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1.
Afr J Reprod Health ; 23(3): 30-41, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782629

RESUMO

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.


Assuntos
Serviços de Saúde Materna/estatística & dados numéricos , Cuidado Pós-Natal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , República Democrática do Congo/epidemiologia , Feminino , Febre/epidemiologia , Pesquisas sobre Serviços de Saúde , Humanos , Malária/epidemiologia , Casamento , Pessoa de Meia-Idade , Hemorragia Pós-Parto/epidemiologia , Período Pós-Parto , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
2.
BMC Infect Dis ; 19(1): 988, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752719

RESUMO

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.


Assuntos
Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Malária/epidemiologia , Plasmodium/isolamento & purificação , Adolescente , Adulto , Idoso , Animais , Antirretrovirais/administração & dosagem , Camarões/epidemiologia , Criança , Pré-Escolar , Coinfecção/parasitologia , Coinfecção/virologia , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Hospitais/estatística & dados numéricos , Humanos , Lactente , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium/classificação , Plasmodium/genética , Prevalência , Adulto Jovem
3.
BMC Infect Dis ; 19(1): 922, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666012

RESUMO

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.


Assuntos
Malária/mortalidade , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/mortalidade , Feminino , Hospitais/estatística & dados numéricos , Humanos , Incidência , Indonésia/epidemiologia , Lactente , Malária/epidemiologia , Malária Falciparum/epidemiologia , Malária Falciparum/mortalidade , Malária Vivax/epidemiologia , Malária Vivax/mortalidade , Masculino , Morbidade , Prevalência
4.
Hum Genet ; 138(11-12): 1341-1357, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31667592

RESUMO

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.


Assuntos
Proteínas de Transporte/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Malária/epidemiologia , Malária/genética , Locos de Características Quantitativas , Benin/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Malária/parasitologia , Masculino
5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 543-545, 2019 Jan 05.
Artigo em Chinês | MEDLINE | ID: mdl-31713391

RESUMO

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.


Assuntos
Técnicas e Procedimentos Diagnósticos , Erradicação de Doenças , Malária , China/epidemiologia , Técnicas e Procedimentos Diagnósticos/normas , Erradicação de Doenças/métodos , Humanos , Malária/sangue , Malária/diagnóstico , Malária/epidemiologia , Microscopia , Reprodutibilidade dos Testes
6.
BMC Public Health ; 19(1): 1456, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694595

RESUMO

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).


Assuntos
Agricultura/estatística & dados numéricos , Doenças Endêmicas/prevenção & controle , Resistência a Inseticidas , Inseticidas/farmacologia , Malária/prevenção & controle , Mosquitos Vetores/efeitos dos fármacos , Animais , Anopheles/efeitos dos fármacos , Fazendeiros/estatística & dados numéricos , Humanos , Larva/efeitos dos fármacos , Malária/epidemiologia , Tanzânia/epidemiologia
7.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 353-355, 2019 Sep 24.
Artigo em Chinês | MEDLINE | ID: mdl-31612666

RESUMO

Following the concerted efforts for nearly 70 years, great achievements have been obtained in parasitic diseases control in China, and some important parasitic diseases have been eliminated or moving towards elimination in the country. With the socioeconomic development, the implementation of the "Road and Belt Initiative" and the increase in the international communication and overseas investment, there is a rise in the number of overseas labors, businessmen, students, travelers, visitors and participants in national and international communication activities, resulting in a gradual increase in the number of cases with parasitic diseases imported from endemic to non-endemic areas of China and from foreign countries to China. The increase in the number of imported cases causes new challenges for the elimination of parasitic diseases in China. The paper describes the current status of malaria, schistosomiasis and leishmaniasis, analyzes the challenges for the current control activities, and proposes the control strategies and interventions.


