

    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.Os autores implementaram um projeto de pesquisa voltado ao fortalecimento do governo local e da comunidade com vistas à estratégia sustentável de controle da malária. O projeto iniciou com diagnóstico prévio, incluindo prevalência da malária, entomologia, KAP (conhecimentos, atitudes e práticas e oferta de serviços de saúde; a seguir, realizou-se inquérito epidemiológico para identificar fatores de risco associados à malária e a escolha de medidas de intervenção adequadas. O programa foi avaliado após cinco anos. Ao adotar a abordagem ecossistêmica para re-analisar os dados, o artigo discute como a malária surge a partir da interação complexa entre fatores culturais, econômicos, ecológicos, sociais e individuais. Medidas de intervenção exigem abordagem intersetorial e transdisciplinar ainda não existente. A

  11. Factors impeding the acceptability and use of malaria preventive measures: implications for malaria elimination in eastern Rwanda

    NARCIS (Netherlands)

    Ingabire, Chantal Marie; Rulisa, Alexis; van Kempen, Luuk; Muvunyi, Claude; Koenraadt, Constantianus J. M.; van Vugt, Michele; Mutesa, Leon; van den Borne, Bart; Alaii, Jane

    2015-01-01

    Long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS) and malaria case treatment with artemisinin-based combination therapy (ACT) have been proven to significantly reduce malaria, but may not necessarily lead to malaria elimination. This study explored factors hindering the

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

    NARCIS (Netherlands)

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

    2012-01-01

    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

  13. Mixture for Controlling Insecticide-Resistant Malaria Vectors

    OpenAIRE

    Pennetier, Cédric; Costantini, Carlo; Corbel, Vincent; Licciardi, Séverine; Dabire, R. K.; Lapied, B.; Chandre, Fabrice; Hougard, Jean-Marc

    2008-01-01

    The spread of resistance to pyrethroids in the major Afrotropical malaria vectors Anopheles gambiae s.s. necessitates the development of new strategies to control resistant mosquito populations. To test the efficacy of nets treated with repellent and insecticide against susceptible and insecticide-resistant An. gambiae mosquito populations, we impregnated mosquito bed nets with an insect repellent mixed with a low dose of organophosphorous insecticide and tested them in a rice-growing area ne...

  14. International Advocacy against DDT and Other Public Health Insecticides for Malaria Control

    Science.gov (United States)

    2011-01-19

    2010 Nov 15. 17. Betlem J. Importancia mundial de los resultados del proyecto : Programa Mundial sobre demonstracion y aumento de alterna- tivas...Demonstration of Sustainable Alternatives for Malaria Vector Control without the Use of DDT in Mexico and Central America”], Proyecto DDT/PNUMA/GEF/OPS [DDT...epidemiológico de la malaria en las comunidades de los proyectos demostrativos en Meso América. Presented at V Reunion del Comite Directivo “Programa

  15. Community-based biological control of malaria mosquitoes using Bacillus thuringiensis var. israelensis (Bti) in Rwanda

    NARCIS (Netherlands)

    Ingabire, Chantal Marie; Hakizimana, Emmanuel; Rulisa, Alexis; Kateera, Fredrick; Borne, Van Den Bart; Muvunyi, Claude Mambo; Mutesa, Leon; Vugt, van Michelle; Koenraadt, Constantianus J.M.; Takken, Willem; Alaii, Jane

    2017-01-01

    Background: Targeting the aquatic stages of malaria vectors via larval source management (LSM) in collaboration with local communities could accelerate progress towards malaria elimination when deployed in addition to existing vector control strategies. However, the precise role that communities

  16. [Current malaria situation in the Republic of Kazakhstan].

    Science.gov (United States)

    Bismil'din, F B; Shapieva, Zh Zh; Anpilova, E N

    2001-01-01

    The Republic of Kazakhstan is situated in the northern hemisphere on the boundary of two continents--Europe and Asia--at a longitude of 45 degrees E--87 degrees E and a latitude of 40 degrees N--55 degrees N. The total area of the republic is 2,724,900 square kilometers. Kazakhstan shares a border with the Russian Federation to the north-west, north and east: the border between the two countries is almost 6500 km long. To the south, Kazakhstan shares a border with the Central Asian states of Turkmenistan (380 km), Uzbekistan (2300 km) and Kyrgystan (980 km). To the south-east, it shares a border with China (1460 km): to the west is the Caspian Sea (600 km). Thus, the total length of Kazakhstan's external borders is 12,000 km. Because of the geographical, natural and climatic features prevailing throughout most of the Republic, there is a potential danger that local transmission of malaria may begin again if the disease is imported from abroad. The areas most at risk are the Panfilov and Uigur raions of Almaty oblast, which share a border with malaria-endemic regions of China, and the Saryagash and Makhtaral' raions of South Kazakhstan oblast along the border with Uzbekistan. The Government of the Republic of Kazakhstan places particular emphasis on malaria prevention and control, taking into account the historical data about the prevalence of malaria from the late 1920s to the early 1940s, amounting to hundreds of thousands of cases every year. Government Decree No. 840 entitled "Urgent Measures to Protect the Population from Blood-Sucking Insects and Ticks Dangerous to Humans", which lays down measures for the control of malarial mosquitoes in the areas most susceptible to malaria resurgence, was adopted in 1996. The Ministry of Health of the Republic of Kazakhstan issued instructions in 1998 and 1999 which were designed to motivate all health facilities in the field of malaria prevention and control. At present, as part of the directives developed by the

  17. 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.

  18. Malaria in the Republic of Djibouti, 1998–2009

    Science.gov (United States)

    Ollivier, Lénaïck; Nevin, Remington L.; Darar, Houssein Y.; Bougère, Jacques; Saleh, Moustapha; Gidenne, Stéphane; Maslin, Jérôme; Anders, Dietmar; Decam, Christophe; Todesco, Alain; Khaireh, Bouh A.; Ahmed, Ammar A.

    2011-01-01

    Historically, native populations in the Republic of Djibouti have experienced only low and unstable malaria transmission and intermittent epidemics. In recent years, efforts at malaria control have been aggressively pursued. This study was performed to inform revised malaria prevention recommendations for military service members and international travelers to the country. Laboratory-confirmed cases of malaria documented at large medical facilities and within military and civilian health care systems in the Republic of Djibouti from 1998 to 2009 were reviewed. In recent years, fewer than 5% of febrile cases among the three largest passive surveillance systems were laboratory-confirmed as malaria, and incidence of confirmed malaria was well below 1/1,000 persons/year. As efforts in the Republic of Djibouti progress toward elimination, and in conjunction with continued efforts at surveillance, emphasizing mosquito-avoidance measures and standby emergency treatment will become reasonable recommendations for malaria prevention. PMID:21896822

  19. A systematic review and synthesis of the strengths and limitations of measuring malaria mortality through verbal autopsy.

    Science.gov (United States)

    Herrera, Samantha; Enuameh, Yeetey; Adjei, George; Ae-Ngibise, Kenneth Ayuurebobi; Asante, Kwaku Poku; Sankoh, Osman; Owusu-Agyei, Seth; Yé, Yazoume

    2017-10-23

    Lack of valid and reliable data on malaria deaths continues to be a problem that plagues the global health community. To address this gap, the verbal autopsy (VA) method was developed to ascertain cause of death at the population level. Despite the adoption and wide use of VA, there are many recognized limitations of VA tools and methods, especially for measuring malaria mortality. This study synthesizes the strengths and limitations of existing VA tools and methods for measuring malaria mortality (MM) in low- and middle-income countries through a systematic literature review. The authors searched PubMed, Cochrane Library, Popline, WHOLIS, Google Scholar, and INDEPTH Network Health and Demographic Surveillance System sites' websites from 1 January 1990 to 15 January 2016 for articles and reports on MM measurement through VA. article presented results from a VA study where malaria was a cause of death; article discussed limitations/challenges related to measurement of MM through VA. Two authors independently searched the databases and websites and conducted a synthesis of articles using a standard matrix. The authors identified 828 publications; 88 were included in the final review. Most publications were VA studies; others were systematic reviews discussing VA tools or methods; editorials or commentaries; and studies using VA data to develop MM estimates. The main limitation were low sensitivity and specificity of VA tools for measuring MM. Other limitations included lack of standardized VA tools and methods, lack of a 'true' gold standard to assess accuracy of VA malaria mortality. Existing VA tools and methods for measuring MM have limitations. Given the need for data to measure progress toward the World Health Organization's Global Technical Strategy for Malaria 2016-2030 goals, the malaria community should define strategies for improving MM estimates, including exploring whether VA tools and methods could be further improved. Longer term strategies should focus

  20. High Mobility and Low Use of Malaria Preventive Measures among the Jarai Male Youth along the Cambodia–Vietnam Border

    Science.gov (United States)

    Gryseels, Charlotte; Peeters Grietens, Koen; Dierickx, Susan; Xuan, Xa Nguyen; Uk, Sambunny; Bannister-Tyrrell, Melanie; Trienekens, Suzan; Ribera, Joan Muela; Hausmann-Muela, Susanna; Gerrets, René; D'Alessandro, Umberto; Sochantha, Tho; Coosemans, Marc; Erhart, Annette

    2015-01-01

    Malaria control along the Vietnam–Cambodia border presents a challenge for both countries' malaria elimination targets as the region is forested, inhabited by ethnic minority populations, and potentially characterized by early and outdoor malaria transmission. A mixed methods study assessed the vulnerability to malaria among the Jarai population living on both sides of the border in the provinces of Ratanakiri (Cambodia) and Gia Lai (Vietnam). A qualitative study generated preliminary hypotheses that were quantified in two surveys, one targeting youth (N = 498) and the other household leaders (N = 449). Jarai male youth, especially in Cambodia, had lower uptake of preventive measures (57.4%) and more often stayed overnight in the deep forest (35.8%) compared with the female youth and the adult population. Among male youth, a high-risk subgroup was identified that regularly slept at friends' homes or outdoors, who had fewer bed nets (32.5%) that were torn more often (77.8%). The vulnerability of Jarai youth to malaria could be attributed to the transitional character of youth itself, implying less fixed sleeping arrangements in nonpermanent spaces or non-bed sites. Additional tools such as long-lasting hammock nets could be suitable as they are in line with current practices. PMID:26283747

  1. Tanzanian Botanical Derivatives in the Control of Malaria Vectors ...

    African Journals Online (AJOL)

    This paper report on assessment of the chemicals derived from Tanzanian botanical resource as a viable source of safe, environmentally friendly and low cost mosquitocidal agents, but has yet to be developed into simple blends and formulations to be used in malaria control campaigns. Selection of bioactive plant species ...

  2. Evaluation of Renal Function in Pregnant Women with Malaria: A Case-Control Study in a Mesoendemic Area

    Directory of Open Access Journals (Sweden)

    Justice Afrifa

    2017-01-01

    Full Text Available Background. Malaria is known to have devastating effects on mortality in tropical and subtropical regions with the effect being magnified in people with weakened immunity such as those in pregnancy. We assessed the effect of malaria on renal function of pregnant women receiving antenatal care in a mesoendemic area of Ghana. Methodology. A case-control study that enrolled a total of 100 pregnant women (50 with confirmed gestational malaria as cases and 50 without malaria as controls. Sociodemographic characteristics, obstetric history (obtained with a questionnaire, urea, creatinine, sodium, and potassium were analyzed using a chemistry automated analyzer. Results. Plasma urea and creatinine were significantly increased (P=0.0003 and P<0.0001, resp. among cases compared to the controls. Also the levels of urea (P=0.033, creatinine (P=0.032, and parasitaemia (0.016 were significantly increased with increasing gestational age. Conclusion. Malaria has a significant impact on renal function (most importantly, urea and creatinine and is also significantly associated with increasing gestational age among our study participants.

  3. Malaria prevalence, spatial clustering and risk factors in a low endemic area of Eastern Rwanda: a cross sectional study

    NARCIS (Netherlands)

    Rulisa, Stephen; Kateera, Fredrick; Bizimana, Jean Pierre; Agaba, Steven; Dukuzumuremyi, Javier; Baas, Lisette; de Dieu Harelimana, Jean; Mens, Petra F.; Boer, Kimberly R.; de Vries, Peter J.

    2013-01-01

    Rwanda reported significant reductions in malaria burden following scale up of control intervention from 2005 to 2010. This study sought to; measure malaria prevalence, describe spatial malaria clustering and investigate for malaria risk factors among health-centre-presumed malaria cases and their

  4. Rapid reduction of malaria following introduction of vector control interventions in Tororo District, Uganda: a descriptive study.

    Science.gov (United States)

    Oguttu, David W; Matovu, Joseph K B; Okumu, David C; Ario, Alex R; Okullo, Allen E; Opigo, Jimmy; Nankabirwa, Victoria

    2017-05-30

    In 2012, Tororo District had the highest malaria burden in Uganda with community Plasmodium prevalence of 48%. To control malaria in the district, the Ministry of Health introduced universal distribution of long lasting insecticide-treated nets (LLINs) in 2013 and added indoor residual spraying (IRS) in 2014. This study assessed malaria incidence, test positivity rates and outpatient (OPD) attendance due to malaria before and after vector control interventions. This study was based on analysis of Health Management Information System (HMIS) secondary malaria surveillance data of 2,727,850 patient records in OPD registers of 61 health facilities from 2012 to 2015. The analysis estimated monthly malaria incidence for the entire population and also separately for malaria cases in OPD. Chi square for trends was used to analyse annual change in malaria incidence and logistic regression for monthly reduction. Following universal LLINs coverage, the annual mean monthly malaria incidence fell from 95 cases in 2013 to 76 cases per 1000 in 2014 with no significant monthly reduction (OR = 0.99, 95% CI 0.96-1.01, P = 0.37). Among children malaria incidence reduced from 130 to 100 cases per 1000 (OR = 0.98, 95% CI 0.97-1.00, P = 0.08) when LLINs were used alone in 2014, but declined to 45 per 1000 in 2015 when IRS was combined with LLINs (OR = 0.94, 95% CI 0.91-0.996, P malaria incidence reduced from 59 to 52 cases per 1000 (OR = 0.99, 95% CI 0.97-1.02, P = 0.8) when LLINs were used alone in 2014, but reduced significantly to 25 per 1000 in 2015 (OR = 0.91, 95% CI 0.88-0.94, P Malaria test positivity rate reduced from 57% in 2013 to 30% (Chi = 15, P malaria incidence was observed in Tororo District following the introduction of IRS in addition to LLINs. There was no significant reduction in malaria incidence following universal distribution of LLINs to communities before introduction of IRS.

  5. [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

  6. Field assessment of a novel spatial repellent for malaria control: a feasibility and acceptability study in Mondulkiri, Cambodia.

    Science.gov (United States)

    Liverani, Marco; Charlwood, Jacques Derek; Lawford, Harriet; Yeung, Shunmay

    2017-10-13

    Large-scale use of insecticide-treated nets and indoor residual spraying have contributed to a significant decrease in malaria transmission worldwide. Further reduction and progress towards elimination, however, require complementary control measures which can address the remaining gaps in protection from mosquito bites. Following the development of novel pyrethroids with high knockdown effects on malaria vectors, programmatic use of spatial repellents has been suggested as one potential strategy to fill the gaps. This report explores social and contextual factors that may influence the relevance, uptake and sustainable use of a spatial repellent in two remote villages in Mondulkiri province, Cambodia, with endemic malaria transmission. The repellent consisted of polyethylene emanators, held in an open plastic frame and impregnated with 10% metofluthrin. In a baseline survey, 90.9% of households in Ou Chra (n = 30/33) and 96.6% in Pu Cha (n = 57/59) were interviewed. Behavioural data were collected for all household occupants (n = 448). In both villages, there were times and places in which people remained exposed to mosquito bites. Prior to the installation of the repellent, 50.6 and 59.5% of respondents noted that bites occurred "very often" inside the house and in the outdoor area surrounding the house, respectively. Indoor biting was reported to occur more frequently in the evening, followed by at night, while outdoor biting occurred more frequently in the early morning. In a follow-up survey, spatial repellents were well received in both villages, although 63.2% of respondents would not replace bed nets with repellents. Most participants (96.6%) were willing to use the product again; the mean willingness to pay was US$ 0.3 per unit. A preference for local procurement methods emerged. Widespread use of spatial repellents would not fill all protective gaps, but, if their entomological efficacy can be ascertained, outdoor application has the potential to

  7. Are multilateral malaria research and control programs the most successful? Lessons from the past 100 years in Africa

    DEFF Research Database (Denmark)

    Alilio, Martin S; Bygbjerg, Ib C; Breman, Joel G

    2004-01-01

    and elimination activities was the connectedness and balance between malaria research and control especially, from 1892 to 1949. A combination of scientific originality, perseverance in research, integrated approaches, and social concern were the keys for success. The elimination of Anopheles gambiae from Upper...... Diseases at the World Health Organization in 1975. The initial highly encouraging operational results, largely obtained in temperate or subtropical areas where transmission was unstable, engendered undue expectations for the success of identical antimalarial measures elsewhere. Many were convinced...... that the eradication was in sight, such that support for malaria research virtually ceased. Young, bright scientists were discouraged from seeking a career in a discipline that appeared to soon become superfluous. It took more than three decades to modify antimalarial strategies and to rehabilitate long-term control...

  8. 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.

  9. Rapid identification of genes controlling virulence and immunity in malaria parasites

    KAUST Repository

    Abkallo, Hussein M.

    2017-07-13

    Identifying the genetic determinants of phenotypes that impact disease severity is of fundamental importance for the design of new interventions against malaria. Here we present a rapid genome-wide approach capable of identifying multiple genetic drivers of medically relevant phenotypes within malaria parasites via a single experiment at single gene or allele resolution. In a proof of principle study, we found that a previously undescribed single nucleotide polymorphism in the binding domain of the erythrocyte binding like protein (EBL) conferred a dramatic change in red blood cell invasion in mutant rodent malaria parasites Plasmodium yoelii. In the same experiment, we implicated merozoite surface protein 1 (MSP1) and other polymorphic proteins, as the major targets of strain-specific immunity. Using allelic replacement, we provide functional validation of the substitution in the EBL gene controlling the growth rate in the blood stages of the parasites.

  10. The Potential for Genetic Control of Malaria-Transmitting Mosquitoes. Report of a Consultants Group Meeting. Working Material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-07-01

    Since the beginning of the Joint FAO/IAEA Division Programme on the research and development of insect pest control methodology, emphasis has been placed on the basic and applied aspects of implementing the Sterile Insect Technique (SIT). Special emphasis has always been directed at the assembly of technological progress into workable systems that can be implemented in developing countries. The general intention is to solve problems associated with insect pests that have an adverse impact on public health and the production of food and fibre. For certain insects, SIT has proven to be a powerful method for control, but for a variety of reasons this technology has not been tried on an operational scale for most of the pest species of insects that exact a toll on the endeavors of humans. The Joint FAO/IAEA Division convened a Consultants Group Meeting to examine 'The Potential for Genetic Control of Malaria-Transmitting Mosquitoes', with emphasis to be placed on the SIT. A group of five scientists met, 26-30 April 1993, to examine the current status and the future potential of genetic control for malaria mosquitoes. In most of the tropical, developing countries, and to some extent in temperate regions of the world, Anopheles mosquitoes cause havoc by transmitting malaria, a dreaded disease that causes high mortality amongst children and diminishes productivity of adults. The importance of malaria as a deterrent to further economic growth in a large part of the world cannot be over-emphasized. Malaria is a severe problem because there are inadequacies in the technology available for control. As a result of the deliberations at the meeting, the consultants prepared a list of recommendations concerning the consensus opinions about the development of genetic control for malaria vector control. This report presents the findings and recommendations of the Consultants Group Meeting.

  11. The Potential for Genetic Control of Malaria-Transmitting Mosquitoes. Report of a Consultants Group Meeting. Working Material

    International Nuclear Information System (INIS)

    1993-01-01

    Since the beginning of the Joint FAO/IAEA Division Programme on the research and development of insect pest control methodology, emphasis has been placed on the basic and applied aspects of implementing the Sterile Insect Technique (SIT). Special emphasis has always been directed at the assembly of technological progress into workable systems that can be implemented in developing countries. The general intention is to solve problems associated with insect pests that have an adverse impact on public health and the production of food and fibre. For certain insects, SIT has proven to be a powerful method for control, but for a variety of reasons this technology has not been tried on an operational scale for most of the pest species of insects that exact a toll on the endeavors of humans. The Joint FAO/IAEA Division convened a Consultants Group Meeting to examine 'The Potential for Genetic Control of Malaria-Transmitting Mosquitoes', with emphasis to be placed on the SIT. A group of five scientists met, 26-30 April 1993, to examine the current status and the future potential of genetic control for malaria mosquitoes. In most of the tropical, developing countries, and to some extent in temperate regions of the world, Anopheles mosquitoes cause havoc by transmitting malaria, a dreaded disease that causes high mortality amongst children and diminishes productivity of adults. The importance of malaria as a deterrent to further economic growth in a large part of the world cannot be over-emphasized. Malaria is a severe problem because there are inadequacies in the technology available for control. As a result of the deliberations at the meeting, the consultants prepared a list of recommendations concerning the consensus opinions about the development of genetic control for malaria vector control. This report presents the findings and recommendations of the Consultants Group Meeting.

  12. Individual and household factors associated with ownership of long-lasting insecticidal nets and malaria infection in south-central Ethiopia: a case-control study.

    Science.gov (United States)

    Deressa, Wakgari

    2017-10-06

    A recent considerable decline in malaria morbidity and mortality in Ethiopia is likely to be followed by changes in the practice of effective preventive measures and malaria risk factors. This study aimed to identify determinants of long-lasting insecticidal nets (LLINs) ownership and risk of malaria infection. A matched case-control study of 191 case and 377 control households was conducted between October 2014 and November 2015 in Adami Tullu district in south-central Ethiopia. Cases were microscopy or rapid diagnostic test confirmed malaria patients identified at three health centers and nine health posts, and matched on age with two neighbourhood controls. Information was collected on socio-demographic factors, house structure, knowledge on malaria and ownership of LLINs. The logistic regression model was used to determine predictors of LLINs ownership and malaria infection. All cases were infections due to either Plasmodium falciparum (71.2%) or Plasmodium vivax (28.8%). About 31% of the study households had at least one LLINs. Significant determinants of LLINs ownership were household's head malaria knowledge [adjusted odds ratio (AOR) = 2.47, 95% confidence interval (CI) 1.44-4.22], educational status [read and write (AOR = 6.88, 95% CI 2.30-20.55), primary education or higher (AOR = 5.40, 95% CI 1.57-18.55)], farmer respondent (AOR = 0.35, 95% CI 0.17-0.76), having ≥ 3 sleeping areas (AOR = 6.71, 95% CI 2.40-18.77) and corrugated roof type (AOR = 2.49, 95% CI 1.36-4.58). This study was unable to identify important risk factors of malaria infection with regard to sex, household wealth index, house structure, ownership of LLINs, keeping livestock inside house, staying overnight outdoor or having malaria during the last 6 months. Household socio-economic status, educational status and knowledge on malaria were important predictors of LLINs ownership. Households with farmer respondents were less likely to own LLINs. Addressing these factors

  13. Plasmodium vivax hospitalizations in a monoendemic malaria region: severe vivax malaria?

    Science.gov (United States)

    Quispe, Antonio M; Pozo, Edwar; Guerrero, Edith; Durand, Salomón; Baldeviano, G Christian; Edgel, Kimberly A; Graf, Paul C F; Lescano, Andres G

    2014-07-01

    Severe malaria caused by Plasmodium vivax is no longer considered rare. To describe its clinical features, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura, Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill cases were compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malaria cases were reported, including 106 hospitalized cases, 81 of which fit the World Health Organization definition for severe malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval = 0.2-0.6%) with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%). Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill were older (38 versus 26 years old, P < 0.001), but similar in other regards. Severe vivax malaria monoinfection with critical illness is more common than previously thought. © The American Society of Tropical Medicine and Hygiene.

  14. Impact of odour-baited mosquito traps for malaria control

    NARCIS (Netherlands)

    Homan, T.

    2016-01-01

    The parasites belonging to the genus Plasmodium are the cause of the second deadliest infectious disease in the world, malaria. Sub Saharan Africa harbours more than 90% of malaria attributable mortality and morbidity, and most deaths occur in children under 18 years old. Malaria is transmitted

  15. Assessing malaria control in the Kassena-Nankana district of northern Ghana through repeated surveys using the RBM tools

    Directory of Open Access Journals (Sweden)

    Adjuik Martin

    2007-08-01

    Full Text Available Abstract Background The goal of Roll Back Malaria (RBM is to reduce malaria morbidity and mortality by 50% by the year 2010, and still further thereafter until the disease becomes no more a threat to public health. To contribute to the monitoring and evaluation process of this goal, two surveys were carried out in 2000 and 2003 in households and health facilities in the Kassena-Nankana district, northern Ghana using the RBM-WHO/AFRO monitoring and evaluation tools for malaria control activities. Methods Data were collected from mothers/caretakers on signs/symptoms of the most recent malaria attack for their under five year old children; the management actions that they took and their perception of health services provided at the health facilities, bednet use, antenatal attendance and place of delivery for the most recent pregnancy, malaria prophylaxis during their last pregnancy. Community health workers and herbalist/traditional healers were also interviewed about the types of health services they provide to community members. Results The results revealed a significant improvement in knowledge among mothers/caretakers over the three-year period; this affected caretakers' initial management of illnesses of their young children. The management in terms of the type and dosage of drugs used also improved significantly (p The intensification of malaria control activities and awareness creation in this district over a three year period had started demonstrating positive results towards reducing malaria disease burden. Conclusion Periodic performance assessments through surveys as described and prompt feedback of results to stakeholders in the locality serves as a catalyst to improving malaria control in malaria-endemic countries.

  16. A global model of malaria climate sensitivity: comparing malaria response to historic climate data based on simulation and officially reported malaria incidence

    Directory of Open Access Journals (Sweden)

    Edlund Stefan

    2012-09-01

    Full Text Available Abstract Background The role of the Anopheles vector in malaria transmission and the effect of climate on Anopheles populations are well established. Models of the impact of climate change on the global malaria burden now have access to high-resolution climate data, but malaria surveillance data tends to be less precise, making model calibration problematic. Measurement of malaria response to fluctuations in climate variables offers a way to address these difficulties. Given the demonstrated sensitivity of malaria transmission to vector capacity, this work tests response functions to fluctuations in land surface temperature and precipitation. Methods This study of regional sensitivity of malaria incidence to year-to-year climate variations used an extended Macdonald Ross compartmental disease model (to compute malaria incidence built on top of a global Anopheles vector capacity model (based on 10 years of satellite climate data. The predicted incidence was compared with estimates from the World Health Organization and the Malaria Atlas. The models and denominator data used are freely available through the Eclipse Foundation’s Spatiotemporal Epidemiological Modeller (STEM. Results Although the absolute scale factor relating reported malaria to absolute incidence is uncertain, there is a positive correlation between predicted and reported year-to-year variation in malaria burden with an averaged root mean square (RMS error of 25% comparing normalized incidence across 86 countries. Based on this, the proposed measure of sensitivity of malaria to variations in climate variables indicates locations where malaria is most likely to increase or decrease in response to specific climate factors. Bootstrapping measures the increased uncertainty in predicting malaria sensitivity when reporting is restricted to national level and an annual basis. Results indicate a potential 20x improvement in accuracy if data were available at the level ISO 3166–2

  17. The epidemiology of Plasmodium vivax and Plasmodium falciparum malaria in China, 2004-2012: from intensified control to elimination.

    Science.gov (United States)

    Zhang, Qian; Lai, Shengjie; Zheng, Canjun; Zhang, Honglong; Zhou, Sheng; Hu, Wenbiao; Clements, Archie C A; Zhou, Xiao-Nong; Yang, Weizhong; Hay, Simon I; Yu, Hongjie; Li, Zhongjie

    2014-11-03

    In China, the national malaria elimination programme has been operating since 2010. This study aimed to explore the epidemiological changes in patterns of malaria in China from intensified control to elimination stages. Data on nationwide malaria cases from 2004 to 2012 were extracted from the Chinese national malaria surveillance system. The secular trend, gender and age features, seasonality, and spatial distribution by Plasmodium species were analysed. In total, 238,443 malaria cases were reported, and the proportion of Plasmodium falciparum increased drastically from population. The areas affected by Plasmodium vivax malaria shrunk, while areas affected by P. falciparum malaria expanded from 294 counties in 2004 to 600 counties in 2012. This study demonstrated that malaria has decreased dramatically in the last five years, especially since the Chinese government launched a malaria elimination programme in 2010, and areas with reported falciparum malaria cases have expanded over recent years. These findings suggest that elimination efforts should be improved to meet these changes, so as to achieve the nationwide malaria elimination goal in China in 2020.

  18. Anopheles Vectors in Mainland China While Approaching Malaria Elimination.

    Science.gov (United States)

    Zhang, Shaosen; Guo, Shaohua; Feng, Xinyu; Afelt, Aneta; Frutos, Roger; Zhou, Shuisen; Manguin, Sylvie

    2017-11-01

    China is approaching malaria elimination; however, well-documented information on malaria vectors is still missing, which could hinder the development of appropriate surveillance strategies and WHO certification. This review summarizes the nationwide distribution of malaria vectors, their bionomic characteristics, control measures, and related studies. After several years of effort, the area of distribution of the principal malaria vectors was reduced, in particular for Anopheles lesteri (synonym: An. anthropophagus) and Anopheles dirus s.l., which nearly disappeared from their former endemic regions. Anopheles sinensis is becoming the predominant species in southwestern China. The bionomic characteristics of these species have changed, and resistance to insecticides was reported. There is a need to update surveillance tools and investigate the role of secondary vectors in malaria transmission. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Challenges for malaria elimination in Brazil.

    Science.gov (United States)

    Ferreira, Marcelo U; Castro, Marcia C

    2016-05-20

    Brazil currently contributes 42 % of all malaria cases reported in the Latin America and the Caribbean, a region where major progress towards malaria elimination has been achieved in recent years. In 2014, malaria burden in Brazil (143,910 microscopically confirmed cases and 41 malaria-related deaths) has reached its lowest levels in 35 years, Plasmodium falciparum is highly focal, and the geographic boundary of transmission has considerably shrunk. Transmission in Brazil remains entrenched in the Amazon Basin, which accounts for 99.5 % of the country's malaria burden. This paper reviews major lessons learned from past and current malaria control policies in Brazil. A comprehensive discussion of the scientific and logistic challenges that may impact malaria elimination efforts in the country is presented in light of the launching of the Plan for Elimination of Malaria in Brazil in November 2015. Challenges for malaria elimination addressed include the high prevalence of symptomless and submicroscopic infections, emerging anti-malarial drug resistance in P. falciparum and Plasmodium vivax and the lack of safe anti-relapse drugs, the largely neglected burden of malaria in pregnancy, the need for better vector control strategies where Anopheles mosquitoes present a highly variable biting behaviour, human movement, the need for effective surveillance and tools to identify foci of infection in areas with low transmission, and the effects of environmental changes and climatic variability in transmission. Control actions launched in Brazil and results to come are likely to influence control programs in other countries in the Americas.

  20. The Influence of Dams on Malaria Transmission in Sub-Saharan Africa.

    Science.gov (United States)

    Kibret, Solomon; Wilson, G Glenn; Ryder, Darren; Tekie, Habte; Petros, Beyene

    2017-06-01

    The construction of dams in sub-Saharan Africa is pivotal for food security and alleviating poverty in the region. However, the unintended adverse public health implications of extending the spatial distribution of water infrastructure are poorly documented and may minimize the intended benefits of securing water supplies. This paper reviews existing studies on the influence of dams on the spatial distribution of malaria parasites and vectors in sub-Saharan Africa. Common themes emerging from the literature were that dams intensified malaria transmission in semi-arid and highland areas with unstable malaria transmission but had little or no impact in areas with perennial transmission. Differences in the impacts of dams resulted from the types and characteristics of malaria vectors and their breeding habitats in different settings of sub-Saharan Africa. A higher abundance of a less anthropophilic Anopheles arabiensis than a highly efficient vector A. gambiae explains why dams did not increase malaria in stable areas. In unstable areas where transmission is limited by availability of water bodies for vector breeding, dams generally increase malaria by providing breeding habitats for prominent malaria vector species. Integrated vector control measures that include reservoir management, coupled with conventional malaria control strategies, could optimize a reduction of the risk of malaria transmission around dams in the region.

  1. Lethal and pre-lethal effects of a fungal biopesticide contribute to substantial and rapid control of malaria vectors.

    Directory of Open Access Journals (Sweden)

    Simon Blanford

    Full Text Available Rapidly emerging insecticide resistance is creating an urgent need for new active ingredients to control the adult mosquitoes that vector malaria. Biopesticides based on the spores of entomopathogenic fungi have shown considerable promise by causing very substantial mortality within 7-14 days of exposure. This mortality will generate excellent malaria control if there is a high likelihood that mosquitoes contact fungi early in their adult lives. However, where contact rates are lower, as might result from poor pesticide coverage, some mosquitoes will contact fungi one or more feeding cycles after they acquire malaria, and so risk transmitting malaria before the fungus kills them. Critics have argued that 'slow acting' fungal biopesticides are, therefore, incapable of delivering malaria control in real-world contexts. Here, utilizing standard WHO laboratory protocols, we demonstrate effective action of a biopesticide much faster than previously reported. Specifically, we show that transient exposure to clay tiles sprayed with a candidate biopesticide comprising spores of a natural isolate of Beauveria bassiana, could reduce malaria transmission potential to zero within a feeding cycle. The effect resulted from a combination of high mortality and rapid fungal-induced reduction in feeding and flight capacity. Additionally, multiple insecticide-resistant lines from three key African malaria vector species were completely susceptible to fungus. Thus, fungal biopesticides can block transmission on a par with chemical insecticides, and can achieve this where chemical insecticides have little impact. These results support broadening the current vector control paradigm beyond fast-acting chemical toxins.

  2. Malaria prophylaxis in the French armed forces: evolution of concepts.

    Science.gov (United States)

    Touze, J E; Paule, P; Baudon, D; Boutin, J P

    2001-01-01

    Malaria is still a serious public health problem in the world and control remains a major priority for the approximately 25.000 French troops deployed, mostly on permanent assignment, in malaria transmission regions. Epidemiological surveillance of malaria provides data necessary to assess morbidity, monitor changing patterns of Plasmodium falciparum drug-sensitivity, and evaluate the efficacy of malaria control measures. About 540 cases were observed in 1999 for an incidence of 4.1 p. 100 men. year. Since 1991, strong emphasis has been placed on prophylaxis. In addition to vector control measures and individual protection against mosquito bites (impregnated bednets, protective clothing, application of repellents, and indoor insecticide spraying), drug prophylaxis has been recommended using a combination of 100 mg of chloroquine and 200 mg of proguanil chlorhydrate (CQ + PG) in a single capsule manufactured by the French Health Army Service. Initially this policy led to a significant decrease in malaria cases among French soldiers. However the incidence of malaria rose in 1995 and 1996. This recrudescence was attributed to poor compliance with chemoprophylaxis and to the declining efficacy of the CQ + PG combination. In response to these problems, a new policy was implemented especially in countries where cycloguanil-resistant Plasmodium falciparum incidence rate is increasing. The new chemoprophylactic regimen calls for a personal prescription of mefloquine. Doxycycline monohydrate is used in case of mefloquine contra-indication or intolerance. Combination of CQ + PG delivered in a single capsule remains a suitable chemoprophylactic regimen in Sahel countries as well as Horn of Africa.

  3. Perceptions of malaria control and prevention in an era of climate change: a cross-sectional survey among CDC staff in China.

    Science.gov (United States)

    Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Liu, Xiaobo; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

    2017-03-31

    Though there was the significant decrease in the incidence of malaria in central and southwest China during the 1980s and 1990s, there has been a re-emergence of malaria since 2000. A cross-sectional survey was conducted amongst the staff of eleven Centers for Disease Control and Prevention (CDC) in China to gauge their perceptions regarding the impacts of climate change on malaria transmission and its control and prevention. Descriptive analysis was performed to study CDC staff's knowledge, attitudes, perceptions and suggestions for malaria control in the face of climate change. A majority (79.8%) of CDC staff were concerned about climate change and 79.7% believed the weather was becoming warmer. Most participants (90.3%) indicated climate change had a negative effect on population health, 92.6 and 86.8% considered that increasing temperatures and precipitation would influence the transmission of vector-borne diseases including malaria. About half (50.9%) of the surveyed staff indicated malaria had re-emerged in recent years, and some outbreaks were occurring in new geographic areas. The main reasons for such re-emergence were perceived to be: mosquitoes in high-density, numerous imported cases, climate change, poor environmental conditions, internal migrant populations, and lack of health awareness. This study found most CDC staff endorsed the statement that climate change had a negative impact on infectious disease transmission. Malaria had re-emerged in some areas of China, and most of the staff believed that this can be managed. However, high densities of mosquitoes and the continuous increase in imported cases of malaria in local areas, together with environmental changes are bringing about critical challenges to malaria control in China. This study contributes to an understanding of climate change related perceptions of malaria control and prevention amongst CDC staff. It may help to formulate in-house training guidelines, community health promotion

  4. Kajian Manajemen Lingkungan Terhadap Kejadian Malaria di Daerah Endemis, Kecamatan Kakuluk Mesak, Kabupaten Belu

    Directory of Open Access Journals (Sweden)

    Antonius Tae Asa

    2015-12-01

    Full Text Available ABSTRACT Background : Malaria is still endemic disease  in Indonesia, especially in Belu district. Many measures had been implemented to reduce malaria cases , but its rate is still quite high in any areas . The fluctuation of malaria cases were influenced by epidemiological and environmental factors. Prevention of malaria had been conducted simultaneously through clinical and environmental intervention. However, such intervention had no more impact, especially the environmental intervention. Such failure may be associated with the location of this area closed to the highest malaria rate (AMI area in Belu District for four years later, namely : AMI 416/1000 population for year 2000, 527/1000 population for year 2001, 418/1000 population for year 2002, 468/1000 population for year 2003, and  it rose tobe  493/1000 population for the year of 2004. Based on this fact, this study was conducted to study  the environmental management related to the occurrence of malaria  in endemic areas in working area of  Atapupu Health Centre, Belu District. Furthermore, the study would  also analyze the impact  of vector and its larva. Method : This was a qualitative research using secondary data of the environmental management measure. The subject of this research was the malaria programmer and health worker who responsible for malaria program.  They were the Head of Public Health Centre, laboratory technician, Co-assistant of entomologist. The program measures would be studied in this research focusing on planning of malaria program, the malaria control measure, collecting and reporting of data, and monitoring – evaluation. Result : Measures had been conducted for reducing malaria cases in Atapupu Health Center through fogging,  mosquito netting by medical officials without involving related sector. Monitoring and evaluating have been conducted just through data collection and reporting the rate of cases which was found  in Passive Case Detection

  5. Malaria early warning tool: linking inter-annual climate and malaria variability in northern Guadalcanal, Solomon Islands.

    Science.gov (United States)

    Smith, Jason; Tahani, Lloyd; Bobogare, Albino; Bugoro, Hugo; Otto, Francis; Fafale, George; Hiriasa, David; Kazazic, Adna; Beard, Grant; Amjadali, Amanda; Jeanne, Isabelle

    2017-11-21

    Malaria control remains a significant challenge in the Solomon Islands. Despite progress made by local malaria control agencies over the past decade, case rates remain high in some areas of the country. Studies from around the world have confirmed important links between climate and malaria transmission. This study focuses on understanding the links between malaria and climate in Guadalcanal, Solomon Islands, with a view towards developing a climate-based monitoring and early warning for periods of enhanced malaria transmission. Climate records were sourced from the Solomon Islands meteorological service (SIMS) and historical malaria case records were sourced from the National Vector-Borne Disease Control Programme (NVBDCP). A declining trend in malaria cases over the last decade associated with improved malaria control was adjusted for. A stepwise regression was performed between climate variables and climate-associated malaria transmission (CMT) at different lag intervals to determine where significant relationships existed. The suitability of these results for use in a three-tiered categorical warning system was then assessed using a Mann-Whitney U test. Of the climate variables considered, only rainfall had a consistently significant relationship with malaria in North Guadalcanal. Optimal lag intervals were determined for prediction using R 2 skill scores. A highly significant negative correlation (R = - 0.86, R 2  = 0.74, p malaria transmission periods in January-June. Cross-validation emphasized the suitability of this relationship for forecasting purposes [Formula: see text]  as did Mann-Whitney U test results showing that rainfall below or above specific thresholds was significantly associated with above or below normal malaria transmission, respectively. This study demonstrated that rainfall provides the best predictor of malaria transmission in North Guadalcanal. This relationship is thought to be underpinned by the unique hydrological conditions

  6. Malaria vector control at a crossroads: public health entomology and the drive to elimination.

    Science.gov (United States)

    Mnzava, Abraham P; Macdonald, Michael B; Knox, Tessa B; Temu, Emmanuel A; Shiff, Clive J

    2014-09-01

    Vector control has been at the core of successful malaria control. However, a dearth of field-oriented vector biologists threatens to undermine global reductions in malaria burden. Skilled cadres are needed to manage insecticide resistance, to maintain coverage with current interventions, to develop new paradigms for tackling 'residual' transmission and to target interventions as transmission becomes increasingly heterogeneous. Recognising this human resource crisis, in September 2013, WHO Global Malaria Programme issued guidance for capacity building in entomology and vector control, including recommendations for countries and implementing partners. Ministries were urged to develop long-range strategic plans for building human resources for public health entomology and vector control (including skills in epidemiology, geographic information systems, operational research and programme management) and to set in place the requisite professional posts and career opportunities. Capacity building and national ownership in all partner projects and a clear exit strategy to sustain human and technical resources after project completion were emphasised. Implementing partners were urged to support global and regional efforts to enhance public health entomology capacity. While the challenges inherent in such capacity building are great, so too are the opportunities to establish the next generation of public health entomologists that will enable programmes to continue on the path to malaria elimination. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Knowledge of prevention, cause, symptom and practices of malaria among women in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Malaria remains a major public health issue in most southern African countries as the disease remains hyper endemic. Burkina Faso continues to face challenges in the treatment of malaria, as the utilization of preventive measures remains low on a national scale. While it has been acknowledged that understanding women's health-seeking behaviours, perception of malaria and its preventive measures will aid in the control of malaria, there is paucity of information on Knowledge, Attitudes and Practices among women in the reproductive age of 15-49 years in Burkina Faso. This study investigated women's knowledge of malaria, attitudes towards malaria, and practices of malaria control in order to create a synergy between community efforts and governmental/non-governmental malaria control interventions in Burkina Faso.The analysis used data from the 2014 Burkina Faso Malaria Indicator Survey (MIS. In total 8111 women aged between 15-49 years were included in the present study. We assessed women's knowledge about 1 preventive measures, 2 causes and 3 symptoms of malaria, as well as malaria prevention practices for their children and during pregnancy. The socio-demographic characteristics were considered for Age, Religion, Education, Wealth index, Number of household members, Sex of household head, Household possession of radio, TV and Received antenatal care. Data were analyzed using STATA, version 14. Associations between variables were tested using a Chi-square and logistic regression, with the level of statistical significance set at 95%.A preponderant proportion of respondents were aged 15-29 years (mean age was 28.63±9.41. About three-quarters of the respondents had no formal education. An estimated two-third of the participants were of Islamic faith, while access to media and behavioural communication were generally poor. The level of knowledge was 53% for rural women and 68.2% for urban dwellers. In sum, there was 56.1% level of accurate knowledge

  8. Knowledge of prevention, cause, symptom and practices of malaria among women in Burkina Faso.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael; Shah, Vaibhav; Kadio, Bernard; Udenigwe, Ogochukwu

    2017-01-01

    Malaria remains a major public health issue in most southern African countries as the disease remains hyper endemic. Burkina Faso continues to face challenges in the treatment of malaria, as the utilization of preventive measures remains low on a national scale. While it has been acknowledged that understanding women's health-seeking behaviours, perception of malaria and its preventive measures will aid in the control of malaria, there is paucity of information on Knowledge, Attitudes and Practices among women in the reproductive age of 15-49 years in Burkina Faso. This study investigated women's knowledge of malaria, attitudes towards malaria, and practices of malaria control in order to create a synergy between community efforts and governmental/non-governmental malaria control interventions in Burkina Faso. The analysis used data from the 2014 Burkina Faso Malaria Indicator Survey (MIS). In total 8111 women aged between 15-49 years were included in the present study. We assessed women's knowledge about 1) preventive measures, 2) causes and 3) symptoms of malaria, as well as malaria prevention practices for their children and during pregnancy. The socio-demographic characteristics were considered for Age, Religion, Education, Wealth index, Number of household members, Sex of household head, Household possession of radio, TV and Received antenatal care. Data were analyzed using STATA, version 14. Associations between variables were tested using a Chi-square and logistic regression, with the level of statistical significance set at 95%. A preponderant proportion of respondents were aged 15-29 years (mean age was 28.63±9.41). About three-quarters of the respondents had no formal education. An estimated two-third of the participants were of Islamic faith, while access to media and behavioural communication were generally poor. The level of knowledge was 53% for rural women and 68.2% for urban dwellers. In sum, there was 56.1% level of accurate knowledge of malaria

  9. Community-based intermittent mass testing and treatment for malaria in an area of high transmission intensity, western Kenya: study design and methodology for a cluster randomized controlled trial.

