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1.
Artículo en Chino | MEDLINE | ID: mdl-32185921

RESUMEN

Since the end of 2019, the coronavirus disease 2019 (COVID-19) has been extensively epidemic in China, which not only seriously threatens the safety and health of Chinese people, but also challenges the management of other infectious diseases. Currently, there are still approximately three thousand malaria cases imported into China every year. If the diagnosis and treatment of malaria cases as well as the investigation and response of the epidemic foci are not carried out timely, it may endanger patients'lives and cause the possible of secondary transmission, which threatens the achievements of malaria elimination in China. Due to the extensive spread and high transmission ability of the COVID-19, there is a possibility of virus infections among malaria cases during the medical care-seeking behaviors and among healthcare professionals during clinical diagnosis and treatment, sample collection and testing and epidemiological surveys. This paper analyzes the challenges of the COVID-19 for Chinese malaria elimination programme, and proposes the countermeasures in response to the COVID-19 outbreak, so as to provide the reference for healthcare professionals.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Malaria , Neumonía Viral/epidemiología , Betacoronavirus , China , Infecciones por Coronavirus/prevención & control , Humanos , Malaria/epidemiología , Malaria/prevención & control , Malaria/transmisión , Programas Nacionales de Salud , Neumonía Viral/prevención & control
2.
Pan Afr Med J ; 35: 11, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32117526

RESUMEN

Globally, Nigeria contributes the greatest proportion of the malaria disease burden. She currently bears the heaviest malaria burden (25% cases) and (19% deaths). Malaria is caused by Plasmodium parasites transmitted by female Anopheles mosquitoes however, a higher parasite biomass (99%) is found in man while only one (1%) is found in mosquitoes. Lending credence to this is the outcome of investigations carried out in Gboko and Otukpo Local Government Areas (LGAs); in which more humans (36.8%) had the malaria parasites than the anthropophagic female Anopheles (0.5%). Control efforts focused on mosquitoes are undermined by the actions or inactions of humans. Nigeria needs to self-audit her role in sustaining the heaviest burden of a preventable, curable disease that can also be eliminated. She can only ignore this imperative at her own peril.


Asunto(s)
Anopheles/parasitología , Malaria/epidemiología , Mosquitos Vectores , Animales , Femenino , Humanos , Malaria/transmisión , Nigeria/epidemiología , Plasmodium/parasitología
3.
Rev Bras Epidemiol ; 23: e200018, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159628

RESUMEN

INTRODUCTION: Malaria is an infectious disease of high transmission in the Amazon region, but its dynamics and spatial distribution may vary depending on the interaction of environmental, socio-cultural, economic, political and health services factors. OBJECTIVE: To verify the existence of malaria case patterns in consonance with the fluviometric regimes in Amazon basin. METHOD: Methods of descriptive and inferential statistics were used in malaria and water level data for 35 municipalities in the Amazonas State, in the period from 2003 to 2014. RESULTS: The existence of a tendency to modulate the seasonality of malaria cases due to distinct periods of rivers flooding has been demonstrated. Differences were observed in the annual hydrological variability accompanied by different patterns of malaria cases, showing a trend of remodeling of the epidemiological profile as a function of the flood pulse. CONCLUSION: The study suggests the implementation of regional and local strategies considering the hydrological regimes of the Amazon basin, enabling municipal actions to attenuate the malaria in the Amazonas State.


Asunto(s)
Hidrología , Malaria/epidemiología , Estaciones del Año , Brasil/epidemiología , Humanos , Incidencia , Malaria/diagnóstico , Características de la Residencia , Ríos , Movimientos del Agua
4.
Infect Dis Poverty ; 9(1): 15, 2020 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-32036790

RESUMEN

BACKGROUND: Malaria surveillance system strengthening is essential in the progress towards malaria elimination. In Nigeria, more attention is being given to this recently as the country is striving towards achieving elimination. However, the surveillance system performance is fraught with challenges including poor data quality with varying magnitude by state. This study evaluated the operation of the Kano State malaria surveillance system and assessed its key attributes. METHODS: An observational study design comprising a survey, record review and secondary data analysis, and mixed methods data collection approach were used. Four key stakeholders' and 35 Roll Back Malaria Focal Persons (RBMs) semi-structured interviews on operation of the system and attributes of the surveillance system, were conducted. We analyzed the abstracted 2013-2016 National Health Management Information System web-based malaria datasets. The surveillance system was evaluated using the "2001 United States Centers for Disease Control's updated guidelines for Evaluating Public Health Surveillance Systems". Data were described using means, standard deviation, frequencies and proportions. Chi-squared for linear trends was used. RESULTS: Overall, 24 RBMs (68.6%) had ≤ 15-year experience on malaria surveillance, 29 (82.9%) had formal training on malaria surveillance; 32 RBMs (91.4%) reported case definitions were easy-to-use, reporting forms were easy-to-fill and data flow channels were clearly defined. Twenty-seven respondents (69.2%) reported data tools could accommodate changes and all RBMs understood malaria case definitions. All respondents (4 stakeholders and 34 RBMs [97.1%]) expressed willingness to continue using the system and 33 (84.6%) reported analyzed data were used for decision-making. Public health facilities constituted the main data source. Overall, 65.0% of funding were from partner agencies. Trend of malaria cases showed significant decline (χ2trend = 7.49; P = 0.0006). Timeliness of reporting was below the target (≥ 80%), except being 82% in 2012. CONCLUSIONS: Malaria surveillance system in Kano State was simple, flexible, acceptable, useful and donor-driven but the data were not representative of all health facilities. Timeliness of reporting was suboptimal. We recommended reporting from private health facilities, strengthening human resource capacity for supportive supervision and ensuring adequate government funding to enhance the system's representativeness and improve data quality.


