scholarly journals Assessing the intrinsic and extrinsic drivers and targeting the observed resilience of malaria in northwestern and southern Tanzania: A protocol for a cross-sectional exploratory study

Author(s):  
Mercy G. Chiduo ◽  
Celine I. Mandara ◽  
Susan F. Rumisha ◽  
Frank Chaky ◽  
Filbert T. Francis ◽  
...  

ABSTRACTBackgroundDespite high coverage and successes in malaria control strategies, some areas of Tanzania have indicated stagnantion or revesal of malaria burden. In malaria research, most studies are designed to assess drivers of malaria transmission focusing only on one dimension, single location while very few studies assess multiple components and their interactions at once. This article describes the protocol used to assess intrinsic and extrinsic drivers of persistent malaria transmission (hotsposts) in four regions from northwestern (Geita and Kigoma) and southern (Ruvuma and Mtwara) Tanzania.MethodsThis cross-sectional study was conducted between July and November 2017 in eight districts (two from each region). Based on the health facilities records, two villages were selected from each district. The study assessed five components individually and their linkages: socio-economic and malaria risk factors, parasitological, entomological, socio-anthropological and health system factors. Households (HHs) and household members were enumerated, socio-economic status and risk factors associated with malaria transmission were assessed. A total of 120 HHs were sampled from each village where malaria testing using rapid test and microscopy were done and blood spots on filter papers for genetic studies were collected. Heads of HHs were interviewed to capture information on knowledge, attitude, practice and beliefs towards malaria and its control. Assessment of adult mosquitoes in 25 HHs in each village and complimented with assessment of immature mosquitoes through larvae was conducted. The performance of the health system was assessed with respect to Information on availability, accessibility, affordability and quality of malaria prevention and case management services were collected from these health facilities.DiscussionThe proposed analysis plan and results from this study are expected to determine factors potentially responsible for persistence of malaria (hotspots) in the study areas. Rather than the traditional methodology of focusing on one metric, the approach proposed here triangulates observations from all five components, highlighting understanding of potential drivers while studying their complex interactions and map spatial heterogeneity. This study will provide an important framework and data which will guide future studies and malaria surveillance in Tanzania and other malaria endemic countries.

Author(s):  
Mercy G Chiduo ◽  
Celine I. Mandara ◽  
Susan F. Rumisha ◽  
Frank Chaky ◽  
Filbert T. Francis ◽  
...  

Abstract Background Despite high coverage and successes in malaria control strategies, some areas of Tanzania have indicated stagnantion or revesal of malaria burden. In malaria research, most studies are designed to assess drivers of malaria transmission focusing only on one dimension, single location while very few studies assess multiple components and their interactions. This article describes the protocol used to assess intrinsic and extrinsic drivers of persistent malaria transmission (hotsposts) in four regions from northwestern (Geita and Kigoma) and southern (Ruvuma and Mtwara) Tanzania.Results: Preliminary results show that 6,297 HHs and 28,361 individuals with median age of 16yrs (IQR= 7-35yrs) were registered from the 16 villages. Over 49% of individuals used bed-nets in the previous night before the survey and 43.9% of HHs had bed-nets covering two members per household. For parasitological survey, 25.8% of registered individuals (n=7,313) were selected from 2,527 HHs (40.1%) and invited for assessment and sampling. The positivity rate (PR) by mRDTs was 33.3% (range = 21.9% to 41.1%); while by microscopy, the PR was 20.6% and varied from 8.0% to 29.0%. Socio-anthropology interviews were conducted with a total of 1,687 heads/representatives of HHs. For qualitative surveys 32 Focus group discussion (two from each village) and 16 key informant interviews (two per district) were conducted. Thirty-one health facilities were visited for health system survey; 19.4% (n=6) were hospitals; 41.9% (n=13) health centres and 38.7% (n=12) dispensaries. For entomological survey, 8,891 adult mosquitoes were collected, whereby Anopheles gambiae complex, An. funestus group and other mosquitoes accounted for 12.0%, 49.7% and 38.3%, respectively.Conclusion: An analysis plan using data from the five components surveyed has been proposed and results from this study are expected to determine factors potentially responsible for persistence of malaria (hotspots) in the study areas. Rather than the traditional methodology of focusing on one metric, the approach will triangulate observations from all five components, highlighting understanding of potential drivers while studying their complex interactions and map spatial heterogeneity. This study will provide an important framework and data which will guide future studies and malaria surveillance in Tanzania and other malaria endemic countries.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mihretu Tarekegn ◽  
Habte Tekie ◽  
Sisay Dugassa ◽  
Yitbarek Wolde-Hawariat