    Science.gov (United States)

    Samuels, Aaron M; Awino, Nobert; Odongo, Wycliffe; Abong'o, Benard; Gimnig, John; Otieno, Kephas; Shi, Ya Ping; Were, Vincent; Allen, Denise Roth; Were, Florence; Sang, Tony; Obor, David; Williamson, John; Hamel, Mary J; Patrick Kachur, S; Slutsker, Laurence; Lindblade, Kim A; Kariuki, Simon; Desai, Meghna

    2017-06-07

    Most human Plasmodium infections in western Kenya are asymptomatic and are believed to contribute importantly to malaria transmission. Elimination of asymptomatic infections requires active treatment approaches, such as mass testing and treatment (MTaT) or mass drug administration (MDA), as infected persons do not seek care for their infection. Evaluations of community-based approaches that are designed to reduce malaria transmission require careful attention to study design to ensure that important effects can be measured accurately. This manuscript describes the study design and methodology of a cluster-randomized controlled trial to evaluate a MTaT approach for malaria transmission reduction in an area of high malaria transmission. Ten health facilities in western Kenya were purposively selected for inclusion. The communities within 3 km of each health facility were divided into three clusters of approximately equal population size. Two clusters around each health facility were randomly assigned to the control arm, and one to the intervention arm. Three times per year for 2 years, after the long and short rains, and again before the long rains, teams of community health volunteers visited every household within the intervention arm, tested all consenting individuals with malaria rapid diagnostic tests, and treated all positive individuals with an effective anti-malarial. The effect of mass testing and treatment on malaria transmission was measured through population-based longitudinal cohorts, outpatient visits for clinical malaria, periodic population-based cross-sectional surveys, and entomological indices.

  10. Spatial and temporal distribution of falciparum malaria in China

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    Lin Hualiang

    2009-06-01

    Full Text Available Abstract Background Falciparum malaria is the most deadly among the four main types of human malaria. Although great success has been achieved since the launch of the National Malaria Control Programme in 1955, malaria remains a serious public health problem in China. This paper aimed to analyse the geographic distribution, demographic patterns and time trends of falciparum malaria in China. Methods The annual numbers of falciparum malaria cases during 1992–2003 and the individual case reports of each clinical falciparum malaria during 2004–2005 were extracted from communicable disease information systems in China Center for Diseases Control and Prevention. The annual number of cases and the annual incidence were mapped by matching them to corresponding province- and county-level administrative units in a geographic information system. The distribution of falciparum malaria by age, gender and origin of infection was analysed. Time-series analysis was conducted to investigate the relationship between the falciparum malaria in the endemic provinces and the imported falciparum malaria in non-endemic provinces. Results Falciparum malaria was endemic in two provinces of China during 2004–05. Imported malaria was reported in 26 non-endemic provinces. Annual incidence of falciparum malaria was mapped at county level in the two endemic provinces of China: Yunnan and Hainan. The sex ratio (male vs. female for the number of cases in Yunnan was 1.6 in the children of 0–15 years and it reached 5.7 in the adults over 15 years of age. The number of malaria cases in Yunnan was positively correlated with the imported malaria of concurrent months in the non-endemic provinces. Conclusion The endemic area of falciparum malaria in China has remained restricted to two provinces, Yunnan and Hainan. Stable transmission occurs in the bordering region of Yunnan and the hilly-forested south of Hainan. The age and gender distribution in the endemic area is

  11. Declines in Malaria Burden and All-Cause Child Mortality following Increases in Control Interventions in Senegal, 2005-2010.

    Science.gov (United States)

    Thwing, Julie; Eckert, Erin; Dione, Demba Anta; Tine, Roger; Faye, Adama; Yé, Yazoume; Ndiop, Medoune; Cisse, Moustapha; Ndione, Jacques Andre; Diouf, Mame Birame; Ba, Mady

    2017-09-01

    Malaria is endemic in Senegal. The national malaria control strategy focuses on achieving universal coverage for major interventions, with a goal of reaching preelimination status by 2018. Senegal began distribution of insecticide-treated nets (ITNs) and introduced artemisinin-based combination therapy in 2006, then introduced rapid diagnostic tests in 2007. We evaluated the impact of these efforts using a plausibility design based on malaria's contribution to all-cause under-five mortality (ACCM) and considering other contextual factors which may influence ACCM. Between 2005 and 2010, household ownership of ITNs increased from 20% to 63%, and the proportion of people sleeping under an ITN the night prior to the survey increased from 6% to 29%. Malaria parasite prevalence declined from 6% to 3% from 2008 to 2010 among children under five. Some nonmalaria indicators of child health improved, for example, increase of complete vaccination coverage from 58% to 64%; however, nutritional indicators deteriorated, with an increase in stunting from 16% to 26%. Although economic indicators improved, environmental conditions favored an increase in malaria transmission. ACCM decreased 40% between 2005 and 2010, from 121 (95% confidence interval [CI] 113-129) to 72 (95% CI 66-77) per 1,000, and declines were greater among age groups, epidemiologic zones, and wealth quintiles most at risk for malaria. After considering coverage of malaria interventions, trends in malaria morbidity, effects of contextual factors, and trends in ACCM, it is plausible that malaria control interventions contributed to a reduction in malaria mortality and to the impressive gains in child survival in Senegal.

  12. Malaria control at the district level in Africa: the case of the muheza district in northeastern Tanzania

    DEFF Research Database (Denmark)

    Alilio, Martin S; Kitua, Andrew; Njunwa, Kato

    2004-01-01

    transmission and incidence over time; use of facility-based care services for malaria; patients' access to professional advice; the trend of treatment failure over time of sulfadoxine-pyrimethamine and chloroquine; survival rates of severe cases at the district hospital; a district malaria control strategy......An assessment was done in Tanzania to determine the extent to which the primary health care services have contributed to reducing the burden of malaria since the system was initiated in the 1980s. Seven descriptive processes and outcome indicators of effectiveness were used: changes of malaria...

  13. The past, present and future use of epidemiological intelligence to plan malaria vector control and parasite prevention in Uganda.

    Science.gov (United States)

    Talisuna, Ambrose O; Noor, Abdisalan M; Okui, Albert P; Snow, Robert W

    2015-04-15

    An important prelude to developing strategies to control infectious diseases is a detailed epidemiological evidence platform to target cost-effective interventions and define resource needs. A review of published and un-published reports of malaria vector control and parasite prevention in Uganda was conducted for the period 1900-2013. The objective was to provide a perspective as to how epidemiological intelligence was used to design malaria control before and during the global malaria eradication programme (GMEP) and to contrast this with the evidence generated in support of the Roll Back Malaria (RBM) initiative from 1998 to date. During the GMEP era, comprehensive investigations were undertaken on the effectiveness of vector and parasite control such as indoor residual house-spraying (IRS) and mass drug administration (MDA) at different sites in Uganda. Nationwide malariometric surveys were undertaken between 1964 and 1967 to provide a profile of risk, epidemiology and seasonality leading to an evidence-based national cartography of risk to characterize the diversity of malaria transmission in Uganda. At the launch of the RBM initiative in the late 1990s, an equivalent level of evidence was lacking. There was no contemporary national evidence-base for the likely impact of insecticide-treated nets (ITN), no new malariometric data, no new national cartography of malaria risk or any evidence of tailored intervention delivery based on variations in the ecology of malaria risk in Uganda. Despite millions of dollars of overseas development assistance over the last ten years in ITN, and more recently the resurrection of the use of IRS, the epidemiological impact of vector control remains uncertain due to an absence of nationwide basic parasite and vector-based field studies. Readily available epidemiological data should become the future business model to maximize malaria funding from 2015. Over the next five to ten years, accountability, impact analysis, financial

  14. The Gates Malaria Partnership: a consortium approach to malaria research and capacity development.

    Science.gov (United States)

    Greenwood, Brian; Bhasin, Amit; Targett, Geoffrey

    2012-05-01

    Recently, there has been a major increase in financial support for malaria control. Most of these funds have, appropriately, been spent on the tools needed for effective prevention and treatment of malaria such as insecticide-treated bed nets, indoor residual spraying and artemisinin combination therapy. There has been less investment in the training of the scientists from malaria-endemic countries needed to support these large and increasingly complex malaria control programmes, especially in Africa. In 2000, with support from the Bill & Melinda Gates Foundation, the Gates Malaria Partnership was established to support postgraduate training of African scientists wishing to pursue a career in malaria research. The programme had three research capacity development components: a PhD fellowship programme, a postdoctoral fellowship programme and a laboratory infrastructure programme. During an 8-year period, 36 African PhD students and six postdoctoral fellows were supported, and two research laboratories were built in Tanzania. Some of the lessons learnt during this project--such as the need to improve PhD supervision in African universities and to provide better support for postdoctoral fellows--are now being applied to a successor malaria research capacity development programme, the Malaria Capacity Development Consortium, and may be of interest to other groups involved in improving postgraduate training in health sciences in African universities. © 2012 Blackwell Publishing Ltd.

  15. Controlled Human Malaria Infection of Tanzanians by Intradermal Injection of Aseptic, Purified, Cryopreserved Plasmodium falciparum Sporozoites

    NARCIS (Netherlands)

    Shekalaghe, S.; Rutaihwa, M.; Billingsley, P.F.; Chemba, M.; Daubenberger, C.A.; James, E.R.; Mpina, M.; Juma, O. Ali; Schindler, T.; Huber, E.; Gunasekera, A.; Manoj, A.; Simon, B.; Saverino, E.; Church, L.W.; Hermsen, C.C.; Sauerwein, R.W.; Plowe, C.; Venkatesan, M.; Sasi, P.; Lweno, O.; Mutani, P.; Hamad, A.; Mohammed, A.; Urassa, A.; Mzee, T.; Padilla, D.; Ruben, A.; Sim, B.K.; Tanner, M.; Abdulla, S.; Hoffman, S.L.

    2014-01-01

    Controlled human malaria infection (CHMI) by mosquito bite has been used to assess anti-malaria interventions in > 1,500 volunteers since development of methods for infecting mosquitoes by feeding on Plasmodium falciparum (Pf) gametocyte cultures. Such CHMIs have never been used in Africa. Aseptic,

  16. Malaria and Agriculture in Kenya

    International Development Research Centre (IDRC) Digital Library (Canada)

    Nancy Minogue

    die every day from malaria, conventional efforts to control the disease have not worked. Malaria parasites are .... and other animals. Mosquito nets. Provide insecticide-treated bednets to groups at high risk for malaria, namely young children and pregnant women, through partnerships with nongovernmental organizations ...

  17. Vector incrimination and effects of antimalarial drugs on malaria transmission and control in the Amazon Basin of Brazil

    Directory of Open Access Journals (Sweden)

    T. A. Klein

    1992-01-01

    Full Text Available World ecosystems differ significantly and a multidisciplinary malaria control approach must be adjusted to meet these requirements. These include a comprehensive understanding of the malaria vectors, their behavior, seasonal distribution and abundance, susceptibility to insecticides (physiological and behavioral, methods to reduce the numbers of human gametocyte carriers through effective health care systems and antimalarial drug treatment, urban malaria transmission versus rural or forest malaria transmission, and the impact of vaccine development. Many malaria vectors are members of species complexes and individual relationship to malaria transmission, seasonal distribution, bitting behavior, etc. is poorly understood. Additionaly, malaria patients are not examined for circulating gametocytes and both falciparum and vivax malaria patients may be highly infective to mosquitoes after treatment with currently used antimalarial drugs. Studies on the physiological and behavioral effects of DDT and other insecticides are inconclusive and need to be evalusted.

  18. Suppression of blood monocyte and neutrophil chemotaxis in acute human malaria

    DEFF Research Database (Denmark)

    Nielsen, H; Kharazmi, A; Theander, T G

    1986-01-01

    tested monocyte chemotactic responsiveness in 19 patients with acute primary attack malaria. In addition, the neutrophil chemotaxis was measured in 12 patients. Before the initiation of antimalarial treatment a significant depression of monocyte chemotaxis was observed in approximately half...... of the patients when compared with healthy control subjects. The depression was found in Plasmodium falciparum malaria as well as in P. vivax or P. ovale malaria patients. The defective responsiveness was not receptor specific, since the responses towards casein and zymosan activated serum proved to be equally...... of treatment, and nearly normalized after 7 days (87% of controls). Furthermore, monocyte phagocytic and candidacidal activities were assessed in the same patients on admission and during the follow-up. In contrast to chemotaxis, these functions were normal in all of the patients whenever measured...

  19. The Farmer Field School: a method for enhancing the role of rural communities in malaria control ?

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    Knols Bart GJ

    2006-01-01

    Full Text Available Abstract Malaria has strong linkages with agriculture, and farmers in malarious regions have a central position in creating or controlling the conditions that favour disease transmission. An interdisciplinary and integrated approach is needed to involve farmers and more than one sector in control efforts. It is suggested that malaria control can benefit from a complementary intervention in rural development, the Farmer Field School (FFS on Integrated Pest Management (IPM. This is a form of education that uses experiential learning methods to build farmers' expertise, and has proven farm-level and empowerment effects. The benefits of incorporating malaria control into the IPM curriculum are discussed. An example of a combined health-agriculture curriculum, labeled Integrated Pest and Vector Management (IPVM, developed in Sri Lanka is presented. Institutional ownership and support for IPVM could potentially be spread over several public sectors requiring a process for institutional learning and reform.

  20. The Malaria Transition on the Arabian Peninsula: Progress toward a Malaria-Free Region between 1960–2010

    Science.gov (United States)

    Snow, Robert W.; Amratia, Punam; Zamani, Ghasem; Mundia, Clara W.; Noor, Abdisalan M.; Memish, Ziad A.; Al Zahrani, Mohammad H.; Al Jasari, Adel; Fikri, Mahmoud; Atta, Hoda

    2014-01-01

    The transmission of malaria across the Arabian Peninsula is governed by the diversity of dominant vectors and extreme aridity. It is likely that where malaria transmission was historically possible it was intense and led to a high disease burden. Here, we review the speed of elimination, approaches taken, define the shrinking map of risk since 1960 and discuss the threats posed to a malaria-free Arabian Peninsula using the archive material, case data and published works. From as early as the 1940s, attempts were made to eliminate malaria on the peninsula but were met with varying degrees of success through to the 1970s; however, these did result in a shrinking of the margins of malaria transmission across the peninsula. Epidemics in the 1990s galvanised national malaria control programmes to reinvigorate control efforts. Before the launch of the recent global ambition for malaria eradication, countries on the Arabian Peninsula launched a collaborative malaria-free initiative in 2005. This initiative led a further shrinking of the malaria risk map and today locally acquired clinical cases of malaria are reported only in Saudi Arabia and Yemen, with the latter contributing to over 98% of the clinical burden. PMID:23548086

  1. Effect of climatic variability on malaria trends in Baringo County, Kenya.

    Science.gov (United States)

    Kipruto, Edwin K; Ochieng, Alfred O; Anyona, Douglas N; Mbalanya, Macrae; Mutua, Edna N; Onguru, Daniel; Nyamongo, Isaac K; Estambale, Benson B A

    2017-05-25

    Malaria transmission in arid and semi-arid regions of Kenya such as Baringo County, is seasonal and often influenced by climatic factors. Unravelling the relationship between climate variables and malaria transmission dynamics is therefore instrumental in developing effective malaria control strategies. The main aim of this study was to describe the effects of variability of rainfall, maximum temperature and vegetation indices on seasonal trends of malaria in selected health facilities within Baringo County, Kenya. Climate variables sourced from the International Research Institute (IRI)/Lamont-Doherty Earth Observatory (LDEO) climate database and malaria cases reported in 10 health facilities spread across four ecological zones (riverine, lowland, mid-altitude and highland) between 2004 and 2014 were subjected to a time series analysis. A negative binomial regression model with lagged climate variables was used to model long-term monthly malaria cases. The seasonal Mann-Kendall trend test was then used to detect overall monotonic trends in malaria cases. Malaria cases increased significantly in the highland and midland zones over the study period. Changes in malaria prevalence corresponded to variations in rainfall and maximum temperature. Rainfall at a time lag of 2 months resulted in an increase in malaria transmission across the four zones while an increase in temperature at time lags of 0 and 1 month resulted in an increase in malaria cases in the riverine and highland zones, respectively. Given the existence of a time lag between climatic variables more so rainfall and peak malaria transmission, appropriate control measures can be initiated at the onset of short and after long rains seasons.

  2. Malaria and the mobile and migrant population in Cambodia: a population movement framework to inform strategies for malaria control and elimination.

    Science.gov (United States)

    Guyant, Philippe; Canavati, Sara E; Chea, Nguon; Ly, Po; Whittaker, Maxine Anne; Roca-Feltrer, Arantxa; Yeung, Shunmay

    2015-06-20

    The relationships between human population movement (HPM) and health are a concern at global level. In the case of malaria, those links are crucial in relation to the spread of drug resistant parasites and to the elimination of malaria in the Greater Mekong sub-Region (GMS) and beyond. The mobile and migrant populations (MMP) who are involved in forest related activities are both at high risk of being infected with malaria and at risk of receiving late and sub-standard treatment due to poor access to health services. In Cambodia, in 2012, the National Malaria Control Programme (NMCP) identified, as a key objective, the development of a specific strategy for MMPs in order to address these challenges. A population movement framework (PMF) for malaria was developed and operationalized in order to contribute to this strategy. A review of the published and unpublished literature was conducted. Based on a synthesis of the results, information was presented and discussed with experienced researchers and programme managers in the Cambodian NMCP and led to the development and refinement of a PMF for malaria. The framework was "tested" for face and content validity with national experts through a workshop approach. In the literature, HPM has been described using various spatial and temporal dimensions both in the context of the spread of anti-malarial drug resistance, and in the context of malaria elimination and previous classifications have categorized MMPs in Cambodia and the GMS through using a number of different criteria. Building on these previous models, the PMF was developed and then refined and populated with in-depth information relevant to Cambodia collected from social science research and field experiences in Cambodia. The framework comprises of the PMF itself, MMP activity profiles and a Malaria Risk Index which is a summation of three related indices: a vulnerability index, an exposure index and an access index which allow a qualitative ranking of malaria

  3. Declining malaria, rising of dengue and Zika virus: insights for mosquito vector control.

    Science.gov (United States)

    Benelli, Giovanni; Mehlhorn, Heinz

    2016-05-01

    The fight against mosquito-borne diseases is a challenge of huge public health importance. To our mind, 2015 was an extraordinary year for malaria control, due to three hot news: the Nobel Prize to Youyou Tu for the discovery of artemisinin, the development of the first vaccine against Plasmodium falciparum malaria [i.e. RTS,S/AS01 (RTS,S)], and the fall of malaria infection rates worldwide, with special reference to sub-Saharan Africa. However, there are major challenges that still deserve attention, in order to boost malaria prevention and control. Indeed, parasite strains resistant to artemisinin have been detected, and RTS,S vaccine does not offer protection against Plasmodium vivax malaria, which predominates in many countries outside of Africa. Furthermore, the recent outbreaks of Zika virus infections, occurring in South America, Central America and the Caribbean, represent the most recent of four arrivals of important arboviruses in the Western Hemisphere, over the last 20 years. Zika virus follows dengue (which slyly arrived in the hemisphere over decades and became more aggressive in the 1990s), West Nile virus (emerged in 1999) and chikungunya (emerged in 2013). Notably, there are no specific treatments for these arboviruses. The emerging scenario highlights that the effective and eco-friendly control of mosquito vectors, with special reference to highly invasive species such as Aedes aegypti and Aedes albopictus, is crucial. The concrete potential of screening plant species as sources of metabolites for parasitological purposes is worthy of attention, as elucidated by the Y. Tu's example. Notably, plant-borne molecules are often effective at few parts per million against Aedes, Ochlerotatus, Anopheles and Culex young instars, can be used for the rapid synthesis of mosquitocidal nanoformulations and even employed to prepare cheap repellents with low human toxicity. In addition, behaviour-based control tools relying to the employ of sound traps and the

  4. Climate forcing and desert malaria: the effect of irrigation.

    Science.gov (United States)

    Baeza, Andres; Bouma, Menno J; Dobson, Andy P; Dhiman, Ramesh; Srivastava, Harish C; Pascual, Mercedes

    2011-07-14

    Rainfall variability and associated remote sensing indices for vegetation are central to the development of early warning systems for epidemic malaria in arid regions. The considerable change in land-use practices resulting from increasing irrigation in recent decades raises important questions on concomitant change in malaria dynamics and its coupling to climate forcing. Here, the consequences of irrigation level for malaria epidemics are addressed with extensive time series data for confirmed Plasmodium falciparum monthly cases, spanning over two decades for five districts in north-west India. The work specifically focuses on the response of malaria epidemics to rainfall forcing and how this response is affected by increasing irrigation. Remote sensing data for the Normalized Difference Vegetation Index (NDVI) are used as an integrated measure of rainfall to examine correlation maps within the districts and at regional scales. The analyses specifically address whether irrigation has decreased the coupling between malaria incidence and climate variability, and whether this reflects (1) a breakdown of NDVI as a useful indicator of risk, (2) a weakening of rainfall forcing and a concomitant decrease in epidemic risk, or (3) an increase in the control of malaria transmission. The predictive power of NDVI is compared against that of rainfall, using simple linear models and wavelet analysis to study the association of NDVI and malaria variability in the time and in the frequency domain respectively. The results show that irrigation dampens the influence of climate forcing on the magnitude and frequency of malaria epidemics and, therefore, reduces their predictability. At low irrigation levels, this decoupling reflects a breakdown of local but not regional NDVI as an indicator of rainfall forcing. At higher levels of irrigation, the weakened role of climate variability may be compounded by increased levels of control; nevertheless this leads to no significant decrease

  5. Is Declining malaria vector population in Africa a result of intervention Measures or sampling tools inefficiency?

    Directory of Open Access Journals (Sweden)

    Eliningaya Kweka

    2013-01-01

    Full Text Available Recent entomological surveys have shown a declining trend of malaria vector population in sub-Saharan Africa and the observation have beenassociated with the scale-up and intensive use of malaria intervention measures such as insecticides treated nets and insecticide residual sprays.However, little is known on the contribution of the mosquito sampling tools inefficiency on the declining trends of malaria vector population. Inthis commentary paper, we explore the possibility of contribution of mosquito sampling tools’ inefficiency to the observed declining trends ofmalaria vector population in Africa.

  6. The Juscelino Kubitschek government and the Brazilian Malaria Control and Eradication Working Group: collaboration and conflicts in Brazilian and international health agenda, 1958-1961

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    Renato da Silva

    2015-03-01

    Full Text Available Malaria, a disease which was under control in the beginning of Juscelino Kubitschek government, became the most important endemic disease in 1958, when Brazil made a commitment with the World Health Organization to convert its control programs into eradication programs. For this purpose a Malaria Control and Eradication Group was set up under the leadership of the malaria specialist Mário Pinotti. Malaria would become an important bargaining chip in the context of the development policies of Kubitschek. This article focuses on path of the Malaria Control and Eradication Working Group in Brazil, in its varying relationships with the arguments and guidelines established at international level

  7. Pengendalian Malaria dalam Upaya Percepatan Pencapaian Target Millennium Development Goals

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    Tri Rini Puji Lestari

    2012-08-01

    health official Malaria Center, and community leaders who observe malaria. Retrieval of data time is 10 – 16 April 2011 by in-depth interviews. It was found that malaria control programs have been implemented by the Departement of Health North Maluku Province, but have not been able to effectively reduce malaria morbidity. This is because malaria control is performed is not comprehensive. Handling is more directed to break the chain transmission to human, their habitats have not been touched up. Key words: Control of malaria, millennium development goals, malaria morbidity

  8. Importance of adequate local spatiotemporal transmission measures in malaria cohort studies: application to the relation between placental malaria and first malaria infection in infants.

    Science.gov (United States)

    Le Port, Agnès; Cottrell, Gilles; Chandre, Fabrice; Cot, Michel; Massougbodji, Achille; Garcia, André

    2013-07-01

    According to several studies, infants whose mothers had a malaria-infected placenta (MIP) at delivery are at increased risk of a first malaria infection. Immune tolerance caused by intrauterine contact with the parasite could explain this phenomenon, but it is also known that infants who are highly exposed to Anopheles mosquitoes infected with Plasmodium are at greater risk of contracting malaria. Consequently, local malaria transmission must be taken into account to demonstrate the immune tolerance hypothesis. From data collected between 2007 and 2010 on 545 infants followed from birth to age 18 months in southern Benin, we compared estimates of the effect of MIP on time to first malaria infection obtained through different Cox models. In these models, MIP was adjusted for either 1) "village-like" time-independent exposure variables or 2) spatiotemporal exposure prediction derived from local climatic, environmental, and behavioral factors. Only the use of exposure prediction improved the model's goodness of fit (Bayesian Information Criterion) and led to clear conclusions regarding the effect of placental infection, whereas the models using the village-like variables were less successful than the univariate model. This demonstrated clearly the benefit of adequately taking transmission into account in cohort studies of malaria.

  9. EDITORIAL THE ROLE OF DRUGS IN CONTROL OF MALARIA In ...

    African Journals Online (AJOL)

    Pharm-chem

    East and Central African Journal of Pharmaceutical Sciences. Vol. 14 (2011). EDITORIAL. THE ROLE OF DRUGS IN CONTROL OF MALARIA. In the early 1960s, President Kwame Nkrumah, the then doyen of Pan African politics, suggested that it would be appropriate to erect a monument in honour of mosquito which had ...

  10. Micro-spatial distribution of malaria cases and control strategies at ward level in Gwanda district, Matabeleland South, Zimbabwe.

    Science.gov (United States)

    Manyangadze, Tawanda; Chimbari, Moses J; Macherera, Margaret; Mukaratirwa, Samson

    2017-11-21

    Although there has been a decline in the number of malaria cases in Zimbabwe since 2010, the disease remains the biggest public health threat in the country. Gwanda district, located in Matabeleland South Province of Zimbabwe has progressed to the malaria pre-elimination phase. The aim of this study was to determine the spatial distribution of malaria incidence at ward level for improving the planning and implementation of malaria elimination in the district. The Poisson purely spatial model was used to detect malaria clusters and their properties, including relative risk and significance levels at ward level. The geographically weighted Poisson regression (GWPR) model was used to explore the potential role and significance of environmental variables [rainfall, minimum and maximum temperature, altitude, Enhanced Vegetation Index (EVI), Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), rural/urban] and malaria control strategies [indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs)] on the spatial patterns of malaria incidence at ward level. Two significant clusters (p malaria cases were identified: (1) ward 24 south of Gwanda district and (2) ward 9 in the urban municipality, with relative risks of 5.583 and 4.316, respectively. The semiparametric-GWPR model with both local and global variables had higher performance based on AICc (70.882) compared to global regression (74.390) and GWPR which assumed that all variables varied locally (73.364). The semiparametric-GWPR captured the spatially non-stationary relationship between malaria cases and minimum temperature, NDVI, NDWI, and altitude at the ward level. The influence of LLINs, IRS and rural or urban did not vary and remained in the model as global terms. NDWI (positive coefficients) and NDVI (range from negative to positive coefficients) showed significant association with malaria cases in some of the wards. The IRS had a protection effect on

  11. Indicators measuring the performance of malaria programs supported by the global fund in Asia, progress and the way forward.

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    Jinkou Zhao

    Full Text Available INTRODUCTION: In 2010, the Global Fund provided more than 75% of external international financing for malaria control. The Global Fund uses performance based funding in the grants it finances. This paper analyses the indicators used to measure the performance of Global Fund supported malaria grants in Asia. METHODS: Indicators used in the performance frameworks for all Global Fund supported malaria grants in Asia were retrieved from grant database and grouped into impact, outcome, output and input categories and categorized by service delivery areas. Indicators of each group were compared over rounds. Indicators used in performance frameworks were compared with internationally adopted indicators included in the Monitoring and Evaluation Toolkit developed by the Global Fund and international technical agencies. RESULTS: Between 2002 and 2010, 1,434 indicators were included in the performance frameworks of the 48 malaria grants awarded in Asia, including 229 impact and 227 outcome indicators, 437 output and 541 input indicators, with an average of 29.9 indicators per grant. The proportion of impact and outcome indicators increased over rounds, with that of input indicators declining from 44.1% in Round 1 to 22.7% in Round 9. CONCLUSIONS: Input indicators, which have predominated the performance frameworks of the Global Fund supported malaria programs in Asia have declined between Rounds 1 and 9. However, increased alignment with internationally adopted indicators included in the Monitoring and Evaluation Toolkit is needed to improve the validity of reported results.

  12. The Impact of Hotspot-Targeted Interventions on Malaria Transmission in Rachuonyo South District in the Western Kenyan Highlands: A Cluster-Randomized Controlled Trial

    Science.gov (United States)

    Bradley, John; Knight, Philip; Stone, William; Osoti, Victor; Makori, Euniah; Owaga, Chrispin; Odongo, Wycliffe; China, Pauline; Shagari, Shehu; Doumbo, Ogobara K.; Sauerwein, Robert W.; Kariuki, Simon; Drakeley, Chris; Stevenson, Jennifer; Cox, Jonathan

    2016-01-01

    Background Malaria transmission is highly heterogeneous, generating malaria hotspots that can fuel malaria transmission across a wider area. Targeting hotspots may represent an efficacious strategy for reducing malaria transmission. We determined the impact of interventions targeted to serologically defined malaria hotspots on malaria transmission both inside hotspots and in surrounding communities. Methods and Findings Twenty-seven serologically defined malaria hotspots were detected in a survey conducted from 24 June to 31 July 2011 that included 17,503 individuals from 3,213 compounds in a 100-km2 area in Rachuonyo South District, Kenya. In a cluster-randomized trial from 22 March to 15 April 2012, we randomly allocated five clusters to hotspot-targeted interventions with larviciding, distribution of long-lasting insecticide-treated nets, indoor residual spraying, and focal mass drug administration (2,082 individuals in 432 compounds); five control clusters received malaria control following Kenyan national policy (2,468 individuals in 512 compounds). Our primary outcome measure was parasite prevalence in evaluation zones up to 500 m outside hotspots, determined by nested PCR (nPCR) at baseline and 8 wk (16 June–6 July 2012) and 16 wk (21 August–10 September 2012) post-intervention by technicians blinded to the intervention arm. Secondary outcome measures were parasite prevalence inside hotpots, parasite prevalence in the evaluation zone as a function of distance from the hotspot boundary, Anopheles mosquito density, mosquito breeding site productivity, malaria incidence by passive case detection, and the safety and acceptability of the interventions. Intervention coverage exceeded 87% for all interventions. Hotspot-targeted interventions did not result in a change in nPCR parasite prevalence outside hotspot boundaries (p ≥ 0.187). We observed an average reduction in nPCR parasite prevalence of 10.2% (95% CI −1.3 to 21.7%) inside hotspots 8 wk post

  13. Epidemiology and control of malaria and other arthropod born diseases

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    F. J. López-Antuñano

    1992-01-01

    Full Text Available Malaria and other arthropod born diseases remain a serious public health problem affecting the lives and health of certain social groups when the two basic strategies to control fail due to : (1 the lack of effective chemoprophylaxis/chemotherapy or the rapid development of drug resistance of the infectious agents and (2 the ineffectiveness of pesticides or the arthropod vectors develop resistance to them. These situations enhances the need for the design and implementation of other alternatives for sustainable health programmes. The application of the epidemiological methods is essential not only for analyzing the relevant data for the understanding of the biological characteristics of the infectious agents, their reservoirs and vectors and the methods for their control, but also for the assessment of the human behaviour, the environmental, social and economic factors involved in disease transmission and the capacity of the health systems to implement interventions for both changes in human behaviour and environmental management to purpose guaranteed prevention and control of malaria and other arthropod born diseases with efficiency, efficacy and equity. This paper discuss the evolution of the malaria arthropod diseases programmes in the American Region and the perspectives for their integration into health promotion programs and emphasis is made in the need to establish solid basis in the decision-making process for the selection of intervention strategies to remove the risk factors determining the probability to get sick or die from ABDs. The implications of the general planning and the polices to be adopted in an area should be analyzed in the light of programme feasibility at the local level, in the multisectoral context specific social groups and taking in consideration the principles of stratification and equity

  14. An Evaluation of the National Malaria Surveillance System of Bhutan, 2006-2012, as it Approaches the Goal of Malaria Elimination

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    Nicole West

    2016-08-01

    Full Text Available Introduction: Bhutan is progressing towards malaria elimination. The purpose of this evaluation was to assess the ability of the surveillance system from 2006-2012 to meet the objectives of the Bhutan Vector-borne Disease Control Programme (VDCP and to highlight priorities requiring attention as the nation transitions to elimination.Methods: The evaluation was conducted using the Center for Disease Control guidelines for evaluating public health surveillance systems. Data sources included a search of publically available literature, VDCP program data, and interviews with malaria surveillance personnel. Blood slide quality assurance and control through formal assessment of slide preparation and measures of between reader correlation was performed. Results: Total malaria cases declined from 2006-2012. The average slide positivity rate decreased from 3.4% in 2006 to 0.2% in 2012. The proportion of non-residents in all cases increased to its highest value of 22.6% in 2012, and significant clustering in the border regions of India was noted, with Sarpang accounting for more cases than any other district from 2009 onward. Case detection was almost exclusively passive, but flexibility and sensitivity was demonstrated by the later addition of active case detection and specification of imported and locally-acquired cases. Spatial data was limited to the village level, not allowing identification of transmission hotspots. For blood smears, statistical measures of between reader agreement and predictive value were not computed. Blood smear quality was suboptimal by at least one criteria in over half of evaluated smears. Timeliness in reporting of cases was on a weekly to monthly basis, and did not meet the WHO goal of immediate notification.Conclusions: As of 2012, the national malaria surveillance system demonstrated flexibility, representativeness, simplicity, and stability. The full potential for data analysis was not yet realized. Attaining the goal of

  15. Toward Malaria Risk Prediction in Afghanistan Using Remote Sensing

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    Safi, N.; Adimi, F.; Soebiyanto, R. P.; Kiang, R. K.

    2010-01-01

    Malaria causes more than one million deaths every year worldwide, with most of the mortality in Sub-Saharan Africa. It is also a significant public health concern in Afghanistan, with approximately 60% of the population, or nearly 14 million people, living in a malaria-endemic area. Malaria transmission has been shown to be dependent on a number of environmental and meteorological variables. For countries in the tropics and the subtropics, rainfall is normally the most important variable, except for regions with high altitude where temperature may also be important. Afghanistan s diverse landscape contributes to the heterogeneous malaria distribution. Understanding the environmental effects on malaria transmission is essential to the effective control of malaria in Afghanistan. Provincial malaria data gathered by Health Posts in 23 provinces during 2004-2007 are used in this study. Remotely sensed geophysical parameters, including precipitation from TRMM, and surface temperature and vegetation index from MODIS are used to derive the empirical relationship between malaria cases and these geophysical parameters. Both neural network methods and regression analyses are used to examine the environmental dependency of malaria transmission. And the trained models are used for predicting future transmission. While neural network methods are intrinsically more adaptive for nonlinear relationship, the regression approach lends itself in providing statistical significance measures. Our results indicate that NDVI is the strongest predictor. This reflects the role of irrigation, instead of precipitation, in Afghanistan for agricultural production. The second strongest prediction is surface temperature. Precipitation is not shown as a significant predictor, contrary to other malarious countries in the tropics or subtropics. With the regression approach, the malaria time series are modelled well, with average R2 of 0.845. For cumulative 6-month prediction of malaria cases, the

  16. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P malaria episodes decreased from 906 (49...

  17. Safety and immunogenicity of an AMA-1 malaria vaccine in Malian adults: results of a phase 1 randomized controlled trial.

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    Mahamadou A Thera

    2008-01-01

    Full Text Available The objective was to evaluate the safety, reactogenicity and immunogenicity of the AMA-1-based blood-stage malaria vaccine FMP2.1/AS02A in adults exposed to seasonal malaria.A phase 1 double blind randomized controlled dose escalation trial was conducted in Bandiagara, Mali, West Africa, a rural town with intense seasonal transmission of Plasmodium falciparum malaria. The malaria vaccine FMP2.1/AS02A is a recombinant protein (FMP2.1 based on apical membrane antigen-1 (AMA-1 from the 3D7 clone of P. falciparum, adjuvanted with AS02A. The comparator vaccine was a cell-culture rabies virus vaccine (RabAvert. Sixty healthy, malaria-experienced adults aged 18-55 y were recruited into 2 cohorts and randomized to receive either a half dose or full dose of the malaria vaccine (FMP2.1 25 microg/AS02A 0.25 mL or FMP2.1 50 microg/AS02A 0.5 mL or rabies vaccine given in 3 doses at 0, 1 and 2 mo, and were followed for 1 y. Solicited symptoms were assessed for 7 d and unsolicited symptoms for 30 d after each vaccination. Serious adverse events were assessed throughout the study. Titers of anti-AMA-1 antibodies were measured by ELISA and P. falciparum growth inhibition assays were performed on sera collected at pre- and post-vaccination time points. Transient local pain and swelling were common and more frequent in both malaria vaccine dosage groups than in the comparator group. Anti-AMA-1 antibodies increased significantly in both malaria vaccine groups, peaking at nearly 5-fold and more than 6-fold higher than baseline in the half-dose and full-dose groups, respectively.The FMP2.1/AS02A vaccine had a good safety profile, was well-tolerated, and was highly immunogenic in malaria-exposed adults. This malaria vaccine is being evaluated in Phase 1 and 2 trials in children at this site.

  18. Malaria among gold miners in southern Pará, Brazil: estimates of determinants and individual costs.

    Science.gov (United States)

    Vosti, S A

    1990-01-01

    As malaria grows more prevalent in the Amazon frontier despite increased expenditures by disease control authorities, national and regional tropical disease control strategies are being called into question. The current crisis involving traditional control/eradication methods has broadened the search for feasible and effective malaria control strategies--a search that necessarily includes an investigation of the roles of a series of individual and community-level socioeconomic characteristics in determining malaria prevalence rates, and the proper methods of estimating these links. In addition, social scientists and policy makers alike know very little about the economic costs associated with malarial infections. In this paper, I use survey data from several Brazilian gold mining areas to (a) test the general reliability of malaria-related questionnaire response data, and suggest categorization methods to minimize the statistical influence of exaggerated responses, (b) estimate three statistical models aimed at detecting the socioeconomic determinants of individual malaria prevalence rates, and (c) calculate estimates of the average cost of a single bout of malaria. The results support the general reliability of survey response data gathered in conjunction with malaria research. Once the effects of vector exposure were controlled for, individual socioeconomic characteristics were only weakly linked to malaria prevalence rates in these very special miners' communities. Moreover, the socioeconomic and exposure links that were significant did not depend on the measure of malaria adopted. Finally, individual costs associated with malarial infections were found to be a significant portion of miners' incomes.

  19. Targeting the breeding sites of malaria mosquitoes: biological and physical control of malaria mosquito larvae

    NARCIS (Netherlands)

    Bukhari, S.T.