Asunto(s)
Malaria/epidemiología , Vigilancia en Salud Pública/métodos , Vigilancia de Guardia , Antimaláricos/uso terapéutico , Control de Enfermedades Transmisibles/métodos , Notificación de Enfermedades/métodos , Femenino , Humanos , Masculino , Nigeria/epidemiología
5.
Mem Inst Oswaldo Cruz ; 114: e190210, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022168

RESUMEN

BACKGROUND: The influence of Plasmodium spp. infection in the health of Southern brown howler monkey, Alouatta guariba clamitans, the main reservoir of malaria in the Atlantic Forest, is still unknown. OBJECTIVES: The aim of this study was to investigate the positivity rate of Plasmodium infection in free-living howler monkeys in an Atlantic Forest fragment in Joinville/SC and to associate the infection with clinical, morphometrical, haematological and biochemical alterations. METHODS: Molecular diagnosis of Plasmodium infection in the captured monkeys was performed by Nested-polymerase chain reaction (PCR) (18S rRNA and coxI). Haematological and biochemical parameters were compared among infected and uninfected monkeys; clinical and morphometrical parameters were also compared. FINDINGS: The positivity rate of Plasmodium infection was 70% among forty captured animals, the highest reported for neotropical primates. None statistical differences were detected in the clinical parameters, and morphometric measures comparing infected and uninfected groups. The main significant alteration was the higher alanine aminotransferase (ALT) levels in infected compared to uninfected monkeys. MAIN CONCLUSIONS: Therefore, Plasmodium infection in howler monkeys may causes haematological/biochemical alterations which might suggest hepatic impairment. Moreover, infection must be monitored for the eco-epidemiological surveillance of malaria in the Atlantic Forest and during primate conservation program that involves the animal movement, such as translocations.


Asunto(s)
Alouatta/parasitología , Reservorios de Enfermedades/parasitología , Malaria/veterinaria , Enfermedades de los Monos/parasitología , Alouatta/sangre , Animales , Animales Salvajes , Brasil/epidemiología , Femenino , Malaria/sangre , Malaria/epidemiología , Masculino , Enfermedades de los Monos/sangre , Enfermedades de los Monos/epidemiología
6.
BMC Med ; 18(1): 9, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31987052

RESUMEN

BACKGROUND: In order to improve malaria burden estimates in low transmission settings, more sensitive tools and efficient sampling strategies are required. This study evaluated the use of serological measures from repeated health facility-based cross-sectional surveys to investigate Plasmodium falciparum and Plasmodium vivax transmission dynamics in an area nearing elimination in Indonesia. METHODS: Quarterly surveys were conducted in eight public health facilities in Kulon Progo District, Indonesia, from May 2017 to April 2018. Demographic data were collected from all clinic patients and their companions, with household coordinates collected using participatory mapping methods. In addition to standard microscopy tests, bead-based serological assays were performed on finger-prick bloodspot samples from 9453 people. Seroconversion rates (SCR, i.e. the proportion of people in the population who are expected to seroconvert per year) were estimated by fitting a simple reversible catalytic model to seroprevalence data. Mixed effects logistic regression was used to examine factors associated with malaria exposure, and spatial analysis was performed to identify areas with clustering of high antibody responses. RESULTS: Parasite prevalence by microscopy was extremely low (0.06% (95% confidence interval 0.03-0.14, n = 6) and 0 for P. vivax and P. falciparum, respectively). However, spatial analysis of P. vivax antibody responses identified high-risk areas that were subsequently the site of a P. vivax outbreak in August 2017 (62 cases detected through passive and reactive detection systems). These areas overlapped with P. falciparum high-risk areas and were detected in each survey. General low transmission was confirmed by the SCR estimated from a pool of the four surveys in people aged 15 years old and under (0.020 (95% confidence interval 0.017-0.024) and 0.005 (95% confidence interval 0.003-0.008) for P. vivax and P. falciparum, respectively). The SCR estimates in those over 15 years old were 0.066 (95% confidence interval 0.041-0.105) and 0.032 (95% confidence interval 0.015-0.069) for P. vivax and P. falciparum, respectively. CONCLUSIONS: These findings demonstrate the potential use of health facility-based serological surveillance to better identify and target areas still receptive to malaria in an elimination setting. Further implementation research is needed to enable integration of these methods with existing surveillance systems.


