scholarly journals Marked reduction in antibiotic usage following intensive malaria control in a cohort of Ugandan children

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul J. Krezanoski ◽  
Michelle E. Roh ◽  
John Rek ◽  
Joaniter I. Nankabirwa ◽  
Emmanuel Arinaitwe ◽  
...  
Keyword(s):  
Vector Control ◽  
Antibiotic Treatment ◽  
Malaria Control ◽  
Marked Reduction ◽  
Antibiotic Usage ◽  
High Transmission ◽  
Symptomatic Malaria ◽  
Highly Effective ◽  
Before And After ◽  
Adjusted Incidence

Abstract Background Intensive malaria control may have additional benefits beyond reducing the incidence of symptomatic malaria. We compared antibiotic treatment of children before and after the implementation of highly effective malaria control interventions in Tororo, a historically high transmission area of Uganda. Methods Two successive cohorts of children, aged 0.5 to 10 years, were followed from September 2011 to October 2019 in a dedicated study clinic. Universal distribution of long-lasting insecticidal nets was conducted in 2013 and 2017. Sustained indoor residual spraying of insecticide (IRS) was initiated in December 2014. Generalized linear mixed-effects models were used to compare the incidence of antimalarial and antibiotic treatments before and after vector control measures were implemented. Results Comparing the period prior to the implementation of IRS to the period after IRS had been sustained for 4–5 years, the adjusted incidence of malaria treatments decreased from 2.68 to 0.05 per person-year (incidence rate ratio [IRR] = 0.02, 95% CI 0.01–0.03, p < 0.001), and the adjusted incidence of antibiotic treatments decreased from 4.14 to 1.26 per person-year (IRR = 0.30, 95% CI 0.27–0.34, p < 0.001). The reduction in antibiotic usage was primarily associated with fewer episodes of symptomatic malaria and fewer episodes of fever with sub-microscopic parasitemia, both of which were frequently treated with antibiotics. Conclusions In a historically high transmission setting, the implementation of highly effective vector control interventions was followed by a marked reduction in antibiotic treatment of children. This added benefit of malaria control could have important implications for antibiotic prescribing practices, efforts to curtail antimicrobial resistance, and health system costs.

scholarly journals Impact of seasonality and malaria control interventions on Anopheles density and species composition from three areas of Uganda with differing malaria endemicity

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Henry Ddumba Mawejje ◽  
Maxwell Kilama ◽  
Simon P. Kigozi ◽  
Alex K. Musiime ◽  
Moses Kamya ◽  
...  
Keyword(s):  
Species Composition ◽  
Vector Control ◽  
Malaria Control ◽  
Mosquito Species ◽  
Density Ratio ◽  
Indoor Residual Spraying ◽  
Sub Saharan Africa ◽  
Malaria Vector Control ◽  
Vector Density ◽  
Llin Distribution

Abstract Background Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the malaria control interventions primarily responsible for reductions in transmission intensity across sub-Saharan Africa. These interventions, however, may have differential impact on Anopheles species composition and density. This study examined the changing pattern of Anopheles species in three areas of Uganda with markedly different transmission intensities and different levels of vector control. Methods From October 2011 to June 2016 mosquitoes were collected monthly using CDC light traps from 100 randomly selected households in three areas: Walukuba (low transmission), Kihihi (moderate transmission) and Nagongera (high transmission). LLINs were distributed in November 2013 in Walukuba and Nagongera and in June 2014 in Kihihi. IRS was implemented only in Nagongera, with three rounds of bendiocarb delivered between December 2014 and June 2015. Mosquito species were identified morphologically and by PCR (Polymerase Chain Reaction). Results In Walukuba, LLIN distribution was associated with a decline in Anopheles funestus vector density (0.07 vs 0.02 mosquitoes per house per night, density ratio [DR] 0.34, 95% CI: 0.18–0.65, p = 0.001), but not Anopheles gambiae sensu stricto (s.s.) nor Anopheles arabiensis. In Kihihi, over 98% of mosquitoes were An. gambiae s.s. and LLIN distribution was associated with a decline in An. gambiae s.s. vector density (4.00 vs 2.46, DR 0.68, 95% CI: 0.49–0.94, p = 0.02). In Nagongera, the combination of LLINs and multiple rounds of IRS was associated with almost complete elimination of An. gambiae s.s. (28.0 vs 0.17, DR 0.004, 95% CI: 0.002–0.009, p < 0.001), and An. funestus sensu lato (s.l.) (3.90 vs 0.006, DR 0.001, 95% CI: 0.0005–0.004, p < 0.001), with a less pronounced decline in An. arabiensis (9.18 vs 2.00, DR 0.15 95% CI: 0.07–0.33, p < 0.001). Conclusions LLIN distribution was associated with reductions in An. funestus s.l. in the lowest transmission site and An. gambiae s.s. in the moderate transmission site. In the highest transmission site, a combination of LLINs and multiple rounds of IRS was associated with the near collapse of An. gambiae s.s. and An. funestus s.l. Following IRS, An. arabiensis, a behaviourally resilient vector, became the predominant species, which may have implications for malaria vector control activities. Development of interventions targeted at outdoor biting remains a priority.