    2011-01-01


    Malaria causes an estimated 225 million cases and 781,000 deaths every year. About 85% of the deaths are in children under five years of age. Malaria is caused by the Plasmodium parasite which is transmitted by the Anopheles mosquito vector. Mainly two methods of intervention are used for

  20. Clinical presentation of severe malaria due plasmodiun falciparum. casecontrol study in Tumaco and Turbo (Colombia. Clínica de la malaria complicada debida a P. falciparum Estudio de casos y controles en Tumaco y Turbo (Colombia

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    Jaime Carmona Fonseca

    2006-04-01

    Full Text Available Background: Latin American studies on severe falciparum malaria are scarce, therefore, the pattern of complications of the region is uknown. Objectives. To identify characterize severe malaria in patients from Tumaco (Nariño and Turbo (Antioquia in Colombia. Methods. The 2000 World Health Organization criteria for complicated malaria were applied in a cases and controls study. Results. 64 cases (P falciparum complicated malaria and 135 controls (P falciparum uncomplicated malaria were included. The time of evolution of the disease (mean 5.6 days in cases and 5.9 in the controls and the frequency of most symptoms were similar in both groups (p>0.05. However, respiratory distress and jaundice was more frequent in the cases (p<0.05. The mean glycemia and creatinina values were similar in both groups; hemoglobin and platelet count were lower in the cases (p<0.05 when compared to controls. On the other hand, blood ureic nitrogen, aspartatoaminotransferase, and total and direct bilirrubin were lower in controls (p<0.05. The frequency of complications in the cases was as follows: hyperparasitaemia 48%, liver dysfunction 44%, acute respiratory distress syndrome 9%, kidney failure 6%, severe thrombocytopenia 5%, severe anemia 3%, cerebral malaria 3% and severe hipoglycemia 2%. The WHO criteria for severe malaria were compared with others and the implications are discussed. Antecedentes y problema: son muy pocos los estudios latinoamericanos sobre malaria por Plasmodium falciparum (P falciparum complicada y se requiere estudiarla para identificar un patrón propio. OBJETIVOS. Identificar las complicaciones presentes en pacientes de Tumaco (Nariño y Turbo (Antioquia en Colombia, con malaria por P falciparum. MÉTODOS. Diseño de casos y controles. Se aplicaron los criterios diagnósticos de complicación OMS-2000 (Organización Mundial de la Salud. RESULTADOS. Se captaron 64 casos (con malaria por P. falciparum complicada y 135 controles (con malaria por

  1. Impact of Malaria Control on Mortality and Anemia among Tanzanian Children Less than Five Years of Age, 1999-2010.

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    Paul Smithson

    Full Text Available Mainland Tanzania scaled up multiple malaria control interventions between 1999 and 2010. We evaluated whether, and to what extent, reductions in all-cause under-five child mortality (U5CM tracked with malaria control intensification during this period.Four nationally representative household surveys permitted trend analysis for malaria intervention coverage, severe anemia (hemoglobin <8 g/dL prevalence (SAP among children 6-59 months, and U5CM rates stratified by background characteristics, age, and malaria endemicity. Prevalence of contextual factors (e.g., vaccination, nutrition likely to influence U5CM were also assessed. Population attributable risk percentage (PAR% estimates for malaria interventions and contextual factors that changed over time were used to estimate magnitude of impact on U5CM.Household ownership of insecticide-treated nets (ITNs rose from near zero in 1999 to 64% (95% CI, 61.7-65.2 in 2010. Intermittent preventive treatment of malaria in pregnancy reached 26% (95% CI, 23.6-28.0 by 2010. Sulfadoxine-pyrimethamine replaced chloroquine in 2002 and artemisinin-based combination therapy was introduced in 2007. SAP among children 6-59 months declined 50% between 2005 (11.1%; 95% CI, 10.0-12.3% and 2010 (5.5%; 95% CI, 4.7-6.4% and U5CM declined by 45% between baseline (1995-9 and endpoint (2005-9, from 148 to 81 deaths/1000 live births, respectively. Mortality declined 55% among children 1-23 months of age in higher malaria endemicity areas. A large reduction in U5CM was attributable to ITNs (PAR% = 11 with other malaria interventions adding further gains. Multiple contextual factors also contributed to survival gains.Marked declines in U5CM occurred in Tanzania between 1999 and 2010 with high impact from ITNs and ACTs. High-risk children (1-24 months of age in high malaria endemicity experienced the greatest declines in mortality and SAP. Malaria control should remain a policy priority to sustain and further accelerate

  2. Pre-elimination of malaria on the island of Príncipe

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    do Rosario Virgilio E

    2010-01-01

    Full Text Available Abstract Background Plasmodium falciparum is the major species responsible for malaria transmission on the island of Príncipe, in the Republic of São Tomé and Príncipe (STP. Indoor residual spraying (IRS has been intensively deployed on the island, since 2003. Other measures included intermittent preventive therapy (IPT, since 2004, as well as artemisinin-based therapy (ACT and long-lasting insecticidal nets (LLINs from 2005. The work was coordinated by the Ministry of Health of STP through their Centro Nacional de Endemias (CNE and the impact of such an integrated control programme on the prevalence and epidemiology of malaria in Príncipe was evaluated. Methods The scaling-up of preventive strategies included IRS, LLINs, IPT for pregnant women, as well as early diagnosis and prompt treatment with ACT. Regular implementation of an island-wide IRS programme was carried out yearly in 2003-2005, and later in 2008. Malaria incidence and prevalence were estimated based on passive case detection and active case detection, respectively. Slide positivity rate (SPR was used as an indicator of any increase of malaria cases during and after the control programme was initiated. Results Regular IRS achieved a coverage of 85-90% for each of the four annual cycles (2003-2005, annually and one spraying in 2008 while usage of LLINs was never superior to 50% from 2006-2009. Coverage of IPT steadily increased from 50% in 2004 to 80% in 2008. Since 2006, over 90% of uncomplicated malaria patients received ACT treatment. Severe malaria cases were hospitalized and treated with quinine. Monthly trends of SPR were constantly over 50% in 2003, but steadily decreased below 10% in 2006. SPR has been below 5% since 2007, but an increase to up to 15% was noted in June 2009 when 16 imported cases were detected. A steep decline by 99% of malaria incidence was observed between 2003 and 2008, with an incidence risk of the population of five per thousand, in 2008. No

  3. Helminths and malaria co-infections are associated with elevated serum IgE

    DEFF Research Database (Denmark)

    Mulu, Andargachew; Kassu, Afework; Legesse, Mengistu

    2014-01-01

    BACKGROUND: Both helminth and malaria infections result in a highly polarized immune response characterized by IgE production. This study aimed to investigate the total serum IgE profile in vivo as a measure of Th2 immune response in malaria patients with and without helminth co-infection. METHODS......: A cross sectional observational study composed of microscopically confirmed malaria positive (N = 197) and malaria negative (N = 216) apparently healthy controls with and without helminth infection was conducted at Wondo Genet Health Center, Southern Ethiopia. A pre-designed structured format was utilized...... to collect socio-demographic and clinical data of the subjects. Detection and quantification of helminths, malaria parasites and determination of serum IgE levels were carried out following standard procedures. RESULTS: Irrespective of helminth infection, individuals infected by malaria showed significantly...

  4. Vaccines for preventing malaria (blood-stage).

    Science.gov (United States)

    Graves, P; Gelband, H

    2006-10-18

    A malaria vaccine is needed because of the heavy burden of mortality and morbidity due to this disease. This review describes the results of trials of blood (asexual)-stage vaccines. Several are under development, but only one (MSP/RESA, also known as Combination B) has been tested in randomized controlled trials. To assess the effect of blood-stage malaria vaccines in preventing infection, disease, and death. In March 2006, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2006, Issue 1), MEDLINE, EMBASE, LILACS, and the Science Citation Index. We also searched conference proceedings and reference lists of articles, and contacted organizations and researchers in the field. Randomized controlled trials comparing blood-stage vaccines (other than SPf66) against P. falciparum, P. vivax, P. malariae, or P. ovale with placebo, control vaccine, or routine antimalarial control measures in people of any age receiving a challenge malaria infection. Both authors independently assessed trial quality and extracted data. Results for dichotomous data were expressed as relative risks (RR) with 95% confidence intervals (CI). Five trials of MSP/RESA vaccine with 217 participants were included; all five reported on safety, and two on efficacy. No severe or systemic adverse effects were reported at doses of 13 to 15 microg of each antigen (39 to 45 microg total). One small efficacy trial with 17 non-immune participants with blood-stage parasites showed no reduction or delay in parasite growth rates after artificial challenge. In the second efficacy trial in 120 children aged five to nine years in Papua New Guinea, episodes of clinical malaria were not reduced, but MSP/RESA significantly reduced parasite density only in children who had not been pretreated with an antimalarial drug (sulfadoxine-pyrimethamine). Infections with the 3D7 parasite subtype of MSP2 (the variant included in the vaccine) were reduced (RR 0.38, 95% CI 0.26 to

  5. Plasmodium vivax associated severe malaria complications among children in some malaria endemic areas of Ethiopia.

    Science.gov (United States)

    Ketema, Tsige; Bacha, Ketema

    2013-07-08

    Although, Plasmodium vivax is a rare parasite in most parts of Africa, it has significant public health importance in Ethiopia. In some parts of the country, it is responsible for majority of malaria associated morbidity. Recently severe life threatening malaria syndromes, frequently associated to P. falciparum, has been reported from P. vivax mono-infections. This prompted designing of the current study to assess prevalence of severe malaria complications related to P. vivax malaria in Ethiopia. The study was conducted in two study sites, namely Kersa and Halaba Kulito districts, located in southwest and southern parts of Ethiopia, respectively. Children, aged ≤ 10 years, who visited the two health centers during the study period, were recruited to the study. Clinical and demographic characteristics such as age, sex, temperature, diarrhea, persistent vomiting, confusion, respiratory distress, hepatomegaly, splenomegaly, hemoglobinuria, and epitaxis were assessed for a total of 139 children diagnosed to have P. vivax mono-infection. Parasitological data were collected following standard procedures. Hemoglobin and glucose level were measured using portable hemocue instrument. Median age of children was 4.25 ± 2.95 years. Geometric mean parasite count and mean hemoglobin level were 4254.89 parasite/μl and 11.55 g/dl, respectively. Higher prevalence rate of malaria and severe malaria complications were observed among children enrolled in Halaba district (P infection (OR = 1.9, 95% CI, 1.08 to 3.34), while female had higher risk to anemia (OR = 1.91, 95% CI, 1.08 - 3.34). The observed number of anemic children was 43%, of which most of them were found in age range from 0-3 years. Furthermore, P. vivax malaria was a risk factor for incidence of anemia (P lower than those reported from other countries. However, incidence of severe malaria complications in one of the sites, Halaba district, where there is highest treatment failure to first line drug, could have

  6. Assessment of climate-driven variations in malaria incidence in Swaziland: toward malaria elimination.

    Science.gov (United States)

    Chuang, Ting-Wu; Soble, Adam; Ntshalintshali, Nyasatu; Mkhonta, Nomcebo; Seyama, Eric; Mthethwa, Steven; Pindolia, Deepa; Kunene, Simon

    2017-06-01

    Swaziland aims to eliminate malaria by 2020. However, imported cases from neighbouring endemic countries continue to sustain local parasite reservoirs and initiate transmission. As certain weather and climatic conditions may trigger or intensify malaria outbreaks, identification of areas prone to these conditions may aid decision-makers in deploying targeted malaria interventions more effectively. Malaria case-surveillance data for Swaziland were provided by Swaziland's National Malaria Control Programme. Climate data were derived from local weather stations and remote sensing images. Climate parameters and malaria cases between 2001 and 2015 were then analysed using seasonal autoregressive integrated moving average models and distributed lag non-linear models (DLNM). The incidence of malaria in Swaziland increased between 2005 and 2010, especially in the Lubombo and Hhohho regions. A time-series analysis indicated that warmer temperatures and higher precipitation in the Lubombo and Hhohho administrative regions are conducive to malaria transmission. DLNM showed that the risk of malaria increased in Lubombo when the maximum temperature was above 30 °C or monthly precipitation was above 5 in. In Hhohho, the minimum temperature remaining above 15 °C or precipitation being greater than 10 in. might be associated with malaria transmission. This study provides a preliminary assessment of the impact of short-term climate variations on malaria transmission in Swaziland. The geographic separation of imported and locally acquired malaria, as well as population behaviour, highlight the varying modes of transmission, part of which may be relevant to climate conditions. Thus, the impact of changing climate conditions should be noted as Swaziland moves toward malaria elimination.

  7. 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.

  8. Malaria in Children, Prospects and Challenges

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2013-01-01

    Full Text Available Malaria is still the number one killer especially among the young children and is responsible for one death per minute in the world. Overall, between 250-500 million cases of the disease occur worldwide causing more than one million deaths annually about 90% of which in children under five years of age. Although the spread of the disease is worldwide but it is seen mostly in tropical and subtropical regions of all continents and is more so in sub-Saharan Africa. Five parasite species transmitted by more than 70 potent Anopheles mosquito vectors are responsible for the occurrence of the disease and its spread. There have beenseveral approaches for malaria diagnosis, management and prevention as a whole and in children (as the most vulnerable group in particular with various degrees of success. In this context works undertaken by international organizations such as Roll Back Malaria, Global Fund, UNICEF, as well as None for Profit international agencies and also at the national levels are promising in malaria control. However, drug and insecticide resistance, constraints in access to health care, poverty and the like are among the main challenges ahead. In this review paper the situation of malaria and its management measures with especial reference to children are discussed

  9. Vectorial capacity and vector control: reconsidering sensitivity to parameters for malaria elimination.

    Science.gov (United States)

    Brady, Oliver J; Godfray, H Charles J; Tatem, Andrew J; Gething, Peter W; Cohen, Justin M; McKenzie, F Ellis; Perkins, T Alex; Reiner, Robert C; Tusting, Lucy S; Sinka, Marianne E; Moyes, Catherine L; Eckhoff, Philip A; Scott, Thomas W; Lindsay, Steven W; Hay, Simon I; Smith, David L

    2016-02-01

    Major gains have been made in reducing malaria transmission in many parts of the world, principally by scaling-up coverage with long-lasting insecticidal nets and indoor residual spraying. Historically, choice of vector control intervention has been largely guided by a parameter sensitivity analysis of George Macdonald's theory of vectorial capacity that suggested prioritizing methods that kill adult mosquitoes. While this advice has been highly successful for transmission suppression, there is a need to revisit these arguments as policymakers in certain areas consider which combinations of interventions are required to eliminate malaria. Using analytical solutions to updated equations for vectorial capacity we build on previous work to show that, while adult killing methods can be highly effective under many circumstances, other vector control methods are frequently required to fill effective coverage gaps. These can arise due to pre-existing or developing mosquito physiological and behavioral refractoriness but also due to additive changes in the relative importance of different vector species for transmission. Furthermore, the optimal combination of interventions will depend on the operational constraints and costs associated with reaching high coverage levels with each intervention. Reaching specific policy goals, such as elimination, in defined contexts requires increasingly non-generic advice from modelling. Our results emphasize the importance of measuring baseline epidemiology, intervention coverage, vector ecology and program operational constraints in predicting expected outcomes with different combinations of interventions. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  10. Malaria in seafarers. 2. The status of malaria in large ports of the world. Protective measures against malaria in crews of ships.

    Science.gov (United States)

    Tomaszunas, S

    1998-01-01

    In 1997, the information was collected in collaboration with WHO on the actual status of malaria in large ports of Africa, Asia, and America, on the level of endemicity, prevailing Plasmodium species and the resistance to antimalarial drugs. The factors determining the risk of infection in seafarers were discussed. The risk is different than it is for other groups of travellers. The strategy of malaria prevention in crews of ships should be based on balancing the actual risk of infection in the visited ports of the tropics with the risk of side effects of antimalarials used for prophylaxis. Five schemes for malaria prevention in seafarers may be recommended, depending on the geographical areas of the ship's voyage.

  11. Content Analysis of Primary and Secondary School Textbooks Regarding Malaria Control: A Multi-Country Study

    Science.gov (United States)

    Nonaka, Daisuke; Jimba, Masamine; Mizoue, Tetsuya; Kobayashi, Jun; Yasuoka, Junko; Ayi, Irene; Jayatilleke, Achini C.; Shrestha, Sabina; Kikuchi, Kimiyo; Haque, Syed E.; Yi, Siyan

    2012-01-01

    Background In tropical settings, malaria education at school is potentially useful, but textbook content related to malaria education has so far received little attention. This study aimed to examine whether school textbooks contain sufficient knowledge and skills to help children in primary and lower secondary schools and their family members to cope with malaria. Methodology/Principal Findings This was a descriptive, cross-country study. We collected textbooks that were used by children in grades one to nine from nine countries endemic for malaria: Laos, Cambodia, Nepal, Bangladesh, Sri Lanka, Zambia, Niger, Benin, and Ghana. Two reviewers per country identified descriptions about malaria by seeking the term “malaria” or a local word that corresponds to malaria in languages other than English. The authors categorized the identified descriptions according to the content of the descriptions. Additionally, the authors examined whether the identified contents addressed life skill messages. Of a total of 474 textbooks collected, 35 contained descriptions about malaria. The most commonly included content was transmission mode/vector (77.1%), followed by preventive measures (60.0%), epidemiology (57.1%), cause/agent (54.3%), signs/symptoms (37.1%) and treatment (22.9%). Treatment-related content was not included in any textbooks from four countries and textbooks failed to recommend the use of insecticide-treated bed nets in five countries. Very few textbooks included content that facilitated prompt treatment, protection of risk groups, and use of recommended therapy. Conclusion/Significance Textbooks rarely included knowledge and skills that are crucial to protect schoolchildren and their families from malaria. This study identified the need for improvement to textbook contents regarding malaria. PMID:22574203

  12. Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana.

    Science.gov (United States)

    Krefis, Anne Caroline; Schwarz, Norbert Georg; Nkrumah, Bernard; Acquah, Samuel; Loag, Wibke; Sarpong, Nimako; Adu-Sarkodie, Yaw; Ranft, Ulrich; May, Jürgen

    2010-07-13

    The socioeconomic and sociodemographic situation are important components for the design and assessment of malaria control measures. In malaria endemic areas, however, valid classification of socioeconomic factors is difficult due to the lack of standardized tax and income data. The objective of this study was to quantify household socioeconomic levels using principal component analyses (PCA) to a set of indicator variables and to use a classification scheme for the multivariate analysis of children<15 years of age presented with and without malaria to an outpatient department of a rural hospital. In total, 1,496 children presenting to the hospital were examined for malaria parasites and interviewed with a standardized questionnaire. The information of eleven indicators of the family's housing situation was reduced by PCA to a socioeconomic score, which was then classified into three socioeconomic status (poor, average and rich). Their influence on the malaria occurrence was analysed together with malaria risk co-factors, such as sex, parent's educational and ethnic background, number of children living in a household, applied malaria protection measures, place of residence and age of the child and the mother. The multivariate regression analysis demonstrated that the proportion of children with malaria decreased with increasing socioeconomic status as classified by PCA (p<0.05). Other independent factors for malaria risk were the use of malaria protection measures (p<0.05), the place of residence (p<0.05), and the age of the child (p<0.05). The socioeconomic situation is significantly associated with malaria even in holoendemic rural areas where economic differences are not much pronounced. Valid classification of the socioeconomic level is crucial to be considered as confounder in intervention trials and in the planning of malaria control measures.

  13. Worldwide incidence of malaria in 2009: estimates, time trends, and a critique of methods.

    Directory of Open Access Journals (Sweden)

    Richard E Cibulskis

    2011-12-01

    Full Text Available BACKGROUND: Measuring progress towards Millennium Development Goal 6, including estimates of, and time trends in, the number of malaria cases, has relied on risk maps constructed from surveys of parasite prevalence, and on routine case reports compiled by health ministries. Here we present a critique of both methods, illustrated with national incidence estimates for 2009. METHODS AND FINDINGS: We compiled information on the number of cases reported by National Malaria Control Programs in 99 countries with ongoing malaria transmission. For 71 countries we estimated the total incidence of Plasmodium falciparum and P. vivax by adjusting the number of reported cases using data on reporting completeness, the proportion of suspects that are parasite-positive, the proportion of confirmed cases due to each Plasmodium species, and the extent to which patients use public sector health facilities. All four factors varied markedly among countries and regions. For 28 African countries with less reliable routine surveillance data, we estimated the number of cases from model-based methods that link measures of malaria transmission with case incidence. In 2009, 98% of cases were due to P. falciparum in Africa and 65% in other regions. There were an estimated 225 million malaria cases (5th-95th centiles, 146-316 million worldwide, 176 (110-248 million in the African region, and 49 (36-68 million elsewhere. Our estimates are lower than other published figures, especially survey-based estimates for non-African countries. CONCLUSIONS: Estimates of malaria incidence derived from routine surveillance data were typically lower than those derived from surveys of parasite prevalence. Carefully interpreted surveillance data can be used to monitor malaria trends in response to control efforts, and to highlight areas where malaria programs and health information systems need to be strengthened. As malaria incidence declines around the world, evaluation of control efforts

  14. Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

    Directory of Open Access Journals (Sweden)

    Deribew Amare

    2010-11-01

    Full Text Available Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34, who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36, who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42 and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45 were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

  15. Optimization of formulation and delivery technology of entomopathogenic fungi for malaria vector control

    NARCIS (Netherlands)

    Mnyone, L.L.

    2010-01-01

    Vector control is one of the most effective means of controlling mosquito-borne diseases such as malaria. The broad goal of this strategy is to protect individuals against infective mosquito bites and, at the community level, to reduce the intensity of disease transmission. With the deployment of

  16. Controlled human malaria infection by intramuscular and direct venous inoculation of cryopreserved Plasmodium falciparum sporozoites in malaria-naïve volunteers: effect of injection volume and dose on infectivity rates

    NARCIS (Netherlands)

    Gómez-Pérez, Gloria P.; Legarda, Almudena; Muñoz, Jose; Sim, B. Kim Lee; Ballester, María Rosa; Dobaño, Carlota; Moncunill, Gemma; Campo, Joseph J.; Cisteró, Pau; Jimenez, Alfons; Barrios, Diana; Mordmüller, Benjamin; Pardos, Josefina; Navarro, Mireia; Zita, Cecilia Justino; Nhamuave, Carlos Arlindo; García-Basteiro, Alberto L.; Sanz, Ariadna; Aldea, Marta; Manoj, Anita; Gunasekera, Anusha; Billingsley, Peter F.; Aponte, John J.; James, Eric R.; Guinovart, Caterina; Antonijoan, Rosa M.; Kremsner, Peter G.; Hoffman, Stephen L.; Alonso, Pedro L.

    2015-01-01

    Controlled human malaria infection (CHMI) by mosquito bite is a powerful tool for evaluation of vaccines and drugs against Plasmodium falciparum malaria. However, only a small number of research centres have the facilities required to perform such studies. CHMI by needle and syringe could help to

  17. Nuclear science fights malaria. Radiation and molecular techniques can play targeted roles

    International Nuclear Information System (INIS)

    Groth, Steffen; Khan, Baldip; Robinson, Alan; Hendrichs, Jorge

    2001-01-01

    Malaria is the most important insect transmitted disease. Globally there are 300 to 500 million clinical cases of malaria a year. They result in two million deaths per year (one every 30 seconds), more than 90% of which occur in sub-Saharan Africa. More than 90% of those affected are children less than five years old. The economic impact of the disease is felt disproportionately by poor families who may spend a fourth of their annual income on prevention and control measures. The causative agents are parasites of the genus Plasmodium and they are transmitted only by female mosquitoes of the genus Anopheles. Among key strategies to control malaria are the surveillance of anti-malarial drug efficacy through monitoring the levels of drug resistance, and the reduction of mosquito populations. Nuclear techniques can play important roles in these efforts to combat malaria. This article reports on IAEA activities associated with drug-resistant malaria and describes how molecular methods making use of radioactive isotopes can provide a great advantage in the diagnosis of resistance. The article further presents the IAEA's plans for initiating a research programme to assess the feasibility of developing the Sterile Insect Technique (SIT) as a complementary method to control the vector of malaria

  18. A decade of malaria during pregnancy in Brazil: what has been done concerning prevention and management

    Directory of Open Access Journals (Sweden)

    Paola Marchesini

    2014-08-01

    Full Text Available In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012 using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

  19. The application of evolutionary medicine principles for sustainable malaria control: a scoping study.

    Science.gov (United States)

    Ocampo, Denise; Booth, Mark

    2016-07-22

    Current interventions against malaria have significantly reduced the number of people infected and the number of deaths. Concerns about emerging resistance of both mosquitoes and parasites to intervention have been raised, and questions remain about how best to generate wider knowledge of the underlying evolutionary processes. The pedagogical and research principles of evolutionary medicine may provide an answer to this problem. Eight programme managers and five academic researchers were interviewed by telephone or videoconference to elicit their first-hand views and experiences of malaria control given that evolution is a constant threat to sustainable control. Interviewees were asked about their views on the relationship between practit groups and academics and for their thoughts on whether or not evolutionary medicine may provide a solution to reported tensions. There was broad agreement that evolution of both parasites and vectors presents an obstacle to sustainable control. It was also widely agreed that through more efficient monitoring, evolution could be widely monitored. Interviewees also expressed the view that even well planned interventions may fail if the evolutionary biology of the disease is not considered, potentially making current tools redundant. This scoping study suggests that it is important to make research, including evolutionary principles, available and easily applicable for programme managers and key decision-makers, including donors and politicians. The main conclusion is that sharing knowledge through the educational and research processes embedded within evolutionary medicine has potential to relieve tensions and facilitate sustainable control of malaria and other parasitic infections.

  20. Malaria vaccines and their potential role in the elimination of malaria

    Directory of Open Access Journals (Sweden)

    Greenwood Brian M

    2008-12-01

    Full Text Available Abstract Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination, now being considered seriously in some epidemiological situations, requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. The feature of the life-cycles of human malarias that presents the greatest challenge to an elimination programme is the persistence of parasites as asymptomatic infections. These are an important source from which transmission to mosquitoes can occur. Consequently, an elimination strategy requires a community-based approach covering all individuals and not just those who are susceptible to clinical malaria. The progress that has been made in development of candidate malaria vaccines is reviewed. It is unlikely that many of these will have the efficacy required for complete elimination of parasites, though they may have an important role to play as part of future integrated control programmes. Vaccines for elimination must have a high level of efficacy in order to stop transmission to mosquitoes. This might be achieved with some pre-erythrocytic stage candidate vaccines or by targeting the sexual stages directly with transmission-blocking vaccines. An expanded malaria vaccine programme with such objectives is now a priority.

  1. Mapping hypoendemic, seasonal malaria in rural Bandarban, Bangladesh: a prospective surveillance

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    Glass Gregory

    2011-05-01

    Full Text Available Abstract Background Until recently the Chittagong Hill tracts have been hyperendemic for malaria. A past cross-sectional RDT based survey in 2007 recorded rates of approximately 15%. This study was designed to understand the present epidemiology of malaria in this region, to monitor and facilitate the uptake of malaria intervention activities of the national malaria programme and to serve as an area for developing new and innovative control strategies for malaria. Methods This research field area was established in two rural unions of Bandarban District of Bangladesh north of Bandarban city, which are known to be endemic for malaria due to Plasmodium falciparum. The project included the following elements: a a demographic surveillance system including an initial census with updates every four months, b periodic surveys of knowledge attitude and practice, c a geographic information system, d weekly active and continuous passive surveillance for malaria infections using smears, rapid tests and PCR, f monthly mosquito surveillance, and e daily weather measures. The programme included both traditional and molecular methods for detecting malaria as well as lab methods for speciating mosquitoes and detecting mosquitoes infected with sporozoites. Results The demographic surveillance enumerated and mapped 20,563 people, 75% of which were tribal non-Bengali. The monthly mosquito surveys identified 22 Anopheles species, eight of which were positive by circumsporozoite ELISA. The annual rate of malaria was close to 1% with 85% of cases in the rainy months of May-October. Definitive clustering identified in the low transmission season persisted during the high transmission season. Conclusion This demographically and geographically defined area, near to the Myanmar border, which is also hypoendemic for malaria, will be useful for future studies of the epidemiology of malaria and for evaluation of strategies for malaria control including new drugs and

  2. 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

    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......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...... 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...

  3. A controlled human malaria infection model enabling evaluation of transmission-blocking interventions

    NARCIS (Netherlands)

    Collins, K.A.; Wang, C.Y.; Adams, M.; Mitchell, H.; Rampton, M.; Elliott, S.; Reuling, I.J.; Bousema, T.; Sauerwein, R.; Chalon, S.; Mohrle, J.J.; McCarthy, J.S.

    2018-01-01

    BACKGROUND: Drugs and vaccines that can interrupt the transmission of Plasmodium falciparum will be important for malaria control and elimination. However, models for early clinical evaluation of candidate transmission-blocking interventions are currently unavailable. Here, we describe a new model

  4. Muscling out malaria

    DEFF Research Database (Denmark)

    Hughes, David Peter; Boomsma, Jacobus Jan

    2006-01-01

    ) [2] highlighted the back-to-back articles in Science 3 and 4 that demonstrated the potential biocontrol of malaria by targeting mosquitoes with entomopathogenic fungi (Metarhizium and Beauveria spp.). The wide impact of the original articles and the need to find alternatives to pesticidal control...... where malaria is endemic, humanity cannot afford shortcuts, because any failures owing to poor management or premature implementation will reduce local governmental support rather than enhance it (Andrew Read, pers. commun.). Therefore, if we are to ‘muscle out malaria', well...... of key importance, and the new focus on fungal biocontrol of malaria should therefore act as a catalyst for further research on the basic biology of fungal pathogens. Understanding morphological, biochemical or immune system-based resistance to insect pathogenic fungi will be easier if we know...

  5. Childhood malaria: mothers' perception and treatment- seeking ...

    African Journals Online (AJOL)

    major strategies for reducing the burden of malaria, therefore ... children. The incidence of history of fever, indicative of malaria in children of the respondents within one ... interventions for the control of childhood malaria. ..... Yellow eyes. 20.

  6. Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Castro, Marcia C; Tsuruta, Atsuko; Kanamori, Shogo; Kannady, Khadija; Mkude, Sixbert

    2009-04-08

    Historically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains. A survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages. Individual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05-0.3, p water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success. Although environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial

  7. Case management of malaria: Diagnosis

    African Journals Online (AJOL)

    triggering control programme action, and detecting gametocyte carriers, who may ... clinical malaria does not generally apply to local-born populations, although it ... deficiencies in the quality of malaria diagnosis in routine laboratories. Quality ...

  8. Acceptability by community health workers in Senegal of combining community case management of malaria and seasonal malaria chemoprevention

    DEFF Research Database (Denmark)

    Tine, Roger Ck; Ndiaye, Pascal; Ndour, Cheikh T

    2013-01-01

    Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. However, little is known about the social acceptability of these interventions. A study was undertaken...... to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs)....

  9. Assessing the social vulnerability to malaria in Rwanda.

    Science.gov (United States)

    Bizimana, Jean-Pierre; Twarabamenye, Emmanuel; Kienberger, Stefan

    2015-01-07

    Since 2004, malaria interventions in Rwanda have resulted in substantial decline of malaria incidence. However, this achievement is fragile as potentials for local malaria transmissions remain. The risk of getting malaria infection is partially explained by social conditions of vulnerable populations. Since vulnerability to malaria is both influenced by social and environmental factors, its complexity cannot be measured by a single value. The aim of this paper is, therefore, to apply a composite indicator approach for assessing social vulnerability to malaria in Rwanda. This assessment informs the decision-makers in targeting malaria interventions and allocating limited resources to reduce malaria burden in Rwanda. A literature review was used to conceptualize the social vulnerability to malaria and to select the appropriate vulnerability indicators. Indicators used in the index creation were classified into susceptibility and lack of resilience vulnerability domains. The main steps followed include selection of indicators and datasets, imputation of missing values, descriptive statistics, normalization and weighting of indicators, local sensitivity analysis and indicators aggregation. Correlation analysis helped to empirically evidence the association between the indicators and malaria incidence. The high values of social vulnerability to malaria are found in Gicumbi, Rusizi, Nyaruguru and Gisagara, and low values in Muhanga, Nyarugenge, Kicukiro and Nyanza. The most influential susceptibility indicators to increase malaria are population change (r = 0.729), average number of persons per bedroom (r = 0.531), number of households affected by droughts and famines (r = 0.591), and area used for irrigation (r = 0.611). The bed net ownership (r = -0.398) and poor housing wall materials (0.378) are the lack of resilience indicators that significantly correlate with malaria incidence. The developed composite index social vulnerability to malaria

  10. Surveillance and Control of Malaria Transmission in Thailand using Remotely Sensed Meteorological and Environmental Parameters

    Science.gov (United States)

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

    2007-01-01

    These slides address the use of remote sensing in a public health application. Specifically, this discussion focuses on the of remote sensing to detect larval habitats to predict current and future endemicity and identify key factors that sustain or promote transmission of malaria in a targeted geographic area (Thailand). In the Malaria Modeling and Surveillance Project, which is part of the NASA Applied Sciences Public Health Applications Program, we have been developing techniques to enhance public health's decision capability for malaria risk assessments and controls. The main objectives are: 1) identification of the potential breeding sites for major vector species; 2) implementation of a risk algorithm to predict the occurrence of malaria and its transmission intensity; 3) implementation of a dynamic transmission model to identify the key factors that sustain or intensify malaria transmission. 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. Textural-contextual classifications are used to identify small larval habitats. Neural network methods are used to model malaria cases as a function of the remotely sensed parameters. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records. Discrete event simulations are used for modeling the detailed interactions among the vector life cycle, sporogonic cycle and human infection cycle, under the explicit influences of selected extrinsic and intrinsic factors

  11. Malaria and urbanization in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Donnelly, Martin J; McCall, P J; Lengeler, Christian

    2005-01-01

    There are already 40 cities in Africa with over 1 million inhabitants and the United Nations Environmental Programme estimates that by 2025 over 800 million people will live in urban areas. Recognizing that malaria control can improve the health of the vulnerable and remove a major obstacle...... to their economic development, the Malaria Knowledge Programme of the Liverpool School of Tropical Medicine and the Systemwide Initiative on Malaria and Agriculture convened a multi-sectoral technical consultation on urban malaria in Pretoria, South Africa from 2nd to 4th December, 2004. The aim of the meeting...... was to identify strategies for the assessment and control of urban malaria. This commentary reflects the discussions held during the meeting and aims to inform researchers and policy makers of the potential for containing and reversing the emerging problem of urban malaria....

  12. Malaria and urbanization in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Klinkenberg Eveline

    2005-02-01

    Full Text Available Abstract There are already 40 cities in Africa with over 1 million inhabitants and the United Nations Environmental Programme estimates that by 2025 over 800 million people will live in urban areas. Recognizing that malaria control can improve the health of the vulnerable and remove a major obstacle to their economic development, the Malaria Knowledge Programme of the Liverpool School of Tropical Medicine and the Systemwide Initiative on Malaria and Agriculture convened a multi-sectoral technical consultation on urban malaria in Pretoria, South Africa from 2nd to 4th December, 2004. The aim of the meeting was to identify strategies for the assessment and control of urban malaria. This commentary reflects the discussions held during the meeting and aims to inform researchers and policy makers of the potential for containing and reversing the emerging problem of urban malaria.

  13. Progress toward elimination of malaria in Nigeria: Uptake of ...

    African Journals Online (AJOL)

    2010, the National Malaria Control Strategic Plan shifted the ..... a multidimensional construct, and a single measure such as ... medicine vendors using strategies for behavioral change .... and health worker readiness to deliver new national.

  14. Exploring the impact of house screening intervention on entomological indices and incidence of malaria in Arba Minch town, southwest Ethiopia: A randomized control trial.

    Science.gov (United States)

    Getawen, Solomon Kinde; Ashine, Temesgen; Massebo, Fekadu; Woldeyes, Daniel; Lindtjørn, Bernt

    2018-05-01

    House is the major site for malaria infection where most human-vector contact takes place. Hence, improving housing might reduce the risk of malaria infection by limiting house entry of vectors. This study aimed to explore the impact of screening doors and windows with wire meshes on density and entomological inoculation rate (EIR) of malaria vector, and malaria incidence, and assess the acceptability, durability, and cost of the intervention. The susceptibility status of malaria vector was also assessed. A two-arm randomized trial was done in Arba Minch Town, southwest Ethiopia. 92 houses were randomly included in the trial. The baseline entomological and malaria prevalence data were collected. The mosquito sampling was done twice per household per month by Centers for Diseases Control and Prevention (CDC) light traps for six months. The baseline prevalence of malaria was assessed by testing 396 (83% of the 447 study participants) household members in all the eligible houses. The 92 houses were then randomized into control and intervention groups using mosquito and malaria prevalence baseline data to make the two groups comparable except the intervention. Then, we put wire-mesh on doors and windows of 46 houses. Post-screening mosquito collection was done in each household twice per month for three months. Each household member was visited twice per month for six months to assess malaria episodes. The frequency of damage to different structure of screening was measured twice. In-depth interview was conducted with 24 purposely selected household heads from intervention group. Speciation of Anopheles mosquito was done by morphological key, and the circum-sporozoite proteins (CSPs) analysis was done using enzyme-linked immunosorbent assay. A generalized estimating equation with a negative binomial distribution was used to assess the impact of the intervention on the indoor density of vectors. Clinical malaria case data were analyzed using Poisson regression with

  15. Malaria case clinical profiles and Plasmodium falciparum parasite genetic diversity: a cross sectional survey at two sites of different malaria transmission intensities in Rwanda.

    Science.gov (United States)

    Kateera, Fredrick; Nsobya, Sam L; Tukwasibwe, Stephen; Mens, Petra F; Hakizimana, Emmanuel; Grobusch, Martin P; Mutesa, Leon; Kumar, Nirbhay; van Vugt, Michele

    2016-04-26

    Malaria remains a public health challenge in sub-Saharan Africa with Plasmodium falciparum being the principal cause of malaria disease morbidity and mortality. Plasmodium falciparum virulence is attributed, in part, to its population-level genetic diversity-a characteristic that has yet to be studied in Rwanda. Characterizing P. falciparum molecular epidemiology in an area is needed for a better understand of malaria transmission and to inform choice of malaria control strategies. In this health-facility based survey, malaria case clinical profiles and parasite densities as well as parasite genetic diversity were compared among P. falciparum-infected patients identified at two sites of different malaria transmission intensities in Rwanda. Data on demographics and clinical features and finger-prick blood samples for microscopy and parasite genotyping were collected(.) Nested PCR was used to genotype msp-2 alleles of FC27 and 3D7. Patients' variables of age group, sex, fever (both by patient report and by measured tympanic temperatures), parasite density, and bed net use were found differentially distributed between the higher endemic (Ruhuha) and lower endemic (Mubuga) sites. Overall multiplicity of P. falciparum infection (MOI) was 1.73 but with mean MOI found to vary significantly between 2.13 at Ruhuha and 1.29 at Mubuga (p < 0.0001). At Ruhuha, expected heterozygosity (EH) for FC27 and 3D7 alleles were 0.62 and 0.49, respectively, whilst at Mubuga, EH for FC27 and 3D7 were 0.26 and 0.28, respectively. In this study, a higher geometrical mean parasite counts, more polyclonal infections, higher MOI, and higher allelic frequency were observed at the higher malaria-endemic (Ruhuha) compared to the lower malaria-endemic (Mubuga) area. These differences in malaria risk and MOI should be considered when choosing setting-specific malaria control strategies, assessing p. falciparum associated parameters such as drug resistance, immunity and impact of used

  16. Spatio-Temporal Analysis to Predict Environmental Influence on Malaria

    Science.gov (United States)

    Baig, S.; Sarfraz, M. S.

    2018-05-01

    Malaria is a vector borne disease which is a major cause of morbidity and mortality. It is one of the major diseases in the category of infectious diseases. The survival and bionomics of malaria is affected by environmental factors such as climatic, demographic and land-use/land-cover etc. Currently, a very few under developing countries are using Geo-informatics approaches to control this disease. Gujrat a district of Pakistan, is still under threat of malaria disease. Current research is carried on malaria incidents obtained from District Executive Officer of Health Gujrat. The objective of this study was to explore the spatio-temporal patterns of malaria in district Gujrat and to identify the areas being affected by Malaria. Furthermore, it has been also analyzed the relationship between malaria incident and environmental factors in highly favorable zones. Data is analyzed based on spatial and temporal patterns using (Moran's I). Moreover cluster and hot spots analysis were performed on the incident data. This study shows positive correlation with rainfall, vegetation index, population density and water bodies; while it shows positive and negative correlation with temperature in different seasons. However, variation between amount of vegetation and water bodies were observed. Finding of this research can help the decision makers to take preventive measures and reduce the morbidity and mortality related with malaria in Gujrat, Pakistan.

  17. Scepticism towards insecticide treated mosquito nets for malaria control in rural community in north-western Tanzania.

    Science.gov (United States)

    Nnko, Soori E; Whyte, Susan R; Geissler, Wenzel P; Aagaard-Hansen, Jens

    2012-04-01

    Despite existence of effective tools for malaria control, malaria continues to be one of the leading killer diseases especially among under-five year children and pregnant women in poor rural populations of Sub Saharan Africa. In Tanzania Mainland the disease contributes to 39.4% of the total OPD attendances. In terms of mortality, malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria in Mwanza region, North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional approach that tend to study low uptake of health interventions in terms of structural practical constraints--cost, accessibility, everyday priorities--or in terms of cognition--insufficient knowledge of benefits e.g. ignorance of public health messages. This paper has shown that, the majority of people who could afford the prices of ITNs and who knew where to obtain the insecticides did not necessarily buy them. This suggests that, although people tend to report cost-related factors as a barrier against the use of ITNs, there are other critical concerns at work. Without underestimating the practical factors, our study have recommended to consider critical examinations of those other concerns that hinder optimal utilization of ITN for malaria control, and the basis for those concerns.

  18. Malaria, malnutrition, and birthweight

    DEFF Research Database (Denmark)

    Cates, Jordan E.; Unger, Holger W.; Briand, Valerie

    2017-01-01

    were identified by the Maternal Malaria and Malnutrition (M3) initiative using a convenience sampling approach and were eligible for pooling given adequate ethical approval and availability of essential variables. Study-specific adjusted effect estimates were calculated using inverse probability...... be multiplicative interaction between malaria infection at enrollment and low MUAC within studies conducted in Africa; however, this finding was not consistent on the additive scale, when accounting for multiple comparisons, or when using other definitions of malaria and malnutrition. The major limitations...... of the study included availability of only 2 cross-sectional measurements of malaria and the limited availability of ultrasound-based pregnancy dating to assess impacts on preterm birth and fetal growth in all studies.  Conclusions : Pregnant women with malnutrition and malaria infection are at increased risk...

  19. Enhancing the application of effective malaria interventions in Africa through training.

    Science.gov (United States)

    Ijumba, Jasper N; Kitua, Andrew Y

    2004-08-01

    Africa bears more than 90% of the entire global malaria disease burden. Surprisingly, even with the current renewed interest in malaria prevention and control and the enabling environment resulting from the Roll Back Malaria initiative and the political commitment made by the African Presidents at the Abuja Summit, there are still no significant initiatives for strengthening capacity for malaria control through training within the African continent itself. The Center for Enhancement of Effective Malaria Interventions (CEEMI) has been established in Dar es Salaam, Tanzania for results-oriented training. It is intended to provide the needed skills for identifying and solving malaria control problems and providing incentives to malaria control workers in their work performance. The intention is to produce implementers with leadership skills for planning and managing malaria control activities and who can use strategic thinking in improving their work performance. To sustain political commitment and support and to sensitize the community on malaria issues, the CEEMI, in collaboration with the Ministry of Health (National Malaria Control Program), the Institute of Journalism and Mass Communication of the University of Dar es Salaam, and the Commonwealth Broadcasting Association have already conducted malaria seminars for Tanzanian Members of Parliament and journalists from Kenya, Malawi, Tanzania, and Uganda. Additionally, a diploma course in health communication is being developed for journalists and for the same purpose. Also being developed is a training module for "Council Malaria Focal Person." This is aimed at complementing the Roll Back Malaria initiative to meet the Abuja targets of reducing morbidity and mortality due to malaria by 50% by 2010. Copyright 2004 The American Society of Tropical Medicine and Hygiene

  20. Malaria chemotherapy.

    Science.gov (United States)

    Winstanley, Peter; Ward, Stephen

    2006-01-01

    Most malaria control strategies today depend on safe and effective drugs, as they have done for decades. But sensitivity to chloroquine, hitherto the workhorse of malaria chemotherapy, has rapidly declined throughout the tropics since the 1980s, and this drug is now useless in many high-transmission areas. New options for resource-constrained governments are few, and there is growing evidence that the burden from malaria has been increasing, as has malaria mortality in Africa. In this chapter, we have tried to outline the main pharmacological properties of current drugs, and their therapeutic uses and limitations. We have summarised the ways in which these drugs are employed, both in the formal health sector and in self-medication. We have briefly touched on the limitations of current drug development, but have tried to pick out a few promising drugs that are under development. Given that Plasmodium falciparum is the organism that kills, and that has developed multi-drug resistance, we have tended to focus upon it. Similarly, given that around 90% of global mortality from malaria occurs in Africa, there is the tendency to dwell on this continent. We give no apology for placing our emphasis upon the use of antimalarial drugs in endemic populations rather than their use for prophylaxis in travellers.

  1. Mefloquine prophylaxis prevents malaria during pregnancy: a double-blind, placebo-controlled study

    NARCIS (Netherlands)

    Nosten, F.; ter Kuile, F.; Maelankiri, L.; Chongsuphajaisiddhi, T.; Nopdonrattakoon, L.; Tangkitchot, S.; Boudreau, E.; Bunnag, D.; White, N. J.

    1994-01-01

    A double-blind, placebo-controlled study of mefloquine antimalarial prophylaxis in pregnancy (> 20 weeks of gestation) was conducted in 339 Karen women living in an area of multidrug-resistant malaria transmission on the Thai-Burmese border. Mefloquine gave > or = 86% (95% confidence interval [CI],

  2. A micro-epidemiological analysis of febrile malaria in Coastal Kenya showing hotspots within hotspots.

    Science.gov (United States)

    Bejon, Philip; Williams, Thomas N; Nyundo, Christopher; Hay, Simon I; Benz, David; Gething, Peter W; Otiende, Mark; Peshu, Judy; Bashraheil, Mahfudh; Greenhouse, Bryan; Bousema, Teun; Bauni, Evasius; Marsh, Kevin; Smith, David L; Borrmann, Steffen

    2014-04-24

    Malaria transmission is spatially heterogeneous. This reduces the efficacy of control strategies, but focusing control strategies on clusters or 'hotspots' of transmission may be highly effective. Among 1500 homesteads in coastal Kenya we calculated (a) the fraction of febrile children with positive malaria smears per homestead, and (b) the mean age of children with malaria per homestead. These two measures were inversely correlated, indicating that children in homesteads at higher transmission acquire immunity more rapidly. This inverse correlation increased gradually with increasing spatial scale of analysis, and hotspots of febrile malaria were identified at every scale. We found hotspots within hotspots, down to the level of an individual homestead. Febrile malaria hotspots were temporally unstable, but 4 km radius hotspots could be targeted for 1 month following 1 month periods of surveillance.DOI: http://dx.doi.org/10.7554/eLife.02130.001. Copyright © 2014, Bejon et al.