Asunto(s)
Brotes de Enfermedades , Malaria Falciparum/epidemiología , Malaria Vivax/epidemiología , Estudios Seroepidemiológicos , Adulto , Análisis por Conglomerados , Estudios Transversales , Pruebas Diagnósticas de Rutina , Femenino , Instituciones de Salud , Humanos , Indonesia/epidemiología , Modelos Logísticos , Malaria/epidemiología , Masculino , Microscopía , Persona de Mediana Edad , Plasmodium falciparum/inmunología , Plasmodium vivax/inmunología , Prevalencia , Análisis Espacial
7.
BMC Public Health ; 20(1): 17, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31910842

RESUMEN

BACKGROUND: A recent study found that the gut microbiota, Lactobacillus and Bifidobacterium, have the ability to modulate the severity of malaria. The modulation of the severity of malaria is not however, the typical focal point of most widespread interventions. Thus, an essential element of information required before serious consideration of any intervention that targets reducing severe malaria incidence is a prediction of the health benefits and costs required to be cost-effective. METHODS: Here, we developed a mathematical model of malaria transmission to evaluate an intervention that targets reducing severe malaria incidence. We consider intervention scenarios of a 2-, 7-, and 14-fold reduction in severe malaria incidence, based on the potential reduction in severe malaria incidence caused by gut microbiota, under entomological inoculation rates occurring in 41 countries in sub-Saharan Africa. For each intervention scenario, disability-adjusted life years averted and incremental cost-effectiveness ratios were estimated using country specific data, including the reported proportions of severe malaria incidence in healthcare settings. RESULTS: Our results show that an intervention that targets reducing severe malaria incidence with annual costs between $23.65 to $30.26 USD per person and causes a 14-fold reduction in severe malaria incidence would be cost-effective in 15-19 countries and very cost-effective in 9-14 countries respectively. Furthermore, if model predictions are based on the distribution of gut microbiota through a freeze-dried yogurt that cost $0.20 per serving, a 2- to 14-fold reduction in severe malaria incidence would be cost-effective in 29 countries and very cost-effective in 25 countries. CONCLUSION: Our findings indicate interventions that target severe malaria can be cost-effective, in conjunction with standard interventions, for reducing the health burden and costs attributed to malaria. While our results illustrate a stronger cost-effectiveness for greater reductions, they consistently show that even a limited reduction in severe malaria provides substantial health benefits, and could be economically viable. Therefore, we suggest that interventions that target severe malaria are worthy of consideration, and merit further empirical and clinical investigation.


Asunto(s)
Antimaláricos/economía , Antimaláricos/uso terapéutico , Transmisión de Enfermedad Infecciosa/economía , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Malaria/economía , Malaria/terapia , Malaria/transmisión , África del Sur del Sahara/epidemiología , Análisis Costo-Beneficio , Humanos , Incidencia , Malaria/epidemiología , Modelos Teóricos
8.
PLoS Negl Trop Dis ; 13(12): e0007906, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31815937

RESUMEN

BACKGROUND: Although malaria cases have substantially decreased in Southeast Brazil, a significant increase in the number of Plasmodium vivax-like autochthonous human cases has been reported in remote areas of the Atlantic Forest in the past few decades in Rio de Janeiro (RJ) state, including an outbreak during 2015-2016. The singular clinical and epidemiological aspects in several human cases, and collectively with molecular and genetic data, revealed that they were due to the non-human primate (NHP) parasite Plasmodium simium; however, the understanding of the autochthonous malarial epidemiology in Southeast Brazil can only be acquired by assessing the circulation of NHP Plasmodium in the foci and determining its hosts. METHODOLOGY: A large sampling effort was carried out in the Atlantic forest of RJ and its bordering states (Minas Gerais, São Paulo, Espírito Santo) for collecting and examining free-living NHPs. Blood and/or viscera were analyzed for Plasmodium infections via molecular and microscopic techniques. PRINCIPAL FINDINGS: In total, 146 NHPs of six species, from 30 counties in four states, were tested, of which majority were collected from RJ. Howler monkeys (Alouatta clamitans) were the only species found infected. In RJ, 26% of these monkeys tested positive, of which 17% were found to be infected with P. simium. Importantly, specific single nucleotide polymorphisms-the only available genetic markers that differentiate P. simium from P. vivax-were detected in all P. simium infected A. clamitans despite their geographical origin of malarial foci. Interestingly, 71% of P. simium infected NHPs were from the coastal slope of a mountain chain (Serra do Mar), where majority of the human cases were found. Plasmodium brasilianum/malariae was initially detected in 14% and 25% free-living howler monkeys in RJ and in the Espírito Santo (ES) state, respectively. Moreover, the malarial pigment was detected in the spleen fragments of 50% of a subsample comprising dead howler monkeys in both RJ and ES. All NHPs were negative for Plasmodium falciparum. CONCLUSIONS/SIGNIFICANCE: Our data indicate that howler monkeys act as the main reservoir for the Atlantic forest human malarial parasites in RJ and other sites in Southeast Brazil and reinforce its zoonotic characteristics.


