Malaria rapid diagnostic test (HRP2/pLDH) positivity, incidence, care accessibility and impact of community WASH Action programme in DR Congo: mixed method study involving 625 households

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. Results Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2–29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were predictors of household malaria. Conclusion This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.

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Malaria Rapid Diagnostic Test (HRP2/pLDH) Positivity, Incidence, Care Accessibility and Impact of Community WASH Action in DR Congo: Mixed Method Study involving 625 Households

10.21203/rs.3.rs-27950/v1 ◽

2020 ◽

Author(s):

Nlandu Roger Ngatu ◽

Basilua Andre Muzembo ◽

Sakiko Kanbara ◽

Roger Wumba ◽

Mitsunori Ikeda ◽

...

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Mixed Method ◽

Malaria Incidence ◽

Control Site ◽

Post Intervention ◽

Stagnant Water ◽

Household Level ◽

Malaria Burden ◽

Study Sites

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub Saharan Africa (SSA). Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Thus, the search for disease control strategies is indispensable. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action.Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (WASH control site) between July 2017 to March 2018, involving 625 households (3,712 individuals). Baseline and post-intervention malaria surveys were conducted in 2017 and 2018, respectively, using the World Bank/WHO Malaria Indicator Questionnaire. In addition, an action research consisting of a six-month (September 2017 - February 2018) prospective study was carried out which comprised two interventions: (1) a community participatory WASH action aiming at eliminating mosquito breeding sites in the residential environment and a (2) community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention rapid diagnostic test (RDT) for malaria was performed among respondents. Furthermore, a six-month prospective hospital-based epidemiological study was simultaneously conducted using records of patients admitted at health settings located at both study sites.Results Prevalence of positive malaria RDT among respondents decreased significantly at WASH-action site (38% vs. 20%; p < 0.05), but no significant change was observed at the WASH control site. There were 96% of respondents (heads of households) who reported at least one malaria event occurring in the previous six-month period, only 66.5% of them received malaria care at a health setting. At household level, long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (IRS) (2%), LLIN-IRS combination (2%); however, 24% of households did not use any measures. Mean household malaria incidence decreased at the WASH action site; 2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases (p < 0.05), whereas no significant change was noted in control site. Moreover, malaria incidence rate was highest (60.9%) among households living in proximity to grassy and/or stagnant water spots. Low household monthly income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), Proximity to high risk area (grassy/stagnant water spots) for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor general WASH status in residential area (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were determinants of household malaria. Furthermore, data collected from referral health settings showed high malaria frequency, 67.4% (1,108/1,645) occurring during the first semester of 2017, including 772 (70%) of pediatric malaria cases and 336 (30%) of cases from Internal medicine departments.Conclusion Findings from this research suggest the necessity for DRC government to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility to reduce malaria burden. This would be a step towards achieving universal health coverage (UHC) in the Congo.

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Malaria Rapid Diagnostic Test (HRP2/pLDH) Positivity, Incidence, Care Accessibility and Impact of Community WASH Action in DR Congo: Mixed Method Study involving 625 Households

10.21203/rs.3.rs-27950/v2 ◽

2021 ◽

Author(s):

Nlandu Roger Ngatu ◽

Basilua Andre Muzembo ◽

Sakiko Kanbara ◽

Roger Wumba ◽

Mitsunori Ikeda ◽

...

Keyword(s):