  3. Rapid urban malaria appraisal (RUMA I: Epidemiology of urban malaria in Ouagadougou

    Directory of Open Access Journals (Sweden)

    Convelbo Natalie

    2005-09-01

    Full Text Available Abstract Background Rapid urbanization in sub-Saharan Africa has a major impact on malaria epidemiology. While much is known about malaria in rural areas in Burkina Faso, the urban situation is less well understood. Methods An assessment of urban malaria was carried out in Ouagadougou in November -December, 2002 during which a rapid urban malaria appraisal (RUMA was applied. Results The school parasitaemia prevalence was relatively high (48.3% at the cold and dry season 2002. Routine malaria statistics indicated that seasonality of malaria transmission was marked. In the health facilities, the number of clinical cases diminished quickly at the start of the cold and dry season and the prevalence of parasitaemia detected in febrile and non-febrile cases was 21.1% and 22.0%, respectively. The health facilities were likely to overestimate the malaria incidence and the age-specific fractions of malaria-attributable fevers were low (0–0.13. Peak prevalence tended to occur in older children (aged 6–15 years. Mapping of Anopheles sp. breeding sites indicated a gradient of endemicity between the urban centre and the periphery of Ouagadougou. A remarkable link was found between urban agriculture activities, seasonal availability of water supply and the occurrence of malaria infections in this semi-arid area. The study also demonstrated that the usage of insecticide-treated nets and the education level of family caretakers played a key role in reducing malaria infection rates. Conclusion These findings show that determining local endemicity and the rate of clinical malaria cases are urgently required in order to target control activities and avoid over-treatment with antimalarials. The case management needs to be tailored to the level of the prevailing endemicity.

  4. morphological identification of malaria vectors within anopheles

    African Journals Online (AJOL)

    DR. AMIN

    Africa among the human population. Determination of risk of malaria transmission requires quick and accurate methods of identification of Anopheles mosquitoes especially when targeting vector control. (Maxwell, et al., 2003). Anopheles mosquito transmits malaria. The most important vectors of malaria are members of.

  5. Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania.

    Science.gov (United States)

    Moshi, Irene R; Ngowo, Halfan; Dillip, Angel; Msellemu, Daniel; Madumla, Edith P; Okumu, Fredros O; Coetzee, Maureen; Mnyone, Ladslaus L; Manderson, Lenore

    2017-07-04

    were reported to be the main reasons for staying outdoors during the evening. Participants reported wearing long sleeved clothes, fanning and slapping themselves, using repellents, and burning cow dung and neem tree leaves to chase away mosquitoes. Community understanding of multiple prevention strategies is crucial given changes in mosquito host seeking behaviour and the increased incidence of outdoor biting. The current low use of outdoor control measures is attributed largely to limited awareness of outdoor transmission. Improved community understanding of outdoor malaria transmission is critical: efforts to reduce or eliminate malaria transmission will not be successful if the control of outdoor transmission is not emphasized.

  6. Malaria after international travel: a GeoSentinel analysis, 2003-2016.

    Science.gov (United States)

    Angelo, Kristina M; Libman, Michael; Caumes, Eric; Hamer, Davidson H; Kain, Kevin C; Leder, Karin; Grobusch, Martin P; Hagmann, Stefan H; Kozarsky, Phyllis; Lalloo, David G; Lim, Poh-Lian; Patimeteeporn, Calvin; Gautret, Philippe; Odolini, Silvia; Chappuis, François; Esposito, Douglas H

    2017-07-20

    More than 30,000 malaria cases are reported annually among international travellers. Despite improvements in malaria control, malaria continues to threaten travellers due to inaccurate perception of risk and sub-optimal pre-travel preparation. Records with a confirmed malaria diagnosis after travel from January 2003 to July 2016 were obtained from GeoSentinel, a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. Records were excluded if exposure country was missing or unascertainable or if there was a concomitant acute diagnosis unrelated to malaria. Records were analyzed to describe the demographic and clinical characteristics of international travellers with malaria. There were 5689 travellers included; 325 were children travel visit. More than half (62%) were hospitalized; children were hospitalized more frequently than adults (73 and 62%, respectively). Ninety-two per cent had a single Plasmodium species diagnosis, most frequently Plasmodium falciparum (4011; 76%). Travellers with P. falciparum were most frequently VFRs (60%). More than 40% of travellers with a trip duration ≤7 days had Plasmodium vivax. There were 444 (8%) travellers with severe malaria; 31 children had severe malaria. Twelve travellers died. Malaria remains a serious threat to international travellers. Efforts must focus on preventive strategies aimed on children and VFRs, and chemoprophylaxis access and preventive measure adherence should be emphasized.

  7. Vertical and horizontal equity of funding for malaria control: a global multisource funding analysis for 2006-2010.

    Science.gov (United States)

    Barrenho, Eliana; Miraldo, Marisa; Shaikh, Mujaheed; Atun, Rifat

    2017-01-01

    International and domestic funding for malaria is critically important to achieve the Sustainable Development Goals. Its equitable distribution is key in ensuring that the available, scarce, resources are deployed efficiently for improved progress and a sustained response that enables eradication. We used concentration curves and concentration indices to assess inequalities in malaria funding by different donors across countries, measuring both horizontal and vertical equity. Horizontal equity assesses whether funding is distributed in proportion to health needs, whereas vertical equity examines whether unequal economic needs are addressed by appropriately unequal funding. We computed the Health Inequity Index and the Kakwani Index to assess the former and the latter, respectively. We used data from the World Bank, Global Fund, Unicef, President's Malaria Initiative and the Malaria Atlas Project to assess the distribution of funding against need for 94 countries. National gross domestic product per capita was used as a proxy for economic need and 'population-at-risk' for health need. The level and direction of inequity varies across funding sources. Unicef and the President's Malaria Initiative were the most horizontally inequitable ( pro-poor ). Inequity as shown by the Health Inequity Index for Unicef decreased from -0.40 (P0.10) in 2006 to -0.38 (P<0.05) in 2008, and decreased to -0.36 (P<0.10) in 2010. Domestic funding was inequitable ( pro-rich ) with inequity increasing from 0.28 (P<0.01) in 2006 to 0.39 (P<0.01) in 2009, and then decreasing to 0.22 (P<0.10) in 2010. Funding from the World Bank and the Global Fund was distributed proportionally according to need. In terms of vertical inequity, all sources were progressive: Unicef and the President's Malaria Initiative were the most progressive with the Kakwani Indices ranging from -0.97 (P<0.01) to -1.29 (P<0.01), and -0.90 (P<0.01) to -1.10 (P<0.01), respectively. Our results suggest that external funding of

  8. Process and effects of a community intervention on malaria in rural Burkina Faso: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gustafsson Lars

    2008-03-01

    Full Text Available Abstract Background In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. Methods A cluster-randomized controlled effectiveness trial was implemented from 2002–2004 in a malaria endemic area of rural Burkina Faso. Six and seven villages were randomly assigned to the intervention and control arms respectively. Febrile children from intervention villages were treated with chloroquine (CQ by their mothers, supported by local women group leaders. CQ was regularly supplied through a revolving fund from local health centres. The trial was evaluated through two cross-sectional surveys at baseline and after two years of intervention. The primary endpoint of the study was the proportion of moderate to severe anaemia in children aged 6–59 months. For assessment of the development of drug efficacy over time, an in vivo CQ efficacy study was nested into the trial. The study is registered under http://www.controlled-trials.com (ISRCTN 34104704. Results The intervention was shown to be feasible under program conditions and a total of 1.076 children and 999 children were evaluated at baseline and follow-up time points respectively. Self-reported CQ treatment of fever episodes at home as well as referrals to health centres increased over the study period. At follow-up, CQ was detected in the blood of high proportions of intervention and control children. Compared to baseline findings, the prevalence of anaemia (29% vs 16%, p P. falciparum parasitaemia, fever and palpable spleens was lower at follow-up but there were no differences between the intervention and control group. CQ efficacy decreased over the study period but this was not associated with the intervention. Discussion The decreasing prevalence of malaria

  9. Population Movement as a Risk Factor for Malaria Infection in High-Altitude Villages of Tahtay-Maychew District, Tigray, Northern Ethiopia: A Case-Control Study.

    Science.gov (United States)

    Haile, Mebrahtom; Lemma, Hailemariam; Weldu, Yemane

    2017-09-01

    Key goal and targets of the Ethiopia National Malaria Control Program are to achieve malaria elimination within specific geographical areas with historically low malaria transmission and to reach near-zero malaria transmission in the remaining malarious areas by 2020. However, back and forth population movement between high-transmission and low-transmission area imposes challenge on the success of national malaria control programs. Therefore, examining the effect of human movement and identification of at-risk populations is crucial in an elimination setting. A matched case-control study was conducted among 520 study participants at a community level in low malaria transmission settings in northern Ethiopia. Study participants who received a malaria test were interviewed regarding their recent travel history. Bivariate and multivariate analyses were carried out to determine if the reported travel was related to malaria infection. Younger age (adjusted odds ratio [AOR] = 3.20, 95% confidence interval [CI]: 1.73, 5.89) and travel in the previous month (AOR = 11.40, 95% CI: 6.91, 18.82) were statistically significant risk factors for malaria infection. Other statistically significant factors, including lower educational level (AOR = 2.21, 95% CI: 1.26, 3.86) and nonagricultural in occupation (AOR = 2.0, 95% CI: 1.02, 3.94), were also found as risk factors for malaria infection. Generally, travel history was found to be a strong predictor for malaria acquisition in the high-altitude villages. Therefore, besides the existing efforts in endemic areas, targeting those who frequently travel to malarious areas is crucial to reduce malaria infection risks and possibility of local transmissions in high-altitude areas of northern Ethiopia.

  10. Malaria in Pregnancy: Morbidities and Management | Yakasai ...

    African Journals Online (AJOL)

    control of malaria in the African Subregion during pregnancy has been recommended by the World Health Organization (WHO). These include intermittent preventive treatment (IPT), use of insecticide treated nets (ITNs) and access to effective case management for malaria illness and anemia. Keywords: malaria in ...

  11. Impact assessment of malaria vector control using routine surveillance data in Zambia: implications for monitoring and evaluation

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2012-12-01

    Full Text Available Abstract Background Malaria vector control using long-lasting insecticidal nets (LLINs and indoor residual spraying (IRS, with pyrethroids and DDT, to reduce malaria transmission has been expansively implemented in Zambia. The impact of these interventions on malaria morbidity and mortality has not previously been formally assessed at the population level in Zambia. Methods The impact of IRS (15 urban districts and LLINs (15 rural districts implementation on severe malaria cases, deaths and case fatality rates in children below the age of five years were compared. Zambian national Health Management Information System data from 2007 to 2008 were retrospectively analysed to assess the epidemiological impact of the two interventions using odds ratios to compare the pre-scaling up year 2007 with the scaling-up year 2008. Results Overall there were marked reductions in morbidity and mortality, with cases, deaths and case fatality rates (CFR of severe malaria decreasing by 31%, 63% and 62%, respectively between 2007 and 2008. In urban districts with IRS introduction there was a significant reduction in mortality (Odds Ratio [OR] = 0.37, 95% CI = 0.31-0.43, P = 0.015, while the reduction in mortality in rural districts with LLINs implementation was not significant (OR = 0.83, 95% CI = 0.67-1.04, P = 0.666. A similar pattern was observed for case fatality rates with a significant reduction in urban districts implementing IRS (OR = 0.34, 95% CI = 0.33-0.36, P = 0.005, but not in rural districts implementing LLINs (OR = 0.96, 95% CI = 0.91-1.00, P = 0.913. No substantial difference was detected in overall reduction of malaria cases between districts implementing IRS and LLINs (P = 0.933. Conclusion Routine surveillance data proved valuable for determining the temporal effects of malaria control with two strategies, IRS and LLINs on severe malaria disease in different types of Zambian districts. However, this analysis did not take into account the effect

  12. Individual-level factors associated with the risk of acquiring human Plasmodium knowlesi malaria in Malaysia: a case-control study.

    Science.gov (United States)

    Grigg, Matthew J; Cox, Jonathan; William, Timothy; Jelip, Jenarun; Fornace, Kimberly M; Brock, Patrick M; von Seidlein, Lorenz; Barber, Bridget E; Anstey, Nicholas M; Yeo, Tsin W; Drakeley, Christopher J

    2017-06-09

    The emergence of human malaria due to the monkey parasite Plasmodium knowlesi threatens elimination efforts in southeast Asia. Changes in land use are thought to be driving the rise in reported P knowlesi cases, but the role of individual-level factors is unclear. To address this knowledge gap we assessed human and environmental factors associated with zoonotic knowlesi malaria risk. We did this population-based case-control study over a 2 year period in the state of Sabah in Malaysia. We enrolled cases with microscopy-positive, PCR-confirmed malaria who presented to two primary referral hospitals serving the adjacent districts of Kudat and Kota Marudu. We randomly selected three malaria-negative community controls per case, who were matched by village within 2 weeks of case detection. We obtained questionnaire data on demographics, behaviour, and residential malaria risk factors, and we also assessed glucose-6-phosphate dehydrogenase (G6PD) enzyme activity. We used conditional logistic regression models to evaluate exposure risk between P knowlesi cases and controls, and between P knowlesi and human-only Plasmodium spp malaria cases. From Dec 5, 2012, to Jan 30, 2015, we screened 414 patients and subsequently enrolled 229 cases with P knowlesi malaria mono-infection and 91 cases with other Plasmodium spp infection. We enrolled 953 matched controls, including 683 matched to P knowlesi cases and 270 matched to non- P knowlesi cases. Age 15 years or older (adjusted odds ratio [aOR] 4·16, 95% CI 2·09-8·29, pwork (3·50, CI, 1·34-9·15, p=0·011), sleeping outside (3·61, 1·48-8·85, p=0·0049), travel (2·48, 1·45-4·23, p=0·0010), being aware of the presence of monkeys in the past 4 weeks (3·35, 1·91-5·88, pworking in agricultural areas were at highest risk of knowlesi malaria, although peri-domestic transmission also occurrs. Human behavioural factors associated with P knowlesi transmission could be targeted in future public health interventions. United

  13. Elimination of Plasmodium falciparum malaria in Tajikistan.

    Science.gov (United States)

    Kondrashin, Anatoly V; Sharipov, Azizullo S; Kadamov, Dilshod S; Karimov, Saifuddin S; Gasimov, Elkhan; Baranova, Alla M; Morozova, Lola F; Stepanova, Ekaterina V; Turbabina, Natalia A; Maksimova, Maria S; Morozov, Evgeny N

    2017-05-30

    Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards

  14. Safety and immunogenicity of an AMA1 malaria vaccine in Malian children: results of a phase 1 randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Mahamadou A Thera

    2010-02-01

    Full Text Available The objective was to evaluate the safety and immunogenicity of the AMA1-based malaria vaccine FMP2.1/AS02(A in children exposed to seasonal falciparum malaria.A Phase 1 double blind randomized controlled dose escalation trial was conducted in Bandiagara, Mali, West Africa, a rural town with intense seasonal transmission of Plasmodium falciparum malaria. The malaria vaccine FMP2.1/AS02(A is a recombinant protein (FMP2.1 based on apical membrane antigen 1 (AMA1 from the 3D7 clone of P. falciparum, formulated in the Adjuvant System AS02(A. The comparator vaccine was a cell-culture rabies virus vaccine (RabAvert. One hundred healthy Malian children aged 1-6 years were recruited into 3 cohorts and randomized to receive either 10 microg FMP2.1 in 0.1 mL AS02(A, or 25 microg FMP2.1 in 0.25 mL AS02(A, or 50 microg FMP2.1 50 microg in 0.5 mL AS02(A, or rabies vaccine. Three doses of vaccine were given at 0, 1 and 2 months, and children were followed for 1 year. Solicited symptoms were assessed for 7 days and unsolicited symptoms for 30 days after each vaccination. Serious adverse events were assessed throughout the study. Transient local pain and swelling were common and more frequent in all malaria vaccine dosage groups than in the comparator group, but were acceptable to parents of participants. Levels of anti-AMA1 antibodies measured by ELISA increased significantly (at least 100-fold compared to baseline in all 3 malaria vaccine groups, and remained high during the year of follow up.The FMP2.1/AS02(A vaccine had a good safety profile, was well-tolerated, and induced high and sustained antibody levels in malaria-exposed children. This malaria vaccine is being evaluated in a Phase 2 efficacy trial in children at this site.ClinicalTrials.gov NCT00358332 [NCT00358332].

  15. Alanine metabolism in acute falciparum malaria

    NARCIS (Netherlands)

    Pukrittayakamee, S.; Krishna, S.; ter Kuile, F.; Wilaiwan, O.; Williamson, D. H.; White, N. J.

    2002-01-01

    We investigated the integrity of the gluconeogenic pathway in severe malaria using alanine metabolism as a measure. Alanine disposition and liver blood flow, assessed by indocyanine green (ICG) clearance, were measured simultaneously in 10 patients with falciparum malaria (six severe and four

  16. Socio-Economic-Political-Cultural Aspects in Malaria Control Programme Implementation in Southern India

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    S. K. Ghosh

    2012-01-01

    Full Text Available Objective. A Socio-economic-political-cultural (SEPC study was undertaken under the Roll Back Malaria (RBM initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

  17. Socio-economic-political-cultural aspects in malaria control programme implementation in southern India.

    Science.gov (United States)

    Ghosh, S K; Patil, Rajan R; Tiwari, S N

    2012-01-01

    Objective. A Socio-economic-political-cultural (SEPC) study was undertaken under the Roll Back Malaria (RBM) initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU) Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

  18. Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc) combined with timely home treatment for malaria control in Ghana.

    Science.gov (United States)

    Ahorlu, Collins K; Koram, Kwadwo A; Seake-Kwawu, Atsu; Weiss, Mitchell G

    2011-05-15

    Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc) combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc) aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6-60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months). Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥ 37.5 °C) compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. The year-two-evaluation result indicates that IPTc given three times in a year (every four months) combined with timely treatment of febrile malaria illness, is effective to reduce malaria parasite prevalence in children aged 6 to 60 months

  19. [History of malaria control in the French armed forces: from Algeria to the Macedonian front during the first World War].

    Science.gov (United States)

    Migliani, R; Meynard, J-B; Milleliri, J-M; Verret, C; Rapp, C

    2014-01-01

    The French joint military health corps has long experience in malaria control. Many military physicians played an essential role in the 19th century: Maillot revolutionized malaria treatment by using quinine during the conquest of Algeria, and Laveran discovered the causal parasite (the genus Plasmodium) there. This experience continued under the direction of Laveran and the Sergent brothers on the eastern front in Greek Macedonia during World War I. The vast coordinated control plan established on this front from 1917 delivered the French infantrymen from malaria and led to victory over the Bulgarian forces, which capitulated in September 1918.

  20. The Invisible and Indeterminable Value of Ecology: From Malaria Control to Ecological Research in the American South.

    Science.gov (United States)

    Way, Albert G

    2015-06-01

    This essay tells the story of the Emory University Field Station, a malaria research station in southwest Georgia that operated from 1939 to 1958. Using the tools of environmental history and the history of science, it examines the station's founding, its fieldwork, and its place within the broader history of malaria control, eradication, and research. A joint effort of Emory University, the U.S. Public Health Service, and the Communicable Disease Center (CDC), this station was closely aligned with a broader movement of ideas about tropical diseases across the globe, but it also offers a case study of how science in the field can veer from mainstream thinking and official policy. As the CDC and other disease-fighting organizations were moving toward a global strategy of malaria eradication through the use of DDT, the Emory Field Station developed a postsanitarian approach to malaria. Drawing on resistance among American conservationists to environmental transformation in the name of malaria control, the station's staff embraced the science and worldview of ecology in an effort to lighten public health's hand on the land and to link human health to the environment in innovative, if sometimes opaque, ways. This essay, then, argues that the Emory Field Station represents an early confluence of ecology with the biomedical sciences, something very similar to what is now the important discipline of disease ecology.

  1. Evidence of endothelial inflammation, T cell activation, and T cell reallocation in uncomplicated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Elhassan, I M; Hviid, L; Satti, G

    1994-01-01

    endothelium. We measured plasma levels of soluble markers of endothelial inflammation and T cell activation in 32 patients suffering from acute, uncomplication P. falciparum malaria, as well as in 10 healthy, aparasitemic control donors. All donors were residents of a malaria-endemic area of Eastern State...... Sudan. In addition, we measured the T cell surface expression of the interleukin-2 receptor (CD25) and the lymphocyte function-associated antigen (LFA-1; CD11a/CD18). We found that the plasma levels of all inflammation and activation markers were significantly increased in the malaria patients compared...... with the control donors. In addition, we found a disease-induced depletion of T cells with high expression of the LFA-1 antigen, particularly in the CD4+ subset. The results obtained provide further support for the hypothesis of T cell reallocation to inflamed endothelium in acute P. falciparum malaria....

  2. A country on the verge of malaria elimination--the Kingdom of Saudi Arabia.

    Directory of Open Access Journals (Sweden)

    Michael Coleman

    Full Text Available Significant headway has been made in the global fight against malaria in the past decade and as more countries enter the elimination phase, attention is now focused on identifying effective strategies to shrink the malaria map. Saudi Arabia experienced an outbreak of malaria in 1998, but is now on the brink of malaria elimination, with just 82 autochthonous cases reported in 2012. A review of published and grey literature was performed to identify the control strategies that have contributed to this achievement. The number of autochthonous malaria cases in Saudi Arabia decreased by 99.8% between 1998 and 2012. The initial steep decline in malaria cases coincided with a rapid scaling up of vector control measures. Incidence continued to be reported at low levels (between 0.01 and 0.1 per 1,000 of the population until the adoption of artesunate plus sulfadoxine-pyrimethamine as first line treatment and the establishment of a regional partnership for a malaria-free Arabian Peninsula, both of which occurred in 2007. Since 2007, incidence has decreased by nearly an order of magnitude. Malaria incidence is now very low, but a high proportion of imported cases, continued potential for autochthonous transmission, and an increased proportion of cases attributable to Plasmodium vivax all present challenges to Saudi Arabia as they work toward elimination by 2015.

  3. A research agenda for malaria eradication: vector control.

    Science.gov (United States)

    2011-01-25

    Different challenges are presented by the variety of malaria transmission environments present in the world today. In each setting, improved control for reduction of morbidity is a necessary first step towards the long-range goal of malaria eradication and a priority for regions where the disease burden is high. For many geographic areas where transmission rates are low to moderate, sustained and well-managed application of currently available tools may be sufficient to achieve local elimination. The research needs for these areas will be to sustain and perhaps improve the effectiveness of currently available tools. For other low-to-moderate transmission regions, notably areas where the vectors exhibit behaviours such as outdoor feeding and resting that are not well targeted by current strategies, new interventions that target predictable features of the biology/ecologies of the local vectors will be required. To achieve elimination in areas where high levels of transmission are sustained by very efficient vector species, radically new interventions that significantly reduce the vectorial capacity of wild populations will be needed. Ideally, such interventions should be implemented with a one-time application with a long-lasting impact, such as genetic modification of the vectorial capacity of the wild vector population.

  4. Malaria vector species in Colombia: a review

    Directory of Open Access Journals (Sweden)

    James Montoya-Lerma

    2011-08-01

    Full Text Available Here we present a comprehensive review of the literature on the vectorial importance of the major Anopheles malaria vectors in Colombia. We provide basic information on the geographical distribution, altitudinal range, immature habitats, adult behaviour, feeding preferences and anthropophily, endophily and infectivity rates. We additionally review information on the life cycle, longevity and population fluctuation of Colombian Anopheles species. Emphasis was placed on the primary vectors that have been epidemiologically incriminated in malaria transmission: Anopheles darlingi, Anopheles albimanus and Anopheles nuneztovari. The role of a selection of local, regional or secondary vectors (e.g., Anopheles pseudopunctipennis and Anopheles neivai is also discussed. We highlight the importance of combining biological, morphological and molecular data for the correct taxonomical determination of a given species, particularly for members of the species complexes. We likewise emphasise the importance of studying the bionomics of primary and secondary vectors along with an examination of the local conditions affecting the transmission of malaria. The presence and spread of the major vectors and the emergence of secondary species capable of transmitting human Plasmodia are of great interest. When selecting control measures, the anopheline diversity in the region must be considered. Variation in macroclimate conditions over a species' geographical range must be well understood and targeted to plan effective control measures based on the population dynamics of the local Anopheles species.

  5. A novel approach for measuring the burden of uncomplicated Plasmodium falciparum malaria: application to data from Zambia.

    Directory of Open Access Journals (Sweden)

    Valerie Crowell

    Full Text Available Measurement of malaria burden is fraught with complexity, due to the natural history of the disease, delays in seeking treatment or failure of case management. Attempts to establish an appropriate case definition for a malaria episode has often resulted in ambiguities and challenges because of poor information about treatment seeking, patterns of infection, recurrence of fever and asymptomatic infection. While the primary reason for treating malaria is to reduce disease burden, the effects of treatment are generally ignored in estimates of the burden of malaria morbidity, which are usually presented in terms of numbers of clinical cases or episodes, with the main data sources being reports from health facilities and parasite prevalence surveys. The use of burden estimates that do not consider effects of treatment, leads to under-estimation of the impact of improvements in case management. Official estimates of burden very likely massively underestimate the impact of the roll-out of ACT as first-line therapy across Africa. This paper proposes a novel approach for estimating burden of disease based on the point prevalence of malaria attributable disease, or equivalently, the days with malaria fever in unit time. The technique makes use of data available from standard community surveys, analyses of fever patterns in malaria therapy patients, and data on recall bias. Application of this approach to data from Zambia for 2009-2010 gave an estimate of 2.6 (95% credible interval: 1.5-3.7 malaria attributable fever days per child-year. The estimates of recall bias, and of the numbers of days with illness contributing to single illness recalls, could be applied more generally. To obtain valid estimates of the overall malaria burden using these methods, there remains a need for surveys to include the whole range of ages of hosts in the population and for data on seasonality patterns in confirmed case series.

  6. Acquired immunity against malaria as a tool for the control of the disease: the strategy proposed by the Malaria Commission of the League of Nations in 1933.

    Science.gov (United States)

    Corbellini, G

    1998-06-01

    The Third General Report of the Malaria Commission, printed in 1933, suggested for the control of malaria a strategy aimed to promote the acquisition of a "relative immunity" through a non radical treatment of the infected people living in highly endemic areas. The paper discusses the content of the Report and describes the scientific (empirical) premises on which it stood. Moreover, it illustrates the criticism that was directed against the immunological strategy and that eventually led to its abandonment.

  7. Efficacy of local neem extracts for sustainable malaria vector control in an African village

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    Duchemin Jean-Bernard

    2008-07-01

    Full Text Available Abstract Background Larval control of malaria vectors has been historically successful in reducing malaria transmission, but largely fell out of favour with the introduction of synthetic insecticides and bed nets. However, an integrated approach to malaria control, including larval control methods, continues to be the best chance for success, in view of insecticide resistance, the behavioural adaptation of the vectors to changing environments and the difficulties of reaching the poorest populations most at risk,. Laboratory studies investigating the effects of neem seed (Azadirachta indica extracts on Anopheles larvae have shown high rates of larval mortality and reductions in adult longevity, as well as low potential for resistance development. Methods This paper describes a method whereby seeds of the neem tree can be used to reduce adult Anopheles gambiae s.l. abundance in a way that is low cost and can be implemented by residents of rural villages in western Niger. The study was conducted in Banizoumbou village, western Niger. Neem seeds were collected from around the village. Dried seeds were ground into a coarse powder, which was then sprinkled onto known Anopheles larvae breeding habitats twice weekly during the rainy season 2007. Adult mosquitoes were captured on a weekly basis in the village and captures compared to those from 2005 and 2006 over the same period. Adult mosquitoes were also captured in a nearby village, Zindarou, as a control data set and compared to those from Banizoumbou. Results It was found that twice-weekly applications of the powder to known breeding habitats of Anopheles larvae in 2007 resulted in 49% fewer adult female Anopheles gambiae s.l. mosquitoes in Banizoumbou, compared with previous captures under similar environmental conditions and with similar habitat characteristics in 2005 and 2006. The productivity of the system in 2007 was found to be suppressed compared to the mean behaviour of 2005 and 2006 in

  8. Thrombocytopenia in malaria: can platelet counts differentiate malaria from other infections

    International Nuclear Information System (INIS)

    Arshad, A.R.

    2015-01-01

    To determine the accuracy of thrombocytopenia as a diagnostic marker for malaria. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, 1 Mountain Medical Battalion (Bagh, Azad Kashmir) from July to September 2013. Methodology: Adult patients presenting with a short history of fever without any localizing symptoms or signs were included. Exclusion criteria included patients with fever of > 7 days duration, those in whom an underlying diagnosis could be easily confirmed on the basis of history and physical examination, those on antibiotics/ antimalarials or antiplatelet agents and patients with Dengue fever. Platelet counts in venous whole blood samples were analysed with Sysmex KX-21 Haematology analyzer. Thick and thin peripheral blood smears were then prepared and examined for malarial parasites. Diagnosis of malaria was established on the basis of smear findings. Results: There were 245 patients in total. Out of the 109 patients with thrombocytopenia, 61 had vivax malaria. Platelets count was normal in 136 patients, including 4 with vivax malaria. Falciparum malaria was not seen in any patient. All cases with malaria were uncomplicated. Various measures of accuracy thus calculated were sensitivity 93.85%, specificity 73.33%, positive predictive value 55.96%, negative predictive value 97.06%, positive likelihood ratio of 3.52, negative likelihood ratio of 0.08, diagnostic odds ratio 41.94 and diagnostic accuracy of 78.78%. Conclusion: Thrombocytopenia has an excellent sensitivity and a very good specificity for vivax malaria. Normal platelet counts provide very strong evidence against malaria as the etiology of fever without a focus. (author)

  9. Towards a strategy for malaria in pregnancy in Afghanistan: analysis of clinical realities and women's perceptions of malaria and anaemia.

    Science.gov (United States)

    Howard, Natasha; Enayatullah, Sayed; Mohammad, Nader; Mayan, Ismail; Shamszai, Zohra; Rowland, Mark; Leslie, Toby

    2015-11-04

    Afghanistan has some of the worst maternal and infant mortality indicators in the world and malaria is a significant public health concern. Study objectives were to assess prevalence of malaria and anaemia, related knowledge and practices, and malaria prevention barriers among pregnant women in eastern Afghanistan. Three studies were conducted: (1) a clinical survey of maternal malaria, maternal anaemia, and neonatal birthweight in a rural district hospital delivery-ward; (2) a case-control study of malaria risk among reproductive-age women attending primary-level clinics; and (3) community surveys of malaria and anaemia prevalence, socioeconomic status, malaria knowledge and reported behaviour among pregnant women. Among 517 delivery-ward participants (1), one malaria case (prevalence 1.9/1000), 179 anaemia cases (prevalence 346/1000), and 59 low-birthweight deliveries (prevalence 107/1000) were detected. Anaemia was not associated with age, gravidity, intestinal parasite prevalence, or low-birthweight at delivery. Among 141 malaria cases and 1010 controls (2), no association was found between malaria infection and pregnancy (AOR 0.89; 95 % CI 0.57-1.39), parity (AOR 0.95; 95 % CI 0.85-1.05), age (AOR 1.02; 95 % CI 1.00-1.04), or anaemia (AOR 1.00; 95 % CI 0.65-1.54). Those reporting insecticide-treated net usage had 40 % reduced odds of malaria infection (AOR 0.60; 95 % CI 0.40-0.91). Among 530 community survey participants (3), malaria and anaemia prevalence were 3.9/1000 and 277/1000 respectively, with 34/1000 experiencing severe anaemia. Despite most women having no formal education, malaria knowledge was high. Most expressed reluctance to take malaria preventive medication during pregnancy, deeming it potentially unsafe. Given the low malaria risk and reported avoidance of medication during pregnancy, intermittent preventive treatment is hard to justify or implement. Preventive strategy should instead focus on long-lasting insecticidal nets for all pregnant

  10. Towards a framework for analyzing determinants of performance of community health workers in malaria prevention and control: a systematic review.

    Science.gov (United States)

    Chipukuma, Helen Mwiinga; Zulu, Joseph Mumba; Jacobs, Choolwe; Chongwe, Gershom; Chola, Mumbi; Halwiindi, Hikabasa; Zgambo, Jessy; Michelo, Charles

    2018-05-08

    Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking. We systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications. We included 16 full text articles that evaluated CHW performance in malaria control. Search terms were used and studies that had performance as an outcome of interest attributed to community-based interventions done by CHWs were included. Sixteen studies were included in the final review and were mostly on malaria Rapid Diagnosis and Treatment, as well as adherence to referral guidelines. Factors determining performance and effective implementation of CHW malaria programs included health system factors such as nature of training of CHWs; type of supervision including feedback process; availability of stocks, supplies, and job aids; nature of work environment and reporting systems; availability of financial resources and transport systems; types of remuneration; health staff confidence in CHWs; and workload. In addition, community dynamics such as nature of community connectedness and support from the community and utilization of services by the community also influenced performance. Furthermore, community health worker characteristics such marital status, sex, and CHW confidence levels also shaped CHW performance. Effectively analyzing and promoting the performance of CHWs in malaria prevention and control programs may require adopting a framework that considers health systems and community factors as well as community health worker characteristics.

  11. Monitoring the operational impact of insecticide usage for malaria control on Anopheles funestus from Mozambique

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    Sharp Brian L

    2007-10-01

    Full Text Available Abstract Background Indoor residual spraying (IRS has again become popular for malaria control in Africa. This combined with the affirmation by WHO that DDT is appropriate for use in the absence of longer lasting insecticide formulations in some malaria endemic settings, has resulted in an increase in IRS with DDT as a major malaria vector control intervention in Africa. DDT was re-introduced into Mozambique's IRS programme in 2005 and is increasingly becoming the main insecticide used for malaria vector control in Mozambique. The selection of DDT as the insecticide of choice in Mozambique is evidence-based, taking account of the susceptibility of Anopheles funestus to all available insecticide choices, as well as operational costs of spraying. Previously lambda cyhalothrin had replaced DDT in Mozambique in 1993. However, resistance appeared quickly to this insecticide and, in 2000, the pyrethroid was phased out and the carbamate bendiocarb introduced. Low level resistance was detected by biochemical assay to bendiocarb in 1999 in both An. funestus and Anopheles arabiensis, although this was not evident in WHO bioassays of the same population. Methods Sentinel sites were established and monitored for insecticide resistance using WHO bioassays. These assays were conducted on 1–3 day old F1 offspring of field collected adult caught An. funestus females to determine levels of insecticide resistance in the malaria vector population. WHO biochemical assays were carried out to determine the frequency of insecticide resistance genes within the same population. Results In surveys conducted between 2002 and 2006, low levels of bendiocarb resistance were detected in An. funestus, populations using WHO bioassays. This is probably due to significantly elevated levels of Acetylcholinesterase levels found in the same populations. Pyrethroid resistance was also detected in populations and linked to elevated levels of p450 monooxygenase activity. One site had

  12. Blantyre Malaria Project Epilepsy Study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study.

    Science.gov (United States)

    Birbeck, Gretchen L; Molyneux, Malcolm E; Kaplan, Peter W; Seydel, Karl B; Chimalizeni, Yamikani F; Kawaza, Kondwani; Taylor, Terrie E

    2010-12-01

    Cerebral malaria, a disorder characterised by coma, parasitaemia, and no other evident cause of coma, is challenging to diagnose definitively in endemic regions that have high rates of asymptomatic parasitaemia and limited neurodiagnostic facilities. A recently described malaria retinopathy improves diagnostic specificity. We aimed to establish whether retinopathy-positive cerebral malaria is a risk factor for epilepsy or other neurodisabilities. Between 2005 and 2007, we did a prospective cohort study of survivors of cerebral malaria with malaria retinopathy in Blantyre, Malawi. Children with cerebral malaria were identified at the time of their index admission and age-matched to concurrently admitted children without coma or nervous system infection. Initially matching of cases to controls was 1:1 but, in 2006, enrolment criteria for cerebral malaria survivors were revised to limit inclusion to children with cerebral malaria and retinopathy on the basis of indirect ophthalmoscopic examination; matching was then changed to 1:2 and the revised inclusion criteria were applied retrospectively for children enrolled previously. Clinical assessments at discharge and standardised nurse-led follow-up every 3 months thereafter were done to identify children with new seizure disorders or other neurodisabilities. A Kaplan-Meier survival analysis was done for incident epilepsy. 132 children with retinopathy-positive cerebral malaria and 264 age-matched, non-comatose controls were followed up for a median of 495 days (IQR 195-819). 12 of 132 cerebral malaria survivors developed epilepsy versus none of 264 controls (odds ratio [OR] undefined; pepilepsy in children with cerebral malaria were a higher maximum temperature (39·4°C [SD 1·2] vs 38·5°C [1·1]; p=0·01) and acute seizures (11/12 vs 76/120; OR 6·37, 95% CI 1·02-141·2), and male sex was a risk factor for new neurodisabilities (20/28 vs 38/93; OR 3·62, 1·44-9·06). Almost a third of retinopathy-positive cerebral

  13. Health care Providers Needs About Malaria Control Program in Puskesmas Kisam Tinggi, South Ogan Komering Ulu District

    Directory of Open Access Journals (Sweden)

    Maya Arisanti

    2015-11-01

    Full Text Available Background: Malaria is an infectious disease that is still a health problem in Indonesia, which can cause death, especially in high-risk groups such as infants, toddlers, pregnant women and can directly lead to anemia and decreased work productivity. South Ogan Komering Ulu District was one of the endemic areas in South Sumatera Province. In a previous study in the District South Ogan Komering Ulu County Superior Data AMI found that high and low knowledge society related to malaria and most of respondents have not received counseling. Objective:The purpose of this study was to determine the needs of health care providers in malaria control programs. Methods:Data collected through in-depth interviews. Informant interviews are two people responsible for malaria at the health department, the head of health centers and two people responsible for malaria in health centers. Results: The results showed that the needs required by the health care providers to improve health care services, especially malaria is a need for laboratory equipment (microscope, reagents, and rapid diagnostic test, the need for microscopic power, the need for malaria drugs that are still effective, procurement of mosquito nets, education malaria to the community, and training needs for existing microscopic officer. Conclusion: The need of health care providers is the fulfillment of the malaria supplies equipment, laboratory personnel and training that support the ability of health care providers. With the fulfillment of the provider of health services to the community are expected to be performing well. Recommendation:Budget is needed to support supplier equipment & training.

  14. Malaria infection during pregnancy in area of stable transmission ...

    African Journals Online (AJOL)

    Malaria infection during pregnancy in area of stable transmission. ... (LBW), a leading cause of neonatal death in areas of stable malaria transmission. ... areas of stable malaria transmission and the effective strategies for prevention and control. Keywords: malaria, pregnancy, semi-immune women, anaemia, low birthweight

  15. Transmission traits of malaria parasites within the mosquito: Genetic variation, phenotypic plasticity, and consequences for control.

    Science.gov (United States)

    Lefevre, Thierry; Ohm, Johanna; Dabiré, Kounbobr R; Cohuet, Anna; Choisy, Marc; Thomas, Matthew B; Cator, Lauren

    2018-04-01

    Evaluating the risk of emergence and transmission of vector-borne diseases requires knowledge of the genetic and environmental contributions to pathogen transmission traits. Compared to the significant effort devoted to understanding the biology of malaria transmission from vertebrate hosts to mosquito vectors, the strategies that malaria parasites have evolved to maximize transmission from vectors to vertebrate hosts have been largely overlooked. While determinants of infection success within the mosquito host have recently received attention, the causes of variability for other key transmission traits of malaria, namely the duration of parasite development and its virulence within the vector, as well as its ability to alter mosquito behavior, remain largely unknown. This important gap in our knowledge needs to be bridged in order to obtain an integrative view of the ecology and evolution of malaria transmission strategies. Associations between transmission traits also need to be characterized, as they trade-offs and constraints could have important implications for understanding the evolution of parasite transmission. Finally, theoretical studies are required to evaluate how genetic and environmental influences on parasite transmission traits can shape malaria dynamics and evolution in response to disease control.

  16. Impact of dams and irrigation schemes in Anopheline (Diptera: Culicidae bionomics and malaria epidemiology

    Directory of Open Access Journals (Sweden)

    Jordi Sanchez-Ribas

    2012-08-01

    Full Text Available Irrigation schemes and dams have posed a great concern on public health systems of several countries, mainly in the tropics. The focus of the present review is to elucidate the different ways how these human interventions may have an effect on population dynamics of anopheline mosquitoes and hence, how local malaria transmission patterns may be changed. We discuss different studies within the three main tropical and sub-tropical regions (namely Africa, Asia and the Pacific and the Americas. Factors such as pre-human impact malaria epidemiological patterns, control measures, demographic movements, human behaviour and local Anopheles bionomics would determine if the implementation of an irrigation scheme or a dam will have negative effects on human health. Some examples of successful implementation of control measures in such settings are presented. The use of Geographic Information System as a powerful tool to assist on the study and control of malaria in these scenarios is also highlighted.

  17. Efficacy of Aquatain, a Monomolecular Film, for the Control of Malaria Vectors in Rice Paddies

    NARCIS (Netherlands)

    Bukhari, S.T.; Takken, W.; Githeko, A.K.; Koenraadt, C.J.M.

    2011-01-01

    Background Rice paddies harbour a large variety of organisms including larvae of malaria mosquitoes. These paddies are challenging for mosquito control because their large size, slurry and vegetation make it difficult to effectively apply a control agent. Aquatain, a monomolecular surface film, can

  18. Community-based biological control of malaria mosquitoes using Bacillus thuringiensis var. israelensis (Bti) in Rwanda: community awareness, acceptance and participation

    NARCIS (Netherlands)

    Ingabire, Chantal Marie; Hakizimana, Emmanuel; Rulisa, Alexis; Kateera, Fredrick; van den Borne, Bart; Muvunyi, Claude Mambo; Mutesa, Leon; van Vugt, Michelle; Koenraadt, Constantianus J. M.; Takken, Willem; Alaii, Jane

    2017-01-01

    Background: Targeting the aquatic stages of malaria vectors via larval source management (LSM) in collaboration with local communities could accelerate progress towards malaria elimination when deployed in addition to existing vector control strategies. However, the precise role that communities can

  19. Community-based biological control of malaria mosquitoes using Bacillus thuringiensis var. israelensis (Bti) in Rwanda: Community awareness, acceptance and participation

    NARCIS (Netherlands)

    Ingabire, C.M.; Hakizimana, E.; Rulisa, A.; Kateera, F.; Borne, B. van den; Muvunyi, C.M.; Mutesa, L.; Vugt, M. van; Koenraadt, C.J.M.; Takken, W.; Alaii, J.