Assuntos
Leishmaniose , Malária , Esquistossomose , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Humanos , Leishmaniose/epidemiologia , Leishmaniose/prevenção & controle , Malária/epidemiologia , Malária/prevenção & controle , Fatores de Risco , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle
8.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 414-417, 2019 Sep 26.
Artigo em Chinês | MEDLINE | ID: mdl-31612678

RESUMO

OBJECTIVE: To explore the spatial-temporal distribution of malaria in Jiangxi Province from 1950 to 2017, so as to provide scientific evidence for developing the malaria elimination strategy. METHODS: The epidemic situation of malaria, demographic data, historical species of malaria parasites and transmission vectors were collected from each county of Jiangxi Province from 1950 to 2017 to create a geographic information system database of malaria in Jiangxi Province. The software ArcGIS 10.3 was used to analyze the incidence of malaria and display the spatial-temporal distribution of malaria in Jiangxi Province, so as to explore the spatial-temporal patterns of malaria in the province. RESULTS: From 1950 to 2017, the prevalence of malaria was classified into 3 stages in Jiangxi Province, including the peak period (from 1950 to 1975), the continuous decline period (from 1976 to 1997), and the low-level fluctuation period (from 1998 to 2017). During the period from 1950 through 2017, the incidence of malaria declined, the epidemic area of malaria shrank, and the intensity of malaria transmission gradually reduced to no local infections in Jiangxi Province. The spatial distribution of epidemic areas of malaria shifted from southern mountainous areas to northern plain areas, and finally aggregated, retained and disappeared in plain areas. The species of malaria parasites shifted from a co-endemic area for Plasmodium vivax, P. falciparum and P. malariae to a single endemic area for P. vivax, and finally a co-endemic area for imported P. vivax, P. falciparum, P. malariae and P. ovale. The transmission vectors shifted from multiple vectors of Anopheles sinensis, An. minimus, An. anthropophagus and others to a single vector of An. sinensis. CONCLUSIONS: There are no local malaria cases for successive 6 years since 2012, and the transmission of malaria has been interrupted in Jiangxi Province, in which the criteria for malaria elimination have been achieved. However, the risk of malaria transmission secondary to imported malaria will emerge in Jiangxi Province for a long period of time.


Assuntos
Anopheles , Malária , Animais , China/epidemiologia , Erradicação de Doenças , Malária/epidemiologia , Malária/parasitologia , Malária/transmissão , Mosquitos Vetores/parasitologia , Plasmodium/fisiologia , Prevalência , Fatores de Risco
9.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(4): 436-438, 2019 Jul 22.
Artigo em Chinês | MEDLINE | ID: mdl-31612684

RESUMO

OBJECTIVE: To analyze the epidemiological characteristics of reported malaria cases in Leshan City, so as to provide insights into malaria control. METHODS: The data pertaining to malaria cases and epidemiological individual information in Leshan City from 2012 to 2018 were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and a descriptive epidemiological analysis was performed. RESULTS: A total of 34 malaria cases were reported in Leshan City from 2012 to 2018, and all cases were confirmed as imported malaria cases by Sichuan provincial malaria diagnosis reference laboratory. Of all 34 cases, there were 14 vivax malaria cases, 18 falciparum malaria cases, a malariae malaria case and an ovale malaria case. The sites where malaria parasite infections occurred mainly included African areas (accounting for 58.82%) and Southeastern Asian areas (accounting for 29.41%), and the malaria cases were mainly reported in January, February, June and July, which accounted for 65.63% of all cases. The cases included 33 men and a woman, and had ages of 21 to 59 years. The cases'occupations mainly involved overseas peasants, technical workers and businessmen. The duration from onset of malaria to diagnosis ranged from 0 to 31 days, and the percentage of definitive diagnosis was 85.29% at initial diagnosis. CONCLUSIONS: There are no local malaria cases in Leshan City; however, imported malaria cases are reported. The monitoring, management and health education of overseas returners should be further strengthened and malaria training should be improved to enhance the diagnostic and treatment capability in professionals, so as to consolidate malaria control achievements.