Asunto(s)
Alouatta/parasitología , Reservorios de Enfermedades/parasitología , Malaria/veterinaria , Enfermedades de los Monos/epidemiología , Plasmodium/clasificación , Plasmodium/aislamiento & purificación , Zoonosis/epidemiología , Animales , Sangre/parasitología , Brasil , Bosques , Humanos , Malaria/epidemiología , Malaria/parasitología , Enfermedades de los Monos/parasitología , Zoonosis/parasitología
9.
Nat Commun ; 10(1): 5615, 2019 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-31819062

RESUMEN

Novel interventions that leverage the heterogeneity of parasite transmission are needed to achieve malaria elimination. To better understand spatial and temporal dynamics of transmission, we applied amplicon next-generation sequencing of two polymorphic gene regions (csp and ama1) to a cohort identified via reactive case detection in a high-transmission setting in western Kenya. From April 2013 to July 2014, we enrolled 442 symptomatic children with malaria, 442 matched controls, and all household members of both groups. Here, we evaluate genetic similarity between infected individuals using three indices: sharing of parasite haplotypes on binary and proportional scales and the L1 norm. Symptomatic children more commonly share haplotypes with their own household members. Furthermore, we observe robust temporal structuring of parasite genetic similarity and identify the unique molecular signature of an outbreak. These findings of both micro- and macro-scale organization of parasite populations might be harnessed to inform next-generation malaria control measures.


Asunto(s)
Malaria/epidemiología , Malaria/transmisión , Parásitos/fisiología , Análisis Espacio-Temporal , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Preescolar , Haplotipos/genética , Humanos , Kenia/epidemiología , Persona de Mediana Edad , Parásitos/genética , Plasmodium falciparum/genética , Plasmodium falciparum/fisiología , Adulto Joven
10.
PLoS Med ; 16(12): e1002992, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31834890

RESUMEN

BACKGROUND: To reduce the risk of drug-induced haemolysis, all patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) prior to prescribing primaquine (PQ)-based radical cure for the treatment of vivax malaria. This systematic review and individual patient meta-analysis assessed the utility of a qualitative lateral flow assay from Access Bio/CareStart (Somerset, NJ) (CareStart Screening test for G6PD deficiency) for the diagnosis of G6PDd compared to the gold standard spectrophotometry (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42019110994). METHODS AND FINDINGS: Articles published on PubMed between 1 January 2011 and 27 September 2019 were screened. Articles reporting performance of the standard CSG from venous or capillary blood samples collected prospectively and considering spectrophotometry as gold standard (using kits from Trinity Biotech PLC, Wicklow, Ireland) were included. Authors of articles fulfilling the inclusion criteria were contacted to contribute anonymized individual data. Minimal data requested were sex of the participant, CSG result, spectrophotometry result in U/gHb, and haemoglobin (Hb) reading. The adjusted male median (AMM) was calculated per site and defined as 100% G6PD activity. G6PDd was defined as an enzyme activity of less than 30%. Pooled estimates for sensitivity and specificity, unconditional negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated comparing CSG results to spectrophotometry using a random-effects bivariate model. Of 11 eligible published articles, individual data were available from 8 studies, 6 from Southeast Asia, 1 from Africa, and 1 from the Americas. A total of 5,815 individual participant data (IPD) were available, of which 5,777 results (99.3%) were considered for analysis, including data from 3,095 (53.6%) females. Overall, the CSG had a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a specificity of 0.95 (95% CI 0.92-0.96). When the prevalence of G6PDd was varied from 5% to 30%, the unconditional NPV was 0.99 (95% CI 0.94-1.00), with an LR+ and an LR- of 18.23 (95% CI 13.04-25.48) and 0.05 (95% CI 0.02-0.12), respectively. Performance was significantly better in males compared to females (p = 0.027) but did not differ significantly between samples collected from capillary or venous blood (p = 0.547). Limitations of the study include the lack of wide geographical representation of the included data and that the CSG results were generated under research conditions, and therefore may not reflect performance in routine settings. CONCLUSIONS: The CSG performed well at the 30% threshold. Its high NPV suggests that the test is suitable to guide PQ treatment, and the high LR+ and low LR- render the test suitable to confirm and exclude G6PDd. Further operational studies are needed to confirm the utility of the test in remote endemic settings.