    2017-01-01

    Background: Targeting the aquatic stages of malaria vectors via larval source management (LSM) in collaboration with local communities could accelerate progress towards malaria elimination when deployed in addition to existing vector control strategies. However, the precise role that communities can

  20. Selective Intermittent Preventive Treatment of Vivax Malaria: Reduction of Malaria Incidence in an Open Cohort Study in Brazilian Amazon

    Science.gov (United States)

    Gil, Luiz Herman Soares; de Lima, Alzemar Alves; Freitag, Elci Marlei; dos Santos, Tatiana Marcondes; do Nascimento Filha, Maria Teixeira; dos Santos Júnior, Alcides Procópio Justiniano; da Silva, Josiane Mendes; Rodrigues, Aline de Freitas; Tada, Mauro Shugiro; Fontes, Cor Jesus Fernandes; Pereira da Silva, Luiz Hildebrando

    2013-01-01

    In children, the Intermittent Preventive Treatment (IPTc), currently called Seasonal Malaria Chemoprevention (SMC), was considered effective on malaria control due to the reduction of its incidence in Papua New Guinea and in some areas with seasonal malaria in Africa. However, the IPT has not been indicated because of its association with drug resistance and for hindering natural immunity development. Thus, we evaluated the alternative IPT impact on malaria incidence in three riverside communities on Madeira River, in the municipality of Porto Velho, RO. We denominate this scheme Selective Intermittent Preventive Treatment (SIPT). The SIPT consists in a weekly dose of two 150 mg chloroquine tablets for 12 weeks, for adults, and an equivalent dose for children, after complete supervised treatment for P. vivax infection. This scheme is recommend by Brazilian Health Ministry to avoid frequent relapses. The clinic parasitological and epidemiological surveillance showed a significant reduction on vivax malaria incidence. The results showed a reduction on relapses and recurrence of malaria after SIPT implementation. The SIPT can be effective on vivax malaria control in localities with high transmission risk in the Brazilian Amazon. PMID:23577276

  1. Selective Intermittent Preventive Treatment of Vivax Malaria: Reduction of Malaria Incidence in an Open Cohort Study in Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Tony Hiroshi Katsuragawa

    2013-01-01

    Full Text Available In children, the Intermittent Preventive Treatment (IPTc, currently called Seasonal Malaria Chemoprevention (SMC, was considered effective on malaria control due to the reduction of its incidence in Papua New Guinea and in some areas with seasonal malaria in Africa. However, the IPT has not been indicated because of its association with drug resistance and for hindering natural immunity development. Thus, we evaluated the alternative IPT impact on malaria incidence in three riverside communities on Madeira River, in the municipality of Porto Velho, RO. We denominate this scheme Selective Intermittent Preventive Treatment (SIPT. The SIPT consists in a weekly dose of two 150 mg chloroquine tablets for 12 weeks, for adults, and an equivalent dose for children, after complete supervised treatment for P. vivax infection. This scheme is recommend by Brazilian Health Ministry to avoid frequent relapses. The clinic parasitological and epidemiological surveillance showed a significant reduction on vivax malaria incidence. The results showed a reduction on relapses and recurrence of malaria after SIPT implementation. The SIPT can be effective on vivax malaria control in localities with high transmission risk in the Brazilian Amazon.

  2. Vertical and horizontal equity of funding for malaria control: a global multisource funding analysis for 2006–2010

    Science.gov (United States)

    Barrenho, Eliana; Miraldo, Marisa; Shaikh, Mujaheed; Atun, Rifat

    2017-01-01

    Background International and domestic funding for malaria is critically important to achieve the Sustainable Development Goals. Its equitable distribution is key in ensuring that the available, scarce, resources are deployed efficiently for improved progress and a sustained response that enables eradication. Methods We used concentration curves and concentration indices to assess inequalities in malaria funding by different donors across countries, measuring both horizontal and vertical equity. Horizontal equity assesses whether funding is distributed in proportion to health needs, whereas vertical equity examines whether unequal economic needs are addressed by appropriately unequal funding. We computed the Health Inequity Index and the Kakwani Index to assess the former and the latter, respectively. We used data from the World Bank, Global Fund, Unicef, President’s Malaria Initiative and the Malaria Atlas Project to assess the distribution of funding against need for 94 countries. National gross domestic product per capita was used as a proxy for economic need and ‘population-at-risk’ for health need. Findings The level and direction of inequity varies across funding sources. Unicef and the President’s Malaria Initiative were the most horizontally inequitable (pro-poor). Inequity as shown by the Health Inequity Index for Unicef decreased from −0.40 (P0.10) in 2006 to −0.38 (P<0.05) in 2008, and decreased to −0.36 (P<0.10) in 2010. Domestic funding was inequitable (pro-rich) with inequity increasing from 0.28 (P<0.01) in 2006 to 0.39 (P<0.01) in 2009, and then decreasing to 0.22 (P<0.10) in 2010. Funding from the World Bank and the Global Fund was distributed proportionally according to need. In terms of vertical inequity, all sources were progressive: Unicef and the President’s Malaria Initiative were the most progressive with the Kakwani Indices ranging from −0.97 (P<0.01) to −1.29 (P<0.01), and −0.90 (P<0.01) to −1.10 (P<0

  3. The influence of seasonal variations on malaria prevalence in Mount ...

    African Journals Online (AJOL)

    Malaria is Cameroon's most serious and complex public health problem. ... The problem of the disease is aggravated by changing climate, poverty, and lack of ... urgently demand re-visiting control measures and policy of urban planning.

  4. The potential contribution of mass treatment to the control of Plasmodium falciparum malaria.

    Directory of Open Access Journals (Sweden)

    Lucy C Okell

    Full Text Available Mass treatment as a means to reducing P. falciparum malaria transmission was used during the first global malaria eradication campaign and is increasingly being considered for current control programmes. We used a previously developed mathematical transmission model to explore both the short and long-term impact of possible mass treatment strategies in different scenarios of endemic transmission. Mass treatment is predicted to provide a longer-term benefit in areas with lower malaria transmission, with reduced transmission levels for at least 2 years after mass treatment is ended in a scenario where the baseline slide-prevalence is 5%, compared to less than one year in a scenario with baseline slide-prevalence at 50%. However, repeated annual mass treatment at 80% coverage could achieve around 25% reduction in infectious bites in moderate-to-high transmission settings if sustained. Using vector control could reduce transmission to levels at which mass treatment has a longer-term impact. In a limited number of settings (which have isolated transmission in small populations of 1000-10,000 with low-to-medium levels of baseline transmission we find that five closely spaced rounds of mass treatment combined with vector control could make at least temporary elimination a feasible goal. We also estimate the effects of using gametocytocidal treatments such as primaquine and of restricting treatment to parasite-positive individuals. In conclusion, mass treatment needs to be repeated or combined with other interventions for long-term impact in many endemic settings. The benefits of mass treatment need to be carefully weighed against the risks of increasing drug selection pressure.

  5. An exploratory survey of malaria prevalence and people's knowledge, attitudes and practices of mosquito larval source management for malaria control in western Kenya

    NARCIS (Netherlands)

    Imbahale, S.S.; Fillinger, U.; Githeko, A.; Mukabana, W.R.; Takken, W.

    2010-01-01

    A large proportion of mosquito larval habitats in urban and rural communities in sub-Saharan Africa are man-made. Therefore, community-based larval source management (LSM) could make a significant contribution to malaria control in an integrated vector management approach. Here we implemented an

  6. Scepticism towards insecticide treated mosquito nets for malaria ...

    African Journals Online (AJOL)

    Scepticism towards insecticide treated mosquito nets for malaria control in rural ... especially among under-five year children and pregnant women in poor rural ... through social marketing strategy for malaria control prior to the introduction of ...

  7. 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...... measured with flow cytometry and ELISA assays, respectively. Regression analyses showed that alpha(+)-thalassemia was associated with a reduced risk of uncomplicated malaria episodes and that this advantageous effect seemed to be more predominant in children older than 5 years of age, but was independent...

  8. Malaria transmission in Tripura: Disease distribution & determinants.

    Science.gov (United States)

    Dev, Vas; Adak, Tridibes; Singh, Om P; Nanda, Nutan; Baidya, Bimal K

    2015-12-01

    Malaria is a major public health problem in Tripura and focal disease outbreaks are of frequent occurrence. The state is co-endemic for both Plasmodium falciparum and P. vivax and transmission is perennial and persistent. The present study was aimed to review data on disease distribution to prioritize high-risk districts, and to study seasonal prevalence of disease vectors and their bionomical characteristics to help formulate vector species-specific interventions for malaria control. Data on malaria morbidity in the State were reviewed retrospectively (2008-2012) for understanding disease distribution and transmission dynamics. Cross-sectional mass blood surveys were conducted in malaria endemic villages of South Tripura district to ascertain the prevalence of malaria and proportions of parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT. The study showed that malaria was widely prevalent and P. falciparum was the predominant infection (>90%), the remaining were P. vivax cases. The disease distribution, however, was uneven with large concentration of cases in districts of South Tripura and Dhalai coinciding with vast forest cover and tribal populations. Both Anopheles minimus s.s. and An. baimaii were recorded to be prevalent and observed to be highly anthropophagic and susceptible to DDT. Of these, An. minimus was incriminated (sporozoite infection rate 4.92%), and its bionomical characteristics revealed this species to be largely indoor resting and endophagic. For effective control of malaria in the state, it is recommended that diseases surveillance should be robust, and vector control interventions including DDT spray coverage, mass distribution of insecticide-treated nets/ long-lasting insecticidal nets should be intensified prioritizing population groups most at risk to

  9. Social science research in malaria prevention, management and control in the last two decades: an overview.

    Science.gov (United States)

    Mwenesi, Halima Abdullah

    2005-09-01

    In the recent past, considerable progress has been made in understanding how human behavior and social organization, macro- and micro-level economic processes, and health and political systems affect responses to malaria at global, national, community, household, and individual levels. Advances in malaria-related social, behavioral, economic, evaluation, health systems, and policy (social science) research have resulted in improvements in the design and implementation of malaria prevention, management and control (PMC) strategies. Indeed, the past two decades chronicle dramatic advances in the implementation of evidence-based interventions, drawn not only from biomedical but also from social science research. Malaria awareness-raising, advocacy, case management, and prevention efforts have reaped the benefits of social science research and as a result, many programs are implemented and evaluated in a more effective manner than in the past. However, the pace at which findings from social science research are integrated into program and policy implementation is unsatisfactory. Additionally, examples remain of programs that fail to utilize findings from social science research and as a result, achieve minimal results. Furthermore, there is a sizeable body of knowledge that is underutilized and which, if assimilated into programs and policies, could accelerate progress in malaria PMC. Examples include information on meaningful community participation, gender, socio-economic status, and health systems. Regrettably, although social science input is necessary for almost all interventions for malaria management and control, the numbers of scientists working in this area are dismal in most of the key disciplines-medical anthropology; demography; geography and sociology; health economics and health policy; social psychology; social epidemiology; and behavior-change communication. Further, skills of program workers charged with implementation of interventions and strategies

  10. 1 Scepticism towards insecticide treated mosquito nets for malaria ...

    African Journals Online (AJOL)

    Abstract: Despite existence of effective tools for malaria control, malaria ... breaks from traditional approach that tend to study low uptake of health ... Key words: scepticism, low uptake, mosquito nets, malaria, social marketing, Tanzania.

  11. Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc combined with timely home treatment for malaria control in Ghana

    Directory of Open Access Journals (Sweden)

    Seake-Kwawu Atsu

    2011-05-01

    Full Text Available Abstract Background Intermittent preventive treatment (IPT has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. Objective The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. Methods This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6 - 60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months. Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Results Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥37.5°C compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. Conclusion The year-two-evaluation result indicates that IPTc given three times in a year (every four months combined with timely treatment of febrile malaria illness, is

  12. Community-randomized trial of lambdacyhalothrin-treated hammock nets for malaria control in Yanomami communities in the Amazon region of Venezuela.

    Science.gov (United States)

    Magris, M; Rubio-Palis, Y; Alexander, N; Ruiz, B; Galván, N; Frias, D; Blanco, M; Lines, J

    2007-03-01

    We conducted a community-randomized controlled trial in an area of moderate malaria transmission in the Amazon region, southern Venezuela, home of the Yanomami indigenous ethnic group. The aim was to compare the malaria incidence rate in villages with lambdacyhalothrin-treated hammock nets (ITHN) or with placebo-treated hammock nets (PTHN). In both arms of the study, intensive surveillance for early case detection was maintained and prompt malaria treatment was administered. Baseline data were collected before the intervention and a population of around 924 Yanomami was followed for 2 years. Despite the recent introduction of nets in the Yanomami villages and the adverse natural conditions in the area, the nets were accepted enthusiastically by the study population, used conscientiously and looked after carefully. The malaria incidence rate per thousand person-years at risk was 114.6 in the IHTN group and 186.8 in the PTHN group. The adjusted rate ratios indicated that ITHN prevent 56% [IRR: 0.44, 95% confidence interval (CI): 52-59%] of new malaria cases. ITHN reduced the prevalence of parasitaemia by 83% [relative risks (RR): 0.17, 95% CI: 47-100%], according to a cross-sectional survey carried out during the high transmission season. The prevalence of splenomegaly and anaemia was too low to detect any possible reduction as a result of ITHN. The main conclusion of the present study is that ITHN can reduce malaria incidence in the area and it is the most feasible method for malaria control in a forested area where indigenous villages are scattered over a large territory. This is the first community-level epidemiological trial to show that ITHN are highly effective against malaria transmitted by Anopheles darlingi.

  13. PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

    African Journals Online (AJOL)

    GB

    2015-10-04

    Oct 4, 2015 ... ABSTRACT. BACKGROUND: Malaria is endemic in Nigeria, with significant records of mortality and morbidity. Adequate community involvement is central to a successful implementation of malaria control programs. This study assessed the effects of a training programme on knowledge of malaria ...

  14. Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland.

    Science.gov (United States)

    Koita, Kadiatou; Novotny, Joseph; Kunene, Simon; Zulu, Zulizile; Ntshalintshali, Nyasatu; Gandhi, Monica; Gosling, Roland

    2013-06-27

    Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to

  15. Malaria epidemiology in low-endemicity areas of the northern coast of Ecuador: high prevalence of asymptomatic infections.

    Science.gov (United States)

    Sáenz, Fabián E; Arévalo-Cortés, Andrea; Valenzuela, Gabriela; Vallejo, Andrés F; Castellanos, Angélica; Poveda-Loayza, Andrea C; Gutierrez, Juan B; Alvarez, Alvaro; Yan, Yi Heng; Benavides, Yoldy; Castro, Luis Enrique; Arévalo-Herrera, Myriam; Herrera, Sócrates

    2017-07-26

    The recent scale-up in malaria control measures in Latin America has resulted in a significant decrease in the number of reported cases in several countries including Ecuador, where it presented a low malaria incidence in recent years (558 reported cases in 2015) with occasional outbreaks of both Plasmodium falciparum and Plasmodium vivax in the coastal and Amazonian regions. This success in malaria control in recent years has led Ecuador to transition its malaria policy from control to elimination. This study evaluated the general knowledge, attitude and practices (KAP) about malaria, as well as its prevalence in four communities of an endemic area in northwest Ecuador. A total of 258 interviews to assess KAP in the community indicated that most people in the study area have a basic knowledge about the disease but did not use to contribute to its control. Six hundred and forty-eight blood samples were collected and analysed by thick blood smear and real-time PCR. In addition, the distribution of the infections was mapped in the study communities. Although, no parasites were found by microscopy, by PCR the total malaria prevalence was 7.5% (6.9% P. vivax and 0.6% P. falciparum), much higher than expected and comparable to that reported in endemic areas of neighbouring countries with higher malaria transmission. Serology using ELISA and immunofluorescence indicated 27% respondents for P. vivax and 22% respondents for P. falciparum. Results suggest that despite a great malaria reduction in Ecuador, transition from control to elimination would demand further improvement in malaria diagnostics, including active case detection to identify and treat parasite asymptomatic carriers, as well as community participation in its elimination.

  16. Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

    Science.gov (United States)

    Katureebe, Agaba; Zinszer, Kate; Arinaitwe, Emmanuel; Charland, Katia; Kigozi, Ruth; Kilama, Maxwell; Nankabirwa, Joaniter; Yeka, Adoke; Mawejje, Henry; Mpimbaza, Arthur; Donnelly, Martin J.; Rosenthal, Philip J.; Lindsay, Steve W.; Staedke, Sarah G.; Smith, David L.; Kamya, Moses R.; Dorsey, Grant

    2016-01-01

    Background Long-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) are the primary vector control interventions used to prevent malaria in Africa. Although both interventions are effective in some settings, high-quality evidence is rarely available to evaluate their effectiveness following deployment by a national malaria control program. In Uganda, we measured changes in key malaria indicators following universal LLIN distribution in three sites, with the addition of IRS at one of these sites. Methods and Findings Comprehensive malaria surveillance was conducted from October 1, 2011, to March 31, 2016, in three sub-counties with relatively low (Walukuba), moderate (Kihihi), and high transmission (Nagongera). Between 2013 and 2014, universal LLIN distribution campaigns were conducted in all sites, and in December 2014, IRS with the carbamate bendiocarb was initiated in Nagongera. High-quality surveillance evaluated malaria metrics and mosquito exposure before and after interventions through (a) enhanced health-facility-based surveillance to estimate malaria test positivity rate (TPR), expressed as the number testing positive for malaria/number tested for malaria (number of children tested for malaria: Walukuba = 42,833, Kihihi = 28,790, and Nagongera = 38,690); (b) cohort studies to estimate the incidence of malaria, expressed as the number of episodes per person-year [PPY] at risk (number of children observed: Walukuba = 340, Kihihi = 380, and Nagongera = 361); and (c) entomology surveys to estimate household-level human biting rate (HBR), expressed as the number of female Anopheles mosquitoes collected per house-night of collection (number of households observed: Walukuba = 117, Kihihi = 107, and Nagongera = 107). The LLIN distribution campaign substantially increased LLIN coverage levels at the three sites to between 65.0% and 95.5% of households with at least one LLIN. In Walukuba, over the 28-mo post-intervention period

  17. Temporal dynamic of malaria in a suburban area along the Niger River.

    Science.gov (United States)

    Sissoko, Mahamadou Soumana; Sissoko, Kourane; Kamate, Bourama; Samake, Yacouba; Goita, Siaka; Dabo, Abdoulaye; Yena, Mama; Dessay, Nadine; Piarroux, Renaud; Doumbo, Ogobara K; Gaudart, Jean

    2017-10-23

    Even if rainfall and temperature are factors classically associated to malaria, little is known about other meteorological factors, their variability and combinations related to malaria, in association with river height variations. Furthermore, in suburban area, urbanization and growing population density should be assessed in relation to these environmental factors. The aim of this study was to assess the impact of combined environmental, meteorological and hydrological factors on malaria incidence through time in the context of urbanization. Population observational data were prospectively collected. Clinical malaria was defined as the presence of parasites in addition to clinical symptoms. Meteorological and hydrological factors were measured daily. For each factors variation indices were estimated. Urbanization was yearly estimated assessing satellite imaging and field investigations. Principal component analysis was used for dimension reduction and factors combination. Lags between malaria incidences and the main components were assessed by cross-correlation functions. Generalized additive model was used to assess relative impact of different environmental components, taking into account lags, and modelling non-linear relationships. Change-point analysis was used to determine transmission periods within years. Malaria incidences were dominated by annual periodicity and varied through time without modification of the dynamic, with no impact of the urbanization. The main meteorological factor associated with malaria was a combination of evaporation, humidity and rainfall, with a lag of 3 months. The relationship between combined temperature factors showed a linear impact until reaching high temperatures limiting malaria incidence, with a lag 3.25 months. Height and variation of the river were related to malaria incidence (respectively 6 week lag and no lag). The study emphasizes no decreasing trend of malaria incidence despite accurate access to care and

  18. Effect of malaria on placental volume measured using three-dimensional ultrasound: a pilot study

    Directory of Open Access Journals (Sweden)

    Rijken Marcus J

    2012-01-01

    Full Text Available Abstract Background The presence of malaria parasites and histopathological changes in the placenta are associated with a reduction in birth weight, principally due to intrauterine growth restriction. The aim of this study was to examine the feasibility of studying early pregnancy placental volumes using three-dimensional (3D ultrasound in a malaria endemic area, as a small volume in the second trimester may be an indicator of intra-uterine growth restriction and placental insufficiency. Methods Placenta volumes were acquired using a portable ultrasound machine and a 3D ultrasound transducer and estimated using the Virtual Organ Computer-aided AnaLysis (VOCAL image analysis software package. Intra-observer reliability and limits of agreement of the placenta volume measurements were calculated. Polynomial regression models for the mean and standard deviation as a function of gestational age for the placental volumes of uninfected women were created and tested. Based on these equations each measurement was converted into a z -score. The z-scores of the placental volumes of malaria infected and uninfected women were then compared. Results Eighty-four women (uninfected = 65; infected = 19 with a posterior placenta delivered congenitally normal, live born, single babies. The mean placental volumes in the uninfected women were modeled to fit 5th, 10th, 50th, 90th and 95th centiles for 14-24 weeks' gestation. Most placenta volumes in the infected women were below the 50th centile for gestational age; most of those with Plasmodium falciparum were below the 10th centile. The 95% intra-observer limits of agreement for first and second measurements were ± 37.0 mL and ± 25.4 mL at 30 degrees and 15 degrees rotation respectively. Conclusion The new technique of 3D ultrasound volumetry of the placenta may be useful to improve our understanding of the pathophysiological constraints on foetal growth caused by malaria infection in early pregnancy.

  19. 2015: The beginning of the end of the war against malaria

    Directory of Open Access Journals (Sweden)

    Richard Tjan

    2015-12-01

    Full Text Available In May 2015 the 62th World Health Assembly formulated a global malaria strategy for 2016-2030 aiming to “reduce the global disease burden by 40% by 2020, and by at least 90% by 2030. It also aims to eliminate malaria in at least 35 new countries by 2030”.(1 As a reminder, it was 60 years ago that the Eighth World Health Assembly decided in 1955 to shift from malaria control to malaria eradication, with the aim to make many areas of free of malaria “within 10 to 15 years”.(2 This has yet to be accomplished in many malaria endemic countries such as Indonesia, where the earliest program was the malaria eradication program of 1959, evolving into the malaria control program, the roll-back malaria program, and finally in 2012 into the malaria elimination program.(3 In view of the ever-present insecticideresistance

  20. Increased carboxyhemoglobin in adult falciparum malaria is associated with disease severity and mortality.

    Science.gov (United States)

    Yeo, Tsin W; Lampah, Daniel A; Kenangalem, Enny; Tjitra, Emiliana; Price, Ric N; Anstey, Nicholas M

    2013-09-01

    Heme oxygenase 1 expression is increased in pediatric patients with malaria. The carboxyhemoglobin level (a measure of heme oxygenase 1 activity) has not been assessed in adult patients with malaria. Results of pulse co-oximetry revealed that the mean carboxyhemoglobin level was elevated in 29 Indonesian adults with severe falciparum malaria (10%; 95% confidence interval [CI], 8%-13%) and in 20 with severe sepsis (8%; 95% CI, 5%-12%), compared with the mean levels in 32 patients with moderately severe malaria (7%; 95% CI, 5%-8%) and 36 controls (3.6%; 95% CI, 3%-5%; P carboxyhemoglobin level was associated with an increased odds of death among patients with severe malaria (odds ratio, 1.2 per percentage point increase; 95% CI, 1.02-1.5). While also associated with severity and fatality, methemoglobin was only modestly increased in patients with severe malaria. Increased carboxyhemoglobin levels during severe malaria and sepsis may exacerbate organ dysfunction by reducing oxygen carriage and cautions against the use of adjunctive CO therapy, which was proposed on the basis of mouse models.

  1. Monitoring and evaluation of malaria in pregnancy - developing a rational basis for control

    NARCIS (Netherlands)

    Brabin, Bernard J.; Wasame, Marian; Uddenfeldt-Wort, Ulrika; Dellicour, Stephanie; Hill, Jenny; Gies, Sabine

    2008-01-01

    Monitoring and evaluation of malaria control in pregnancy is essential for assessing the efficacy and effectiveness of health interventions aimed at reducing the major burden of this disease on women living in endemic areas. Yet there is no currently integrated strategic approach on how this should

  2. Spatio-Temporal Dynamics of Asymptomatic Malaria: Bridging the Gap Between Annual Malaria Resurgences in a Sahelian Environment.

    Science.gov (United States)

    Coulibaly, Drissa; Travassos, Mark A; Tolo, Youssouf; Laurens, Matthew B; Kone, Abdoulaye K; Traore, Karim; Sissoko, Mody; Niangaly, Amadou; Diarra, Issa; Daou, Modibo; Guindo, Boureima; Rebaudet, Stanislas; Kouriba, Bourema; Dessay, Nadine; Piarroux, Renaud; Plowe, Christopher V; Doumbo, Ogobara K; Thera, Mahamadou A; Gaudart, Jean

    2017-12-01

    In areas of seasonal malaria transmission, the incidence rate of malaria infection is presumed to be near zero at the end of the dry season. Asymptomatic individuals may constitute a major parasite reservoir during this time. We conducted a longitudinal analysis of the spatio-temporal distribution of clinical malaria and asymptomatic parasitemia over time in a Malian town to highlight these malaria transmission dynamics. For a cohort of 300 rural children followed over 2009-2014, periodicity and phase shift between malaria and rainfall were determined by spectral analysis. Spatial risk clusters of clinical episodes or carriage were identified. A nested-case-control study was conducted to assess the parasite carriage factors. Malaria infection persisted over the entire year with seasonal peaks. High transmission periods began 2-3 months after the rains began. A cluster with a low risk of clinical malaria in the town center persisted in high and low transmission periods. Throughout 2009-2014, cluster locations did not vary from year to year. Asymptomatic and gametocyte carriage were persistent, even during low transmission periods. For high transmission periods, the ratio of asymptomatic to clinical cases was approximately 0.5, but was five times higher during low transmission periods. Clinical episodes at previous high transmission periods were a protective factor for asymptomatic carriage, but carrying parasites without symptoms at a previous high transmission period was a risk factor for asymptomatic carriage. Stable malaria transmission was associated with sustained asymptomatic carriage during dry seasons. Control strategies should target persistent low-level parasitemia clusters to interrupt transmission.

  3. Is outdoor vector control needed for malaria elimination? An individual-based modelling study.

    Science.gov (United States)

    Zhu, Lin; Müller, Günter C; Marshall, John M; Arheart, Kristopher L; Qualls, Whitney A; Hlaing, WayWay M; Schlein, Yosef; Traore, Sekou F; Doumbia, Seydou; Beier, John C

    2017-07-03

    Residual malaria transmission has been reported in many areas even with adequate indoor vector control coverage, such as long-lasting insecticidal nets (LLINs). The increased insecticide resistance in Anopheles mosquitoes has resulted in reduced efficacy of the widely used indoor tools and has been linked with an increase in outdoor malaria transmission. There are considerations of incorporating outdoor interventions into integrated vector management (IVM) to achieve malaria elimination; however, more information on the combination of tools for effective control is needed to determine their utilization. A spatial individual-based model was modified to simulate the environment and malaria transmission activities in a hypothetical, isolated African village setting. LLINs and outdoor attractive toxic sugar bait (ATSB) stations were used as examples of indoor and outdoor interventions, respectively. Different interventions and lengths of efficacy periods were tested. Simulations continued for 420 days, and each simulation scenario was repeated 50 times. Mosquito populations, entomologic inoculation rates (EIRs), probabilities of local mosquito extinction, and proportion of time when the annual EIR was reduced below one were compared between different intervention types and efficacy periods. In the village setting with clustered houses, the combinational intervention of 50% LLINs plus outdoor ATSBs significantly reduced mosquito population and EIR in short term, increased the probability of local mosquito extinction, and increased the time when annual EIR is less than one per person compared to 50% LLINs alone; outdoor ATSBs alone significantly reduced mosquito population in short term, increased the probability of mosquito extinction, and increased the time when annual EIR is less than one compared to 50% LLINs alone, but there was no significant difference in EIR in short term between 50% LLINs and outdoor ATSBs. In the village setting with dispersed houses, the

  4. A multi-criteria decision analysis approach to assessing malaria risk in northern South America

    Directory of Open Access Journals (Sweden)

    Temitope O. Alimi

    2016-03-01

    Full Text Available Abstract Background Malaria control in South America has vastly improved in the past decade, leading to a decrease in the malaria burden. Despite the progress, large parts of the continent continue to be at risk of malaria transmission, especially in northern South America. The objectives of this study were to assess the risk of malaria transmission and vector exposure in northern South America using multi-criteria decision analysis. Methods The risk of malaria transmission and vector exposure in northern South America was assessed using multi-criteria decision analysis, in which expert opinions were taken on the key environmental and population risk factors. Results Results from our risk maps indicated areas of moderate-to-high risk along rivers in the Amazon basin, along the coasts of the Guianas, the Pacific coast of Colombia and northern Colombia, in parts of Peru and Bolivia and within the Brazilian Amazon. When validated with occurrence records for malaria, An. darlingi, An. albimanus and An. nuneztovari s.l., t-test results indicated that risk scores at occurrence locations were significantly higher (p < 0.0001 than a control group of geographically random points. Conclusion In this study, we produced risk maps based on expert opinion on the spatial representation of risk of potential vector exposure and malaria transmission. The findings provide information to the public health decision maker/policy makers to give additional attention to the spatial planning of effective vector control measures. Therefore, as the region tackles the challenge of malaria elimination, prioritizing areas for interventions by using spatially accurate, high-resolution (1 km or less risk maps may guide targeted control and help reduce the disease burden in the region.

  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. Malaria profiles and challenges in artemisinin resistance containment in Myanmar.

    Science.gov (United States)

    Nwe, Thet Wai; Oo, Tin; Wai, Khin Thet; Zhou, Shuisen; van Griensven, Johan; Chinnakali, Palanivel; Shah, Safieh; Thi, Aung

    2017-04-25

    This study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar. Using National Malaria Control Programme (NMCP) data, a cross-sectional descriptive study of 52 townships in artemisinin-resistant containment areas in Myanmar was conducted. Annual program data were analysed, and trends over time are graphically presented. In the 52 study townships populated by 8.7 million inhabitants, malaria incidence showed a decreasing trend from 10.54 per 1 000 population in 2010 to 2.53 in 2014, and malaria mortalities also decreased from 1.83 per 100 000 population in 2010 to 0.17 in 2014. The proportion of confirmed to total tested malaria cases also decreased from 6 to 1%, while identification of cases improved. All cases from all parasites species, including Plasmodium falciparum, decreased. Coverage of LLIN (long-lasting insecticidal net)/ITN (insecticide-treated mosquito nets) and indoor residual spraying (IRS) was high in targeted areas with at-risk persons, even though the total population was not covered. In addition to passive case detection (PCD), active case detection (ACD) was conducted in hard-to-reach areas and worksites where mobile migrant populations were present. ACD improved in most areas from 2012 to 2014, but continues to need to be strengthened. The findings provide useful data on the malaria situation in artemisinin-resistant initiative areas, which may be useful for the NMCP to meet its elimination goal. These profiles could contribute to better planning, implementation, and evaluation of intervention activities.

  7. Prevalence and risk factors of asymptomatic malaria among ...

    African Journals Online (AJOL)

    Background: Enhanced malaria control has resulted in its reduction in some areas of Sub Saharan Africa including Rwanda. However, asymptomatic hosts serve as a reservoir for the malaria parasite for communities. The objective of this study was to determine the prevalence of malaria parasites and risk factors associated ...

  8. Malaria in South Africa: 110 years of learning to control the disease ...

    African Journals Online (AJOL)

    Major donor agencies are partnering with African governments in an attempt to curb transmission of malaria parasites, and in some countries on the edges of the distribution of malaria, there is talk of eliminating the disease. South Africa is at the very southernmost fringe of malaria distribution on the African continent and ...

  9. Applications and limitations of Centers for Disease Control and Prevention miniature light traps for measuring biting densities of African malaria vector populations: a pooled-analysis of 13 comparisons with human landing catches.

    Science.gov (United States)

    Briët, Olivier J T; Huho, Bernadette J; Gimnig, John E; Bayoh, Nabie; Seyoum, Aklilu; Sikaala, Chadwick H; Govella, Nicodem; Diallo, Diadier A; Abdullah, Salim; Smith, Thomas A; Killeen, Gerry F

    2015-06-18

    Measurement of densities of host-seeking malaria vectors is important for estimating levels of disease transmission, for appropriately allocating interventions, and for quantifying their impact. The gold standard for estimating mosquito-human contact rates is the human landing catch (HLC), where human volunteers catch mosquitoes that land on their exposed body parts. This approach necessitates exposure to potentially infectious mosquitoes, and is very labour intensive. There are several safer and less labour-intensive methods, with Centers for Disease Control light traps (LT) placed indoors near occupied bed nets being the most widely used. This paper presents analyses of 13 studies with paired mosquito collections of LT and HLC to evaluate these methods for their consistency in sampling indoor-feeding mosquitoes belonging to the two major taxa of malaria vectors across Africa, the Anopheles gambiae sensu lato complex and the Anopheles funestus s.l. group. Both overall and study-specific sampling efficiencies of LT compared with HLC were computed, and regression methods that allow for the substantial variations in mosquito counts made by either method were used to test whether the sampling efficacy varies with mosquito density. Generally, LT were able to collect similar numbers of mosquitoes to the HLC indoors, although the relative sampling efficacy, measured by the ratio of LT:HLC varied considerably between studies. The overall best estimate for An. gambiae s.l. was 1.06 (95% credible interval: 0.68-1.64) and for An. funestus s.l. was 1.37 (0.70-2.68). Local calibration exercises are not reproducible, since only in a few studies did LT sample proportionally to HLC, and there was no geographical pattern or consistent trend with average density in the tendency for LT to either under- or over-sample. LT are a crude tool at best, but are relatively easy to deploy on a large scale. Spatial and temporal variation in mosquito densities and human malaria transmission

  10. Malaria Control In the Northern Transvaal

    African Journals Online (AJOL)

    Relatively 'few symptomless carriers were found, except in areas adjoining the lower Crocodile,. Komati, Letaba and Mutale rivers. These findings suggest that the immune status has fallen to very low levels except in these low-lying river areas where low-level transmission has persisted. MALARIA MOSQUITO VECTORS.

  11. Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: a WHO-coordinated, prospective, international, observational cohort study.

    Science.gov (United States)

    Kleinschmidt, Immo; Bradley, John; Knox, Tessa Bellamy; Mnzava, Abraham Peter; Kafy, Hmooda Toto; Mbogo, Charles; Ismail, Bashir Adam; Bigoga, Jude D; Adechoubou, Alioun; Raghavendra, Kamaraju; Cook, Jackie; Malik, Elfatih M; Nkuni, Zinga José; Macdonald, Michael; Bayoh, Nabie; Ochomo, Eric; Fondjo, Etienne; Awono-Ambene, Herman Parfait; Etang, Josiane; Akogbeto, Martin; Bhatt, Rajendra M; Chourasia, Mehul Kumar; Swain, Dipak K; Kinyari, Teresa; Subramaniam, Krishanthi; Massougbodji, Achille; Okê-Sopoh, Mariam; Ogouyemi-Hounto, Aurore; Kouambeng, Celestin; Abdin, Mujahid Sheikhedin; West, Philippa; Elmardi, Khalid; Cornelie, Sylvie; Corbel, Vincent; Valecha, Neena; Mathenge, Evan; Kamau, Luna; Lines, Jonathan; Donnelly, Martin James

    2018-04-09

    Scale-up of insecticide-based interventions has averted more than 500 million malaria cases since 2000. Increasing insecticide resistance could herald a rebound in disease and mortality. We aimed to investigate whether insecticide resistance was associated with loss of effectiveness of long-lasting insecticidal nets and increased malaria disease burden. This WHO-coordinated, prospective, observational cohort study was done at 279 clusters (villages or groups of villages in which phenotypic resistance was measurable) in Benin, Cameroon, India, Kenya, and Sudan. Pyrethroid long-lasting insecticidal nets were the principal form of malaria vector control in all study areas; in Sudan this approach was supplemented by indoor residual spraying. Cohorts of children from randomly selected households in each cluster were recruited and followed up by community health workers to measure incidence of clinical malaria and prevalence of infection. Mosquitoes were assessed for susceptibility to pyrethroids using the standard WHO bioassay test. Country-specific results were combined using meta-analysis. Between June 2, 2012, and Nov 4, 2016, 40 000 children were enrolled and assessed for clinical incidence during 1·4 million follow-up visits. 80 000 mosquitoes were assessed for insecticide resistance. Long-lasting insecticidal net users had lower infection prevalence (adjusted odds ratio [OR] 0·63, 95% CI 0·51-0·78) and disease incidence (adjusted rate ratio [RR] 0·62, 0·41-0·94) than did non-users across a range of resistance levels. We found no evidence of an association between insecticide resistance and infection prevalence (adjusted OR 0·86, 0·70-1·06) or incidence (adjusted RR 0·89, 0·72-1·10). Users of nets, although significantly better protected than non-users, were nevertheless subject to high malaria infection risk (ranging from an average incidence in net users of 0·023, [95% CI 0·016-0·033] per person-year in India, to 0·80 [0·65-0·97] per person

  12. 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...... covering the study area of the Bandim Health Project (BHP) and at the outpatient clinic of the national hospital in Bissau. Cross-sectional surveys were conducted in the community in different malaria seasons. RESULTS: Malaria was overdiagnosed in both health centres and hospital. Sixty-four per cent...... 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...

  13. A Stochastic Model for Malaria Transmission Dynamics

    Directory of Open Access Journals (Sweden)

    Rachel Waema Mbogo

    2018-01-01

    Full Text Available Malaria is one of the three most dangerous infectious diseases worldwide (along with HIV/AIDS and tuberculosis. In this paper we compare the disease dynamics of the deterministic and stochastic models in order to determine the effect of randomness in malaria transmission dynamics. Relationships between the basic reproduction number for malaria transmission dynamics between humans and mosquitoes and the extinction thresholds of corresponding continuous-time Markov chain models are derived under certain assumptions. The stochastic model is formulated using the continuous-time discrete state Galton-Watson branching process (CTDSGWbp. The reproduction number of deterministic models is an essential quantity to predict whether an epidemic will spread or die out. Thresholds for disease extinction from stochastic models contribute crucial knowledge on disease control and elimination and mitigation of infectious diseases. Analytical and numerical results show some significant differences in model predictions between the stochastic and deterministic models. In particular, we find that malaria outbreak is more likely if the disease is introduced by infected mosquitoes as opposed to infected humans. These insights demonstrate the importance of a policy or intervention focusing on controlling the infected mosquito population if the control of malaria is to be realized.

  14. Simulation of the Costs and Consequences of Potential Vaccines for Plasmodium Falciparum Malaria

    OpenAIRE

    Tediosi, Fabrizio

    2010-01-01

    Malaria is one of the major public health problems for low income countries, a major global health priority, and it has also a dramatic economic impact. Funding for malaria control is on the rise and both international donors and governments of malaria endemic countries need tools and evidence to assess which are the best and most efficient strategies to control malaria. Standard tools traditionally used to assess the public health and economic impact of malaria control inte...

  15. Non-Genetic Determinants of Mosquito Competence for Malaria Parasites

    Science.gov (United States)

    Lefèvre, Thierry; Vantaux, Amélie; Dabiré, Kounbobr R.; Mouline, Karine; Cohuet, Anna

    2013-01-01

    Understanding how mosquito vectors and malaria parasites interact is of fundamental interest, and it also offers novel perspectives for disease control. Both the genetic and environmental contexts are known to affect the ability of mosquitoes to support malaria development and transmission, i.e., vector competence. Although the role of environment has long been recognized, much work has focused on host and parasite genetic effects. However, the last few years have seen a surge of studies revealing a great diversity of ways in which non-genetic factors can interfere with mosquito-Plasmodium interactions. Here, we review the current evidence for such environmentally mediated effects, including ambient temperature, mosquito diet, microbial gut flora, and infection history, and we identify additional factors previously overlooked in mosquito-Plasmodium interactions. We also discuss epidemiological implications, and the evolutionary consequences for vector immunity and parasite transmission strategies. Finally, we propose directions for further research and argue that an improved knowledge of non-genetic influences on mosquito-Plasmodium interactions could aid in implementing conventional malaria control measures and contribute to the design of novel strategies. PMID:23818841

  16. Non-genetic determinants of mosquito competence for malaria parasites.

    Directory of Open Access Journals (Sweden)

    Thierry Lefèvre

    Full Text Available Understanding how mosquito vectors and malaria parasites interact is of fundamental interest, and it also offers novel perspectives for disease control. Both the genetic and environmental contexts are known to affect the ability of mosquitoes to support malaria development and transmission, i.e., vector competence. Although the role of environment has long been recognized, much work has focused on host and parasite genetic effects. However, the last few years have seen a surge of studies revealing a great diversity of ways in which non-genetic factors can interfere with mosquito-Plasmodium interactions. Here, we review the current evidence for such environmentally mediated effects, including ambient temperature, mosquito diet, microbial gut flora, and infection history, and we identify additional factors previously overlooked in mosquito-Plasmodium interactions. We also discuss epidemiological implications, and the evolutionary consequences for vector immunity and parasite transmission strategies. Finally, we propose directions for further research and argue that an improved knowledge of non-genetic influences on mosquito-Plasmodium interactions could aid in implementing conventional malaria control measures and contribute to the design of novel strategies.

  17. Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005-2010 period.

    Science.gov (United States)

    Pribluda, Victor S; Barojas, Adrian; Añez, Arletta; López, Cecilia G; Figueroa, Ruth; Herrera, Roxana; Nakao, Gladys; Nogueira, Fernando Ha; Pianetti, Gerson A; Povoa, Marinete M; Viana, Giselle Mr; Gomes, Margarete S Mendonça; Escobar, Jose P; Sierra, Olga L Muñoz; Norena, Susana P Rendon; Veloz, Raúl; Bravo, Marcy Silva; Aldás, Martha R; Hindssemple, Alison; Collins, Marilyn; Ceron, Nicolas; Krishnalall, Karanchand; Adhin, Malti; Bretas, Gustavo; Hernandez, Nelly; Mendoza, Marjorie; Smine, Abdelkrim; Chibwe, Kennedy; Lukulay, Patrick; Evans, Lawrence

    2012-06-15

    Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country's Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly

  18. Designing a sustainable strategy for malaria control?

    Directory of Open Access Journals (Sweden)

    Mharakurwa Sungano

    2011-08-01

    Full Text Available Abstract Malaria in the 21st century is showing signs of declining over much of its distribution, including several countries in Africa where previously this was not thought to be feasible. Yet for the most part the strategies to attack the infection are similar to those of the 1950s. Three major Journals have recently drawn attention to the situation, stressing the importance of research, describing the successes and defining semantics related to control. But there is a need to stress the importance of local sustainability, and consider somewhat urgently how individual endemic countries can plan and implement the programmes that are currently financed, for the most part, by donor institutions. On an immediate basis research should be more focused on a data driven approach to control. This will entail new thinking on the role of local infrastructure and in training of local scientists in local universities in epidemiology and field malariology so that expanded control programmes can become operational. Donor agencies should encourage and facilitate development of career opportunities for such personnel so that local expertise is available to contribute appropriately.

  19. Social marketing of insecticide-treated bed net for malaria control ...

    African Journals Online (AJOL)

    Background: The effectiveness of the insecticide-treated bed net in reducing the morbidity and mortality associated with malaria has been proved at all levels of malaria transmission. Several models on how to achieve massive coverage have been suggested, but social marketing of the nets is highly favoured for its ...