Assuntos
Malária , Adulto , África , Ásia Sudeste , China/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Feminino , Humanos , Malária/epidemiologia , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de Risco , Adulto Jovem
10.
BMC Public Health ; 19(1): 1294, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615478

RESUMO

BACKGROUND: The hematological changes following the initial drug regimen has been poorly understood in Thailand. This study was designed to determine the prevalence of malaria parasite recurrence and hematological alteration of patients during the initial drug regimen. METHODS: A retrospective study was conducted at Phop Phra Hospital, Tak Province, located in northwestern Thailand. All data from patients who were diagnosed with Plasmodium spp. infection - including types of Plasmodium spp., clinical characteristics, and hematological parameters - were retrieved and analyzed. RESULTS: The results demonstrated that during years 2012-2018, 95 out of 971 patients (9.78%) were infected with malaria two or more times. The gender, nationality, symptom of headache, type of Plasmodium spp., and career of each patient were associated with recurrence (P-value< 0.05). Among patients treated with malarial drug, the leukocyte count and red cell distribution width (RDW) were significantly changed when compared to untreated patients with recurrence (P-value< 0.05). CONCLUSION: This study indicated the high prevalence of malarial recurrence in Tak Province, Western Thailand, and its relationship to certain characteristics of individuals. Patients who were treated with antimalarial drugs exhibited leukocyte and RDW changes following the initial drug regimen. This data could be useful for prompt detection, treatment, and prevention of malarial recurrence in endemic areas of Thailand.


Assuntos
Antimaláricos/uso terapêutico , Índices de Eritrócitos/efeitos dos fármacos , Leucócitos/efeitos dos fármacos , Malária/tratamento farmacológico , Malária/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Recidiva , Estudos Retrospectivos , Tailândia/epidemiologia , Resultado do Tratamento , Adulto Jovem
11.
Afr Health Sci ; 19(2): 1924-1929, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656475

RESUMO

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.


Assuntos
Infecções por HIV/epidemiologia , Complicações na Gravidez/epidemiologia , Natimorto/epidemiologia , Adolescente , Adulto , Anemia/epidemiologia , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Lactente , Mortalidade Infantil , Transmissão Vertical de Doença Infecciosa , Malária/epidemiologia , Idade Materna , Paridade , Cuidado Pós-Natal/organização & administração , Gravidez , Adulto Jovem
12.
Afr Health Sci ; 19(2): 1910-1923, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656474

RESUMO

Background: There is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities. Objective: To assess the patterns of presentations, services offered and predictors of a prolonged stay at the Children Emergency Room of a tertiary hospital in Southern Nigeria. Methods: This prospective cross-sectional, study was conducted at the University of Calabar Teaching Hospital, Nigeria from 1st January-31st December 2014. Socio-demographic and clinical characteristics of consecutively recruited children (n=633) were recorded in a proforma. Binary logistic regression was conducted to determine predictors of prolonged stay (>72 hours). Result: The median age of participants was 2 (1 - 4.6) years. Three-fifths of children were admitted at off-hours and the commonest symptom was fever (73.9%). About 16.4% (95%CI:13.6% - 19.4%, n= 103/633) of the children had prolonged stay while those with sepsis had the longest mean stay (65.5±72.1 hours). Children admitted on account of Sickle cell disease (OR:11.2, 95%CI:1.3-95.1, P-value = 0.03), Malaria (OR:10.7, 95%CI:1.4-82.5, P-value = 0.02) or sepsis (OR:10.5, 95%CI:1.3 - 82.7, P-value = 0.03) had higher odds of prolonged hospital stay. There was no significant difference in hospital stay among children admitted by the consultant as compared to other health personnel (P-value = 0.08). Conclusion: Prevention and proper management of Sickle cell disease and malaria reduces paediatric hospital stay in our environment. Paediatric emergency medicine should be re-organized to cater for high volume of off-hour admissions.