Asunto(s)
Pruebas Diagnósticas de Rutina , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Glucosafosfato Deshidrogenasa/genética , Primaquina/uso terapéutico , Pruebas Diagnósticas de Rutina/métodos , Enfermedades Endémicas , Femenino , Deficiencia de Glucosafosfato Deshidrogenasa/tratamiento farmacológico , Humanos , Malaria/tratamiento farmacológico , Malaria/epidemiología , Malaria Vivax/epidemiología , Masculino , Sistemas de Atención de Punto , Primaquina/efectos adversos , Sensibilidad y Especificidad
11.
Malar J ; 18(1): 359, 2019 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-31707994

RESUMEN

BACKGROUND: A major health burden in Cameroon is malaria, a disease that is sensitive to climate, environment and socio-economic conditions, but whose precise relationship with these drivers is still uncertain. An improved understanding of the relationship between the disease and its drivers, and the ability to represent these relationships in dynamic disease models, would allow such models to contribute to health mitigation and adaptation planning. This work collects surveys of malaria parasite ratio and entomological inoculation rate and examines their relationship with temperature, rainfall, population density in Cameroon and uses this analysis to evaluate a climate sensitive mathematical model of malaria transmission. METHODS: Co-located, climate and population data is compared to the results of 103 surveys of parasite ratio (PR) covering 18,011 people in Cameroon. A limited set of campaigns which collected year-long field-surveys of the entomological inoculation rate (EIR) are examined to determine the seasonality of disease transmission, three of the study locations are close to the Sanaga and Mefou rivers while others are not close to any permanent water feature. Climate-driven simulations of the VECTRI malaria model are evaluated with this analysis. RESULTS: The analysis of the model results shows the PR peaking at temperatures of approximately 22 °C to 26 °C, in line with recent work that has suggested a cooler peak temperature relative to the established literature, and at precipitation rates at 7 mm day-1, somewhat higher than earlier estimates. The malaria model is able to reproduce this broad behaviour, although the peak occurs at slightly higher temperatures than observed, while the PR peaks at a much lower rainfall rate of 2 mm day-1. Transmission tends to be high in rural and peri-urban relative to urban centres in both model and observations, although the model is oversensitive to population which could be due to the neglect of population movements, and differences in hydrological conditions, housing quality and access to healthcare. The EIR follows the seasonal rainfall with a lag of 1 to 2 months, and is well reproduced by the model, while in three locations near permanent rivers the annual cycle of malaria transmission is out of phase with rainfall and the model fails. CONCLUSION: Malaria prevalence is maximum at temperatures of 24 to 26 °C in Cameroon and rainfall rates of approximately 4 to 6 mm day-1. The broad relationships are reproduced in a malaria model although prevalence is highest at a lower rainfall maximum of 2 mm day-1. In locations far from water bodies malaria transmission seasonality closely follows that of rainfall with a lag of 1 to 2 months, also reproduced by the model, but in locations close to a seasonal river the seasonality of malaria transmission is reversed due to pooling in the transmission to the dry season, which the model fails to capture.


Asunto(s)
Clima , Malaria/epidemiología , Malaria/transmisión , Densidad de Población , Lluvia , Temperatura Ambiental , Camerún/epidemiología , Humanos , Modelos Teóricos , Prevalencia
12.
BMC Public Health ; 19(1): 1456, 2019 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694595

RESUMEN

BACKGROUND: Pesticides remain the mainstay for the control of agricultural pests and disease vectors. However, their indiscriminate use in agriculture has led to development of resistance to both crop pests and disease vectors. This threatens to undermine the success gained through the implementation of chemical based vector control programs. We investigated the practices of farmers with regard to pesticide usage in the vegetable growing areas and their impact on susceptibility status of An. gambiae s.l. METHODS: A stratified multistage sampling technique using the administrative structure of the Tanzanian districts as sampling frame was used. Wards, villages and then participants with farms where pesticides are applied were purposively recruited at different stages of the process, 100 participants were enrolled in the study. The same villages were used for mosquito larvae sampling from the farms and the surveys were complimented by the entomological study. Larvae were reared in the insectary and the emerging 2-3 days old female adults of Anopheles gambiae s.l were subjected to susceptibility test. RESULTS: Forty eight pesticides of different formulations were used for control of crop and Livestock pests. Pyrethroids were the mostly used class of pesticides (50%) while organophosphates and carbamates were of secondary importance. Over 80% of all farmers applied pesticides in mixed form. Susceptibility test results confirmed high phenotypic resistance among An. gambiae populations against DDT and the pyrethroids (Permethrin-0.75%, Cyfluthrin-0.15%, Deltametrin-0.05% and Lambdacyhalothrin-0.05%) with mortality rates 54, 61, 76 and 71%, respectively. Molecular analysis showed An. arabiensis as a dominant species (86%) while An. gambiae s.s constituted only 6%. The kdr genes were not detected in all of the specimens that survived insecticide exposures. CONCLUSION: The study found out that there is a common use of pyrethroids in farms, Livestocks as well as in public health. The study also reports high phenotypic resistance among An. gambiae s.l against most of the pyrethroids tested. The preponderance of pyrethroids in agriculture is of public health concern because this is the class of insecticides widely used in vector control programs and this calls for combined integrated pest and vector management (IPVM).


