scholarly journals Combining malaria vaccination with chemoprevention: a promising new approach to malaria control

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Brian Greenwood ◽  
Matthew Cairns ◽  
Mike Chaponda ◽  
R. Matthew Chico ◽  
Alassane Dicko ◽  
...  
Keyword(s):  
Malaria Control ◽  
Malaria Vaccine ◽  
Intermittent Preventive Treatment ◽  
Substantial Reduction ◽  
Preventive Treatment ◽  
Clinical Malaria ◽  
Severe Anaemia ◽  
African Countries ◽  
Post Discharge ◽  
Recent Trial

AbstractMalaria control has stalled in a number of African countries and novel approaches to malaria control are needed for these areas. The encouraging results of a recent trial conducted in young children in Burkina Faso and Mali in which a combination of the RTS,S/AS01E malaria vaccine and seasonal malaria chemoprevention led to a substantial reduction in clinical cases of malaria, severe malaria, and malaria deaths compared with the administration of either intervention given alone suggests that there may be other epidemiological/clinical situations in which a combination of malaria vaccination and chemoprevention could be beneficial. Some of these potential opportunities are considered in this paper. These include combining vaccination with intermittent preventive treatment of malaria in infants, with intermittent preventive treatment of malaria in pregnancy (through vaccination of women of child-bearing age before or during pregnancy), or with post-discharge malaria chemoprevention in the management of children recently admitted to hospital with severe anaemia. Other potential uses of the combination are prevention of malaria in children at particular risk from the adverse effects of clinical malaria, such as those with sickle cell disease, and during the final stages of a malaria elimination programme when vaccination could be combined with repeated rounds of mass drug administration. The combination of a pre-erythrocytic stage malaria vaccine with an effective chemopreventive regimen could make a valuable contribution to malaria control and elimination in a variety of clinical or epidemiological situations, and the potential of this approach to malaria control needs to be explored.

scholarly journals Pharmacovigilance of Malaria Intermittent Preventive Treatment in Infants Coupled With Routine Immunizations in 6 African Countries

2012 ◽  
Vol 205 (suppl 1) ◽  
pp. S82-S90 ◽  
Author(s):  
A. de Sousa ◽  
L. P. Rabarijaona ◽  
O. Tenkorang ◽  
E. Inkoom ◽  
H. V. Ravelomanantena ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
African Countries

scholarly journals Prevalence of asymptomatic malaria parasitaemia following mass testing and treatment in Pakro sub-district of Ghana

2019 ◽  
Author(s):  
Ignatius Cheng Ndong ◽  
Daniel Okyere ◽  
Juliana Yartey Enos ◽  
Benedicta Ayiedu Mensah ◽  
Alexander Kwadwo Nyarko ◽  
...  
Keyword(s):  
Malaria Control ◽  
Lower Cost ◽  
Health Centre ◽  
Scale Up ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Asymptomatic Malaria ◽  
Community Based ◽  
High Coverage ◽  
Asymptomatic Parasitaemia

Abstract Background: Global efforts to scale-up malaria control interventions are gaining steam. These include the use of Long-Lasting Insecticide Nets, Intermittent Preventive Treatment and Test, Treat and Track (T3) using ACTs. Intermittent preventive treatment of children (IPTc) in Ghana has demonstrated a parasite load reduction of 90%. However, unanswered questions include – whether mass treatment of population sub-groups such as IPTc could be scaled-up to whole populations as in mass testing, treatment and tracking (MTTT)? What is needed to implement MTTT at scale? Can MTTT reduce asymptomatic parasitaemia levels in children under 15? And whether MTTT of populations complemented by community-based management of malaria (CBMm) using volunteers could be an effective strategy for malaria control at a lower cost. Methods: A population of 5,000 asymptomatic individuals in seven communities in the Pakro sub-district of Ghana participated in this study. A register was developed for each community following a census. MTTT engaged trained community-based health volunteers (CBHVs) who conducted house-to-house testing using RDTs every four months and treated positive cases with ACTs. Between interventions, CBMm was done on symptomatic cases. Results: MTTT Coverage was 98.8% in July 2017 and 79.3% in July 2018. Of those tested, asymptomatic infection with malaria parasites reduced from 1,795 (36.3%) in July 2017 to 1,303 (32.9%) in July 2018. Implementing MTTT significantly averted asymptomatic parasitaemia by 24% from July 2017 to July 2018 after adjusting for age, ITN use and temperature (OR=0.76, CI=0.67, 0.85 p ≤ 0.001). In comparison, treatment of symptomatic patients at the Health Centre reduced parasitaemia by 9% over the same period which was however, not statistically significant (OR=0.91, CI=0.67, 1.38 p = 0.672). A total of 223 (5.1%) cases were averted in children under 15 years (X² = 9.7, p < 0.002). An important observation was a decrease in hospital attendance, which negatively affected the internally generated funds (IGF) scheme of the participating health facilities. Conclusion: This study has demonstrated that implementing MTTT was feasible and could reduce prevalence of malaria asymptomatic parasitaemia in children under 15 years of age. Furthermore, the use of CBHVs could ensure high coverage at lower cost.