Assuntos
Emergências/epidemiologia , Hospitais de Ensino/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Anemia Falciforme/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Febre/epidemiologia , Mortalidade Hospitalar , Humanos , Lactente , Malária/epidemiologia , Masculino , Nigéria/epidemiologia , Estudos Prospectivos , Sepse/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo
14.
BMC Public Health ; 19(1): 1318, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638928

RESUMO

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.


Assuntos
Participação da Comunidade , Malária/prevenção & controle , Controle de Mosquitos/métodos , Mosquitos Vetores , Adulto , Etiópia/epidemiologia , Características da Família , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/epidemiologia , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
15.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 315-318, 2019 Jul 29.
Artigo em Chinês | MEDLINE | ID: mdl-31544416

RESUMO

OBJECTIVE: To analyze the epidemic situation of malaria and explore the targeted control strategy in Guangxi from 2011 to 2018. METHODS: The malaria surveillance data were collected in Guangxi Zhuang Autonomous Region from 2011 to 2018, and a descriptive method was employed to analyze the epidemiological features of the malaria cases. RESULTS: A total of 2 944 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2011 to 2018, including a case with local infection (0.03%) and 2 943 imported cases (99.97%). There were 2 933 cases (99.63%) positive for Plasmodium confirmed by laboratory testing, including 2 166 cases (73.86%) with P. falciparum malaria, 388 cases (13.23%) with P. ovale malaria, 276 cases (9.41%) with P. vivax malaria, 40 cases (1.36%) with P. malariae malaria and 62 cases (2.11%) with mixed infections, and 11 clinically diagnosed cases (0.37%). The malaria cases were distributed in 91 counties (districts) of 14 cities in Guangxi, with the largest number of cases found in Nanning City (2 515 cases, 85.43%). The malaria cases were originated from 29 countries in Africa (94.67%), 7 countries in Southeast Asia (5.10%), one country in South America (0.07%), 2 countries in South Asia and China (0.10%). In African countries, most malaria cases were from Ghana (1 947 cases, 66.13%), and in Southeast Asian countries, most cases were from Myanmar (75 cases, 2.55%). Most malaria cases were young men, and 2 899 cases (98.13%) were male, while 2 583 cases (87.74%) were at ages of 20 to 49 years. Gold washing and mining was the predominant occupation (2 561 cases, 86.99%), and the malaria cases were reported in each month across the year, with the largest number of cases detected in June (665 cases, 22.59%), while no season-specific distribution was found. There were 1 431 cases (48.61%) reported by disease control and prevention institutions, 1 511 cases (51.30%) reported by medical institutions, and 2 cases (0.07%) reported by inspection and quarantine institutions. During the period from 2011 to 2018, there were 6 deaths of imported malaria cases in Guangxi, and no secondary cases were reported. CONCLUSIONS: The epidemic situation of local malaria has been effectively controlled in Guangxi; however, there is a great challenge for the management of overseas imported malaria. Strengthening the monitoring and management of migrant labors is the key to consolidate the achievements of malaria elimination.


Assuntos
Malária , Adulto , China/epidemiologia , Feminino , Humanos , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/parasitologia , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Plasmodium , Adulto Jovem
16.
Genes (Basel) ; 10(9)2019 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505774

RESUMO

The emergence and spread of drug resistance is a problem hindering malaria elimination in Southeast Asia. In this study, genetic variations in drug resistance markers of Plasmodium falciparum were determined in parasites from asymptomatic populations located in three geographically dispersed townships of Myanmar by PCR and sequencing. Mutations in dihydrofolate reductase (pfdhfr), dihydropteroate synthase (pfdhps), chloroquine resistance transporter (pfcrt), multidrug resistance protein 1 (pfmdr1), multidrug resistance-associated protein 1 (pfmrp1), and Kelch protein 13 (k13) were present in 92.3%, 97.6%, 84.0%, 98.8%, and 68.3% of the parasites, respectively. The pfcrt K76T, pfmdr1 N86Y, pfmdr1 I185K, and pfmrp1 I876V mutations were present in 82.7%, 2.5%, 87.5%, and 59.8% isolates, respectively. The most prevalent haplotypes for pfdhfr, pfdhps, pfcrt and pfmdr1 were 51I/59R/108N/164L, 436A/437G/540E/581A, 74I/75E/76T/220S/271E/326N/356T/371I, and 86N/130E/184Y/185K/1225V, respectively. In addition, 57 isolates had three different point mutations (K191T, F446I, and P574L) and three types of N-terminal insertions (N, NN, NNN) in the k13 gene. In total, 43 distinct haplotypes potentially associated with multidrug resistance were identified. These findings demonstrate a high prevalence of multidrug-resistant P. falciparum in asymptomatic infections from diverse townships in Myanmar, emphasizing the importance of targeting asymptomatic infections to prevent the spread of drug-resistant P. falciparum.