Abstract Background Ethiopia embarked on combating malaria with an aim to eliminate malaria from low transmission districts by 2030. A continuous monitoring of malaria prevalence in areas under elimination settings is important to evaluate the status of malaria transmission and the effectiveness of the currently existing malaria intervention strategies. The aim of this study was to assess the prevalence of malaria and associated risk factors in selected areas of Dembiya district. Methods A cross-sectional parasitological and retrospective survey was conducted in the two localities of Dembiya District, selected based on their long standing history of implementing malaria prevention and elimination strategies. Thin and thick blood smears collected from 735 randomly selected individuals between October and December, 2018 were microscopically examined for malaria parasites. Six years (2012–2017) retrospective malaria data was collected from the medical records of the health centres. Structured questionnaires were prepared to collect information about the socio-economic data of the population. Logistic regression analysis was used to determine a key risk factor explaining the prevalence of malaria. The data were analysed using SPSS version 20 and p ≤ 0.05 were considered statistically significant. Results The 6-year retrospective malaria prevalence trend indicates an overall malaria prevalence of 22.4%, out of which Plasmodium falciparum was the dominant species. From a total of 735 slides examined for the presence of malaria parasites, 3.5% (n = 26) were positive for malaria parasites, in which P. falciparum was more prevalent (n = 17; 2.3%), Plasmodium vivax (n = 5; 0.7%), and mixed infections (n = 4; 0.5%). Males were 2.6 times more likely to be infected with malaria than females (AOR = 2.6; 95% CI 1.0, 6.4), and individuals with frequent outdoor activity were 16.4 times more vulnerable than individuals with limited outdoor activities (AOR = 16.4, 95% CI 1.8, 147.9). Furthermore, awareness about malaria transmission was significantly associated with the prevalence of malaria. Conclusions Malaria is still a public health problem in Dembiya district irrespective of the past and existing vector control interventions. Therefore, the authorities should work on designing alternative intervention strategies targeting outdoor malaria transmission and improving community awareness about malaria transmission and control methods in the study area. For this, continuous monitoring of vectors’ susceptibility, density, and behaviour is very important in such areas.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Obafemi J. Babalola