Asunto(s)
Agricultura/estadística & datos numéricos , Enfermedades Endémicas/prevención & control , Resistencia a los Insecticidas , Insecticidas/farmacología , Malaria/prevención & control , Mosquitos Vectores/efectos de los fármacos , Animales , Anopheles/efectos de los fármacos , Agricultores/estadística & datos numéricos , Humanos , Larva/efectos de los fármacos , Malaria/epidemiología , Tanzanía/epidemiología
13.
Hum Genet ; 138(11-12): 1341-1357, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31667592

RESUMEN

Recent research efforts to identify genes involved in malaria susceptibility using genome-wide approaches have focused on severe malaria. Here, we present the first GWAS on non-severe malaria designed to identify genetic variants involved in innate immunity or innate resistance mechanisms. Our study was performed on two cohorts of infants from southern Benin (525 and 250 individuals used as discovery and replication cohorts, respectively) closely followed from birth to 18-24 months of age, with an assessment of a space- and time-dependent environmental risk of exposure. Both the recurrence of mild malaria attacks and the recurrence of malaria infections as a whole (symptomatic and asymptomatic) were considered. Post-GWAS functional analyses were performed using positional, eQTL, and chromatin interaction mapping to identify the genes underlying association signals. Our study highlights a role of PTPRT, a tyrosine phosphatase receptor involved in STAT3 pathway, in the protection against both mild malaria attacks and malaria infections (p = 9.70 × 10-8 and p = 1.78 × 10-7, respectively, in the discovery cohort). Strong statistical support was also found for a role of MYLK4 (meta-analysis, p = 5.29 × 10-8 with malaria attacks), and for several other genes, whose biological functions are relevant in malaria infection. Results shows that GWAS on non-severe malaria can successfully identify new candidate genes and inform physiological mechanisms underlying natural protection against malaria.


Asunto(s)
Proteínas Portadoras/genética , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Malaria/epidemiología , Malaria/genética , Sitios de Carácter Cuantitativo , Benin/epidemiología , Preescolar , Estudios de Cohortes , Femenino , Genotipo , Humanos , Lactante , Recién Nacido , Malaria/parasitología , Masculino
14.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 543-545, 2019 Jan 05.
Artículo en Chino | MEDLINE | ID: mdl-31713391

RESUMEN

OBJECTIVE: To understand the laboratory technicians' abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination. METHODS: Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed. RESULTS: A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians' ability to the mixed infections was significantly lower than the ability to the others (χ2 = 37.169, P < 0.05), however, in the laboratory technicians' abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ2 = 2.782, P > 0.05), and the prefecture, county and township levels (χ2 = 0.358, P > 0.05) . CONCLUSIONS: The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians' abilities in blood slide making and microscopic examination skills.


Asunto(s)
Técnicas y Procedimientos Diagnósticos , Erradicación de la Enfermedad , Malaria , China/epidemiología , Técnicas y Procedimientos Diagnósticos/normas , Erradicación de la Enfermedad/métodos , Humanos , Malaria/sangre , Malaria/diagnóstico , Malaria/epidemiología , Microscopía , Reproducibilidad de los Resultados
15.
BMC Infect Dis ; 19(1): 922, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666012

RESUMEN

BACKGROUND: In southern Papua, Indonesia, malaria is highly prevalent in young children and is a significant cause of morbidity and early mortality. The association between malaria and delayed mortality is unknown. METHODS: Routinely-collected hospital surveillance data from southern Papua, Indonesia, were used to assess the risk of recurrent malaria and mortality within 12 months of an initial presentation with malaria in all children younger than 5 years old attending the local hospital. Analysis was primarily by Kaplan Meier and Cox regression methods. RESULTS: In total 15,716 children presenting with malaria between April 2004 and December 2013 were included in the analysis; 6184 (39.3%) with Plasmodium falciparum, 7499 (47.7%) with P. vivax, 203 (1.3%) with P. malariae, 3 with P. ovale and 1827 (11.6%) with mixed infections. Within 1 year, 48.4% (7620/15,716) of children represented a total of 16,957 times with malaria (range 1 to 11 episodes), with the incidence of malaria being greater in patients initially presenting with P. vivax infection (1334 [95%CI 1307-1361] per 1000 patient years) compared to those with P. falciparum infection (920 [896-944]). In total 266 (1.7%) children died within 1 year of their initial presentation, 129 (48.5%) within 30 days and 137 (51.5%) between 31 and 365 days. There was no significant difference in the mortality risk in patients infected with P. vivax versus P. falciparum either before 30 days (Hazard Ratio (HR) 1.02 [0.69,1.49]) or between 31 and 365 days (HR = 1.30 [0.90,1.88]). Children who died had a greater incidence of malaria, 2280 [95%CI 1946-2671] per 1000 patient years preceding their death, compared to 1141 [95%CI 1124-1158] per 1000 patient years in those surviving. CONCLUSIONS: Children under-5 years old with P. vivax malaria, are at significant risk of multiple representations with malaria and of dying within 1 year of their initial presentation. Preventing recurrent malaria must be a public health priority in this vulnerable population.