scholarly journals Associations between Malaria-Preventive Regimens and Plasmodium falciparum Drug Resistance-Mediating Polymorphisms in Ugandan Pregnant Women

2020 ◽  
Vol 64 (12) ◽  
Author(s):  
Patience Nayebare ◽  
Victor Asua ◽  
Melissa D. Conrad ◽  
Richard Kajubi ◽  
Abel Kakuru ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Genetic Polymorphisms ◽  
Protective Efficacy ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Drug Susceptibility ◽  
Recent Trial ◽  
Content Type ◽  
High Level ◽  
Selection Of

ABSTRACT Intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine (SP) is recommended for malaria-endemic parts of Africa, but efficacy is compromised by resistance, and, in recent trials, dihydroartemisinin-piperaquine (DP) has shown better antimalarial protective efficacy. We utilized blood samples from a recent trial to evaluate selection by IPTp with DP or SP of Plasmodium falciparum genetic polymorphisms that alter susceptibility to these drugs. The prevalence of known genetic polymorphisms associated with altered drug susceptibility was determined in parasitemic samples, including 375 collected before IPTp drugs were administered, 125 randomly selected from those receiving SP, and 80 from those receiving DP. For women receiving DP, the prevalence of mixed/mutant sequences was greater in samples collected during IPTp than that in samples collected prior to the intervention for PfMDR1 N86Y (20.3% versus 3.9%; P < 0.001), PfMDR1 Y184F (73.0% versus 53.0%; P < 0.001), and PfCRT K76T (46.4% versus 24.0%; P < 0.001). Considering SP, prior to IPTp, the prevalence of all 5 common antifolate mutations was over 92%, and this prevalence increased following exposure to SP, although none of these changes were statistically significant. For two additional mutations associated with high-level SP resistance, the prevalence of PfDHFR 164L (13.7% versus 4.0%; P = 0.004), but not PfDHPS 581G (1.9% versus 3.0%; P = 0.74), was greater in samples collected during IPTp compared to those collected before the intervention. Use of IPTp in Uganda selected for parasites with mutations associated with decreased susceptibility to IPTp regimens. Thus, a potential drawback of IPTp is selection of parasites with decreased drug susceptibility.

scholarly journals Quality of Sulfadoxine-Pyrimethamine Given as Antimalarial Prophylaxis in Pregnant Women in Selected Health Facilities in Central Region of Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Danny F. Yeboah ◽  
Richmond Afoakwah ◽  
Ekene K. Nwaefuna ◽  
Orish Verner ◽  
Johnson N. Boampong
Keyword(s):  
Pregnant Women ◽  
Central Region ◽  
Malaria Infection ◽  
High Performance ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Health Facilities ◽  
African Countries ◽  
Malaria During Pregnancy

The use of sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries and crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in some selected health facilities in the Central Region of Ghana to prevent maternal malaria in pregnant women. A total of 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana participated in the study. Parasite density ofPlasmodium falciparumwas determined from peripheral blood of the pregnant women using microscopy. High performance liquid chromatography (HPLC) and dissolution tester were used to determine the quality of the SP. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. SP failed the dissolution test. Pregnant women who did not receive IPT-SP were 44%. Low haemoglobin level was recorded in 73.5% of the pregnant women. The results indicated that SP was substandard. IPT-SP is ineffective in preventing malaria infection.

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