ObjectiveWe aim to assess the implementation of malaria prevention,diagnosis and treatment strategies, to assess implementation trendsfrom 2011 to 2014 and if surveillance targets were met.IntroductionMalaria is a preventable disease but 3.4 billion people at riskglobally with 207 million cases and 627 deaths reported in 2013.Africa accounts for 80% of cases and 90% of all malaria deaths.Nigeria accounts for 25% of malaria burden in Africa. The goal ofmalaria control is to reduce malaria –related transmissions, cases anddeaths to a level where it is no longer a public health concernMethodsKaduna state, north western Nigeria with estimated populationof 7.3 million has 23 districts and 1252 health facilities. Of these461 sent malaria surveillance data to National Health ManagementInformation System monthly. Data from January 2011 to December2014 was analysed. We evaluated variables related to malariainterventions strategies such as malaria diagnosis, malaria treatment,malaria prevention in pregnancy. Frequencies, proportions andtrend analysis were done and odd ratios for associations betweenvariables were calculated with confidence interval set at 95%. Epiinfo statistical software was used for the analysis.ResultsData completeness was 89.8%. Of the 1,008,728 people thatvisited health facilities, 56.6% presented with fever. Among thefever cases, 34.2% was tested with rapid diagnostic test (RDT) and5.5% with microscopy. Artemisinin based combination therapy wasgiven to 361,464 of which 36.4% had confirmed malaria. Those aged< 5 years with suspected fever were 1.28 (95% confidential interval(C.I), 1.27-1.29; p<0.01)) more likely not to be tested with eitherRDT or microscopy and they are 2.62 (95% C.I., 2.63 – 6.67;p<0.01) times more likely to have ACT for confirmed malaria. ACTprescription to presumptive malaria increases from 31.8% in 2013to 200.2% in 2014. There is a progressive increase of long lastinginsecticidal net distribution and access to second dose of IntermittentPreventive Therapy (IPT-2) for pregnant women.ConclusionsGenerally, progress in Malaria control transition to Eliminationin Kaduna State, Nigeria is favorable with malaria prevalence at36.4%. Some targets were met within the period and recommendstrengthening of these malaria control strategies with focus onvulnerable groups and prevent uncontrolled ACT prescription forpresumptive malaria.


2021 ◽  
Vol 53 (1) ◽  
Author(s):  
Julia Rose Dahm ◽  
Jordana Burdon Bailey ◽  
Robert F. Kelly ◽  
Patrick Chikungwa ◽  
Julius Chulu ◽  
...  

AbstractGoats are critical in mixed smallholder agricultural systems in lower and middle-income countries, while fleas are important human and animal health concerns around the world. Convenience sampling was used to describe and consider risk factors for flea infestations of peri-urban goats, with the aim of informing the iterative development of animal husbandry and management based control strategies. Seven hundred and ninety-two goats were examined in 228 households across 10 peri-urban communities surrounding Blantyre in southern Malawi. The prevalence of Ctenocephalides felis fleas was 18.3, 37.1 and 100% at the levels of individual goats, households and communities, respectively, highlighting a neglected human and animal health concern. Constant introduction of new livestock coupled to a lack of biosecurity within communities, the ubiquitous presence of dog and cat hosts for C. felis, the frequency and thoroughness of cleaning overnight goat accommodation, and goat age less than 12 months old were identified as risk factors for flea infestation. This focal cross-sectional study highlights the significance of fleas in peri-urban communities and uncovers trends and commonalities that are needed to inform sustainable disease management. The majority of the peri-urban goat keepers were female, had resided in the same community throughout their whole life and had primary level education. Advice on the planned management of fleas in livestock needs to be tailored towards this demographic group. This approach affords an opportunity to promote public health measures to address household flea infestations and zoonotic disease spread.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Che Pantalius Nji ◽  
Jules Clément Nguedia Assob ◽  
Jane-Francis Tatah Kihla Akoachere

Urinary tract infections (UTI) are among the most common pediatric infections and if not promptly diagnosed and treated, it could cause long term complications. Worldwide and in Cameroon, little attention has been paid to this growing problem in the pediatric population. Identification of risk factors will contribute significantly to prevention. A cross-sectional case-control study was carried out in children ≤ 15 years to identify the risk factors of UTI, etiologic agents, and their antibiotic susceptibility. Samples (urine) were collected from in and outpatients with symptoms of UTI attending two health facilities in Buea. Controls were age- and sex-matched children in the community and those visiting these health facilities for unrelated reasons. Samples were analyzed by microscopy, culture, and antibiotic susceptibility of bacteria isolates tested by the disc diffusion technique. Questionnaires were administered to collect sociodemographic, clinical characteristics and data on risk factors. Odds ratios and bivariate and multivariate analyses were used to assess the relationship between predictors (symptoms and risk factors) and UTI. P < 0.05 was considered significant. A total of 405 participants (200 cases and 205 controls) were investigated. UTI prevalence was 12% in cases. From the UTI cases, bacteria was the major cause of infection, with E. coli (39.4%) predominating. Parasitic organisms, Trichomonas vaginalis (0.5%) and Schistosoma spp (0.5%), and yeast (6%) were also detected. Urinary urgency ( F = 4.98 , P = 0.027 ) and back pain ( F = 12.37 , P = 0.001 ) were associated to UTI following bivariate analysis. These parameters could be used to predict UTI in the pediatric population in the study area. Third generation cephalosporins: ceftriaxone (90.1%) and cefadroxil (85.4%) were the most effective and thus recommended for treatment.