Asunto(s)
Malaria/mortalidad , Preescolar , Coinfección/epidemiología , Coinfección/mortalidad , Femenino , Hospitales/estadística & datos numéricos , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Malaria/epidemiología , Malaria Falciparum/epidemiología , Malaria Falciparum/mortalidad , Malaria Vivax/epidemiología , Malaria Vivax/mortalidad , Masculino , Morbilidad , Prevalencia
16.
BMC Infect Dis ; 19(1): 988, 2019 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-31752719

RESUMEN

BACKGROUND: Malaria and the human immunodeficiency virus (HIV) infection constitute public health problems in Cameroon including the South West Region (SWR). This study determined the prevalence of malaria parasites and haematological abnormalities in HIV positive patients in Limbe, Cameroon from April-July 2014. METHODS: The study was cross-sectional and involved 411 participants who were administered structured questionnaires to record socio-demographic and clinical data. Three hundred and nine (309) HIV positive patients and one hundred and two (102) HIV negative individuals were examined clinically and venous blood collected for malaria parasite detection, HIV infection diagnosis and full blood count analysis. RESULTS: Overall malaria parasite prevalence was 14.1% (58/411). This prevalence was significantly higher (P <  0.001) in the HIV negative participants (33.3%, 34/102) compared to the HIV positive patients (7.8%, 24/309). Amongst HIV positive participants, malaria parasite prevalence was significantly higher in female patients (P = 0.003), febrile patients (P <  0.001), anaemic patients (P = 0.015) and in patients who were not on antiretroviral treatment (ART) (P = 0.03) when compared with their respective counterparts. Among the HIV negative group, though not significant, malaria parasite prevalence was higher in females, febrile and anaemic patients when compared with their respective counterparts. Overall anaemia prevalence was 52.1% (214/309) and was significantly higher (P = 0.004) in HIV positive patients (56%, 173) than in HIV negative participants (40.2%, 41). Malaria/HIV co-infected patients had a significantly lower mean value of Hb (P = 0.002), RBC (P = 0.002) and Hct (P = 0.001) when compared with HIV-infected patients. CONCLUSION: HIV negative participants had a higher prevalence of malaria parasites than their HIV positive counterparts. Anaemia prevalence was higher in HIV positive patients than in HIV negative participants. Malaria/HIV co-infected patients presented with more red blood cell abnormalities than HIV-infected patients.


Asunto(s)
Coinfección/epidemiología , Infecciones por VIH/epidemiología , Malaria/epidemiología , Plasmodium/aislamiento & purificación , Adolescente , Adulto , Anciano , Animales , Antirretrovirales/administración & dosificación , Camerún/epidemiología , Niño , Preescolar , Coinfección/parasitología , Coinfección/virología , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Hospitales/estadística & datos numéricos , Humanos , Lactante , Malaria/parasitología , Masculino , Persona de Mediana Edad , Plasmodium/clasificación , Plasmodium/genética , Prevalencia , Adulto Joven
17.
Afr J Reprod Health ; 23(3): 30-41, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31782629

RESUMEN

Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention. Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156-4.174], p=.016); within 7 days (OR=1.972, 95% CI: [1.102-3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082-4.172], p=.029) among reproductive health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038- 3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060-3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192-3.366], p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand washing, prevention of malaria.


Asunto(s)
Servicios de Salud Materna/estadística & datos numéricos , Atención Posnatal/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , República Democrática del Congo/epidemiología , Femenino , Fiebre/epidemiología , Encuestas de Atención de la Salud , Humanos , Malaria/epidemiología , Matrimonio , Persona de Mediana Edad , Hemorragia Posparto/epidemiología , Periodo Posparto , Embarazo , Atención Prenatal/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
18.
BMC Public Health ; 19(1): 1318, 2019 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-31638928

RESUMEN

BACKGROUND: Integrated vector management (IVM) remains a key strategy in the fight against vector-borne diseases including malaria. However, impacts of the strategy should be regularly monitored based on feedback obtained through research. The objective of this study was to assess the impact of IVM for malaria control in Botor-Tolay district, southwestern Ethiopia after three years (2016-2018) of IVM implementation. METHOD: Prior to the implementation of IVM, a survey of socio-demographic, malaria burden, and communities' perception towards malaria control was conducted in 200 households selected at random from 12 villages using standard questionnaire. Households were revisited after three years of project implementation for impact assessment. Compiled malaria case data was obtained from district health bureau for the three years period of the study while adult mosquito collection was conducted during each year using CDC light traps. Monthly larval mosquito collections were made each year using standard dipping method. Community education and mobilization (CEM) was made through different community-based structures. RESULTS: The proportion of respondents who sought treatment in health facilities showed a significant increase from 76% in 2015 to 90% in 2018(P < 0.001). An average of 6.3 working and 2.3 school days were lost per year in a household due to parents and children falling sick with malaria. Malaria costs in a household in Botor-Tolay averaged 13.3 and 4.5 USD per episode for medical treatment and transportation respectively. Significantly fewer adult mosquitoes were collected in 2018 (0.37/house/trap-night) as compared to 2015 (0.73/house/trap-night) (P < .001). Malaria cases significantly declined in 2018 (262) when compared to the record in 2015 (1162) (P < 0.001). Despite improved human behavioral changes towards mosquito and malaria control, there were many setbacks too. These include reluctance to seek treatment in a timely manner, low user compliance of LLINs and low net repairing habit. CONCLUSION: The coordinated implementation of community-based education, environmental management, larviciding together with main core vector control interventions in Botor-Tolay district in Southwestern Ethiopia have contributed to significant decline in malaria cases reported from health facilities. However, commitment to seeking treatment by people with clinical symptoms of malaria and to repair of damaged mosquito nets remained low.