scholarly journals Widespread zoophagy and detection of Plasmodium spp. in Anopheles mosquitoes in southeastern Madagascar

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Micaela Finney ◽  
Benjamin A. McKenzie ◽  
Bernadette Rabaovola ◽  
Alice Sutcliffe ◽  
Ellen Dotson ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Vector Control ◽  
Plasmodium Vivax ◽  
Malaria Control ◽  
Feeding Behaviour ◽  
Enzyme Linked Immunosorbent Assay ◽  
Habitat Gradient ◽  
Blood Meals ◽  
Feeding Behaviours ◽  
Southeastern Madagascar

Abstract Background Malaria is a top cause of mortality on the island nation of Madagascar, where many rural communities rely on subsistence agriculture and livestock production. Understanding feeding behaviours of Anopheles in this landscape is crucial for optimizing malaria control and prevention strategies. Previous studies in southeastern Madagascar have shown that Anopheles mosquitoes are more frequently captured within 50 m of livestock. However, it remains unknown whether these mosquitoes preferentially feed on livestock. Here, mosquito blood meal sources and Plasmodium sporozoite rates were determined to evaluate patterns of feeding behaviour in Anopheles spp. and malaria transmission in southeastern Madagascar. Methods Across a habitat gradient in southeastern Madagascar 7762 female Anopheles spp. mosquitoes were collected. Of the captured mosquitoes, 492 were visibly blood fed and morphologically identifiable, and a direct enzyme-linked immunosorbent assay (ELISA) was used to test for swine, cattle, chicken, human, and dog blood among these specimens. Host species identification was confirmed for multiple blood meals using PCR along with Sanger sequencing. Additionally, 1,607 Anopheles spp. were screened for the presence of Plasmodium falciparum, P. vivax-210, and P. vivax 247 circumsporozoites (cs) by ELISA. Results Cattle and swine accounted, respectively, for 51% and 41% of all blood meals, with the remaining 8% split between domesticated animals and humans. Of the 1,607 Anopheles spp. screened for Plasmodium falciparum, Plasmodium vivax 210, and Plasmodium vivax 247 cs-protein, 45 tested positive, the most prevalent being P. vivax 247, followed by P. vivax 210 and P. falciparum. Both variants of P. vivax were observed in secondary vectors, including Anopheles squamosus/cydippis, Anopheles coustani, and unknown Anopheles spp. Furthermore, evidence of coinfection of P. falciparum and P. vivax 210 in Anopheles gambiae sensu lato (s.l.) was found. Conclusions Here, feeding behaviour of Anopheles spp. mosquitoes in southeastern Madagascar was evaluated, in a livestock rich landscape. These findings suggest largely zoophagic feeding behaviors of Anopheles spp., including An. gambiae s.l. and presence of both P. vivax and P. falciparum sporozoites in Anopheles spp. A discordance between P. vivax reports in mosquitoes and humans exists, suggesting high prevalence of P. vivax circulating in vectors in the ecosystem despite low reports of clinical vivax malaria in humans in Madagascar. Vector surveillance of P. vivax may be relevant to malaria control and elimination efforts in Madagascar. At present, the high proportion of livestock blood meals in Madagascar may play a role in buffering (zooprophylaxis) or amplifying (zoopotentiation) the impacts of malaria. With malaria vector control efforts focused on indoor feeding behaviours, complementary approaches, such as endectocide-aided vector control in livestock may be an effective strategy for malaria reduction in Madagascar.