Author(s):  
Nontokozo Lilian Mbatha ◽  
Kebogile Elizabeth Mokwena ◽  
Sphiwe Madiba

Postnatal depression (PND) remains underdiagnosed and undertreated in different socio-economic backgrounds in South Africa. This study determined the prevalence of and clinical and obstetric risk factors for PND symptoms among HIV positive women in health facilities in a rural health district in South Africa. The Edinburgh Postnatal Depression Scale was used to measure PND from 386 women who had delivered a live infant. More than half (58.5%) tested HIV positive during the current pregnancy. The prevalence of PND symptoms was 42.5%. Logistic regression analysis yielded significant associations between clinical and obstetric variables of pre-term baby (p-value < 0.01), baby health status p-value < 0.01), baby hospitalization, (p-value < 0.01), and knowing the baby’s HIV status (p-value = 0.047). Maternal variables associated with PND were level of education (p-value < 0.01), monthly income (p-value < 0.01), and source of income (p-value = 0.05). At multivariate analysis, none of the clinical and obstetrical risk factors were independently associated with the PND. The high prevalence of PND symptoms underscore the need to integrate routine screening for PND in prevention of mother to child transmission of HIV programmes to enable early diagnosing and treatment of PND.


2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
David Z. Munisi ◽  
Joram Buza ◽  
Emmanuel A. Mpolya ◽  
Safari M. Kinung’hi

In Tanzania,Schistosoma mansoniis of great public health importance. Understanding the prevalence and infection intensity is important for targeted, evidence-based control strategies. This study aimed at studying the prevalence, intensity, and risk factors ofS. mansoniamong schoolchildren in the study area. A cross-sectional study was conducted in Busanga and Kibuyi villages. Sampled 513 schoolchildren provided stool specimens which were examined using kato-katz method. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. The prevalence ofS. mansoniinfection was 84.01%, with geometric mean egg intensity of 167.13 (95% CI: 147.19–189.79) eggs per gram of stool (epg). Other parasites detected wereAscaris lumbricoides(1.4%) and hookworms (1.4%). The geometric mean infection intensity in Busanga and Kibuyi were 203.70 (95% CI: 169.67–244.56) and 135.98 (95% CI: 114.33–161.73) epg, respectively. Light, moderate, and heavy infection intensities were 34.11%, 39.91%, and 25.99%, respectively. Village of residence, parent’s level of education, toilet use, and treatment history were predictors of infection. The high prevalence and infection intensity in this study were associated with village, parent’s level of education, inconsistent toilet use, and treatment history. To control the disease among at-risk groups, these factors need to be considered in designing integrated schistosomiasis control interventions.


2021 ◽  
Vol 3 (6) ◽  
pp. 89-94
Author(s):  
Philippe Salomon Nguwoh ◽  
Akenji Blaise Mboringong ◽  
Joseph Fokam ◽  
Christian Ngounouh Taheu ◽  
Ibrahima Halilou ◽  
...  

Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first appeared in December 2019 in Wuhan, China and has subsequently become a worldwide pandemic. During the pandemic, health care workers (HCWs) were very exposed to COVID-19 infected patients. The aim of this study was to determine seroprevalence of SARS-CoV-2 (COVID-19) among HCWs in three health facilities of Yaounde. Methods: A cross-sectional study involving 368 HCWs was conducted from January 18th to February 13th, 2021, in three health facilities located in city of Yaounde. Data of study participants were collected by face-to-face interviews using standard questionnaire. Blood samples were collected in labelled dry tubes and analyzed using Rapid Diagnostic Test (RDT) cassettes (Abbott PanbioTMCOVID-19 IgG/IgM Rapid Test Device). The data collected was analyzed using Epi info version 7. Any value of p <0.05 was considered statistically significant. Results: The average age was 30.25 (SD±10.43) years old, range from 21 to 72 years old. Overall, the positivity rates of IgM, IgG and IgM+IgG were 6.79% (n=25), 17.93% (n=66) and 1.09% (n=4) respectively. Multivariate analysis showed that, the rate of IgM positivity was highest in laboratory personnel (χ2= 7.99, p=0.3) and IgG (χ2= 8.50, p=0.29), IgM+IgG (χ2= 1.92, p=0.26) respectively in pharmacy and clinical personnel. The clinical signs such as fever (˃38°C) or history of fever was statistically significant with IgM (χ2=11.71, p= 0.0006) while, sore throat was statistically significant associated with IgM (χ2= 14.3, p= 0.0008) and IgG (χ2= 6.33, p= 0.04). Conclusion: The results of this study reveal a high seroprevalence of circulation of the virus in hospital milieu in Yaounde suggesting the continuation of the COVID-19 « Track-Test-Treat » system to break the chain of transmission.


2018 ◽  
Author(s):  
Tadesse Menjetta ◽  
Daniel Dana ◽  
Serkadis Debalke

Schistosomiasis/Bilharziasis is one of the neglected tropical parasitic diseases caused by different species of genus schistosoma. Among the species, S.mansoni (causative agents of intestinal schistosomiasis) is one of the causes of severe intestinal parasitic infections with high public and medical importance in Ethiopia. There is scarcity of information about the status of S.mansoni infection among the fisherman in the present study area and in the country at large. Therefore this study was designed to determine the prevalence and risk factors of S.mansoni infection among fishermen at Lake Hawassa, southern Ethiopia. A cross-sectional study was conducted among the fishermen from April to June 2013 in Hawassa, Southern Ethiopia. A total of 243 fishermen were included by Systematic Random Sampling from the lists of the fishermen members in the registration book of fishermen associations in the Hawassa Town. Data on socio-demographic features and risk factors were collected by using semi-structured questionnaires. Stool samples were collected and processed using Kato-Katz thick smear techniques and examined between 30- 40 minute for hook worm and after 24 hours for S.mansoni and other soil transmitted helminths (STHs). The overall prevalence of S.mansoni among the fishermen was 29.21% (71/243) and the mean intensity of infection was 158.88 eggs per gram (EPG). The prevalence of intestinal helminths including S.mansoni was 69.54% (169/243). Moreover, the prevalence of soil transmitted helminths (STHs) were 40.74% (99/243), 35.80% (87/243) and 5.76% (14/243) for A. lumbricoides, T. trichiura and hookworm species, respectively. Almost similar prevalence of S.mansoni, 31.82%, 31.75%, 31.94% were recorded in age groups of 15-19, 20-24 and 25-29 years, respectively. Fishermen who are swimming always were 2.92 times [95% CI: 1.554, 5.502] more likely to acquire S.mansoni infection than other water contacting habit of the study participants. The results of current investigation indicated the moderate endemicity of S.mansoni among the fishermen at Lake Hawassa, southern Ethiopia. Fishermen could be the potential risk group for S.mansoni infection and might be responsible for the transmission of S.mansoni to other segments of the communities. Since high prevalence of STH were recorded among the fishermen, integrated prevention and control strategies from different sectors might be important to tackle the problem. Key words: S.mansoni, Soil transmitted helminths, Fishermen, Lake Hawassa, Ethiopia


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