Asunto(s)
Participación de la Comunidad , Malaria/prevención & control , Control de Mosquitos/métodos , Mosquitos Vectores , Adulto , Etiopía/epidemiología , Composición Familiar , Femenino , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Malaria/epidemiología , Masculino , Aceptación de la Atención de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios
19.
Parasit Vectors ; 12(1): 501, 2019 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-31655608

RESUMEN

Malaria still has a devastating impact on public health and welfare in Cameroon. Despite the increasing number of studies conducted on disease prevalence, transmission patterns or treatment, there are to date, not enough studies summarising findings from previous works in order to identify gaps in knowledge and areas of interest where further evidence is needed to drive malaria elimination efforts. The present study seeks to address these gaps by providing a review of studies conducted so far on malaria in Cameroon since the 1940s to date. Over 250 scientific publications were consulted for this purpose. Although there has been increased scale-up of vector control interventions which significantly reduced the morbidity and mortality to malaria across the country from a prevalence of 41% of the population reporting at least one malaria case episode in 2000 to a prevalence of 24% in 2017, the situation is not yet under control. There is a high variability in disease endemicity between epidemiological settings with prevalence of Plasmodium parasitaemia varying from 7 to 85% in children aged 6 months to 15 years after long-lasting insecticidal nets (LLINs) scale-up. Four species of Plasmodium have been recorded across the country: Plasmodium falciparum, P. malariae, P. ovale and P. vivax. Several primate-infecting Plasmodium spp. are also circulating in Cameroon. A decline of artemisinin-based combinations therapeutic efficacy from 97% in 2006 to 90% in 2016 have been reported. Several mutations in the P. falciparum chloroquine resistance (Pfcrt) and P. falciparum multidrug resistance 1 (Pfmdr1) genes conferring resistance to either 4-amino-quinoleine, mefloquine, halofanthrine and quinine have been documented. Mutations in the Pfdhfr and Pfdhps genes involved in sulfadoxine-pyrimethamine are also on the rise. No mutation associated with artemisinin resistance has been recorded. Sixteen anopheline species contribute to malaria parasite transmission with six recognized as major vectors: An. gambiae, An. coluzzii, An. arabiensis, An. funestus, An. nili and An. moucheti. Studies conducted so far, indicated rapid expansion of DDT, pyrethroid and carbamate resistance in An. gambiae, An. coluzzii, An. arabiensis and An. funestus threatening the performance of LLINs. This review highlights the complex situation of malaria in Cameroon and the need to urgently implement and reinforce integrated control strategies in different epidemiological settings, as part of the substantial efforts to consolidate gains and advance towards malaria elimination in the country.


Asunto(s)
Malaria/epidemiología , Malaria/prevención & control , Animales , Anopheles/clasificación , Anopheles/genética , Anopheles/parasitología , Camerún/epidemiología , Humanos , Resistencia a los Insecticidas , Malaria/terapia , Malaria/transmisión , Control de Mosquitos/tendencias , Mosquitos Vectores/clasificación , Mosquitos Vectores/genética , Mosquitos Vectores/parasitología , Plasmodium/clasificación , Plasmodium/patogenicidad , Prevalencia , Salud Pública
20.
Afr Health Sci ; 19(2): 1924-1929, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31656475

RESUMEN

Background: Neanatal comploications are the commonest problems facing babies in Tanzania. An attempt has been made to investigate determinants of neonatal outcomes among postnatal women. Methods: Using a case-contrrol study design, 165 women were selected from 3 health facilities, where they had had antenatal care (ANC), labour, delivery and post natal care. Results: Chi- square test revealed that gestational age (p-value, 0.01), HIV status (p-value, 0.000) and malaria (p-value, 0.001<0.05) were significantly associated with adverse neonatal outcomes. Conclusion: The study concluded that implementation of community-based intervention is needed to ensure survival of newborns.


Asunto(s)
Infecciones por VIH/epidemiología , Complicaciones del Embarazo/epidemiología , Mortinato/epidemiología , Adolescente , Adulto , Anemia/epidemiología , Estudios de Casos y Controles , Femenino , Edad Gestacional , Humanos , Lactante , Mortalidad Infantil , Transmisión Vertical de Enfermedad Infecciosa , Malaria/epidemiología , Edad Materna , Paridad , Atención Posnatal/organización & administración , Embarazo , Adulto Joven
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