  20. Artemether-lumefantrine: an oral antimalarial for uncomplicated malaria in children

    DEFF Research Database (Denmark)

    Adjei, George O; Goka, Bamenla Q; Binka, Fred

    2009-01-01

    Artemether-lumefantrine (AL; Coartem, Riamet) is the first fixed-dose artemisinin combination therapy (ACT) regimen to be manufactured under Good Manufacturing Practice conditions, and is the most widely adopted ACT regimen used in malaria control programs. AL is approved for the treatment...... of uncomplicated malaria in adults, children and infants, and as treatment of uncomplicated malaria in nonimmune travelers returning from malarious areas. AL is efficacious for treating uncomplicated malaria in children and the frequency of associated adverse events is not higher than other available ACT regimens....... In this review, available evidence on efficacy and safety of AL in the treatment of uncomplicated malaria, with emphasis on children where appropriate, and focusing on characteristics that are potentially important for malaria control policy decisions, are presented and discussed....

  1. Susceptibility of Anopheles gambiae to insecticides used for malaria vector control in Rwanda.

    Science.gov (United States)

    Hakizimana, Emmanuel; Karema, Corine; Munyakanage, Dunia; Iranzi, Gad; Githure, John; Tongren, Jon Eric; Takken, Willem; Binagwaho, Agnes; Koenraadt, Constantianus J M

    2016-12-01

    The widespread emergence of resistance to pyrethroids is a major threat to the gains made in malaria control. To monitor the presence and possible emergence of resistance against a variety of insecticides used for malaria control in Rwanda, nationwide insecticide resistance surveys were conducted in 2011 and 2013. Larvae of Anopheles gambiae sensu lato mosquitoes were collected in 12 sentinel sites throughout Rwanda. These were reared to adults and analysed for knock-down and mortality using WHO insecticide test papers with standard diagnostic doses of the recommended insecticides. A sub-sample of tested specimens was analysed for the presence of knockdown resistance (kdr) mutations. A total of 14,311 mosquitoes were tested and from a sample of 1406 specimens, 1165 (82.9%) were identified as Anopheles arabiensis and 241 (17.1%) as Anopheles gambiae sensu stricto. Mortality results indicated a significant increase in resistance to lambda-cyhalothrin from 2011 to 2013 in 83% of the sites, permethrin in 25% of the sites, deltamethrin in 25% of the sites and DDT in 50% of the sites. Mosquitoes from 83% of the sites showed full susceptibility to bendiocarb and 17% of sites were suspected to harbour resistance that requires further confirmation. No resistance was observed to fenitrothion in all study sites during the entire survey. The kdr genotype results in An. gambiae s.s. showed that 67 (50%) possessed susceptibility (SS) alleles, while 35 (26.1%) and 32 (23.9%) mosquitoes had heterozygous (RS) and homozygous (RR) alleles, respectively. Of the 591 An. arabiensis genotyped, 425 (71.9%) possessed homozygous (SS) alleles while 158 (26.7%) and 8 (1.4%) had heterozygous (RS) and homozygous (RR) alleles, respectively. Metabolic resistance involving oxidase enzymes was also detected using the synergist PBO. This is the first nationwide study of insecticide resistance in malaria vectors in Rwanda. It shows the gradual increase of insecticide resistance to pyrethroids (lambda

  2. Liver function assessment in malaria, typhoid and malaria-typhoid co-infection in Aba, Abia State, Nigeria.

    Science.gov (United States)

    Enemchukwu, B N; Ibe, C C; Udedi, S C; Iroha, A; Ubaoji, K I; Ogundapo, S S

    2014-06-01

    Malaria and typhoid fever are among the most endemic diseases in the tropics and are associated with poverty and underdevelopment with significant morbidity and mortality. Both diseases can lead to liver damage if not properly treated. The liver function assessment was therefore conducted on (90) volunteer patients; comprising (30) patients with malaria only, (30) with typhoid only and (30) with malaria-typhoid co-infection randomly selected from Abia State University Teaching Hospital, Aba, Abia State, Nigeria and (20) healthy individuals were used as control. Blood samples collected from these subjects were screened for malaria parasite and Staphylococcus typhi using standard methods. Mean serum levels of ALP (112.55±84.23), AST (31.33±12.80), ALT (23.10±11.84), TB (19.43±5.02), CB (5.91±3.03) and ALP (116.69±48.68), AST (28.33±11.72), ALT (22.8±5.94), TB (19.31±5.84),CB (5.60±2.50) were obtained for those subjects with malaria and typhoid respectively and subjects with malaria-typhoid co-infection recorded the following; ALP (134.33±56.62), AST (33.97±8.43), ALT (24.40±4.37),TB (21.27±2.96),CB (6.58±3.10) while the control subjects had mean serum levels ofALP (71.05±18.18), AST (16.65±7.45), ALT (13.85±6.09), TB (10.05±4.85) and CB (3.00±1.67). These mean values were subjected to a statistical test using students t-test which revealed a significant increase (p<0.05).The results suggest that malaria, typhoid and malaria-typhoid co-infection can elevate ALP, AST, ALT, TB and CB serum levels and can lead to liver damage if not properly treated.

  3. PERCEPTIONS ABOUT MALARIA TRANSMISSION AND CONTROL ...

    African Journals Online (AJOL)

    An ethnobotanical survey was conducted in Mola, Kariba district, in order to collect information on some common herbal remedies used by traditional healers and rural folk in the treatment and prevention of malaria. Structured questionnaires were administered to 220 respondents in Mola, Kariba. Two hundred and twenty ...

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

    NARCIS (Netherlands)

    Loscertales, María-Paz; Brabin, Bernard J.

    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 no

  5. Social determinants of long lasting insecticidal hammock use among the Ra-glai ethnic minority in Vietnam: implications for forest malaria control.

    Directory of Open Access Journals (Sweden)

    Koen Peeters Grietens

    Full Text Available BACKGROUND: Long-lasting insecticidal hammocks (LLIHs are being evaluated as an additional malaria prevention tool in settings where standard control strategies have a limited impact. This is the case among the Ra-glai ethnic minority communities of Ninh Thuan, one of the forested and mountainous provinces of Central Vietnam where malaria morbidity persist due to the sylvatic nature of the main malaria vector An. dirus and the dependence of the population on the forest for subsistence--as is the case for many impoverished ethnic minorities in Southeast Asia. METHODS: A social science study was carried out ancillary to a community-based cluster randomized trial on the effectiveness of LLIHs to control forest malaria. The social science research strategy consisted of a mixed methods study triangulating qualitative data from focused ethnography and quantitative data collected during a malariometric cross-sectional survey on a random sample of 2,045 study participants. RESULTS: To meet work requirements during the labor intensive malaria transmission and rainy season, Ra-glai slash and burn farmers combine living in government supported villages along the road with a second home at their fields located in the forest. LLIH use was evaluated in both locations. During daytime, LLIH use at village level was reported by 69.3% of all respondents, and in forest fields this was 73.2%. In the evening, 54.1% used the LLIHs in the villages, while at the fields this was 20.7%. At night, LLIH use was minimal, regardless of the location (village 4.4%; forest 6.4%. DISCUSSION: Despite the free distribution of insecticide-treated nets (ITNs and LLIHs, around half the local population remains largely unprotected when sleeping in their forest plot huts. In order to tackle forest malaria more effectively, control policies should explicitly target forest fields where ethnic minority farmers are more vulnerable to malaria.

  6. Malaria severity: Possible influence of the E670G PCSK9 polymorphism: A preliminary case-control study in Malian children.

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    Arama, Charles; Diarra, Issa; Kouriba, Bourèma; Sirois, Francine; Fedoryak, Olesya; Thera, Mahamadou A; Coulibaly, Drissa; Lyke, Kirsten E; Plowe, Christopher V; Chrétien, Michel; Doumbo, Ogobara K; Mbikay, Majambu

    2018-01-01

    Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) is a hepatic secretory protein which promotes the degradation of low-density lipoprotein receptors leading to reduced hepatic uptake of plasma cholesterol. Non-synonymous single-nucleotide polymorphisms in its gene have been linked to hypo- or hyper- cholesterolemia, depending on whether they decrease or increase PCSK9 activity, respectively. Since the proliferation and the infectivity of Plasmodium spp. partially depend on cholesterol from the host, we hypothesize that these PCSK9 genetic polymorphisms could influence the course of malaria infection in individuals who carry them. Here we examined the frequency distribution of one dominant (C679X) and two recessive (A443T, I474V) hypocholesterolemic polymorphisms as well as that of one recessive hypercholesterolemic polymorphism (E670G) among healthy and malaria-infected Malian children. Dried blood spots were collected in Bandiagara, Mali, from 752 age, residence and ethnicity-matched children: 253 healthy controls, 246 uncomplicated malaria patients and 253 severe malaria patients. Their genomic DNA was extracted and genotyped for the above PCSK9 polymorphisms using Taqman assays. Associations of genotype distributions and allele frequencies with malaria were evaluated. The minor allele frequency of the A443T, I474V, E670G, and C679X polymorphisms in the study population sample was 0.12, 0.20, 0.26, and 0.02, respectively. For each polymorphism, the genotype distribution among the three health conditions was statistically insignificant, but for the hypercholesterolemic E670G polymorphism, a trend towards association of the minor allele with malaria severity was observed (P = 0.035). The association proved to be stronger when allele frequencies between healthy controls and severe malaria cases were compared (Odd Ratio: 1.34; 95% Confidence Intervals: 1.04-1.83); P = 0.031). Carriers of the minor allele of the E670G PCSK9 polymorphism might be more susceptible

  7. Fighting malaria in Madhya Pradesh (Central India: Are we loosing the battle?

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    Thimasarn Krongthong

    2009-05-01

    Full Text Available Abstract Malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement. Fifty four million individuals of various ethnic origins, accounting for 8% of the total population of India, contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country. Ambitious goals to control tribal malaria by launching "Enhanced Malaria Control Project" (EMCP by the National Vector Borne Disease Control Programme (NVBDCP, with the World Bank assistance, became effective in September 1997 in eight north Indian states. Under EMCP, the programme used a broader mix of new interventions, i.e. insecticide-treated bed nets, spraying houses with effective residual insecticides, use of larvivorous fishes, rapid diagnostic tests for prompt diagnosis, treatment of the sick with effective radical treatment and increased public awareness and IEC. However, the challenge is to scale up these services. A retrospective analysis of data on malaria morbidity and associated mortality reported under the existing surveillance system of the Madhya Pradesh (Central India for the years 1996–2007 was carried out to determine the impact of EMCP on malaria morbidity and associated mortality. Analysis revealed that despite the availability of effective intervention tools for the prevention and control of malaria, falciparum malaria remains uncontrolled and deaths due to malaria have increased. Precisely, the aim of this epidemiological analysis is to draw lessons applicable to all international aid efforts, bureaucracy, policy makers and programme managers in assessing its project performance as a new Global Malaria Action Plan is launched with ambitious goal of reducing malaria and its elimination by scaling up the use of existing tools.

  8. Potential use of birthweight indicators in rural Tanzania for monitoring malaria control in pregnancy

    NARCIS (Netherlands)

    Uddenfeldt Wort, Ulrika; Warsame, Marian; Brabin, Bernard J.

    2008-01-01

    Objective: Birthweight outcomes in rural Tanzania were determined in relation to place of delivery (hospital, dispensary or home), parity and maternal age (adolescent or non-adolescent) in order to evaluate the usefulness of birthweight data for monitoring malaria control in pregnancy. Study design:

  9. Rapid urban malaria appraisal (RUMA in sub-Saharan Africa

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    Akogbeto Martin

    2005-09-01

    Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.

  10. Prevalence of Malaria Plasmodium in Abeokuta, Nigeria

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    Okonko, I. O.

    2009-01-01

    Full Text Available This study reports the prevalence of malaria caused by plasmodium between genders in Abeokuta, the capital city of Ogun State located in the forest zone of southwestern Nigeria between January 2002 and December 2004. Blood film examination for malaria parasites in 708 patients; 366 males and 342 females. Microscopic examination of thick films techniques was employed for this study. Of the 708 (100% patients examined, 577 (81.5% were Plasmodium-positive. A high malaria parasite prevalence rate of 81.5% was noted in this study. Female subjects were more infected (42.4% than males (41.9% however, there was no significant difference in the sex of the subjects studied (p=0.05. A high malaria parasite prevalence rate of 86.9% was noted in samples collected in year 2003 than in other years studied. There was significant difference in the years under study (p=0.05. This study shows that a good percentage of people were infested by malaria Plasmodium. This could be attributed to lack of adequate accommodation and poor sanitary conditions in the area under study. Although several efforts have been made to effectively control the high incidence of malaria in Nigeria, these have been largely unsuccessful due to a number of reasons such as irrigated urban agriculture which can be the malaria vector’s breeding ground in the city, stagnant gutters and swamps in our environment where mosquitoes breed in millions, and lack of political will and commitment of the government in its disease management program, low awareness of the magnitude of malaria problem, poor health practices by individuals and communities and resistance to drugs. Therefore, future interventions in Nigeria should be directed toward controlling malaria in the context of a moderate transmission setting; thus, large-scale distribution of insecticide-treated nets or widespread use of indoor residual spraying may be less cost-effective than enhanced surveillance with effective case management or

  11. Spatial heterogeneity of malaria in Indian reserves of Southwestern Amazonia, Brazil

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    Santos Ricardo

    2008-11-01

    approach in this paper helped to determine where the greatest needs lie for more intensively focused malaria control activities in Indian reserves in the region. It also provided a reference to assess the effectiveness of control measures that have been put in place by Brazilian public health authorities.

  12. The farmer field school: a method for enhancing the role of rural communities in malaria control?

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    Berg, van den H.; Knols, B.G.J.

    2006-01-01

    Malaria has strong linkages with agriculture, and farmers in malarious regions have a central position in creating or controlling the conditions that favour disease transmission. An interdisciplinary and integrated approach is needed to involve farmers and more than one sector in control efforts. It

  13. Associations between Burkitt lymphoma among children in Malawi and infection with HIV, EBV and malaria: results from a case-control study.

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    Nora Mutalima

    Full Text Available BACKGROUND: Burkitt lymphoma, a childhood cancer common in parts of sub-Saharan Africa, has been associated with Epstein Barr Virus (EBV and malaria, but its association with human immunodeficiency virus (HIV is not clear. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a case-control study of Burkitt lymphoma among children (aged < or = 15 years admitted to the pediatric oncology unit in Blantyre, Malawi between July 2005 and July 2006. Cases were 148 children diagnosed with Burkitt lymphoma and controls were 104 children admitted with non-malignant conditions or cancers other than hematological malignancies and Kaposi sarcoma. Interviews were conducted and serological samples tested for antibodies against HIV, EBV and malaria. Odds ratios for Burkitt lymphoma were estimated using unconditional logistic regression adjusting for sex, age, and residential district. Cases had a mean age of 7.1 years and 60% were male. Cases were more likely than controls to be HIV positive (Odds ratio (OR = 12.4, 95% Confidence Interval (CI 1.3 to 116.2, p = 0.03. ORs for Burkitt lymphoma increased with increasing antibody titers against EBV (p = 0.001 and malaria (p = 0.01. Among HIV negative participants, cases were thirteen times more likely than controls to have raised levels of both EBV and malaria antibodies (OR = 13.2; 95% CI 3.8 to 46.6; p = 0.001. Reported use of mosquito nets was associated with a lower risk of Burkitt lymphoma (OR = 0.2, 95% CI, 0.03 to 0.9, p = 0.04. CONCLUSIONS: Our findings support prior evidence that EBV and malaria act jointly in the pathogenesis of Burkitt lymphoma, suggesting that malaria prevention may decrease the risk of Burkitt lymphoma. HIV may also play a role in the etiology of this childhood tumor.

  14. Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial.

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    Obinna Onwujekwe

    Full Text Available The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT. Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs with basic instruction (control; RDTs with provider training (provider arm; and RDTs with provider training plus a school-based community intervention (provider-school arm. The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93% of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36: stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26 in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19 in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47. Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.ClinicalTrials.gov NCT01350752.

  15. Monitoring and evaluation of malaria in pregnancy – developing a rational basis for control

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    Dellicour Stephanie

    2008-12-01

    Full Text Available Abstract Monitoring and evaluation of malaria control in pregnancy is essential for assessing the efficacy and effectiveness of health interventions aimed at reducing the major burden of this disease on women living in endemic areas. Yet there is no currently integrated strategic approach on how this should be achieved. Malaria control in pregnancy is formulated in relation to epidemiological patterns of exposure. Current emphasis is on intermittent preventive treatment (IPTp during pregnancy with sulphadoxine-pyrimethamine in higher transmission areas, combined with insecticide treated bed nets (ITNs and case management. Emphasis in lower transmission areas is primarily on case management. This paper discusses a rational basis for monitoring and evaluation based on: assessments of therapeutic and prophylactic drug efficacy; proportional reductions in parasite prevalence; seasonal effects; rapid assessment methodologies; birthweight and/or anaemia nomograms; case-coverage methods; maternal mortality indices; operational and programmatic indicators; and safety and pharmacovigilance of antimalarials in pregnancy. These approaches should be incorporated more effectively within National Programmes in order to facilitate surveillance and improve identification of high-risk women. Systems for utilizing routinely collected data should be strengthened, with greater attention to safety and pharmacovigilance with the advent of artemisinin combination therapies, and prospects of inadvertent exposures to artemisinins in the first trimester. Integrating monitoring activities within malaria control, reproductive health and adolescent-friendly services will be critical for implementation. Large-scale operational research is required to further evaluate the validity of currently proposed indicators, and in order to clarify the breadth and scale of implementation to be deployed.

  16. Malaria prevalence in Nias District, North Sumatra Province, Indonesia

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    Laowo Idaman

    2007-08-01

    Full Text Available Abstract Background The Nias district of the North Sumatra Province of Indonesia has long been known to be endemic for malaria. Following the economic crisis at the end of 1998 and the subsequent tsunami and earthquake, in December 2004 and March 2005, respectively, the malaria control programme in the area deteriorated. The present study aims to provide baseline data for the establishment of a suitable malaria control programme in the area and to analyse the frequency distribution of drug resistance alleles associated with resistance to chloroquine and sulphadoxine-pyrimethamine. Methods Malariometric and entomology surveys were performed in three subdistricts. Thin and thick blood smears were stained with Giemsa and examined under binocular light microscopy. Blood blots on filter paper were also prepared for isolation of parasite and host DNA to be used for molecular analysis of band 3 (SAO, pfcrt, pfmdr1, dhfr, and dhps. In addition, haemoglobin measurement was performed in the second and third surveys for the subjects less than 10 years old. Results Results of the three surveys revealed an average slide positivity rate of 8.13%, with a relatively higher rate in certain foci. Host genetic analysis, to identify the Band 3 deletion associated with Southeast Asian Ovalocytosis (SAO, revealed an overall frequency of 1.0% among the 1,484 samples examined. One hundred six Plasmodium falciparum isolates from three sub-districts were successfully analysed. Alleles of the dhfr and dhps genes associated with resistance to sulphadoxine-pyrimethamine, dhfr C59R and S108N, and dhps A437G and K540E, were present at frequencies of 52.2%, 82.5%, 1.18% and 1.18%, respectively. The pfmdr1 alleles N86Y and N1042D, putatively associated with mefloquine resistance, were present at 31.4% and 2%, respectively. All but one sample carried the pfcrt 76T allele associated with chloroquine resistance. Entomologic surveys identified three potential anopheline vectors in

  17. Malaria Surveillance - United States, 2015.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M; Tan, Kathrine R

    2018-05-04

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate transmission control measures if locally acquired cases are identified. This report summarizes confirmed malaria cases in persons with onset of illness in 2015 and summarizes trends in previous years. Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all NMSS and NNDSS cases, CDC reference laboratory reports, and CDC clinical consultations. CDC received reports of 1,517 confirmed malaria cases, including one congenital case, with an onset of symptoms in 2015 among persons who received their diagnoses in the United States. Although the number of

  18. Habitat hydrology and geomorphology control the distribution of malaria vector larvae in rural Africa.

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    Hardy, Andrew J; Gamarra, Javier G P; Cross, Dónall E; Macklin, Mark G; Smith, Mark W; Kihonda, Japhet; Killeen, Gerry F; Ling'ala, George N; Thomas, Chris J

    2013-01-01

    Larval source management is a promising component of integrated malaria control and elimination. This requires development of a framework to target productive locations through process-based understanding of habitat hydrology and geomorphology. We conducted the first catchment scale study of fine resolution spatial and temporal variation in Anopheles habitat and productivity in relation to rainfall, hydrology and geomorphology for a high malaria transmission area of Tanzania. Monthly aggregates of rainfall, river stage and water table were not significantly related to the abundance of vector larvae. However, these metrics showed strong explanatory power to predict mosquito larval abundances after stratification by water body type, with a clear seasonal trend for each, defined on the basis of its geomorphological setting and origin. Hydrological and geomorphological processes governing the availability and productivity of Anopheles breeding habitat need to be understood at the local scale for which larval source management is implemented in order to effectively target larval source interventions. Mapping and monitoring these processes is a well-established practice providing a tractable way forward for developing important malaria management tools.

  19. Epidemiology of Plasmodium vivax Malaria in Peru.

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    Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E; Moreno, Marta; Lescano, Andres G; Sanchez, Juan F; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M

    2016-12-28

    Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s-2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005-2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine-primaquine for P. vivax Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. © The American Society of Tropical Medicine and Hygiene.

  20. Epidemiology of Plasmodium vivax Malaria in Peru

    Science.gov (United States)

    Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E.; Moreno, Marta; Lescano, Andres G.; Sanchez, Juan F.; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M.

    2016-01-01

    Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s–2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005–2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine–primaquine for P. vivax. Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax. Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. PMID:27799639

  1. Larvivorous fish for preventing malaria transmission

    Science.gov (United States)

    Walshe, Deirdre P; Garner, Paul; Adeel, Ahmed A; Pyke, Graham H; Burkot, Thomas R

    2017-01-01

    studies were conducted in a variety of settings, including localized water bodies (such as wells, domestic water containers, fishponds, and pools (seven studies); riverbed pools below dams (two studies)); rice field plots (five studies); and water canals (two studies). All included studies were at high risk of bias. The research was insufficient to determine whether larvivorous fish reduce the density of Anopheles larvae and pupae (12 studies, unpooled data, very low certainty evidence). Some studies with high stocking levels of fish seemed to arrest the increase in immature anopheline populations, or to reduce the number of immature anopheline mosquitoes, compared with controls. However, this finding was not consistent, and in studies that showed a decrease in immature anopheline populations, the effect was not always consistently sustained. In contrast, some studies reported larvivorous fish reduced the number of water sources withAnopheles larvae and pupae (five studies, unpooled data, low certainty evidence). None of the included studies reported effects of larvivorous fish on local native fish populations or other species. Authors' conclusions We do not know whether introducing larvivorous fish reduces malaria transmission or the density of adult anopheline mosquito populations. In research studies that examined the effects on immature anopheline stages of introducing fish to potential malaria vector larval habitats, high stocking levels of fish may reduce the density or presence of immature anopheline mosquitoes in the short term. We do not know whether this translates into impact on malaria transmission. Our interpretation of the current evidence is that countries should not invest in fish stocking as a stand alone or supplementary larval control measure in any malaria transmission areas outside the context of research using carefully controlled field studies or quasi-experimental designs. Such research should examine the effects on native fish and other non

  2. Topography and malaria transmission heterogeneity in western Kenya highlands: prospects for focal vector control

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    Ndenga Bryson A

    2006-11-01

    Full Text Available Abstract Background Recent resurgence of malaria in the highlands of Western Kenya has called for a more comprehensive understanding of the previously neglected complex highland vector ecology. Besides other drivers of malaria epidemiology, topography is likely to have a major effect on spatial vector and parasite distribution. The aim of this study was to determine the effects of topography on malaria spatial vector distribution and parasite prevalence. Methodology Indoor resting adult malaria vectors and blood parasites were collected in three villages along a 4 km transect originating from the valley bottom and ending at the hilltop for 13 months. Members of the Anopheles gambiae complex were identified by PCR. Blood parasites were collected from children 6–13 years old and densities categorized by site of home location and age of the children. Results Ninety eight percent (98% of An. gambiae s.s. and (99% Anopheles funestus were collected in houses located at the edge of the valley bottom, whereas 1% of An. gambiae s.s. were collected at mid hill and at the hilltop respectively. No An. funestus were collected at the hilltop. Malaria prevalence was 68% at the valley bottom, 40.2% at mid hill and 26.7% at the hilltop. Children aged six years and living at the edge of the valley bottom had an annual geometric mean number of 66.1 trophozoites for every 200 white blood cells, while those living at mid-hill had a mean of 84.8, and those living at hilltop had 199.5 trophozoites. Conclusion Malaria transmission in this area is mainly confined to the valley bottom. Effective vector control could be targeted at the foci. However, the few vectors observed at mid-hill maintained a relatively high prevalence rate. The higher variability in blood parasite densities and their low correlation with age in children living at the hilltop suggests a lower stability of transmission than at the mid-hill and valley bottom.

  3. The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on caregivers' knowledge, perceptions and health-seeking behaviour towards childhood malaria

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    Duchateau Luc

    2010-02-01

    Full Text Available Abstract Background Malaria remains the most important public health problem in tropical and subtropical areas. Mothers' or caregivers' ability to recognize childhood malaria-related morbidity is crucial as knowledge, attitudes and health seeking behavior of caregivers towards childhood malaria could influence response to signs of the disease. Methods A total of 1,003 caregivers in 'at-risk' villages in close proximity to the Gilgel-Gibe hydroelectric dam in south-western Ethiopia, and 953 caregivers in 'control' villages further away from the dam were surveyed using structured questionnaires to assess their knowledge, perceptions and health seeking behaviour about childhood malaria. Results Malaria (busa was ranked as the most serious health problem. Caregivers perceived childhood malaria as a preventable ('at-risk' 96%, 'control' 86% and treatable ('at-risk' 98% and 'control' 96% disease. Most caregivers correctly associated the typical clinical manifestations with malaria attacks. The use of insecticide-treated nets (ITNs was mentioned as a personal protective measure, whereas the role of indoor residual spraying (IRS in malaria prevention and control was under-recognized. Most of the caregivers would prefer to seek treatment in health-care services in the event of malaria and reported the use of recommended anti-malarials. Conclusion Health education to improve knowledge, perceptions and health-seeking behaviour related to malaria is equally important for caregivers in 'at risk' villages and caregivers in 'control' villages as minimal differences seen between both groups. Concluding, there may be a need of more than one generation after the introduction of the dam before differences can be noticed. Secondly, differences in prevalence between 'control' and 'at-risk' villages may not be sufficient to influence knowledge and behaviour.

  4. The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on caregivers' knowledge, perceptions and health-seeking behaviour towards childhood malaria.

    Science.gov (United States)

    Yewhalaw, Delenasaw; Kassahun, Wondwossen; Woldemichael, Kifle; Tushune, Kora; Sudaker, Morankar; Kaba, Daniel; Duchateau, Luc; Van Bortel, Wim; Speybroeck, Niko

    2010-02-11

    Malaria remains the most important public health problem in tropical and subtropical areas. Mothers' or caregivers' ability to recognize childhood malaria-related morbidity is crucial as knowledge, attitudes and health seeking behavior of caregivers towards childhood malaria could influence response to signs of the disease. A total of 1,003 caregivers in 'at-risk' villages in close proximity to the Gilgel-Gibe hydroelectric dam in south-western Ethiopia, and 953 caregivers in 'control' villages further away from the dam were surveyed using structured questionnaires to assess their knowledge, perceptions and health seeking behaviour about childhood malaria. Malaria (busa) was ranked as the most serious health problem. Caregivers perceived childhood malaria as a preventable ('at-risk' 96%, 'control' 86%) and treatable ('at-risk' 98% and 'control' 96%) disease. Most caregivers correctly associated the typical clinical manifestations with malaria attacks. The use of insecticide-treated nets (ITNs) was mentioned as a personal protective measure, whereas the role of indoor residual spraying (IRS) in malaria prevention and control was under-recognized. Most of the caregivers would prefer to seek treatment in health-care services in the event of malaria and reported the use of recommended anti-malarials. Health education to improve knowledge, perceptions and health-seeking behaviour related to malaria is equally important for caregivers in 'at risk' villages and caregivers in 'control' villages as minimal differences seen between both groups. Concluding, there may be a need of more than one generation after the introduction of the dam before differences can be noticed. Secondly, differences in prevalence between 'control' and 'at-risk' villages may not be sufficient to influence knowledge and behaviour.

  5. A STAT6 Intronic Single-Nucleotide Polymorphism is Associated with Clinical Malaria in Ghanaian Children

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    Daniel Amoako-Sakyi

    2016-01-01

    Full Text Available Malaria pathogenesis may be influenced by IgE responses and cytokine cross-regulation. Several mutations in the IL-4/STAT6 signaling pathway can alter cytokine cross-regulation and IgE responses during a Plasmodium falciparum malarial infection. This study investigated the relationship between a STAT6 intronic single-nucleotide polymorphism (rs3024974, total IgE, cytokines, and malaria severity in 238 Ghanaian children aged between 0.5 and 13 years. Total IgE and cytokine levels were measured by ELISA, while genotyping was done by polymerase chain reaction-restriction fragment length polymorphism (RFLP. Compared with healthy controls, heterozygosity protected against clinical malaria: uncomplicated malaria (odds ratios [OR] = 0.13, P < 0.001, severe malarial anemia (OR = 0.18, P < 0.001, and cerebral malaria (OR = 0.39, P = 0.022. Levels of total IgE significantly differed among malaria phenotypes (P = 0.044 and rs3024974 genotypes (P = 0.037. Neither cytokine levels nor IL-6/IL-10 ratios were associated with malaria phenotypes or rs3024974 genotypes. This study suggests a role for rs3024974 in malaria pathogenesis and offers further insights into an IL-4/STAT6 pathway mutation in malaria pathogenesis.

  6. Dynamic alteration in splenic function during acute falciparum malaria

    International Nuclear Information System (INIS)

    Looareesuwan, S.; Ho, M.; Wattanagoon, Y.; White, N.J.; Warrell, D.A.; Bunnag, D.; Harinasuta, T.; Wyler, D.J.

    1987-01-01

    Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated 51 Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes [mean +/- SD] vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies

  7. Burden of asymptomatic malaria among a tribal population in a forested village of central India: a hidden challenge for malaria control in India.

    Science.gov (United States)

    Chourasia, M K; Raghavendra, K; Bhatt, R M; Swain, D K; Valecha, N; Kleinschmidt, I

    2017-06-01

    Chhattisgarh in India is a malaria-endemic state with seven southern districts that contributes approximately 50-60% of the reported malaria cases in the state every year. The problem is further complicated due to asymptomatic malaria cases which are largely responsible for persistent transmission. This study was undertaken in one of the forested villages of the Keshkal subdistrict in Kondagaon district to ascertain the proportion of the population harbouring subclinical malarial infections. Community-based cross-sectional study. Mass blood surveys were undertaken of the entire population of the village in the post-monsoon seasons of 2013 and 2014. Fingerprick blood smears were prepared from individuals of all ages to detect malaria infections in their blood. Individuals with fever at the time of the survey were tested with rapid diagnostic tests, and parasitaemia in thick blood smears was confirmed by microscopy. Malaria-positive cases were treated with anti-malarials in accordance with the national drug policy. Peripheral blood smears of 134 and 159 individuals, including children, were screened for malaria infection in 2013 and 2014, respectively. Overall, the malaria slide positivity rates were 27.6% and 27.7% in 2013 and 2014, respectively, and the prevalence rates of asymptomatic malaria were 20% and 22.8%. This study showed that, for two consecutive years, the prevalence of asymptomatic malaria infection was significantly higher among children aged ≤14 years (34.4% and 34.1% for 2013 and 2014, respectively) compared with adults (15.2% and 18.2% for 2013 and 2014, respectively; P = 0.023 and 0.04, respectively). The number of asymptomatic malaria cases, especially Plasmodium falciparum, is significant, reinforcing the underlying challenge facing the malaria elimination programme in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Understanding the population genetics of Plasmodium vivax is essential for malaria control and elimination

    Directory of Open Access Journals (Sweden)

    Arnott Alicia

    2012-01-01

    Full Text Available Abstract Traditionally, infection with Plasmodium vivax was thought to be benign and self-limiting, however, recent evidence has demonstrated that infection with P. vivax can also result in severe illness and death. Research into P. vivax has been relatively neglected and much remains unknown regarding the biology, pathogenesis and epidemiology of this parasite. One of the fundamental factors governing transmission and immunity is parasite diversity. An understanding of parasite population genetic structure is necessary to understand the epidemiology, diversity, distribution and dynamics of natural P. vivax populations. In addition, studying the population structure of genes under immune selection also enables investigation of the dynamic interplay between transmission and immunity, which is crucial for vaccine development. A lack of knowledge regarding the transmission and spread of P. vivax has been particularly highlighted in areas where malaria control and elimination programmes have made progress in reducing the burden of Plasmodium falciparum, yet P. vivax remains as a substantial obstacle. With malaria elimination back on the global agenda, mapping of global and local P. vivax population structure is essential prior to establishing goals for elimination and the roll-out of interventions. A detailed knowledge of the spatial distribution, transmission and clinical burden of P. vivax is required to act as a benchmark against which control targets can be set and measured. This paper presents an overview of what is known and what is yet to be fully understood regarding P. vivax population genetics, as well as the importance and application of P. vivax population genetics studies.

  9. Health promotion: From malaria control to elimination

    African Journals Online (AJOL)

    2011 - 2014 of the National Department of Health (NDoH) lists key objectives in achieving malaria .... message' through industrial theatre or comedy shows for schools, workplaces with the ... Health Care Re-engineering. Pretoria: NDoH, 2011.

  10. The Puf-family RNA-binding protein Puf2 controls sporozoite conversion to liver stages in the malaria parasite.

    Directory of Open Access Journals (Sweden)

    Katja Müller

    Full Text Available Malaria is a vector-borne infectious disease caused by unicellular, obligate intracellular parasites of the genus Plasmodium. During host switch the malaria parasite employs specialized latent stages that colonize the new host environment. Previous work has established that gametocytes, sexually differentiated stages that are taken up by the mosquito vector, control expression of genes required for mosquito colonization by translational repression. Sexual parasite development is controlled by a DEAD-box RNA helicase of the DDX6 family, termed DOZI. Latency of sporozoites, the transmission stage injected during an infectious blood meal, is controlled by the eIF2alpha kinase IK2, a general inhibitor of protein synthesis. Whether RNA-binding proteins participate in translational regulation in sporozoites remains to be studied. Here, we investigated the roles of two RNA-binding proteins of the Puf-family, Plasmodium Puf1 and Puf2, during sporozoite stage conversion. Our data reveal that, in the rodent malaria parasite P. berghei, Puf2 participates in the regulation of IK2 and inhibits premature sporozoite transformation. Inside mosquito salivary glands puf2⁻ sporozoites transform over time to round forms resembling early intra-hepatic stages. As a result, mutant parasites display strong defects in initiating a malaria infection. In contrast, Puf1 is dispensable in vivo throughout the entire Plasmodium life cycle. Our findings support the notion of a central role for Puf2 in parasite latency during switch between the insect and mammalian hosts.

  11. Conquering the intolerable burden of malaria: what's new, what's needed: a summary.

    Science.gov (United States)

    Breman, Joel G; Alilio, Martin S; Mills, Anne

    2004-08-01

    approach for countering the spread and intensity of Plasmodium falciparum resistance to chloroquine, sulfadoxine/pyrimethamine, and other antimalarial drugs. Although costly, ACT ($1.20-2.50 per adult treatment) becomes more cost-effective as resistance to alternative drugs increases; early use of ACT may delay development of resistance to these drugs and prevent the medical toll associated with use of ineffective drugs. The burden of malaria in one district in Tanzania has not decreased since the primary health care approach replaced the vertical malaria control efforts of the 1960s. Despite decentralization, this situation resulted, in part, from weak district management capacity, poor coordination, inadequate monitoring, and lack of training of key staff. Experience in the Solomon Islands showed that spraying with DDT, use of insecticide-treated bed nets (ITNs), and health education were all associated with disease reduction. The use of nets permitted a reduction in DDT spraying, but could not replace it without an increased malaria incidence. Baseline data and reliable monitoring of key outcome indicators are needed to measure whether the ambitious goals for the control of malaria and other diseases has occurred. Such systems are being used for evidence-based decision making in Tanzania and several other countries. Baseline cluster sampling surveys in several countries across Africa indicate that only 53% of the children with febrile illness in malarious areas are being treated; chloroquine (CQ) is used 84% of the time, even where the drug may be ineffective. Insecticide-treated bed nets were used only 2% of the time by children less than five years of age. Progress in malaria vaccine research has been substantial over the past five years; 35 candidate malaria vaccines are in development, many of which are in clinical trials. Development of new vaccines and drugs has been the result of increased investments and formation of public-private partnerships. Before malaria

  12. Mapping multiple components of malaria risk for improved targeting of elimination interventions.

    Science.gov (United States)

    Cohen, Justin M; Le Menach, Arnaud; Pothin, Emilie; Eisele, Thomas P; Gething, Peter W; Eckhoff, Philip A; Moonen, Bruno; Schapira, Allan; Smith, David L

    2017-11-13

    There is a long history of considering the constituent components of malaria risk and the malaria transmission cycle via the use of mathematical models, yet strategic planning in endemic countries tends not to take full advantage of available disease intelligence to tailor interventions. National malaria programmes typically make operational decisions about where to implement vector control and surveillance activities based upon simple categorizations of annual parasite incidence. With technological advances, an enormous opportunity exists to better target specific malaria interventions to the places where they will have greatest impact by mapping and evaluating metrics related to a variety of risk components, each of which describes a different facet of the transmission cycle. Here, these components and their implications for operational decision-making are reviewed. For each component, related mappable malaria metrics are also described which may be measured and evaluated by malaria programmes seeking to better understand the determinants of malaria risk. Implementing tailored programmes based on knowledge of the heterogeneous distribution of the drivers of malaria transmission rather than only consideration of traditional metrics such as case incidence has the potential to result in substantial improvements in decision-making. As programmes improve their ability to prioritize their available tools to the places where evidence suggests they will be most effective, elimination aspirations may become increasingly feasible.

  13. Predisposition of Nigerian children with severe malaria to urinary ...

    African Journals Online (AJOL)

    The predisposition of children with severe malaria to urinary tract infection was investigated in a group of 112 clinically diagnosed and para sitologically confirmed severe malaria patients (test) and in another subset of 114 apparently physically healthy non-malaria infected subjects (control). Standard bacteriological and ...

  14. Management of malaria in pregnancy

    Directory of Open Access Journals (Sweden)

    Stephen J Rogerson

    2017-01-01

    Full Text Available Pregnant women are especially susceptible to malaria infection. Without existing immunity, severe malaria can develop requiring emergency treatment, and pregnancy loss is common. In semi-immune women, consequences of malaria for the mother include anaemia while stillbirth, premature delivery and foetal growth restriction affect the developing foetus. Preventive measures include insecticide-treated nets and (in some African settings intermittent preventive treatment. Prompt management of maternal infection is key, using parenteral artemisinins for severe malaria, and artemisinin combination treatments (ACTs in the second and third trimesters of pregnancy. ACTs may soon also be recommended as an alternative to quinine as a treatment in the first trimester of pregnancy. Monitoring the safety of antimalarials and understanding their pharmacokinetics is particularly important in pregnancy with the altered maternal physiology and the risks to the developing foetus. As increasing numbers of countries embrace malaria elimination as a goal, the special needs of the vulnerable group of pregnant women and their infants should not be overlooked.

  15. Knowledge, Beliefs, and Practices of Malaria Preventive Measures ...

    African Journals Online (AJOL)

    International Journal of Medicine and Health Development ... Method: A cross sectional survey of 300 consecutive pregnant women attending the antenatal ... Treatment choices of malaria amongst the women were oral drugs 123 (49.4%), ...

  16. Estimation of effectiveness of interventions for malaria control in pregnancy using the screening method

    NARCIS (Netherlands)

    Msyamboza, K.; Senga, E.; Tetteh-Ashong, E.; Kazembe, P.; Brabin, B. J.

    2007-01-01

    BACKGROUND: The evaluation of the effectiveness of antimalarial drugs and bed net use in pregnant women is an important aspect of monitoring and surveillance of malaria control in pregnancy. In principle the screening method for assessing vaccine efficacy can be applied in non-vaccine settings for

  17. A situational analysis of pharmacovigilance plans in the Global Fund Malaria and U.S. President's Malaria Initiative proposals.

    Science.gov (United States)

    Stergachis, Andy; Bartlein, Rebecca J K; Dodoo, Alexander; Nwokike, Jude; Kachur, S Patrick

    2010-05-30

    Pharmacovigilance programmes can monitor and help ensure the safe use of medicines that are critical to the success of global public health programmes. The widespread deployment of artemisinin-based combination therapy (ACT) by national malaria control programmes as part of the overall Global Malaria Action Plan for malaria control to elimination and eradication makes ACT an excellent candidate for pharmacovigilance activities. In 2008, The Roll Back Malaria partnership issued guidelines for inclusion of pharmacovigilance in Global Fund and other related proposals. In light of this recommendation and the rapid scale-up of ACT worldwide, an analysis of Global Fund Round 8 proposals and the President's Malaria Initiative (PMI) 2009 Malaria Operational Plans was conducted to assess if and how pharmacovigilance has been incorporated into countries' national malaria plans and donor budget requests. The Global Fund-Malaria Round 8 proposals for the 26 countries and the PMI Malaria Operational Plans (MOPs) for fiscal year 2009 for the 15 countries that were approved and received funding from either the Global Fund-Malaria Round 8 or PMI were accessed through the programme websites. The analysis consisted of conducting word counts and key word in context analyses of each proposal and plan. Twelve out of 26 (46%) of the Global Fund proposals mentioned that established pharmacovigilance systems were present in their countries. Four of the fifteen PMI MOPs (27%) mentioned that established pharmacovigilance systems were present in their countries. Only seven of the 26 (27%) Global Fund proposals included a request for funding for new or current pharmacovigilance activities. Seven of 15 (47%) MOPs included a request for funding for pharmacovigilance activities. There were relatively few requests for funding for pharmacovigilance activities, demonstrating a lack of emphasis placed on pharmacovigilance systems in recipient countries. The findings stress the need for more active

  18. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns

    Directory of Open Access Journals (Sweden)

    Kouyaté Bocar

    2008-01-01

    Full Text Available Abstract Background Malaria is a leading cause of death in children below five years of age in sub-Saharan Africa. All-cause and malaria-specific mortality rates for children under-five years old in a mesoendemic malaria area (The Gambia were compared with those from a hyper/holoendemic area (Burkina Faso. Methods Information on observed person-years (PY, deaths and cause of death was extracted from online search, using key words: "Africa, The Gambia, Burkina Faso, malaria, Plasmodium falciparum, mortality, child survival, morbidity". Missing person-years were estimated and all-cause and malaria-specific mortality were calculated as rates per 1,000 PY. Studies were classified as longitudinal/clinical studies or surveys/censuses. Linear regression was used to investigate mortality trends. Results Overall, 39 and 18 longitudinal/clinical studies plus 10 and 15 surveys and censuses were identified for The Gambia and Burkina Faso respectively (1960–2004. Model-based estimates for under-five all-cause mortality rates show a decline from 1960 to 2000 in both countries (Burkina Faso: from 71.8 to 39.0, but more markedly in The Gambia (from 104.5 to 28.4. The weighted-average malaria-specific mortality rate per 1000 person-years for Burkina Faso (15.4, 95% CI: 13.0–18.3 was higher than that in The Gambia (9.5, 95% CI: 9.1–10.1. Malaria mortality rates did not decline over time in either country. Conclusion Child mortality in both countries declined significantly in the period 1960 to 2004, possibly due to socio-economic development, improved health services and specific intervention projects. However, there was little decline in malaria mortality suggesting that there had been no major impact of malaria control programmes during this period. The difference in malaria mortality rates across countries points to significant differences in national disease control policies and/or disease transmission patterns.