scholarly journals Community Knowledge, Perceptions, And Practices Regarding Malaria and Its Control In Jabi Tehnan District, Amhara Region, Northwest Ethiopia

2021 ◽  
Author(s):  
Abebe Asale ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Alayu Tesager ◽  
Aklilu Belay ◽  
...  
Keyword(s):  
Vector Control ◽  
Malaria Control ◽  
Community Education ◽  
Indoor Residual Spraying ◽  
Community Empowerment ◽  
Malaria Episode ◽  
Malaria Vectors ◽  
Bed Nets ◽  
Health Seeking ◽  
Malaria Parasites

Abstract Background: Key program components of malaria control in Ethiopia include community empowerment and mobilization, vector control using long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), prompt diagnosis and treatment, and disease surveillance. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behavior, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening). Method: The study was conducted in Jabi Tehnan district, Northwestern Ethiopi,a from November 2019 to March 2020. A total of 3,010 households distributed over 38 kebeles (villages) were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters taking into account agro-ecological differences. A total of 1,256 children under 10 years of age were screened for malaria parasites using microscopy in order to determine malaria prevalence. Furthermore, five-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics.Result: Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health seeking behavior remains a key behavioral challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average households lost 2.53 working days per person-per malaria episode and theey spent US$ 18 per person perepisode. Out of the 1,256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, 50% of the total cases reported from households whose age was 15 and beyond. The second most affected group was the age group between 5 and 14 years followed by children under 10, with 31% and 14% burden,respectively.Conclusion: Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low.Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritised in the study area to bring about the desired behavioral changes.

scholarly journals Nextgen Vector Surveillance Tools: sensitive, specific, cost-effective and epidemiologically relevant

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Robert Farlow ◽  
Tanya L. Russell ◽  
Thomas R. Burkot
Keyword(s):  
Decision Making ◽  
Vector Control ◽  
Malaria Control ◽  
Cost Effective ◽  
Effective Control ◽  
Next Generation ◽  
Vector Data ◽  
Vector Surveillance ◽  
Current Vector ◽  
Control Programmes

Abstract Background Vector surveillance provides critical data for decision-making to ensure that malaria control programmes remain effective and responsive to any threats to a successful control and elimination programme. The quality and quantity of data collected is dependent on the sampling tools and laboratory techniques used which may lack the sensitivity required to collect relevant data for decision-making. Here, 40 vector control experts were interviewed to assess the benefits and limitations of the current vector surveillance tools and techniques. In addition, experts shared ideas on “blue sky” indicators which encompassed ideas for novel methods to monitor presently used indicators, or to measure novel vector behaviours not presently measured. Algorithms for deploying surveillance tools and priorities for understanding vector behaviours are also needed for collecting and interpreting vector data. Results The available tools for sampling and analysing vectors are often hampered by high labour and resource requirements (human and supplies) coupled with high outlay and operating costs and variable tool performance across species and geographic regions. The next generation of surveillance tools needs to address the limitations of present tools by being more sensitive, specific and less costly to deploy to enable the collection and use of epidemiologically relevant vector data to facilitate more proactive vector control guidance. Ideas and attributes for Target Product Profiles (TPPs) generated from this analysis provide targets for research and funding to develop next generation tools. Conclusions More efficient surveillance tools and a more complete understanding of vector behaviours and populations will provide a basis for more cost effective and successful malaria control. Understanding the vectors’ behaviours will allow interventions to be deployed that target vulnerabilities in vector behaviours and thus enable more effective control. Through defining the strengths and weaknesses of the current vector surveillance methods, a foundation and initial framework was provided to define the TPPs for the next generation of vector surveillance methods. The draft TTPs presented here aim to ensure that the next generation tools and technologies are not encumbered by the limitations of present surveillance methods and can be readily deployed in low resource settings.

scholarly journals Highly Effective Birth Control Use Before and After Women's Incarceration

2015 ◽  
Vol 24 (6) ◽  
pp. 530-539 ◽  
Author(s):  
Megha Ramaswamy ◽  
Hsiang-Feng Chen ◽  
Karen L. Cropsey ◽  
Jennifer G. Clarke ◽  
Patricia J. Kelly
Keyword(s):  
Birth Control ◽  
Highly Effective ◽  
Before And After ◽  
Women's Incarceration

scholarly journals Malaria vector control practices in an irrigated rice agro-ecosystem in central Kenya and implications for malaria control

