[Assessment of a rapid diagnostic test and portable fluorescent microscopy for malaria diagnosis in Cotonou (Bénin)]. / Évaluation d'un test de diagnostic rapide et d'un microscope à fluorescence portable pour le diagnostic du paludisme à Cotonou (Bénin).

The aim of the study was to determine the accuracy of a rapid diagnostic test (SD Bioline Malaria Ag P.f/ Pan®) and fluorescent microscopy (CyScope®) in confirming presumptive malaria diagnosis in Cotonou. Thick blood smear was used as the reference technique for comparison. Testing was conducted on persons between the ages of 6 months and 70 years at two hospitals from June to October 2010. If malaria was suspected in the sample by the nurse based on clinical findings and sent to laboratory for confirmation, one thick smear, one rapid diagnostic test and one slide for the fluorescent microscopy were performed. All tests were read in hospital laboratories involved with the quality control of thick blood smear in the parasitology laboratory of National University Hospital of Cotonou. A total of 354 patients with clinical diagnosis of malaria were included. Malaria prevalence determined by thick smear, rapid diagnostic test and fluorescent microscopy was 22.8%, 25.4%, and 25.1% respectively. The sensitivity, specificity, positive and negative predictive values compared to the thick smears were 96.3, 95.6, 86.7, and 98.9% for rapid diagnostic test; and 97.5, 96.7, 89.8, and 99.27% for fluorescent microscopy. With these performances, these tests meet acceptability standards recommended by WHO for rapid tests (sensitivity > 95%). These two methods have advantages for the confirmation of malaria diagnosis in peripheral health structures that lack the resources to conduct diagnosis confirmation by the thick blood smear.

Assessment of microbial larvicide spraying with Bacillus thuringiensis israelensis, for the prevention of malaria.

OBJECTIVES: The aim of this study was to assess the contribution of microbial larvicide spraying, Bacillus thuringiensis israelensis, as prevention strategy against malaria. METHODS: An experimental study consisted in spraying B. thuringiensis israelensis in a district during 1 year has been conducted. Another district (control) was not sprayed. Eight hundred and two children were evaluated, thick drop and swab examination was performed for those presenting with fever. The larval density was calculated in their habitats as well as larvicide remanence. Capture of mosquitoes with human bait allowed determining human exposure to bites at night, and identifying anopheles after dissection. RESULTS: The incidence of pediatric malaria was 13.8% in the sprayed district and 31.4% in the control district. The parasitic load ranged from 2000 to 42,000 parasites/µL in the sprayed district and 2000 to 576,000 parasites/µL in the control district. Plasmodium falciparum was the most frequent (97.8%) plasmodial species. In the control district, at least 20 larvae by liter of water were counted; anopheles larvae were found in 11 larval habitats out of 15 (73.33%). The human exposure to anopheles bites at night was 14.25 in the sprayed district and 33.13 in the control district. The remanence of B. thuringiensis israelensis was estimated at 9 days in the sprayed district. CONCLUSION: The larvicide B. thuringiensis israelensis may be used in vector control strategy for the prevention of malaria.

[Evaluation of the use of insecticide-treated nets and intermittent preventive treatment in three health zones in Benin]. / Évaluation de l'utilisation des moustiquaires imprégnées d'insecticide et du traitement préventif intermittent dans trois zones sanitaires au Bénin.

This study aims to evaluate the results of the Project to Support the Fight against Malaria in the departments of Mono and Couffo in Benin on insecticide-treated nets (ITNs) use by children under 5 years and pregnant women and the coverage by Intermittent Preventive Treatment (IPT) with Sulfadoxin-Pyrimethamin (SP). This assessment is made from two household surveys. The first at the start up and the second after fifteen months of implementation. The availability of ITN in households and their use by pregnant women and children under 5 years have increased respectively from 8, 5 and 4% in 2005 to 24, 31 and 16 % in 2006. The percentage of pregnant women under IPT with sulfadoxine-pyrimethamine (SP) is 10% while 21% of pregnant women received at least one dose of SP. The availability of ITN in households and their use by children under 5 years and the prevention of malaria during pregnancy remains a concern in these health areas. The promotion of long lasting insecticide treated nets with effective communication strategies for behavior change could improve the results. Research on causes of poor compliance of IPT should be emphasized as well as strengthening management of drugs in health centers.

[Monitoring and assessment indicators in 2001 of "Roll Back Malaria" initiative in Benin]. / Indicateurs de suivi et d'evaluation en 2001 de l'initiative <> au Benin.

Within the context of WHO/CDS/RBM/2000, a survey was conducted in 2001 by the National Malaria Control Program of Benin. Following a well-thought-out choice, the survey took place simultaneously in health areas corresponding to epidemiological regions. Morbidity due to malaria is very high among children under five years admitted in external clinic (44.3% of cases) and (46.5%) for hospitalization. The crude rate of mortality is 129%. The use of non-impregnated bednet is usually met in three health areas, where 47.4% of the household have at least one non-impregnated bednet versus 5.4% of household with impregnated bednets. Percentage of pregnant women sleeping under an impregnated bednet and following chemoprophylaxis is respectively 43.3% and 3.8%. Results obtained at the end of this database survey in 2001 have facilitated the definition of indicators of the process, results and impact which remain very useful for the implementation of the monitoring and assessment system of "Roll Back Malaria" in Benin.