Assuntos
Antimaláricos/farmacologia , Resistência a Múltiplos Medicamentos , Malária/parasitologia , Plasmodium falciparum/genética , Polimorfismo Genético , Di-Hidropteroato Sintase/genética , Humanos , Malária/epidemiologia , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Mianmar , Plasmodium falciparum/efeitos dos fármacos , Plasmodium falciparum/patogenicidade , Proteínas de Protozoários/genética , Tetra-Hidrofolato Desidrogenase/genética
17.
Malar J ; 18(1): 309, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31514740

RESUMO

BACKGROUND: Intensive malaria transmission along international borders is a significant impediment to malaria elimination in the Greater Mekong Subregion (GMS) of Southeast Asia. Passive case detection (PCD) was used to study the dynamics and trends of malaria transmission at the China-Myanmar border to provide epidemiologic information for improved malaria control. METHODS: PCD was conducted in one hospital and 12 clinics near the Laiza town in northeast Myanmar from 2011 to 2016. Clinical malaria was diagnosed by microscopy and demographic information was captured using a structured questionnaire at the time of the patient's presentation for care. RESULTS: Over the study period, 6175 (19.7%) malaria cases were confirmed by microscopy from 31,326 suspected cases. The four human malaria parasite species were all identified, with Plasmodium vivax and Plasmodium falciparum accounting for 5607 (90.8%) and 481 (7.8%) of the confirmed cases, respectively. In contrast to the steady decline of malaria in the general GMS, the study site had an upward trend of malaria incidence with vivax malaria outbreaks in 2013 and 2016. Adult males, children under the age of 15, and those with occupations such as farming, being a soldier or student, had significantly higher risks of clinical malaria compared to having fevers from other aetiologies. A self-reported history of clinical malaria was also associated with a higher risk of confirmed malaria. CONCLUSIONS: The China-Myanmar border area has experienced an overall upward trend of malaria incidence in recent years with P. vivax becoming the predominant species. Evidence-based control strategies need to focus on high-risk populations.


Assuntos
Malária/epidemiologia , Plasmodium/isolamento & purificação , Fatores Socioeconômicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Malária/diagnóstico , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia , Plasmodium/classificação , Adulto Jovem
19.
Korean J Parasitol ; 57(4): 329-339, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31533400

RESUMO

Indonesia and South Korea have become inseparable in various respects since the 2 countries established diplomatic relation in 1973. Indonesia is a tropical region that stretches across the equator, comprised of 5 main islands (Java, Kalimantan, Sumatra, Sulawesi, and Papua) and 4 archipelagoes (Riau, Bangka Belitung, Nusa Tenggara, and Maluku). As most population of Eastern Indonesia (Sulawesi, Papua and Nusa Tenggara & Maluku) live in poor areas, it is expected that there will be many parasites. Nevertheless, little is known about the status of parasites in Indonesia. This study examines the prevalences of malaria and lymphatic filaria, which are prevalent in Indonesia, as well as those of soil-transmitted-helminths (STH). As a result, the Plasmodium falciparum and P. vivax case loads are almost equal. The current prevalence of P. vivax is uniformly low (<5%) in all age groups and annual parasite incidence (API) showed decreasing tendency as 0.84 per 1,000 population in 2016. However, more than 65 million people still live in malaria epidemic regions. Lymphatic filariasis remains an important public health problem and 236 cities were classified as endemic areas in 514 cities/districts in 2017. It is difficult to ascertain the current prevalence rate of STH in Indonesia, although West Sumba and Southwest Sumba in East Nusa Tenggara reported prevalence rate of more than 20%. The study also considers the (sero) prevalences of other parasites identified in Indonesia. This report should be useful not only to parasitologists but also to travelers and people with business in Indonesia.


