Evolution of Malaria Incidence in Five Health Districts, in the Context of the Scaling Up of Seasonal Malaria Chemoprevention, 2016 to 2018, in Mali.

CONTEXT: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation. METHODS: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors. RESULTS: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative humidity, rainfall, and minimum temperature components. The average monthly incidence and the relative humidity varied according to the health district, and the average temperature and rainfall were similar. A decrease in incidence was observed in children under five years old in 2017 and 2018 compared to 2016. CONCLUSION: A decrease in the incidence of malaria was observed after the SMC rounds. SMC should be applied at optimal periods.

[Study on the clinical and epidemiological characteristics of the first 1030 cases of covid-19 in Mali]. / Etude sur les caracteristiques cliniques et epidemiologiques des 1030 premiers cas de covid-19 au Mali.

AIMS: Since the confirmation of the first cases of COVID-19 in Mali in March 2020 and the outbreakspreading to the whole country, clinical and epidemiological data fromaffected patients are used to characterize the disease. This study was to describe the clinica lsigns and epidemiologicalparameters of COVID-19 in the Malian context. MATERIALS AND METHODS: This is a cross-sectional study. All confirmed cases of COVID-19 in Mali between March 25, 2020 to May 24, 2020 have been included. Clinical and epidemiological data from patients with COVID-19 were extracted from the official line list of cases and the national reference laboratory register. RESULTS: The mean age of the 1,030 patients was 45.6 ± 18.4 years; 67.2% of patients were men. Asymptomatic patients accounted for 31.1%. The most common symptoms on admission were cough (60.8%) followed by fever (47.6%). The largest number of cases was recorded in Bamako. CONCLUSION: SARS-CoV-2 infection of the first 1,030 cases in Mali was marked by the predominance of cough and fever.

BUTS: Depuis la confirmation des premiers cas de COVID-19 au Mali en Mars 2020 et sa propagation à tout le pays, des données cliniques et épidémiologiques des patients atteints sont utilisées pour caractériser la maladie. Cette étude avait pour objectif d'étudier les signes cliniques et épidémiologiques de la COVID-19 dans le contexte malien. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude transversale. Tous les cas confirmés de COVID-19 du Mali entre le 25 Mars 2020 au 24 Mai 2020 ont été inclus. Les données cliniques et épidémiologiques des patients atteints de COVID-19ont été extraites. RÉSULTATS: L'âge moyen descas était de 45,6±18,4 ans ; 67,2% des patients étaient des hommes. Les patients asymptomatiques représentaient 31,1%. Les symptômes les plus courants à l'admission étaient la toux (60,8%) suivi de la fièvre (47,6%). Le plus grand nombre de cas a été enregistré à Bamako. CONCLUSION: L'infection par le SARS-CoV-2 des 1 030 premiers cas au Mali a été marquée par la prédominance de la toux et de la fièvre.

Factors Associated with Intermittent Preventive Treatment of Malaria During Pregnancy in Mali.

Intermittent preventive treatment in pregnancy (IPTp) with 3 or more doses of sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization to prevent malaria in pregnant women living in high-risk areas. According to the 2015 malaria indicator survey in Mali, malaria prevalence is 34.6%. The high risk of malaria among pregnant women and children led the Malian government to provide free SP during antenatal clinics visits. The Malian National Program of Malaria Control recommends at least 3 doses during pregnancy. The proportion of pregnant women taking 3 or more doses of IPTp-SP (IPTp 3+) still remains low. In Mali, only 36.7% of pregnant women with a live birth in the past 2 yr received IPTp 3+. To investigate the factors associated with this low coverage, we carried out a secondary data analysis using the database of the Mali 2015 Malaria Indicator Survey. Multiple logistic regression was used to analyze these factors among 2,382 interviewed women. Taking less than 3 doses was higher among women below 20 yr (adjusted odds ratio [AOR] = 1.43, 95% confidence interval [CI, 1.03; 1.98]); however, media accessibility (listening to radio) (AOR = 0.71, 95% CI [0.53-0.95]) and residing in Segou (AOR = 0.56, 95% CI [0.35-0.90]) seem to favor the opposite after adjusting the potential confusion. Residence, educational level, and wealth index were not statistically associated with taking 3 doses of IPTp-SP. This study identifies that women less than 20 yr of age were significantly associated with taking lower than 3 doses of IPTp-SP.

Discrepant prevalence and incidence of Leishmania infection between two neighboring villages in Central Mali based on Leishmanin skin test surveys.

UNLABELLED: Apart from a single report, the last publication of cutaneous leishmaniasis (CL) in Mali dates back more than 20 years. The absence of information on the current status of CL in Mali led us to conduct a cohort study in Kemena and Sougoula, two villages in Central Mali from which cases of CL have been recently diagnosed by Mali's reference dermatology center in Bamako. In May 2006, we determined the baseline prevalence of Leishmania infection in the two villages using the leishmanin skin test (LST). LST-negative individuals were then re-tested over two consecutive years to estimate the annual incidence of Leishmania infection. The prevalence of Leishmania infection was significantly higher in Kemena than in Sougoula (45.4% vs. 19.9%; OR: 3.36, CI: 2.66-4.18). The annual incidence of Leishmania infection was also significantly higher in Kemena (18.5% and 17% for 2007 and 2008, respectively) than in Sougoula (5.7% for both years). These data demonstrate that the risk of Leishmania infection was stable in both villages and confirm the initial observation of a significantly higher risk of infection in Kemena (OR: 3.78; CI: 2.45-6.18 in 2007; and OR: 3.36; CI: 1.95-5.8 in 2008; P<0.005). The absence of spatial clustering of LST-positive individuals in both villages indicated that transmission may be occurring anywhere within the villages. Although Kemena and Sougoula are only 5 km apart and share epidemiologic characteristics such as stable transmission and random distribution of LST-positive individuals, they differ markedly in the prevalence and annual incidence of Leishmania infection. Here we establish ongoing transmission of Leishmania in Kemena and Sougoula, Central Mali, and are currently investigating the underlying factors that may be responsible for the discrepant infection rates we observed between them. TRIAL REGISTRATION: ClinicalTrials.gov NCT00344084.