  19. [Establishment of malaria early warning system in Jiangsu Province II application of digital earth system in malaria epidemic management and surveillance].

    Science.gov (United States)

    Wang, Wei-Ming; Zhou, Hua-Yun; Liu, Yao-Bao; Li, Ju-Lin; Cao, Yuan-Yuan; Cao, Jun

    2013-04-01

    To explore a new mode of malaria elimination through the application of digital earth system in malaria epidemic management and surveillance. While we investigated the malaria cases and deal with the epidemic areas in Jiangsu Province in 2011, we used JISIBAO UniStrong G330 GIS data acquisition unit (GPS) to collect the latitude and longitude of the cases located, and then established a landmark library about early-warning areas and an image management system by using Google Earth Free 6.2 and its image processing software. A total of 374 malaria cases were reported in Jiangsu Province in 2011. Among them, there were 13 local vivax malaria cases, 11 imported vivax malaria cases from other provinces, 20 abroad imported vivax malaria cases, 309 abroad imported falciparum malaria cases, 7 abroad imported quartan malaria cases (Plasmodium malaria infection), and 14 abroad imported ovale malaria cases (P. ovale infection). Through the analysis of Google Earth Mapping system, these malaria cases showed a certain degree of aggregation except the abroad imported quartan malaria cases which were highly sporadic. The local vivax malaria cases mainly concentrated in Sihong County, the imported vivax malaria cases from other provinces mainly concentrated in Suzhou City and Wuxi City, the abroad imported vivax malaria cases concentrated in Nanjing City, the abroad imported falciparum malaria cases clustered in the middle parts of Jiangsu Province, and the abroad imported ovale malaria cases clustered in Liyang City. The operation of Google Earth Free 6.2 is simple, convenient and quick, which could help the public health authority to make the decision of malaria prevention and control, including the use of funds and other health resources.

  20. 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.

  1. Project MEDSAT: The design of a remote sensing platform for malaria research and control

    Science.gov (United States)

    1991-04-01

    Project MEDSAT was proposed with the specific goal of designing a satellite to remotely sense pertinent information useful in establishing strategies to control malaria. The 340 kg MEDSAT satellite is to be inserted into circular earth orbit aboard the Pegasus Air-Launched Space Booster at an inclination of 21 degrees and an altitude of 473 km. It is equipped with a synthetic aperture radar and a visible thermal/infrared sensor to remotely sense conditions at the target area of Chiapas, Mexico. The orbit is designed so that MEDSAT will pass over the target site twice each day. The data from each scan will be downlinked to Hawaii for processing, resulting in maps indicating areas of high malaria risk. These will be distributed to health officials at the target site. A relatively inexpensive launch by Pegasus and a design using mainly proven, off-the-shelf technology permit a low mission cost, while innovations in the satellite controls and the scientific instruments allow a fairly complex mission.

  2. Inhaled nitric oxide for the adjunctive therapy of severe malaria: Protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Lavery James V

    2011-07-01

    Full Text Available Abstract Background Severe malaria remains a major cause of global morbidity and mortality. Despite the use of potent anti-parasitic agents, the mortality rate in severe malaria remains high. Adjunctive therapies that target the underlying pathophysiology of severe malaria may further reduce morbidity and mortality. Endothelial activation plays a central role in the pathogenesis of severe malaria, of which angiopoietin-2 (Ang-2 has recently been shown to function as a key regulator. Nitric oxide (NO is a major inhibitor of Ang-2 release from endothelium and has been shown to decrease endothelial inflammation and reduce the adhesion of parasitized erythrocytes. Low-flow inhaled nitric oxide (iNO gas is a US FDA-approved treatment for hypoxic respiratory failure in neonates. Methods/Design This prospective, parallel arm, randomized, placebo-controlled, blinded clinical trial compares adjunctive continuous inhaled nitric oxide at 80 ppm to placebo (both arms receiving standard anti-malarial therapy, among Ugandan children aged 1-10 years of age with severe malaria. The primary endpoint is the longitudinal change in Ang-2, an objective and quantitative biomarker of malaria severity, which will be analysed using a mixed-effects linear model. Secondary endpoints include mortality, recovery time, parasite clearance and neurocognitive sequelae. Discussion Noteworthy aspects of this trial design include its efficient sample size supported by a computer simulation study to evaluate statistical power, meticulous attention to complex ethical issues in a cross-cultural setting, and innovative strategies for safety monitoring and blinding to treatment allocation in a resource-constrained setting in sub-Saharan Africa. Trial Registration ClinicalTrials.gov Identifier: NCT01255215

  3. Intramuscular Artesunate for Severe Malaria in African Children: A Multicenter Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Peter G Kremsner

    2016-01-01

    Full Text Available Current artesunate (ARS regimens for severe malaria are complex. Once daily intramuscular (i.m. injection for 3 d would be simpler and more appropriate for remote health facilities than the current WHO-recommended regimen of five intravenous (i.v. or i.m. injections over 4 d. We compared both a three-dose i.m. and a three-dose i.v. parenteral ARS regimen with the standard five-dose regimen using a non-inferiority design (with non-inferiority margins of 10%.This randomized controlled trial included children (0.5-10 y with severe malaria at seven sites in five African countries to assess whether the efficacy of simplified three-dose regimens is non-inferior to a five-dose regimen. We randomly allocated 1,047 children to receive a total dose of 12 mg/kg ARS as either a control regimen of five i.m. injections of 2.4 mg/kg (at 0, 12, 24, 48, and 72 h (n = 348 or three injections of 4 mg/kg (at 0, 24, and 48 h either i.m. (n = 348 or i.v. (n = 351, both of which were the intervention arms. The primary endpoint was the proportion of children with ≥ 99% reduction in parasitemia at 24 h from admission values, measured by microscopists who were blinded to the group allocations. Primary analysis was performed on the per-protocol population, which was 96% of the intention-to-treat population. Secondary analyses included an analysis of host and parasite genotypes as risks for prolongation of parasite clearance kinetics, measured every 6 h, and a Kaplan-Meier analysis to compare parasite clearance kinetics between treatment groups. A post hoc analysis was performed for delayed anemia, defined as hemoglobin ≤ 7 g/dl 7 d or more after admission. The per-protocol population was 1,002 children (five-dose i.m.: n = 331; three-dose i.m.: n = 338; three-dose i.v.: n = 333; 139 participants were lost to follow-up. In the three-dose i.m. arm, 265/338 (78% children had a ≥ 99% reduction in parasitemia at 24 h compared to 263/331 (79% receiving the five-dose i

  4. Adaptation is.... Predicting malaria's changing course in East Africa

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC

    Health experts say controlling malaria is crucial if the three East African nations are to achieve the UN Millennium. Development Goal of halving the incidence of infectious diseases such as malaria, tuberculosis, and HIV/AIDS by 2015. Looking ahead:Prevention and treatment. Improved malaria prediction will be an.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008.

    Directory of Open Access Journals (Sweden)

    Yoko Akachi

    Full Text Available BACKGROUND: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. METHODS AND FINDINGS: We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002-2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs/indoor residual spraying (IRS. As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774-63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369-0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002-2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05. Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3-2.8] child deaths per 1000 live births. CONCLUSIONS: Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently

  7. Population hemoglobin mean and anemia prevalence in Papua New Guinea: new metrics for defining malaria endemicity?

    Directory of Open Access Journals (Sweden)

    Nicolas Senn

    Full Text Available BACKGROUND: The hypothesis is that hemoglobin-based metrics are useful tools for estimating malaria endemicity and for monitoring malaria control strategies. The aim of this study is to compare population hemoglobin mean and anemia prevalence to established indicators of malaria endemicity, including parasite rates, rates of enlarged spleens in children, and records of (presumptive malaria diagnosis among populations living with different levels of malaria transmission. METHODOLOGY/PRINCIPAL FINDINGS: Convenience sample, multisite cross-sectional household surveys conducted in Papua New Guinea. Correlations (r(2 between population Hb mean and anemia prevalence and altitude, parasite rate, and spleen rate were investigated in children ages 2 to 10 years, and in the general population; 21,664 individuals from 156 different communities were surveyed. Altitude ranged from 5 to 2120 meters. In young children, correlations between altitude and parasite rate, population Hb mean, anemia prevalence, and spleen rate were high (r(2: -0.77, 0.73, -0.81, and -0.68; p1500 m (p<0.001. CONCLUSIONS/SIGNIFICANCE: In PNG, where Plasmodium vivax accounts for an important part of all malaria infections, population hemoglobin mean and anemia prevalence correlate well with altitude, parasite, and spleen rates. Hb measurement is simple and affordable, and may be a useful new tool, alone or in association with other metrics, for estimating malaria endemicity and monitoring effectiveness of malaria control programs. Further prospective studies in areas with different malaria epidemiology and different factors contributing to the burden of anemia are warranted to investigate the usefulness of Hb metrics in monitoring malaria transmission intensity.

  8. The hormonal effects of long-term DDT exposure on malaria vector-control workers in Limpopo Province, South Africa

    International Nuclear Information System (INIS)

    Dalvie, M.A.; Myers, J.E.; Lou Thompson, Mary; Dyer, Silke; Robins, T.G.; Omar, Shaheed; Riebow, John; Molekwa, Josef; Kruger, Phillip; Millar, R.

    2004-01-01

    DDT [1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane] compounds, used in many developing countries, including South Africa, for the control of malaria vectors, have been shown to be endocrine disruptors in vitro and in vivo. The study hypothesis was that male malaria vector-control workers highly exposed to DDT in the past should demonstrate clinically significant exposure-related anti-androgenic and/or estrogenic effects that should be reflected in abnormalities in reproductive hormone levels. A cross-sectional study of 50 workers from three camps situated near the Malaria Control Center (MCC) in Tzaneen was performed. Tests included blood sampling before and after a gonadotropin-releasing hormone (GnRH) challenge (100 μg). Serum o'p' and p'p' isomers of DDE, DDT, and DDD and basal and post-GnRH challenge hormone levels, including luteinizing hormone, follicle-stimulating hormone, testosterone, sex hormone-binding globulin, estradiol (E2), and inhibin, were measured. The mean number of years worked at the MCC was 15.8±7.8 years and the mean serum DDT was 94.3±57.1 μg/g of lipid. Mean baseline E2 levels (62.4±29.9 pg/mL) exceeded the laboratory reference range. Associations between DDT exposure measures (years worked at the MCC and DDT compounds) and hormonal outcomes were weak and inconsistent. The most important finding was a positive relationship of baseline E2 and baseline testosterone with DDT compounds, especially with p'p'-DDT and -DDD. The strongest association found, adjusted for age and SHBG, was between baseline estradiol and p'p'-DDT (β-circumflex=1.14±0.33 pg/mL/μg/g lipid, P=0.001, R 2 =0.31, n=46). An overall anti-androgenic mechanism best explains the results, but with a number of inconsistencies. Associations might be due to chance, as multiple comparisons were made. The results therefore do not suggest an overt anti-androgenic or estrogenic effect of long-term DDT exposure on hormone levels, but correlations do exist in a manner that is not

  9. Role of Activins in Hepcidin Regulation during Malaria.

    Science.gov (United States)

    Spottiswoode, Natasha; Armitage, Andrew E; Williams, Andrew R; Fyfe, Alex J; Biswas, Sumi; Hodgson, Susanne H; Llewellyn, David; Choudhary, Prateek; Draper, Simon J; Duffy, Patrick E; Drakesmith, Hal

    2017-12-01

    Epidemiological observations have linked increased host iron with malaria susceptibility, and perturbed iron handling has been hypothesized to contribute to the potentially life-threatening anemia that may accompany blood-stage malaria infection. To improve our understanding of these relationships, we examined the pathways involved in regulation of the master controller of iron metabolism, the hormone hepcidin, in malaria infection. We show that hepcidin upregulation in Plasmodium berghei murine malaria infection was accompanied by changes in expression of bone morphogenetic protein (BMP)/sons of mothers against decapentaplegic (SMAD) pathway target genes, a key pathway involved in hepcidin regulation. We therefore investigated known agonists of the BMP/SMAD pathway and found that Bmp gene expression was not increased in infection. In contrast, activin B, which can signal through the BMP/SMAD pathway and has been associated with increased hepcidin during inflammation, was upregulated in the livers of Plasmodium berghei -infected mice; hepatic activin B was also upregulated at peak parasitemia during infection with Plasmodium chabaudi Concentrations of the closely related protein activin A increased in parallel with hepcidin in serum from malaria-naive volunteers infected in controlled human malaria infection (CHMI) clinical trials. However, antibody-mediated neutralization of activin activity during murine malaria infection did not affect hepcidin expression, suggesting that these proteins do not stimulate hepcidin upregulation directly. In conclusion, we present evidence that the BMP/SMAD signaling pathway is perturbed in malaria infection but that activins, although raised in malaria infection, may not have a critical role in hepcidin upregulation in this setting. Copyright © 2017 Spottiswoode et al.

  10. Plasmodium vivax malaria among pregnant women in Eastern Sudan

    Directory of Open Access Journals (Sweden)

    Duria Abdulwhab Rayis

    2016-06-01

    Full Text Available Objective: To determine the epidemiology of malaria [especially Plasmodium vivax (P. vivax] among pregnant women in Eastern Sudan. Methods: A cross sectional study was conducted in the antenatal care of New Halfa hospital, Eastern Sudan to investigate the prevalence, manifestations and determinants of malaria (especially P. vivax among pregnant women. Results: Out of 2 378 pregnant women, there were 48 (2.0% and 36 (1.5% Plasmodium falciparum (P. falciparum and P. vivax infection, respectively. There was no significant difference in the age, parity, gestational age between women with malaria and healthy controls. The mean ± SD of the temperature was significantly higher in patients with P. vivax than in patient with P. falciparum malaria [(38.6 ± 0.7 °C vs. (38.1 ± 0.6 °C, P = 0.001]. Patients with P. vivax malaria had slightly (not reach statistical significance lower hemoglobin level compared with P. falciparum malaria and healthy controls. The geometric parasite count showed no significant difference between patients with P. vivax and P. falciparum malaria infections (12 189.9 vs. 9 755.1 trophozoite/µL, P = 0.356. Conclusions: P. vivax malaria is an existing health problem in Eastern Sudan. Further research is also needed.

  11. A qualitative study on health workers' and community members' perceived sources, role of information and communication on malaria treatment, prevention and control in southeast Nigeria.

    Science.gov (United States)

    Umeano-Enemuoh, Jane C; Uzochukwu, Benjamim; Ezumah, Nkoli; Mangham-Jefferies, Lindsay; Wiseman, Virginia; Onwujekwe, Obinna

    2015-10-22

    It has been widely acknowledged that well-planned and executed communication programmes can contribute to achieving malaria prevention and treatment goals. This however requires a good understanding of current sources and roles of information used by both health workers and communities. The study aimed at determining health workers' and community members' sources, value and use of information on malaria prevention and treatment in Nigeria. Qualitative data was collected from six selected communities (three urban and three rural) in Enugu state, southeast Nigeria. A total of 18 Focus Group Discussions (FGDs) with 179 community members and 26 in-depth interviews (IDIs) with health workers in public and private health facilities were used to collect data on where people receive treatment for malaria and access information on malaria. The FGDS and IDIs also provided data on the values, uses and effects of information and communication on malaria treatment seeking and provision of services. The findings revealed that the major sources of information on malaria for health workers and community members were advertisements in the mass media, workshops and seminars organized by donor agencies, facility supervision, posters, other health workers, television and radio adverts. Community involvement in the design and delivery of information on malaria control was seen as a strong strategy for improving both consumer and provider knowledge. Information from the different sources catalyzed appropriate provision and consumption of malaria treatment amongst health workers and community members. Health workers and consumers receive information on malaria prevention and treatment from multiple sources of communication and information, which they find useful. Harnessing these information sources to encourage consistent and accurate messages around malaria prevention and treatment is a necessary first step in the design and implementation of malaria communication and behaviour change

  12. Behavioural effects of fungal infection by Metarhizium anisopliae in adult malaria mosquitoes

    NARCIS (Netherlands)

    Ondiaka, S.N.

    2012-01-01

    Malaria remains a major global health problem with the burden of disease greatest in Sub-Saharan Africa. The strategies for malaria control differ throughout the world according to levels of endemicity and the magnitude of disease but the focus remains either to control malaria parasites or

  13. Evaluation of new tools for malaria vector control in Cameroon: focus on long lasting insecticidal nets.

    Science.gov (United States)

    Etang, Josiane; Nwane, Philippe; Piameu, Michael; Manga, Blaise; Souop, Daniel; Awono-Ambene, Parfait

    2013-01-01

    From 2006 to 2011, biological activity of insecticides for Indoor Residual Spraying (IRS), conventional treatment of nets (CTNs) or long lasting insecticidal nets (LLINs) was evaluated before their approval in Cameroon. The objective of the study was to select the best tools for universal malaria vector control coverage. Bioassays were performed using WHO cones and the Kisumu susceptible strain of Anopheles gambiae s.s.. Among tested products, residual activity and wash resistance of Alpha-cypermethrin LLINs (Interceptor) and CTNs (Fendona) were assessed during 5 months in the Ntougou neighborhood. All the 14 tested products were found effective (95-100% knockdown and mortality rates), although a significant decrease of efficacy was seen with lambda-cyhalothrinWP IRS, alpha-cypermethrin CTNs and LLINs (peducation toward universal coverage of malaria vector control in Cameroon.

  14. A new world malaria map: Plasmodium falciparum endemicity in 2010.

    Science.gov (United States)

    Gething, Peter W; Patil, Anand P; Smith, David L; Guerra, Carlos A; Elyazar, Iqbal R F; Johnston, Geoffrey L; Tatem, Andrew J; Hay, Simon I

    2011-12-20

    Transmission intensity affects almost all aspects of malaria epidemiology and the impact of malaria on human populations. Maps of transmission intensity are necessary to identify populations at different levels of risk and to evaluate objectively options for disease control. To remain relevant operationally, such maps must be updated frequently. Following the first global effort to map Plasmodium falciparum malaria endemicity in 2007, this paper describes the generation of a new world map for the year 2010. This analysis is extended to provide the first global estimates of two other metrics of transmission intensity for P. falciparum that underpin contemporary questions in malaria control: the entomological inoculation rate (PfEIR) and the basic reproductive number (PfR). Annual parasite incidence data for 13,449 administrative units in 43 endemic countries were sourced to define the spatial limits of P. falciparum transmission in 2010 and 22,212 P. falciparum parasite rate (PfPR) surveys were used in a model-based geostatistical (MBG) prediction to create a continuous contemporary surface of malaria endemicity within these limits. A suite of transmission models were developed that link PfPR to PfEIR and PfR and these were fitted to field data. These models were combined with the PfPR map to create new global predictions of PfEIR and PfR. All output maps included measured uncertainty. An estimated 1.13 and 1.44 billion people worldwide were at risk of unstable and stable P. falciparum malaria, respectively. The majority of the endemic world was predicted with a median PfEIR of less than one and a median PfRc of less than two. Values of either metric exceeding 10 were almost exclusive to Africa. The uncertainty described in both PfEIR and PfR was substantial in regions of intense transmission. The year 2010 has a particular significance as an evaluation milestone for malaria global health policy. The maps presented here contribute to a rational basis for control and

  15. A new world malaria map: Plasmodium falciparum endemicity in 2010

    Directory of Open Access Journals (Sweden)

    Gething Peter W

    2011-12-01

    Full Text Available Abstract Background Transmission intensity affects almost all aspects of malaria epidemiology and the impact of malaria on human populations. Maps of transmission intensity are necessary to identify populations at different levels of risk and to evaluate objectively options for disease control. To remain relevant operationally, such maps must be updated frequently. Following the first global effort to map Plasmodium falciparum malaria endemicity in 2007, this paper describes the generation of a new world map for the year 2010. This analysis is extended to provide the first global estimates of two other metrics of transmission intensity for P. falciparum that underpin contemporary questions in malaria control: the entomological inoculation rate (PfEIR and the basic reproductive number (PfR. Methods Annual parasite incidence data for 13,449 administrative units in 43 endemic countries were sourced to define the spatial limits of P. falciparum transmission in 2010 and 22,212 P. falciparum parasite rate (PfPR surveys were used in a model-based geostatistical (MBG prediction to create a continuous contemporary surface of malaria endemicity within these limits. A suite of transmission models were developed that link PfPR to PfEIR and PfR and these were fitted to field data. These models were combined with the PfPR map to create new global predictions of PfEIR and PfR. All output maps included measured uncertainty. Results An estimated 1.13 and 1.44 billion people worldwide were at risk of unstable and stable P. falciparum malaria, respectively. The majority of the endemic world was predicted with a median PfEIR of less than one and a median PfRc of less than two. Values of either metric exceeding 10 were almost exclusive to Africa. The uncertainty described in both PfEIR and PfR was substantial in regions of intense transmission. Conclusions The year 2010 has a particular significance as an evaluation milestone for malaria global health policy. The

  16. Scepticism towards insecticide treated mosquito nets for malaria control in a rural community in northwestern Tanzania

    DEFF Research Database (Denmark)

    Nnko, Soori; Whyte, Susan Reynolds; Geissler, Wenzel

    2012-01-01

    in Mwanza region, North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional...... attendances. In terms of mortality, malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria...

  17. An evaluation of the effect of parity and age on malaria parasitaemia in pregnancy.

    Science.gov (United States)

    Nnaji, G A; Okafor, C I; Ikechebelu, J I

    2006-11-01

    A higher prevalence of malaria infection (peripheral or placental) has been reported in the primigravidae and secondigravidae when compared with multigravidae. This study set out to determine the effect of parity and age on the prevalence of malaria parasitaemia in pregnancy at the booking antenatal visit at the Nnamdi Azikiwe University Teaching Hospital, Nnewi. Peripheral blood smears were examined in 420 pregnant women at their booking antenatal visit and in 200 control subjects attending the outpatient clinic on the same day for malaria parasites. These subjects (pregnant women and controls) met the inclusion criteria of being HIV sero-negative, not sickle-cell positive, did not have a history of recent blood transfusion and had been resident in Nnewi for 1 year. The result showed that there was a statistically significant difference between the prevalence rate of malaria parasitaemia in the primigravidae (87.9%: 109 of 124) and grand multigravidae (63.6%: 28 of 44); and the rates were found to decrease with increasing parity. The primigravidae had a higher mean parasite density (2,155/micro l) when compared with the multigravidae (1,950/micro l). This study also revealed that pregnant women <20 years had the highest prevalence rate of 86.4% (19 of 22). This study demonstrates the higher prevalence of malaria parasitaemia in pregnant women of lower parity, i.e. primigravidae and secondigravidae. Therefore, targeting malaria control efforts to women in their first and second pregnancy will be an important strategy to reach most infected women and minimise resource expenditure. These women should be motivated to use insecticide treated bed nets (ITBN) and other personal malarial control measures during pregnancy.

  18. Predictors of childhood severe malaria in a densely populated area ...

    African Journals Online (AJOL)

    Coma, convulsions and unconsciousness were more indicative of cerebral malaria. Hemoglobin and blood glucose levels decreased significantly in severe malaria patients compared with uncomplicated malaria patients or controls (P < 0.001). On the contrary, blood transaminases and CRP levels increased significantly in ...

  19. Attitudes to malaria, prevention, treatment and management ...

    African Journals Online (AJOL)

    SERVER

    2007-11-05

    Nov 5, 2007 ... consequences of malaria treatment pattern and management strategies in an urban center. Questionnaires were issued ... anopheles mosquitoes as malaria vector are some of the factors militating against prevention and proper management of the .... bush clearing, drainage and gutter control in preventing.

  20. Effects of Training on Knowledge, Attitude and Practices of Malaria Prevention and Control among Community Role Model Care Givers in South Western Nigeria.

    Science.gov (United States)

    Olalekan, Adebimpe W; Adebukola, Adebimpe M

    2015-10-01

    Malaria is endemic in Nigeria, with significant records of mortality and morbidity. Adequate community involvement is central to a successful implementation of malaria control programs. This study assessed the effects of a training programme on knowledge of malaria prevention and control among community role model care givers. A descriptive cross sectional study of a pre-and post-test design method was conducted among 400 eligible community members in Osun State. Training was given in the form of organized lectures, health education and practical demonstration sessions. Scores of pre-test and post-test conducted after four months interval were compared. Multistage sampling method was adopted in selecting study participants, while data was analyzed using the SPSS software version 17.0. Mean age was 43.8 (±1.4) years. Average knowledge score of cause, transmission, risk factors and consequences, awareness of common symptoms and preventive practices improved during post-training test when compared with pr-training test. The overall descriptive mean knowledge score in pre-test and post-test were 2.1 and 3.5 respectively out of an average maximum score of 5.0, giving an increment of 66.7%. Role model care givers with formal education were twice and three times more likely to know about disease 'transmission' (OR 1.9, 95%CI 0.11-0.19, p=0.002) and 'consequences' (OR 2.9, 95%CI 0.25-0.65, p=0.040) respectively compared to those without formal education. Training on malaria improved the knowledge of malaria prevention and control among role model community care givers towards a successful implementation of malaria control programmes.

  1. Malaria in Suriname: a new era : impact of modified intervention strategies on Anopheles darlingi populations and malaria incidence

    NARCIS (Netherlands)

    Hiwat-van Laar, H.

    2011-01-01

    Malaria is an infectious disease caused by Plasmodiumblood parasites which live inside the human host and are spread by Anopheles mosquitoes.Every year an estimated 225 million new cases and near 800.000 malaria deaths are reported. Control of the disease is a formidable task involving all three

  2. Malaria control in humanitarian emergencies: An interagency field handbook, 2nd Edition

    OpenAIRE

    Howard, N; Clements-Hunt, A

    2013-01-01

    This second edition represents a thorough updating and revision of the first edition. The structure remains similar, but includes an additional chapter on humanitarian coordination. All chapters have been revised to reflect changes in best practices, improvements in technologies, availability of new tools, and changes in WHO recommendations. The interagency handbook was developed to set out effective malaria control responses in humanitarian emergencies, particularly during the acute phase wh...

  3. Narrative review of current context of malaria and management strategies in Uganda (Part I).

    Science.gov (United States)

    Kassam, Rosemin; Collins, John B; Liow, Eric; Rasool, Nabeela

    2015-12-01

    In accordance with international targets, the Uganda National Malaria Control Strategic Plan established specific targets to be achieved by 2010. For children under five, this included increasing the number of children sleeping under mosquito nets and those receiving a first-line antimalarial to 85%, and decreasing case fatality to 2%. This narrative review offers contextual information relevant to malaria management in Uganda since the advent of artemisinin combination therapy (ACT) as first-line antimalarial treatment in 2004. A comprehensive search using key words and phrases was conducted using the web search engines Google and Google Scholar, as well as the databases of PubMed, ERIC, EMBASE, CINAHL, OvidSP (MEDLINE), PSYC Info, Springer Link, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews were searched. A total of 147 relevant international and Ugandan literature sources meeting the inclusion criteria were included. This review provides an insightful understanding on six topic areas: global and local priorities, malarial pathology, disease burden, malaria control, treatment guidelines for uncomplicated malaria, and role of the health system in accessing antimalarial medicines. Plasmodium falciparum remains the most common cause of malaria in Uganda, with children under five being most vulnerable due to their underdeveloped immunity. While international efforts to scale up malaria control measures have resulted in considerable decline in malaria incidence and mortality in several regions of sub-Saharan Africa, this benefit has yet to be substantiated for Uganda. At the local level, key initiatives have included implementation of a new antimalarial drug policy in 2004 and strengthening of government health systems and programs. Examples of such programs include removal of user fees, training of frontline health workers, providing free ACT from government systems and subsidized ACT from licensed private

  4. Malaria in Brazil: an overview.

    Science.gov (United States)

    Oliveira-Ferreira, Joseli; Lacerda, Marcus V G; Brasil, Patrícia; Ladislau, José L B; Tauil, Pedro L; Daniel-Ribeiro, Cláudio Tadeu

    2010-04-30

    Malaria is still a major public health problem in Brazil, with approximately 306,000 registered cases in 2009, but it is estimated that in the early 1940s, around six million cases of malaria occurred each year. As a result of the fight against the disease, the number of malaria cases decreased over the years and the smallest numbers of cases to-date were recorded in the 1960s. From the mid-1960s onwards, Brazil underwent a rapid and disorganized settlement process in the Amazon and this migratory movement led to a progressive increase in the number of reported cases. Although the main mosquito vector (Anopheles darlingi) is present in about 80% of the country, currently the incidence of malaria in Brazil is almost exclusively (99,8% of the cases) restricted to the region of the Amazon Basin, where a number of combined factors favors disease transmission and impair the use of standard control procedures. Plasmodium vivax accounts for 83,7% of registered cases, while Plasmodium falciparum is responsible for 16,3% and Plasmodium malariae is seldom observed. Although vivax malaria is thought to cause little mortality, compared to falciparum malaria, it accounts for much of the morbidity and for huge burdens on the prosperity of endemic communities. However, in the last few years a pattern of unusual clinical complications with fatal cases associated with P. vivax have been reported in Brazil and this is a matter of concern for Brazilian malariologists. In addition, the emergence of P. vivax strains resistant to chloroquine in some reports needs to be further investigated. In contrast, asymptomatic infection by P. falciparum and P. vivax has been detected in epidemiological studies in the states of Rondonia and Amazonas, indicating probably a pattern of clinical immunity in both autochthonous and migrant populations. Seropidemiological studies investigating the type of immune responses elicited in naturally-exposed populations to several malaria vaccine candidates in

  5. Malaria in Brazil: an overview

    Directory of Open Access Journals (Sweden)

    Brasil Patrícia

    2010-04-01

    Full Text Available Abstract Malaria is still a major public health problem in Brazil, with approximately 306 000 registered cases in 2009, but it is estimated that in the early 1940s, around six million cases of malaria occurred each year. As a result of the fight against the disease, the number of malaria cases decreased over the years and the smallest numbers of cases to-date were recorded in the 1960s. From the mid-1960s onwards, Brazil underwent a rapid and disorganized settlement process in the Amazon and this migratory movement led to a progressive increase in the number of reported cases. Although the main mosquito vector (Anopheles darlingi is present in about 80% of the country, currently the incidence of malaria in Brazil is almost exclusively (99,8% of the cases restricted to the region of the Amazon Basin, where a number of combined factors favors disease transmission and impair the use of standard control procedures. Plasmodium vivax accounts for 83,7% of registered cases, while Plasmodium falciparum is responsible for 16,3% and Plasmodium malariae is seldom observed. Although vivax malaria is thought to cause little mortality, compared to falciparum malaria, it accounts for much of the morbidity and for huge burdens on the prosperity of endemic communities. However, in the last few years a pattern of unusual clinical complications with fatal cases associated with P. vivax have been reported in Brazil and this is a matter of concern for Brazilian malariologists. In addition, the emergence of P. vivax strains resistant to chloroquine in some reports needs to be further investigated. In contrast, asymptomatic infection by P. falciparum and P. vivax has been detected in epidemiological studies in the states of Rondonia and Amazonas, indicating probably a pattern of clinical immunity in both autochthonous and migrant populations. Seropidemiological studies investigating the type of immune responses elicited in naturally-exposed populations to several

  6. Sustained Malaria Control Over an 8-Year Period in Papua New Guinea: The Challenge of Low-Density Asymptomatic Plasmodium Infections.

    Science.gov (United States)

    Koepfli, Cristian; Ome-Kaius, Maria; Jally, Shadrach; Malau, Elisheba; Maripal, Samuel; Ginny, Jason; Timinao, Lincoln; Kattenberg, Johanna Helena; Obadia, Thomas; White, Michael; Rarau, Patricia; Senn, Nicolas; Barry, Alyssa E; Kazura, James W; Mueller, Ivo; Robinson, Leanne J

    2017-12-12

    The scale-up of effective malaria control in the last decade has resulted in a substantial decline in the incidence of clinical malaria in many countries. The effects on the proportions of asymptomatic and submicroscopic infections and on transmission potential are yet poorly understood. In Papua New Guinea, vector control has been intensified since 2008, and improved diagnosis and treatment was introduced in 2012. Cross-sectional surveys were conducted in Madang Province in 2006 (with 1280 survey participants), 2010 (with 2117 participants), and 2014 (with 2516 participants). Infections were quantified by highly sensitive quantitative polymerase chain reaction (PCR) analysis, and gametocytes were quantified by reverse-transcription qPCR analysis. Plasmodium falciparum prevalence determined by qPCR decreased from 42% in 2006 to 9% in 2014. The P. vivax prevalence decreased from 42% in 2006 to 13% in 2010 but then increased to 20% in 2014. Parasite densities decreased 5-fold from 2006 to 2010; 72% of P. falciparum and 87% of P. vivax infections were submicroscopic in 2014. Gametocyte density and positivity correlated closely with parasitemia, and population gametocyte prevalence decreased 3-fold for P. falciparum and 29% for P. vivax from 2010 to 2014. Sustained control has resulted in reduced malaria transmission potential, but an increasing proportion of gametocyte carriers are asymptomatic and submicroscopic and represent a challenge to malaria control. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. 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.

  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

    2016-02-12

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

    Directory of Open Access Journals (Sweden)

    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

  10. Remotely Sensed Environmental Conditions and Malaria Mortality in Three Malaria Endemic Regions in Western Kenya.

    Directory of Open Access Journals (Sweden)

    Maquins Odhiambo Sewe

    Full Text Available Malaria is an important cause of morbidity and mortality in malaria endemic countries. The malaria mosquito vectors depend on environmental conditions, such as temperature and rainfall, for reproduction and survival. To investigate the potential for weather driven early warning systems to prevent disease occurrence, the disease relationship to weather conditions need to be carefully investigated. Where meteorological observations are scarce, satellite derived products provide new opportunities to study the disease patterns depending on remotely sensed variables. In this study, we explored the lagged association of Normalized Difference Vegetation Index (NVDI, day Land Surface Temperature (LST and precipitation on malaria mortality in three areas in Western Kenya.The lagged effect of each environmental variable on weekly malaria mortality was modeled using a Distributed Lag Non Linear Modeling approach. For each variable we constructed a natural spline basis with 3 degrees of freedom for both the lag dimension and the variable. Lag periods up to 12 weeks were considered. The effect of day LST varied between the areas with longer lags. In all the three areas, malaria mortality was associated with precipitation. The risk increased with increasing weekly total precipitation above 20 mm and peaking at 80 mm. The NDVI threshold for increased mortality risk was between 0.3 and 0.4 at shorter lags.This study identified lag patterns and association of remote- sensing environmental factors and malaria mortality in three malaria endemic regions in Western Kenya. Our results show that rainfall has the most consistent predictive pattern to malaria transmission in the endemic study area. Results highlight a potential for development of locally based early warning forecasts that could potentially reduce the disease burden by enabling timely control actions.

  11. Automated innovative diagnostic, data management and communication tool, for improving malaria vector control in endemic settings.

    Science.gov (United States)

    Vontas, John; Mitsakakis, Konstantinos; Zengerle, Roland; Yewhalaw, Delenasaw; Sikaala, Chadwick Haadezu; Etang, Josiane; Fallani, Matteo; Carman, Bill; Müller, Pie; Chouaïbou, Mouhamadou; Coleman, Marlize; Coleman, Michael

    2016-01-01

    Malaria is a life-threatening disease that caused more than 400,000 deaths in sub-Saharan Africa in 2015. Mass prevention of the disease is best achieved by vector control which heavily relies on the use of insecticides. Monitoring mosquito vector populations is an integral component of control programs and a prerequisite for effective interventions. Several individual methods are used for this task; however, there are obstacles to their uptake, as well as challenges in organizing, interpreting and communicating vector population data. The Horizon 2020 project "DMC-MALVEC" consortium will develop a fully integrated and automated multiplex vector-diagnostic platform (LabDisk) for characterizing mosquito populations in terms of species composition, Plasmodium infections and biochemical insecticide resistance markers. The LabDisk will be interfaced with a Disease Data Management System (DDMS), a custom made data management software which will collate and manage data from routine entomological monitoring activities providing information in a timely fashion based on user needs and in a standardized way. The ResistanceSim, a serious game, a modern ICT platform that uses interactive ways of communicating guidelines and exemplifying good practices of optimal use of interventions in the health sector will also be a key element. The use of the tool will teach operational end users the value of quality data (relevant, timely and accurate) to make informed decisions. The integrated system (LabDisk, DDMS & ResistanceSim) will be evaluated in four malaria endemic countries, representative of the vector control challenges in sub-Saharan Africa, (Cameroon, Ivory Coast, Ethiopia and Zambia), highly representative of malaria settings with different levels of endemicity and vector control challenges, to support informed decision-making in vector control and disease management.

  12. 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…

  13. Malaria and protective behaviours: is there a malaria trap?

    Science.gov (United States)

    Berthélemy, Jean-Claude; Thuilliez, Josselin; Doumbo, Ogobara; Gaudart, Jean

    2013-06-13

    In spite of massive efforts to generalize efficient prevention, such as insecticide-treated mosquito nets (ITN) or long-lasting insecticidal nets (LLINs), malaria remains prevalent in many countries and ITN/LLINs are still only used to a limited extent. This study proposes a new model for malaria economic analysis by combining economic epidemiology tools with the literature on poverty traps. A theoretical model of rational protective behaviour in response to malaria is designed, which includes endogenous externalities and disease characteristics. Survey data available for Uganda provide empirical support to the theory of prevalence-elastic protection behaviours, once endogeneity issues related to epidemiology and poverty are solved. Two important conclusions emerge from the model. First, agents increase their protective behaviour when malaria is more prevalent in a society. This is consistent with the literature on "prevalence-elastic behaviour". Second, a 'malaria trap' defined as the result of malaria reinforcing poverty while poverty reduces the ability to deal with malaria can theoretically exist and the conditions of existence of the malaria trap are identified. These results suggest the possible existence of malaria traps, which provides policy implications. Notably, providing ITN/LLINs at subsidized prices is not sufficient. To be efficient an ITN/LLINs dissemination campaigns should include incentive of the very poor for using ITN/LLINs.

  14. Atovaquone and proguanil hydrochloride for treatment of malaria.

    Science.gov (United States)

    Kremsner, P G; Looareesuwan, S; Chulay, J D

    1999-05-01

    Safe and effective new drugs are needed for treatment of malaria. Atovaquone and proguanil hydrochloride is a new antimalarial combination that has recently become available in many countries. Data from clinical trials evaluating atovaquone/proguanil for treatment of malaria were reviewed. In 10 open-label clinical trials, treatment of uncomplicated falciparum malaria with 1000 mg atovaquone and 400 mg proguanil hydrochloride (or the equivalent based on body weight in patients proguanil has been used to provide radical cure of asymptomatic Plasmodium falciparum infections prior to initiation of placebo-controlled trials of malaria prophylaxis. Recurrent parasitemia occurred within 28 days in 0 of 99 subjects who subsequently received prophylaxis with atovaquone/proguanil and 1 of 81 subjects who subsequently received placebo. Atovaquone/proguanil is also effective for treatment of malaria caused by the other three Plasmodium species that cause malaria in humans. For treatment of vivax malaria, therapy with primaquine in addition to atovaquone/proguanil is needed to prevent relapse from latent hepatic hypnozoites. Atovaquone and proguanil hydrochloride is a safe and effective combination for treatment of malaria.

  15. Public Health Interventions for Control of Malaria in the Population Living in the Terai Region of Nepal.

    Science.gov (United States)

    Awasthi, Kiran Raj; Adefemi, Kazeem; Awasthi, Mamata Sherpa; Chalise, Binaya

    2018-01-01

    Infectious diseases are a major problem for developing countries. Controlling and eradicating these diseases have remained a challenge because of the multitudes of social and environmental factors involved. However, a multi-sectoral and collective effort in dealing with these diseases has been shown to result in positive outcomes. This paper looks at the current situation of Malaria in Nepal and a population that is at high risk. It explains the impact that social and environmental determinants have on this target population. This review then critically examines the various possible public health interventions that could potentially help in the control of malaria in this high risk population, drawing from evidences and experiences reported from other countries with suggestions for adapting these interventions to the Nepali environment.

  16. Hidden burden of malaria in Indian women

    Directory of Open Access Journals (Sweden)

    Sharma Vinod P

    2009-12-01

    Full Text Available Abstract Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP; of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state, that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tragic outcome can be averted by following the Roll Back Malaria/WHO recommendations of the use of malaria prevention i.e. indoor residual spraying (IRS/insecticide-treated bed nets (ITN preferably long-lasting treated bed nets (LLIN; intermittent preventive therapy (IPT; early diagnosis, prompt and complete treatment using microscopic/malaria rapid diagnostics test (RDT and case management. High incidence in pregnancy has arisen because of malaria surveillance lacking coverage, lack of age and sex wise data, staff shortages, and intermittent preventive treatment (IPT applicable in high transmission states/pockets is not included in the national drug policy- an essential component of fighting malaria in pregnancy in African settings. Inadequate surveillance and gross under-reporting has been highlighted time and again for over three decades. As a result the huge problem of malaria in pregnancy reported occasionally by researchers has remained hidden. Malaria in pregnancy may quicken severity in patients with drug resistant parasites, anaemia, endemic poverty, and malnutrition. There is, therefore, urgent need to streamline malaria control strategies to make a difference in tackling this grim scenario in human health.

  17. Malaria: Knowledge and prevention practices among school adolescents in a coastal community in Calabar, Nigeria

    Science.gov (United States)

    Gyuse, Abraham N.; Etokidem, Aniekan J.

    2010-01-01

    ABSTRACT Background Malaria prevention and treatment constitute an unbearable economic burden to most African countries, especially south of the Sahara, where about 500 million cases occur annually. The problem of malaria among adolescents has largely been overshadowed by the huge burden of the disease among young children. Attention to malaria among adolescents has also been diverted by the huge burden of HIV/AIDS among adolescents. Some surveys reveal a lack of knowledge and many misconceptions about the transmission and treatment of malaria, which could adversely affect malaria control measures and antimalarial therapy. Such a knowledge gap could have an adverse effect on school children, who could be used as change agents and as role models for their siblings and peers in the malaria control strategy. Objectives To determine the malaria prevention practices of school adolescents in the coastal community of Calabar, Nigeria. Method This was a cross-sectional survey involving secondary schools in southern Calabar. Four hundred adolescents were randomly selected from the 4565 learners in 5 out of 17 secondary schools in southern Calabar, Cross River State, Nigeria. A self-administered, semi-structured questionnaire was administered to the respondents. Results Most respondents (77.5%) were aware that the vector transmits the malaria parasite through biting. Fewer respondents would prevent malaria attacks by clearing the vegetation in the peri-domestic environment (13.5%), filling up potholes (16.9%), opening up drainage (11%), using insecticide-treated nets (25.7%) or using antimalarial drugs (11.2%). Less than one-tenth (8%) would use various other methods such as not accepting unscreened blood, while only 11% obtained the information from their teachers. Conclusion The study identified knowledge gaps among school children. There is a need to empower teachers with information about the cause of malaria and prevention strategies.

  18. Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005–2010 period

    Directory of Open Access Journals (Sweden)

    Pribluda Victor S

    2012-06-01

    Full Text Available Abstract Background Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM programme has provided technical assistance to Amazon Malaria Initiative (AMI countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Methods Trained personnel from the National Malaria Control Programmes (NMCPs, often in collaboration with country’s Official Medicine Control Laboratory (OMCL, developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC, were performed utilizing a portable mini-laboratory. Results Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines

  19. Equal Opportunity, Equal Work: Increasing Women's Participation in the U.S. President's Malaria Initiative Africa Indoor Residual Spraying Project

    OpenAIRE

    Donner, Abigail; Belemvire, Allison; Johns, Ben; Mangam, Keith; Fiekowsky, Elana; Gunn, Jayleen; Hayden, Mary; Ernst, Kacey

    2017-01-01

    Background: One of the primary control measures for malaria transmission is indoor residual spraying (IRS). Historically, few women have worked in IRS programs, despite the income-generating potential. Increasing women's roles in IRS requires understanding the barriers to women's participation and implementing measures to address them. The U.S. President's Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project is the largest implementer of IRS globally. To address gender ineq...