Assuntos
Doenças Parasitárias/epidemiologia , Filariose Linfática/epidemiologia , Helmintíase/epidemiologia , Helmintíase/transmissão , Indonésia/epidemiologia , Malária/epidemiologia , Doenças Parasitárias/transmissão , Prevalência , Esquistossomose Japônica/epidemiologia , Solo/parasitologia , Teníase/epidemiologia
20.
Malar J ; 18(1): 318, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533845

RESUMO

BACKGROUND: Intermittent preventive treatment (IPT) of malaria is recommended as policy for certain high-risk populations, but not currently for schoolchildren. A cluster-randomized trial was conducted to evaluate the effect of IPT with dihydroartemisinin-piperaquine (DP) on primary schoolchildren in Jinja, Uganda. Results of the impact of IPT of schoolchildren on community-level transmission have been reported previously. Here, secondary outcomes from a school-based survey are presented. METHODS: Eighty-four clusters (one primary school plus 100 households) were randomized to intervention and control (1:1 ratio). Participants from intervention schools received monthly IPT with DP for up to 6 rounds (June-December 2014). At endline (November-December 2014), randomly selected children from all 84 schools were surveyed (13 per school) and thick blood smears were done. Those with fever or history of fever were tested with rapid diagnostic tests (RDTs) for malaria. Haemoglobin was measured in every fifth participant. Outcome measures included prevalence of asexual parasites and gametocytes (by microscopy), and prevalence of anaemia. Prevalence outcomes were analysed using generalized linear Poisson models with log link function, incorporating a cluster-level random intercept and quantified using prevalence risk ratios. RESULTS: Among 23,280 students listed on the 42 intervention school registers, 10,079 (43.3%) aged 5-20 years were enrolled into the IPT intervention and received at least one dose of DP; of these, 9286 (92.1%) received at least one full (3-day) course. In total, 1092 children were enrolled into the final school survey (546 per arm) and had a thick blood smear done; of these, 255 had haemoglobin measured (129 intervention, 126 control). Children in the intervention arm were less likely to have asexual parasites (9.2% intervention vs 44.1% control, adjusted risk ratio [aRR] 0.22 [95% CI 0.16-0.30] p < 0.001), gametocytes (3.1% intervention vs 9.5% control, aRR 0.34 [95% CI 0.20-0.56] p < 0.001), fever (20.2% intervention vs 56.2% control, aRR 0.35 [95% CI 0.25-0.50] p < 0.001), or symptomatic malaria (5.1% intervention vs 35.7% control, aRR 0.14 [95% CI 0.08-0.26] p < 0.001). Prevalence of anaemia and mean haemoglobin were similar in both study arms. CONCLUSIONS: School-aged children are a major reservoir of malaria parasites. Delivering IPT to schoolchildren would benefit individual children and may reduce transmission. School-based IPT could help to intensify malaria control toward elimination, and should be considered for policies and programmes. Trial registration Clinicaltrials.gov (NCT02009215), Registered 11 December 2013. https://clinicaltrials.gov/ct2/show/NCT02009215.


Assuntos
Anemia/epidemiologia , Antimaláricos/uso terapêutico , Artemisininas/uso terapêutico , Malária/prevenção & controle , Quinolinas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Análise por Conglomerados , Combinação de Medicamentos , Feminino , Humanos , Malária/epidemiologia , Masculino , Prevalência , Estudantes , Uganda/epidemiologia
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