2008 ◽  
Vol 7 (1) ◽  
Author(s):  
Peter N Ng'ang'a ◽  
Josephat Shililu ◽  
Gayathri Jayasinghe ◽  
Violet Kimani ◽  
Charity Kabutha ◽  
...  
Keyword(s):  
Vector Control ◽  
Malaria Vector ◽  
Malaria Control ◽  
Malaria Vector Control ◽  
Irrigated Rice ◽  
Central Kenya

scholarly journals Effect of common and experimental anti-tuberculosis treatments onMycobacterium tuberculosisgrowing as biofilms

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2717 ◽  
Author(s):  
James P. Dalton ◽  
Benedict Uy ◽  
Narisa Phummarin ◽  
Brent R. Copp ◽  
William A. Denny ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Lung Disease ◽  
Antibiotic Treatment ◽  
Antibiotic Susceptibility ◽  
Minimum Inhibitory Concentrations ◽  
Light Levels ◽  
Solid Media ◽  
H37rv Strain ◽  
Before And After ◽  
Phenotypic State

Much is known regarding the antibiotic susceptibility of planktonic cultures ofMycobacterium tuberculosis, the bacterium responsible for the lung disease tuberculosis (TB). As planktonically-grownM. tuberculosisare unlikely to be entirely representative of the bacterium during infection, we set out to determine how effective a range of anti-mycobacterial treatments were againstM. tuberculosisgrowing as a biofilm, a bacterial phenotype known to be more resistant to antibiotic treatment. Light levels from bioluminescently-labelledM. tuberculosisH37Rv (strain BSG001) were used as a surrogate for bacterial viability, and were monitored before and after one week of treatment. After treatment, biofilms were disrupted, washed and inoculated into fresh broth and plated onto solid media to rescue any surviving bacteria. We found that in this phenotypic stateM. tuberculosiswas resistant to the majority of the compounds tested. Minimum inhibitory concentrations (MICs) increased by 20-fold to greater than 1,000-fold, underlying the potential of this phenotype to cause significant problems during treatment.

scholarly journals Efficacy of a Gluten-Free Diet in the Gilles de la Tourette Syndrome: A Pilot Study

2018 ◽  
Author(s):  
Luis Rodrigo ◽  
Nuria Álvarez ◽  
Enrique Fernández-Bustillo ◽  
Javier Salas-Puig ◽  
Marcos Huerta ◽  
...  
Keyword(s):  
Pilot Study ◽  
Tourette Syndrome ◽  
Marked Reduction ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Prospective Pilot Study ◽  
Before And After ◽  
One Year

The Gilles de la Tourette syndrome (GTS) and Non-Coeliac Gluten Sensitivity (NCGS) may be associated. We analyse the efficacy of a gluten-free diet (GFD) in 29 patients with GTS (23 children; 6 adults) in a prospective pilot study. All of them followed a GFD for one year. The YGTSS, Y-BOCS/CY-BOCS and GTS-QOL questionnaires were compared before and after the GFD. 74% of children and 50% of adults were males, not significant (NS). At the beginning of the study, 69% of children and 100% of adults had associated OCD (NS). At baseline, the YGTSS scores were 55.0 &plusmn; 17.5 (children) and 55.8 &plusmn; 19.8 (adults) (NS), the Y-BOCS/CY-BOCS scores were 15.3 (SD = 12.3) (children) and 26.8 (9.2) (adults) (p = 0.043), and the GTS-QOL scores were 42.8 &plusmn; 18.5 (children) and 64 &plusmn; 7.9 (adults) (p = 0.000). NCGS was frequent in both groups, with headaches reported by 47.0% of children and 83.6% of adults (p = 0.001). After one year on a GFD there was a marked reduction in measures of tics (YGTSS) (p = 0.001), and the intensity and frequency of OCD (Y-BOCS/CY-BOCS) (p = 0.001), along with improved QOL (p = 0.001) in children and adults. In conclusion, a GFD maintained for one year in GTS patients led to a marked reduction in tics and OCD both in children and adults.

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