  20. Stress Response and Artemisinin Resistance in Malaria Parasite

    Science.gov (United States)

    2017-07-01

    AWARD NUMBER: W81XWH-16-1-0241 TITLE: Stress Response and Artemisinin Resistance in Malaria Parasite PRINCIPAL INVESTIGATOR: Juan C. Pizarro...SUBTITLE Stress Response and Artemisinin Resistance in Malaria Parasite 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-1-0241 5c. PROGRAM ELEMENT...13. SUPPLEMENTARY NOTES 14. ABSTRACT In malaria , drug resistance is a major treat to disease control efforts. Unfortunately, there is a significant

  1. Knowledge of malaria prevention among pregnant women and female caregivers of under-five children in rural southwest Nigeria

    Directory of Open Access Journals (Sweden)

    Ayodeji M. Adebayo

    2015-02-01

    Full Text Available Introduction. The morbidity and mortality from malaria are still unacceptably high in the developing countries, especially among the vulnerable groups like pregnant women and under-five children, despite all control efforts. The knowledge about the preventive measures of malaria is an important preceding factor for the acceptance and use of malaria preventive measures like Insecticide Treated Nets (ITN by community members. Therefore, this study assessed the knowledge of malaria prevention among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria.Methodology. This is part of a larger malaria prevention study in rural Southwest Nigeria. A descriptive cross-sectional survey was conducted among pregnant women and caregivers of under-five children in Igbo-Ora, a rural town in Southwest Nigeria using a semi-structured, interviewer-administered questionnaire. Information was obtained on knowledge of malaria prevention, and overall composite scores were computed for knowledge of malaria prevention and ITN use. Data were analyzed using SPSS version 16. Associations between variables were tested using a Chi-square with the level of statistical significance set at 5%.Results. Of the 631 respondents, 84.9% were caregivers of under-five children and 67.7% were married. Mean age was 27.7 ± 6.3 years with 53.4% aged between 20 and 29 years. Majority (91.1% had at least primary school education and 60.2% were traders. Overall, 57.7% had poor knowledge of malaria prevention. A good proportion (83.5% were aware of the use of ITN for malaria prevention while 30.6% had poor knowledge of its use. Respondents who were younger (<30 years, had at least primary education and earn <10,000/per month had significantly poor knowledge of ITN use in malaria prevention. Majority (60.0% respondents had poor attitude regarding use of ITNs.Conclusion. This study showed that the knowledge of malaria prevention is still low among under

  2. About Malaria

    Science.gov (United States)

    ... Emergency Consultations, and General Public. Contact Us About Malaria Recommend on Facebook Tweet Share Compartir Malaria is ... from sub-Saharan Africa and South Asia. About Malaria Topics FAQs Frequently Asked Question, Incubation period, uncomplicated & ...

  3. The economic value of an improved malaria treatment programme in Zambia: results from a contingent valuation survey

    Directory of Open Access Journals (Sweden)

    Rehnberg Clas

    2005-12-01

    Full Text Available Abstract Background Zambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control. Aims and objectives This paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status. Methods A contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids. Findings The study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.

  4. Supporting capacity for research on malaria in Africa

    DEFF Research Database (Denmark)

    Greenwood, Brian; Gaye, Oumar; Kamya, Moses R

    2018-01-01

    Substantial progress has been made in the control of malaria in Africa but much remains to be done before malaria elimination on the continent can be achieved. Further progress can be made by enhancing uptake of existing control tools but, in high transmission areas, additional tools will be needed....... Development and evaluation of these new tools will require a substantial cadre of African scientists well trained in many different disciplines. This paper describes the activities undertaken by the Malaria Capacity Development Consortium (MCDC) to support the careers of PhD students and postdoctoral fellows...... undertaking research on malaria at five African universities. A systematic assessment of constraints on PhD training and research support systems was undertaken at each partner African university at the beginning of the programme and many of these constraints were remedied. The success of the programme...

  5. Steady progress toward a malaria vaccine.

    Science.gov (United States)

    Lyke, Kirsten E

    2017-10-01

    Great progress has been made in reducing malaria morbidity and mortality, yet the parasite continues to cause a startling 200 million infections and 500 000 deaths annually. Malaria vaccine development is pushing new boundaries by steady advancement toward a licensed product. Despite 50 years of research, the complexity of Plasmoidum falciparum confounds all attempts to eradicate the organism. This very complexity has pushed the boundaries of vaccine development to new heights, yet it remains to be seen if an affordable vaccine can provide durable and high-level protection. Novel vaccines such as RTS,S/AS01E are on the edge of licensure, but old techniques have resurged with the ability to deliver vialed, whole organism vaccines. Novel adjuvants, multistage/multiantigen approaches and transmission blocking vaccines all contribute to a multipronged battle plan to conquer malaria. Vaccines are the most cost-effective tools to control infectious diseases, yet the complexity of malaria has frustrated all attempts to develop an effective product. This review concentrates on recent advances in malaria vaccine development that lend hope that a vaccine can be produced and malaria eradicated.

  6. Agro-ecology, household economics and malaria in Uganda: empirical correlations between agricultural and health outcomes.

    Science.gov (United States)

    Wielgosz, Benjamin; Kato, Edward; Ringler, Claudia

    2014-07-03

    the lack of data integrating both the health and agricultural information necessary to satisfy the differing methodologies used by the two sectors. A national platform for collaboration between the agricultural and health sectors could help align programs to achieve better measurements of agricultural interactions with vector reproduction and evaluate the potential for agricultural policy and programs to support rural malaria control.

  7. Malaria situation in an endemic area, southeastern iran.

    Directory of Open Access Journals (Sweden)

    Sajjad Fekri

    2014-06-01

    Full Text Available Malaria is an endemic infectious disease in southeastern parts of Iran. Despite years of efforts and intervention programs against malaria, transmission still occurs in Jask County.The epidemiological perspective of malaria in Jask County was conducted by gathering data from Jask County health center, during 2006-2010. A knowledge, attitude and practice study was also carried out. Data analysis was conducted using SPSS ver. 11.5.A total of 2875 malaria cases were recorded, with highest and lowest numbers in 2007 and 2010, respectively. The number of cases had a decreasing trend from 1022 cases in 2006 to 114 cases in 2010. The main causative parasitic agent was Plasmodium vivax. Blood examination rate and slide positive rate were also decreased from 39.5% and 4.3% in 2006 to 15.6% and 1.4% in 2010, respectively. Most of people interviewed in the KAP study had a good knowledge about malaria transmission and symptoms but their use of the bed net for prevention was low (35%.Malaria incidence had significant reduction during the study years. The main reason for this may be due to changing environmental condition for Anopheline breeding and survival because of drought. Another reason may be integration of vector management by using long lasting insecticide treated bed nets, active case detection and treatment by implementation of mobile teams and increasing in financial sources of malaria control program. Knowledge, attitude and practice of people were good in malaria control and prevention, but needs to do more activities for health education and awareness.

  8. Bayesian Geostatistical Modeling of Malaria Indicator Survey Data in Angola

    Science.gov (United States)

    Gosoniu, Laura; Veta, Andre Mia; Vounatsou, Penelope

    2010-01-01

    The 2006–2007 Angola Malaria Indicator Survey (AMIS) is the first nationally representative household survey in the country assessing coverage of the key malaria control interventions and measuring malaria-related burden among children under 5 years of age. In this paper, the Angolan MIS data were analyzed to produce the first smooth map of parasitaemia prevalence based on contemporary nationwide empirical data in the country. Bayesian geostatistical models were fitted to assess the effect of interventions after adjusting for environmental, climatic and socio-economic factors. Non-linear relationships between parasitaemia risk and environmental predictors were modeled by categorizing the covariates and by employing two non-parametric approaches, the B-splines and the P-splines. The results of the model validation showed that the categorical model was able to better capture the relationship between parasitaemia prevalence and the environmental factors. Model fit and prediction were handled within a Bayesian framework using Markov chain Monte Carlo (MCMC) simulations. Combining estimates of parasitaemia prevalence with the number of children under we obtained estimates of the number of infected children in the country. The population-adjusted prevalence ranges from in Namibe province to in Malanje province. The odds of parasitaemia in children living in a household with at least ITNs per person was by 41% lower (CI: 14%, 60%) than in those with fewer ITNs. The estimates of the number of parasitaemic children produced in this paper are important for planning and implementing malaria control interventions and for monitoring the impact of prevention and control activities. PMID:20351775

  9. Spatial analysis of land cover determinants of malaria incidence in the Ashanti Region, Ghana.

    Science.gov (United States)

    Krefis, Anne Caroline; Schwarz, Norbert Georg; Nkrumah, Bernard; Acquah, Samuel; Loag, Wibke; Oldeland, Jens; Sarpong, Nimako; Adu-Sarkodie, Yaw; Ranft, Ulrich; May, Jürgen

    2011-03-23

    Malaria belongs to the infectious diseases with the highest morbidity and mortality worldwide. As a vector-borne disease malaria distribution is strongly influenced by environmental factors. The aim of this study was to investigate the association between malaria risk and different land cover classes by using high-resolution multispectral Ikonos images and Poisson regression analyses. The association of malaria incidence with land cover around 12 villages in the Ashanti Region, Ghana, was assessed in 1,988 children <15 years of age. The median malaria incidence was 85.7 per 1,000 inhabitants and year (range 28.4-272.7). Swampy areas and banana/plantain production in the proximity of villages were strong predictors of a high malaria incidence. An increase of 10% of swampy area coverage in the 2 km radius around a village led to a 43% higher incidence (relative risk [RR] = 1.43, p<0.001). Each 10% increase of area with banana/plantain production around a village tripled the risk for malaria (RR = 3.25, p<0.001). An increase in forested area of 10% was associated with a 47% decrease of malaria incidence (RR = 0.53, p = 0.029). Distinct cultivation in the proximity of homesteads was associated with childhood malaria in a rural area in Ghana. The analyses demonstrate the usefulness of satellite images for the prediction of malaria endemicity. Thus, planning and monitoring of malaria control measures should be assisted by models based on geographic information systems.

  10. Rationalizing Historical successes of malaria control in Africa in terms of mosquito resource availabilty management

    NARCIS (Netherlands)

    Killeen, G.F.; Seyoum, A.; Knols, B.G.J.

    2004-01-01

    Environmental management of mosquito resources is a promising approach with which to control malaria, but it has seen little application in Africa for more than half a century. Here we present a kinetic model of mosquito foraging for aquatic habitats and vertebrate hosts that allows estimation of

  11. A review of malaria transmission dynamics in forest ecosystems

    Science.gov (United States)

    2014-01-01

    Malaria continues to be a major health problem in more than 100 endemic countries located primarily in tropical and sub-tropical regions around the world. Malaria transmission is a dynamic process and involves many interlinked factors, from uncontrollable natural environmental conditions to man-made disturbances to nature. Almost half of the population at risk of malaria lives in forest areas. Forests are hot beds of malaria transmission as they provide conditions such as vegetation cover, temperature, rainfall and humidity conditions that are conducive to distribution and survival of malaria vectors. Forests often lack infrastructure and harbor tribes with distinct genetic traits, socio-cultural beliefs and practices that greatly influence malaria transmission dynamics. Here we summarize the various topographical, entomological, parasitological, human ecological and socio-economic factors, which are crucial and shape malaria transmission in forested areas. An in-depth understanding and synthesis of the intricate relationship of these parameters in achieving better malaria control in various types of forest ecosystems is emphasized. PMID:24912923

  12. Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008

    Science.gov (United States)

    Akachi, Yoko; Atun, Rifat

    2011-01-01

    Background Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. Methods and Findings We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002–2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs)/indoor residual spraying (IRS). As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774–63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369–0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002–2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05). Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3–2.8] child deaths per 1000 live births. Conclusions Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently

  13. Effect of schistosoma infection on malaria immune response: A systematic review.

    Science.gov (United States)

    Yesuf, Elias Ali; Dejene, Tariku

    2011-01-01

    Background Worldwide an estimated 225 million cases and about 800, 000 deaths due to malaria were documented in 2009. Malaria vaccines have been developed as a malaria control strategy. Immune response to these vaccines might be affected by the blood fluke schistosoma which is often co-endemic with malaria in Sub-Saharan Africa where most of phase II and Phase III malaria vaccine trials were conducted.Objectives To systematically search, appraise and synthesize the best available evidence on the effect of schistosoma infection on the immune response to malaria antigens and provide direction to future malaria vaccination trials.Types of participants The review considered studies with above 5 year old individuals as participants.Phenomenon of interest The phenomenon of interest was the presence of schistosoma infectionTypes of outcomes Blood serum levels of Th1 and Th2 specific to Merozoite Surface Proteins 1, 2, and 3 of malaria were considered as primary outcomes. While blood serum levels of IgG1, IgG2, IgG3, IFN-γ, IL-10 and TGF-β directed against Merozoite Surface Proteins were considered as secondary outcomes.Types of studies Studies with any quantitative study designs were considered for inclusion.Search Strategy Any quantitative English language articles published between 1994 and April 2011 were sought using a comprehensive search strategy.Assessment of methodological quality It was done using Joanna Briggs Institutes' Meta Analysis of Statistical Assessment and Review Instrument critical appraisal tools.Data extraction Data extraction was carried out using the Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument data extraction tool.Data synthesis Meta- analysis was conducted using random effects model with an inverse variance method with RevMan5 software. Heterogeneity between the studies was assessed using ξ test at a p-value of SMD (95% CI), 0.15 (-2.00, 2.31), p=0.89.Similarly a small and statistically not significant

  14. Imported childhood malaria: the Dublin experience, 1999-2006.

    LENUS (Irish Health Repository)

    Leahy, T R

    2009-09-01

    Imported childhood malaria has never been studied in Ireland. We aimed to document the incidence and species of malaria in children presenting to paediatric hospitals in Dublin and to examine management and outcome measures.

  15. Handheld Computers for Malaria Monitoring (Mozambique) | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malaria is the principal cause of morbidity and mortality in Mozambique and is considered a major impediment to development. The effectiveness of any malaria control program depends on reliable data delivered in timely fashion, something that is currently lacking in the nation's health service. This grant will allow the ...

  16. Handheld Computers for Malaria Monitoring (Mozambique) | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malaria is the principal cause of morbidity and mortality in Mozambique and is considered a major impediment to development. The effectiveness of any malaria control program depends on reliable data delivered in timely fashion, something that is currently lacking in the nation's health service. This grant will allow the ...

  17. Housing Improvements and Malaria Risk in Sub-Saharan Africa: A Multi-Country Analysis of Survey Data.

    Directory of Open Access Journals (Sweden)

    Lucy S Tusting

    2017-02-01

    Full Text Available Improvements to housing may contribute to malaria control and elimination by reducing house entry by malaria vectors and thus exposure to biting. We tested the hypothesis that the odds of malaria infection are lower in modern, improved housing compared to traditional housing in sub-Saharan Africa (SSA.We analysed 15 Demographic and Health Surveys (DHS and 14 Malaria Indicator Surveys (MIS conducted in 21 countries in SSA between 2008 and 2015 that measured malaria infection by microscopy or rapid diagnostic test (RDT. DHS/MIS surveys record whether houses are built with finished materials (e.g., metal or rudimentary materials (e.g., thatch. This information was used to develop a binary housing quality variable where houses built using finished wall, roof, and floor materials were classified as "modern", and all other houses were classified as "traditional". Conditional logistic regression was used to determine the association between housing quality and prevalence of malaria infection in children aged 0-5 y, adjusting for age, gender, insecticide-treated net (ITN use, indoor residual spraying, household wealth, and geographic cluster. Individual survey odds ratios (ORs were combined to determine a summary OR using a random effects meta-analysis. Of 284,532 total children surveyed, 139,318 were tested for malaria infection using microscopy (n = 131,652 or RDT (n = 138,540. Within individual surveys, malaria prevalence measured by microscopy ranged from 0.4% (Madagascar 2011 to 45.5% (Burkina Faso 2010 among children living in modern houses and from 0.4% (The Gambia 2013 to 70.6% (Burkina Faso 2010 in traditional houses, and malaria prevalence measured by RDT ranged from 0.3% (Senegal 2013-2014 to 61.2% (Burkina Faso 2010 in modern houses and from 1.5% (The Gambia 2013 to 79.8% (Burkina Faso 2010 in traditional houses. Across all surveys, modern housing was associated with a 9% to 14% reduction in the odds of malaria infection (microscopy

  18. Plasmodium falciparum malaria associated with ABO blood ...

    African Journals Online (AJOL)

    The present study was carried out to investigate the relationship between blood group types and P. falciparum malaria, as well as malaria preventive measures. The venous blood specimens were collected, processed, Giemsa-stained and examined microscopically. ABO groups were determined by agglutination test using ...

  19. Battling malaria in rural Zambia with modern technology: a qualitative study on the value of cell phones, geographical information systems, asymptomatic carriers and rapid diagnostic tests to identify, treat and control malaria

    Directory of Open Access Journals (Sweden)

    David Nygren

    2014-02-01

    Full Text Available During the last decade much progress has been made in reducing malaria transmission in Macha, Southern Province, Zambia. Introduction of artemisinin combination therapies as well as mass screenings of asymptomatic carriers is believed to have contributed the most. When an endemic malaria situation is moving towards a non-endemic situation the resident population loses acquired immunity and therefore active case detection and efficient surveillance is crucial to prevent epidemic outbreaks. Our purpose was to evaluate the impact of cell phone surveillance and geographical information systems on malaria control in Macha. Furthermore, it evaluates what screening and treatment of asymptomatic carriers and implementation of rapid diagnostic tests in rural health care has led to. Ten in-depth semistructured interviews, field observations and data collection were performed at the Macha Research Trust and at surrounding rural health centers. This qualitative method was inspired by rapid assessment procedure. The cell phone surveillance has been easily integrated in health care, and its integration with Geographical Information Systems has provided the ability to follow malaria transmission on a weekly basis. In addition, active case detection of asymptomatic carriers has been fruitful, which is reflected in it soon being applied nationwide. Furthermore, rapid diagnostic tests have provided rural health centers with reliable malaria diagnostics, thereby decreasing excessive malaria treatments and selection for drug resistance. This report reflects the importance of asymptomatic carriers in targeting malaria elimination, as well as development of effective surveillance systems when transmission decreases. Such an approach would be cost-efficient in the long run through positive effects in reduced child mortality and relief in health care.

  20. Dynamics of malaria transmission and susceptibility to clinical malaria episodes following treatment of Plasmodium falciparum asymptomatic carriers: results of a cluster-randomized study of community-wide screening and treatment, and a parallel entomology study.

    Science.gov (United States)

    Tiono, Alfred B; Guelbeogo, Moussa W; Sagnon, N Falé; Nébié, Issa; Sirima, Sodiomon B; Mukhopadhyay, Amitava; Hamed, Kamal

    2013-11-12

    In malaria-endemic countries, large proportions of individuals infected with Plasmodium falciparum are asymptomatic and constitute a reservoir of parasites for infection of newly hatched mosquitoes. Two studies were run in parallel in Burkina Faso to evaluate the impact of systematic identification and treatment of asymptomatic carriers of P. falciparum, detected by rapid diagnostic test, on disease transmission and susceptibility to clinical malaria episodes. A clinical study assessed the incidence of symptomatic malaria episodes with a parasite density >5,000/μL after three screening and treatment campaigns ~1 month apart before the rainy season; and an entomological study determined the effect of these campaigns on malaria transmission as measured by entomological inoculation rate. The intervention arm had lower prevalence of asymptomatic carriers of asexual parasites and lower prevalence of gametocyte carriers during campaigns 2 and 3 as compared to the control arm. During the entire follow-up period, out of 13,767 at-risk subjects, 2,516 subjects (intervention arm 1,332; control arm 1,184) had symptomatic malaria. Kaplan-Meier analysis of the incidence of first symptomatic malaria episode with a parasite density >5,000/μL showed that, in the total population, the two treatment arms were similar until Week 11-12 after campaign 3, corresponding with the beginning of the malaria transmission season, after which the probability of being free of symptomatic malaria was lower in the intervention arm (logrank p entomological inoculation rate was comparable in both arms, with September peaks in both indices. Community screening and targeted treatment of asymptomatic carriers of P. falciparum had no effect on the dynamics of malaria transmission, but seemed to be associated with an increase in the treated community's susceptibility to symptomatic malaria episodes after the screening campaigns had finished. These results highlight the importance of further

  1. An assessment of the usefulness of a rapid immuno-chromatographic test, "Determine™ malaria pf" in evaluation of intervention measures in forest villages of central India

    Directory of Open Access Journals (Sweden)

    Shukla Manmohan

    2001-08-01

    Full Text Available Abstract Background Plasmodium falciparum malaria, is a major health problem in forested tribal belt of central India. Rapid and accurate methods are needed for the diagnosis of P. falciparum. We performed a blinded evaluation of the recently introduced Determine™ malaria pf test (Abbott, Laboratories, Japan compared with microscopy and splenomegaly in children in epidemic prone areas of district Mandla to assess the impact of intervention measures. Methods Children aged 2–10 yrs with and without fever were examined for spleen enlargement by medical specialist by establishing a mobile field clinic. From these children thick blood smears were prepared from finger prick and read by a technician. Simultaneously, rapid tests were performed by a field lab attendant. The figures for specificity, sensitivity and predictive values were calculated using microscopy as gold standard. Results In all 349 children were examined. The sensitivity and specificity for Determine rapid diagnostic test were 91 and 80% respectively. The positive predictive values (PPV, negative predictive values (NPV and accuracy of the test were respectively 79, 91 and 85%. On the contrary, the sensitivity and specificity of spleen in detecting malaria infection were 57 and 74 % respectively with PPV of 73%, NPV 59 % and an accuracy of 65%. Conclusions Determine™ malaria rapid diagnostic test is easier and quicker to perform and has other advantages over microscopy in not requiring prior training of personnel or quality control. Thus, highlighting the usefulness of a rapid antigen test in assessing prevailing malaria situation in remote areas.

  2. STATUS HEMATOLOGI PENDERITA MALARIA SEREBRAL

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    Nurhayati Nurhayati

    2009-05-01

    Full Text Available AbstrakMalaria masih merupakan masalah kesehatan masyarakat dunia. Berdasarkan klasifikasi klinis, malaria dibedakan atas malaria berat dan malaria tanpa komplikasi. Malaria serebral merupakan komplikasi terberat dari malaria falsiparum.Telah dilakukan penelitian seksi silang terhadap penderita malaria falciparum yang dirawat inap di Bangsal Penyakit Dalam RS. Perjan. Dr. M. Djamil Padang dari bulan Juni 2002 sampai Juni 2006. Pada penelitian ini didapatkan jumlah sampel sebanyak 60 orang, terdiri dari 16 orang penderita malaria serebral dan 44 orang penderita malaria tanpa komplikasi.Data penelitian menunjukan terdapat perbedaan bermakna nilai hematokrit (p<0,05 dan jumlah leukosit (p<0,05 antara penderita malaria serebral dengan penderita malaria tanpa komplikasi. Dan terdapat korelasi positif antara nilai hemoglobin dengan hematokrit (r=0,864; p<0,05 pada penderita malaria falsiparum.Kata kunci: malaria serebral, malaria tanpa komplikasi, malaria falsiparumAbstract Malaria is still a problem of health of world society. Based on the clinical classification, are distinguished on severe malaria and uncomplicated malaria. Cerebral malaria is the worst complication of falciparum malaria. Cross section of the research done at the Hospital Dr. M. Djamil Padang againts medical record of malaria patients who are hospitalized in the Internal Medicine from June 2002 until June 2004. In this study, a total sample of 60 people, consisting of 16 cerebral malaria and 44 uncomplicated malaria. Data showed there were significant differences for hematocrit values (p <0.05 and total leukocytes values (p <0.05 between cerebral malaria and uncomplicated malaria patients. There is a positive correlation between hemoglobin with hematocrit values (r = 0.864; p <0.05 of falciparum malaria patients. Keywords: cerebral malaria, uncomplicated malaria, falciparum malaria

  3. Large-scale drivers of malaria and priority areas for prevention and control in the Brazilian Amazon region using a novel multi-pathogen geospatial model.

    Science.gov (United States)

    Valle, Denis; Lima, Joanna M Tucker

    2014-11-20

    Most of the malaria burden in the Americas is concentrated in the Brazilian Amazon but a detailed spatial characterization of malaria risk has yet to be undertaken. Utilizing 2004-2008 malaria incidence data collected from six Brazilian Amazon states, large-scale spatial patterns of malaria risk were characterized with a novel Bayesian multi-pathogen geospatial model. Data included 2.4 million malaria cases spread across 3.6 million sq km. Remotely sensed variables (deforestation rate, forest cover, rainfall, dry season length, and proximity to large water bodies), socio-economic variables (rural population size, income, and literacy rate, mortality rate for children age under five, and migration patterns), and GIS variables (proximity to roads, hydro-electric dams and gold mining operations) were incorporated as covariates. Borrowing information across pathogens allowed for better spatial predictions of malaria caused by Plasmodium falciparum, as evidenced by a ten-fold cross-validation. Malaria incidence for both Plasmodium vivax and P. falciparum tended to be higher in areas with greater forest cover. Proximity to gold mining operations was another important risk factor, corroborated by a positive association between migration rates and malaria incidence. Finally, areas with a longer dry season and areas with higher average rural income tended to have higher malaria risk. Risk maps reveal striking spatial heterogeneity in malaria risk across the region, yet these mean disease risk surface maps can be misleading if uncertainty is ignored. By combining mean spatial predictions with their associated uncertainty, several sites were consistently classified as hotspots, suggesting their importance as priority areas for malaria prevention and control. This article provides several contributions. From a methodological perspective, the benefits of jointly modelling multiple pathogens for spatial predictions were illustrated. In addition, maps of mean disease risk were

  4. Efficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa

    DEFF Research Database (Denmark)

    Theander, Thor Grundtvig; Lusingu, John Peter Andrea

    2015-01-01

    and a booster dose at month 20 (R3R group); three doses of RTS,S/AS01 and a dose of comparator vaccine at month 20 (R3C group); or a comparator vaccine at months 0, 1, 2, and 20 (C3C [control group]). Participants were followed up until Jan 31, 2014. Cases of clinical and severe malaria were captured through......, the vaccine has the potential to make a substantial contribution to malaria control when used in combination with other effective control measures, especially in areas of high transmission. FUNDING: GlaxoSmithKline Biologicals SA and the PATH Malaria Vaccine Initiative....

  5. A sub-microscopic gametocyte reservoir can sustain malaria transmission.

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    Stephan Karl

    Full Text Available Novel diagnostic tools, including PCR and high field gradient magnetic fractionation (HFGMF, have improved detection of asexual Plasmodium falciparum parasites and especially infectious gametocytes in human blood. These techniques indicate a significant number of people carry gametocyte densities that fall below the conventional threshold of detection achieved by standard light microscopy (LM.To determine how low-level gametocytemia may affect transmission in present large-scale efforts for P. falciparum control in endemic areas, we developed a refinement of the classical Ross-Macdonald model of malaria transmission by introducing multiple infective compartments to model the potential impact of highly prevalent, low gametocytaemic reservoirs in the population. Models were calibrated using field-based data and several numerical experiments were conducted to assess the effect of high and low gametocytemia on P. falciparum transmission and control. Special consideration was given to the impact of long-lasting insecticide-treated bed nets (LLIN, presently considered the most efficient way to prevent transmission, and particularly LLIN coverage similar to goals targeted by the Roll Back Malaria and Global Fund malaria control campaigns. Our analyses indicate that models which include only moderate-to-high gametocytemia (detectable by LM predict finite eradication times after LLIN introduction. Models that include a low gametocytemia reservoir (requiring PCR or HFGMF detection predict much more stable, persistent transmission. Our modeled outcomes result in significantly different estimates for the level and duration of control needed to achieve malaria elimination if submicroscopic gametocytes are included.It will be very important to complement current methods of surveillance with enhanced diagnostic techniques to detect asexual parasites and gametocytes to more accurately plan, monitor and guide malaria control programs aimed at eliminating malaria.

  6. Association of haptoglobin phenotypes with susceptibility to Falciparum Malaria in Sudan

    International Nuclear Information System (INIS)

    Elagib, Atif Abdel Rahman

    1999-09-01

    The predisposing factors for the development of serious and diverse complications caused by falciparum are not very well understood. The search for host molecular markers which the disease presentation and prognosis, is an important issue in malaria research. Along this time line, the haptoglobin phenotype of Sudanese individuals infected with falciparum malaria both complicated and non-complicated, and non-infected controls, from randomly selected individuals were determined. Anti-human Haptoglobin antibodies was radiolabelled with 125 I , using chloramine T-method.Haptoglobin phenotype determination was performed by electrophoresis separation of sera on polyacrylamide gel followed by benzidine staining, which was shown to be time and material saving, and as sensitive as Western blotting. The distribution of the haptoglobin (1-1), (2-1) among 273 uncomplicated falicparm malaria patients, was found to be 60.8%, 29.2% and 6.9%, respectively. The distribution among 208 randomly selected individuals infected with falciparm malaria both controls, from randomly selected individuals were determined. Hyptogolobin phenotype was performed by electrophoresis separation of sera on polyacrylamide gel followed by benzidine staining, which was shown to be time and material saving, and as sensitive as Western blotting. The distribution of the haptoglobin phenotypes (1-1), (2-1) and (2-2) among 273 uncomplicated facilparum malaria patients, was found to be 60.8 % , 29.7 % and 6.9 %, respectively. The distribution among 208 randomly selected healthy controls was 26.0 %, 55.8 % and 18.3 % respectively . The results show that the number of individuals with haptoglobin phentype (1-1) is significantly higher among patients with falcilparum malaria (complicated and complicated) when compared to the controls. However, the controls showed a normal distribution of the phenotypes comparable to available data obtained from similar African populations. Consequently, we suggest that the

  7. Assessment Of Renal Function In Malaria Patients In Minna, North ...

    African Journals Online (AJOL)

    Data obtained were analyzed using one-way analysis of variance to compare variation among malaria patients and individuals without malaria, Duncan multiple range test to compare variation among means, and correlation matrix to evaluate correlation between the parameters measured. Proteinuria in malaria cases ...

  8. Prospects for Malaria Elimination in Mesoamerica and Hispaniola

    Science.gov (United States)

    Herrera, Sócrates; Ochoa-Orozco, Sergio Andrés; González, Iveth J.; Peinado, Lucrecia; Quiñones, Martha L.; Arévalo-Herrera, Myriam

    2015-01-01

    Malaria remains endemic in 21 countries of the American continent with an estimated 427,000 cases per year. Approximately 10% of these occur in the Mesoamerican and Caribbean regions. During the last decade, malaria transmission in Mesoamerica showed a decrease of ~85%; whereas, in the Caribbean region, Hispaniola (comprising the Dominican Republic [DR] and Haiti) presented an overall rise in malaria transmission, primarily due to a steady increase in Haiti, while DR experienced a significant transmission decrease in this period. The significant malaria reduction observed recently in the region prompted the launch of an initiative for Malaria Elimination in Mesoamerica and Hispaniola (EMMIE) with the active involvement of the National Malaria Control Programs (NMCPs) of nine countries, the Regional Coordination Mechanism (RCM) for Mesoamerica, and the Council of Health Ministries of Central America and Dominican Republic (COMISCA). The EMMIE initiative is supported by the Global Fund for Aids, Tuberculosis and Malaria (GFATM) with active participation of multiple partners including Ministries of Health, bilateral and multilateral agencies, as well as research centers. EMMIE’s main goal is to achieve elimination of malaria transmission in the region by 2020. Here we discuss the prospects, challenges, and research needs associated with this initiative that, if successful, could represent a paradigm for other malaria-affected regions. PMID:25973753

  9. The Potential of the Sterile Insect Technique and other Genetic Methods for Control of Malaria-Transmitting Mosquitoes. Report of a Consultants Meeting

    International Nuclear Information System (INIS)

    1996-01-01

    This report updates information provided by a 1993 consultant group on the use of genetic methods for control of malaria-transmitting mosquitoes. Human malaria parasites of the genus Plasmodium are exclusively transmitted by mosquitoes of the genus Anopheles. Where these two groups co-exist, the transmission of the parasite to humans can create a major health problem. Malaria currently causes 2 million deaths world-wide and approximately 400 million clinical cases annually. There are ca. 15 major vector species and 30-40 vectors of lesser importance. This report considers the practicality of developing the sterile insect technique (SIT) or other genetic mechanisms in order to eradicate mosquito vectors from specific areas. This would interrupt transmission and eliminate malaria in those areas.

  10. An Overview of Application of Nanotechnology in Malaria Control

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    Pam DD

    2017-07-01

    Full Text Available Infectious diseases caused by parasites are of immense global significance as about 30% of world’s population experiences parasitic infections. malaria is the most life threatening disease and accounts for one to two million deaths round the globe every year. Currently, there is no available effective vaccine against malaria. The shortcomings of malaria preventive and curative drug treatments have become a major reason for the failure to eradicate the disease. There is an urgent need for an effective antimalarial agent due to increasing drug resistance of Plasmodium falciparum. Nanotechnology has been identified as the new frontier in the fight against this disease. Nanomedicine is a new technology utilizing nanometer scale drug delivery systems as therapeutics, able to confer advantages which include improved drug pharmacokinetic profiles, organ, cell and parasite targeted drug delivery, reduce doses and reduction in drug toxicity. Nanomedicine can address the challenges associated with current anti-malarial drugs by reformulating the drugs in nanomedicine drug delivery systems (NMDDS. The development of these particulate carriers as vehicles for delivery of active compounds is a novel area of research that provides a new hope in malarial chemotherapy.

  11. PENELITIAN VEKTOR MALARIA YANG DILAKUKAN OLEH INSTITUSI KESEHATAN TAHUN 1975-1990

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    Santyo Kirnowardoyo

    2012-09-01

    Full Text Available Studies on the ecology of Anopheles aconitus, An.sundaicus, An. balabacensis and An. punctulatus group were carried out in the year of 1975-1990. The results were found useful to support malaria control programme. Studies on other species of malaria vectors revealed limitted results. Based on the results of these studies, simple methods of vector control which could be done through community participation, could be formulated. Therefore, in malarious areas in Java and Bali where An. aconitus and An. sundaicus are the main vectors, residual house sprayings could be minimized or even stopped. On the other hand health education to motivate community participation on vector control and survaillance should be intensified by the programme, to keep the malaria transmission under control. Study on the ecology of An. balabacensis was carried out only in Balikpapan, East Kalimantan. The result showed that the effectivity of malaria transmission by An. balabacensis was very high. Residual sprayings by DDT were still effective to control malaria incidence in this area. Studies on the ecology of An. punctulatus groups were done by NAMRU-2 but the results will not be discussed here. Studies on the ecology of other species of malaria vector were still needed, especially in the Easten part of Indonesia and at the Borders betwen Indonesia and neighboring countries.

  12. International travel increase and malaria importation in Romania, 2008-2009.

    Science.gov (United States)

    Neghina, Raul; Neghina, Adriana M; Marincu, Iosif; Iacobiciu, Ioan

    2011-09-01

    This report aims to assess the epidemiological characteristics of imported malaria in Romania in the context of international travel increase, and to compare them with the data reported by other European countries. Data on malaria cases were provided by the National Centre for Surveillance and Control of the Communicable Disease, whereas the data regarding international travels to and from Romania were retrieved from the Romanian Statistical Yearbook. The number of Romanian citizens who traveled to Africa in 2007 increased by over 600% as compared to the previous year. During the years 2008-2009, 25 cases of imported malaria were registered in Romania, with no fatalities. All patients were male and most of them (84%) acquired the infection in Africa. Plasmodium falciparum was involved in 68% of cases. The majority of the affected patients (41%) were aged 31 to 40 years. Labor was the main reason for traveling (72%), and 92% of cases took either partial or no chemoprophylaxis. The continuous growth of professional and leisure voyages to malaria-endemic regions may lead to a dramatic increase of imported cases, especially if prophylactic measures are not strictly followed.

  13. Malaria prevention practices and delivery outcome: a cross sectional study of pregnant women attending a tertiary hospital in northeastern Nigeria.

    Science.gov (United States)

    Muhammad, Hamzat U; Giwa, Fatima J; Olayinka, Adebola T; Balogun, Shakir M; Ajayi, IkeOluwapo; Ajumobi, Olufemi; Nguku, Patrick

    2016-06-18

    Malaria in pregnancy remains a public health problem in Nigeria. It causes maternal anaemia and adversely affects birth outcome leading to low birth weight, abortions and still births. Nigeria has made great strides in addressing the prevention and control of malaria in pregnancy. However, recent demographic survey shows wide disparities in malaria control activities across the geopolitical zones. This situation has been compounded by the political unrest and population displacement especially in the Northeastern zone leaving a significant proportion of pregnant women at risk of diseases, including malaria. The use of malaria preventive measures during pregnancy and the risk of malaria parasitaemia, anaemia and low birth weight babies were assessed among parturient women in an insurgent area. A cross-sectional survey was conducted among 184 parturient women at Federal Medical Centre, Nguru in Yobe state, between July and November 2014. Information on demographics, antenatal care and prevention practices was collected using an interviewer-administered questionnaire. Maternal peripheral and the cord blood samples were screened for malaria parasitaemia by microscopy of Giemsa-stained blood films. The presence of anaemia was also determined by microhaemocrit method using the peripheral blood samples. Data was analysed using descriptive and analytical statistics. Prevalence of malaria parasitaemia, anaemia and low birth weight babies was 40.0, 41.0 and 37.0 %, respectively, and mothers aged younger than 25 years were mostly affected. Eighty (43.0 %) of the women received up to two doses of sulfadoxine-pyrimethamine for intermittent preventive treatment (IPTp-SP) during pregnancy and most, 63 (83.0 %) of those tested malaria positive received less than these. Presence of malaria infection at antenatal clinic enrollment (OR: 6.6; 95 % CI: 3.4-13.0), non-adherence to direct observation therapy for administration of IPTp-SP (OR: 4.6; 95 % CI: 2.2-9.5) and receiving

  14. Monitoring antifolate resistance in intermittent preventive therapy for malaria

    DEFF Research Database (Denmark)

    Venkatesan, Meera; Alifrangis, Michael; Roper, Cally

    2013-01-01

    Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps have rendered sulfadoxine-pyrimethamine (SP) ineffective for malaria treatment in most regions of the world. Yet, SP is efficacious as intermittent preventive therapy in pregnant women (IPTp) and infants (IPTi) and as seasonal malaria...... control in children (SMC). SP-IPTp is being widely implemented in sub-Saharan Africa. SP-IPTi is recommended where the prevalence of SP-resistant malaria parasites is low, whereas SMC is recommended for areas of intense seasonal malaria transmission. The continuing success of these interventions depends...

  15. Malaria and World War II: German malaria experiments 1939-45.

    Science.gov (United States)

    Eckart, W U; Vondra, H

    2000-06-01

    The epidemiological and pharmacological fight against malaria and German malaria research during the Nazi dictatorship were completely under the spell of war. The Oberkommando des Heeres (German supreme command of the army) suffered the bitter experience of unexpected high losses caused by malaria especially at the Greek front (Metaxes line) but also in southern Russia and in the Ukraine. Hastily raised anti-malaria units tried to teach soldiers how to use the synthetic malaria drugs (Plasmochine, Atebrine) properly. Overdoses of these drugs were numerous during the first half of the war whereas in the second half it soon became clear that it would not be possible to support the army due to insufficient quantities of plasmochine and atebrine. During both running fights and troop withdrawals at all southern and southeastern fronts there was hardly any malaria prophylaxis or treatment. After war and captivity many soldiers returned home to endure heavy malaria attacks. In German industrial (Bayer, IG-Farben) and military malaria laboratories of the Heeres-Sanitäts-Akademie (Army Medical Academy) the situation was characterised by a hasty search for proper dosages of anti-malaria drugs, adequate mechanical and chemical prophylaxis (Petroleum, DDT, and other insecticides) as well as an anti-malaria vaccine. Most importantly, large scale research for proper atebrine and plasmochine dosages was conducted in German concentration camps and mental homes. In Dachau Professor Claus Schilling tested synthetic malaria drugs and injected helpless prisoners with high and sometimes lethal doses. Since the 1920s he had been furiously looking for an anti-malaria vaccine in Italian mental homes and from 1939 he continued his experiments in Dachau. Similar experiments were also performed in Buchenwald and in a psychiatric clinic in Thuringia, where Professor Gerhard Rose tested malaria drugs with mentally ill Russian prisoners of war. Schilling was put to death for his criminal

  16. A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Govella Nico J

    2008-01-01

    Full Text Available Abstract Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs. New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04. Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience.

  17. Environmental factors and population at risk of malaria in Nkomazi municipality, South Africa.

    Science.gov (United States)

    Adeola, A M; Botai, O J; Olwoch, J M; Rautenbach, C J de W; Adisa, O M; Taiwo, O J; Kalumba, A M

    2016-05-01

    Nkomazi local municipality of South Africa is a high-risk malaria region with an incidence rate of about 500 cases per 100 000. We examined the influence of environmental factors on population (age group) at risk of malaria. r software was used to statistically analyse data. Using remote sensing technology, a Landsat 8 image of 4th October 2015 was classified using object-based classification and a 5-m resolution. Spot height data were used to generate a digital elevation model of the area. A total of 60 718 malaria cases were notified across 48 health facilities in Nkomazi municipality between January 1997 and August 2015. Malaria incidence was highly associated with irrigated land (P = 0.001), water body (P = 0.011) and altitude ≤400 m (P = 0.001). The multivariate model showed that with 10% increase in the extent of irrigated areas, malaria risk increased by almost 39% in the entire study area and by almost 44% in the 2-km buffer zone of selected villages. Malaria incidence is more pronounced in the economically active population aged 15-64 and in males. Both incidence and case fatality rate drastically declined over the study period. A predictive model based on environmental factors would be useful in the effort towards malaria elimination by fostering appropriate targeting of control measures and allocating of resources. © 2016 John Wiley & Sons Ltd.

  18. Poverty and malaria in the Yunnan province, China

    OpenAIRE

    Bi, Yan; Tong, Shilu

    2014-01-01

    Poverty and malaria appear to have an intertwined link. This paper aims to define the relationship between poverty and malaria in Yunnan, China, and to make recommendations for future research in this important area. Data on malaria prevalence and the population’s income in each county between 2005 and 2010 were obtained from the Yunnan Center for Disease Control and Prevention and the Yunnan Bureau of Statistics, respectively. Geographic mapping shows an apparent spatial convergence of pover...

  19. A brief review on features of falciparum malaria during pregnancy

    Directory of Open Access Journals (Sweden)

    Alexandre Manirakiza

    2017-12-01

    Full Text Available Malaria in pregnancy is a serious public health problem in tropical areas. Frequently, the placenta is infected by accumulation of Plasmodium falciparum-infected erythrocytes in the intervillous space. Falciparum malaria acts during pregnancy by a range of mechanisms, and chronic or repeated infection and co-infections have insidious effects. The susceptibility of pregnant women to malaria is due to both immunological and humoral changes. Until a malaria vaccine becomes available, the deleterious effects of malaria in pregnancy can be avoided by protection against infection and prompt treatment with safe, effective antimalarial agents; however, concurrent infections such as with HIV and helminths during pregnancy are jeopardizing malaria control in sub-Saharan Africa.

  20. 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