Mixed Method ◽

Preventive Measures ◽

Malaria Incidence ◽

Indoor Residual Spraying ◽

Control Site ◽

Malaria Rapid Diagnostic Test ◽

Post Intervention ◽

Household Level ◽

Malaria Burden ◽

Referral Hospitals

Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub Saharan Africa. Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Thus, the search for disease control strategies is indispensable. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (WASH control site) between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys focusing on malaria episodes and preventive measures in previous six-month period using the World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both the WASH action and Control sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among respondents. Furthermore, a six-month hospital-based epidemiological study was conducted from 1 January through June 2017. Medical records of patients admitted at selected referral hospitals (one hospital per study site) were used to determine malaria trend in the sites. Results Long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (2%), LLIN and indoor residual spraying combination (2%); however, 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) have reported at least one malaria episode occurring in the previous six-month period (January-June 2017); of them only 66.5% of them received malaria care at a health setting. In the Action Research, at household level, mean number of self-reported incident malaria cases decreased at WASH action site (2.3±2.2 cases vs. 1.2±0.7 cases, respectively; p<0.05), whereas it remained unchanged at the Control site. Similarly, RDT results showed that the prevalence rate of positive RDT among the respondents decreased significantly at WASH-action site (38% in pre-test vs. 20% in post-test; p<0.05), whereas no significant change was observed at the Control site. Data collected from referral hospitals showed high malaria incidence rate, 67.4%, as compared to other diseases (70% of pediatric malaria cases and 30% of cases from Internal medicine departments). Low household monthly income (ORa=2.37; 95%CI: 1.05-3.12; p<0.05), proximity to high risk area (grassy/stagnant water spots) for malaria (ORa=5.13; 95%CI: 2-29-8.07; p<0.001), poor general WASH status in residential area (ORa=4.10; 95%CI: 2.11-7.08; p<0.001) were predictors of household malaria. Conclusion This research showed high prevalence of positive malaria RDT among study participants, which was significantly reduced by a 6-month WASH intervention. Additionally, hospital-based epidemiological data showed high malaria incidence. The findings suggest the necessity for DRC government to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility to reduce malaria burden in Congolese population. This would be a step towards achieving universal health coverage in the Congo.

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Rapid Diagnostic Test (HRP2/pLDH) Positivity, Household Malaria Incidence and Impact of Community Participatory WASH Action in Kongo Central, DR Congo: A Mixed Method Study

SSRN Electronic Journal ◽

10.2139/ssrn.3559625 ◽

2020 ◽

Author(s):

Nlandu Roger Ngatu ◽

Sakiko Kanbara ◽

Roger Wumba ◽

Mitsunori Ikeda ◽

Tomohiro Hirao ◽

...

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Mixed Method ◽

Malaria Incidence ◽

Mixed Method Study ◽

Dr Congo

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Evaluation of the VIKIA Malaria Ag Pf/Pan malaria rapid diagnostic test in a non-endemic setting

10.26226/morressier.56d6be7cd462b80296c96113 ◽

2016 ◽

Author(s):

Sandrine Houze

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Malaria Rapid Diagnostic Test ◽

Endemic Setting

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Clinical overlap between malaria and pneumonia: can malaria rapid diagnostic test play a role?

The Journal of Infection in Developing Countries ◽

10.3855/jidc.945 ◽

2011 ◽

Vol 5 (03) ◽

pp. 199-203 ◽

Cited By ~ 10

Author(s):

Kingsley Nnanna Ukwaja ◽

Olufemi B Aina ◽

Ademola A Talabi

Keyword(s):

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Diagnostic Tests ◽

Health Centre ◽

Rapid Diagnostic Tests ◽

Case Definition ◽

Sub Saharan Africa ◽

Malaria Rapid Diagnostic Test ◽

Chi Square ◽

Symptom Overlap

Introduction: Malaria and pneumonia account for 40% of mortality among children under five years of age in sub-Saharan Africa. Due to lack of diagnostic facilities, their management is based on the integrated management of childhood illnesses (IMCI) strategy. Symptoms of malaria and pneumonia overlap in African children, necessitating dual IMCI classifications at health centres and treatment with both antibiotics and antimalarials. This study determined the prevalence of malaria-pneumonia symptom overlap and confirmed the diagnosis of malaria in these cases using a rapid diagnostic test. Methodology: Consecutive consultations of 1,216 children (two months to five years old) were documented over a three-month period in a comprehensive health centre. Malaria rapid diagnostic tests were conducted only for children who had symptom overlap. Results: Of the 1,216 children enrolled, 1,090 (90%) reported cough or fever. Among the children fulfilling the malaria case definition, 284 (30%) also met the pneumonia case definition. Twenty-three percent (284) of all children enrolled met the criteria for both malaria and pneumonia. However, only 130 (46%) of them had a positive result for malaria using a malaria rapid diagnostic test. During a malaria-pneumonia overlap, female children (chi-square 5.9, P = 0.01) and children ≥ one year (chi-square 4.8, P = 0.003) were more likely to seek care within two days of fever. Conclusion: Dual treatment with antimalarials and antibiotics in children with malaria-pneumonia overlap may result in unnecessary over-prescription of antimalarial medications. Use of rapid diagnostic tests in their management can potentially avoid over-prescribing of malaria medications.

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