scholarly journals Risk factors associated with malaria infection identified through reactive case detection in Zanzibar, 2012–2019

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Humphrey R. Mkali ◽  
Erik J. Reaves ◽  
Shabbir M. Lalji ◽  
Abdul-Wahid Al-mafazy ◽  
Joseph J. Joseph ◽  
...  
Keyword(s):  
Risk Factors ◽  
Malaria Infection ◽  
Universal Access ◽  
Behavioural Change ◽  
P Value ◽  
Case Detection ◽  
Reactive Case Detection ◽  
Factors Associated ◽  
Household Members ◽  
Index Cases

Abstract Background Over the past two decades, Zanzibar substantially reduced malaria burden. As malaria decreases, sustainable improvements in control interventions may increasingly depend on accurate knowledge of malaria risk factors to further target interventions. This study aimed to investigate the risk factors associated with malaria infection in Zanzibar. Methods Surveillance data from Zanzibar’s Malaria Case Notification system from August 2012 and December 2019 were analyzed. This system collects data on malaria cases passively detected and reported by all health facilities (index cases), and household-based reactive case detection (RCD) activities linked to those primary cases. All members of households of the index cases were screened for malaria using a malaria rapid diagnostic test (RDT). Individuals with a positive RDT were treated with artemisinin-based combination therapy. Univariate and multivariate logistic regression analyses were done to investigate the association between RDT positivity among the household members and explanatory factors with adjustment for seasonality and clustering at Shehia level. Results A total of 30,647 cases were reported of whom household RCD was completed for 21,443 (63%) index case households and 85,318 household members tested for malaria. The findings show that younger age (p-value for trend [Ptrend] < 0.001), history of fever in the last 2 weeks (odds ratio [OR] = 35.7; 95% CI 32.3–39.5), travel outside Zanzibar in the last 30 days (OR = 2.5; 95% CI 2.3–2.8) and living in Unguja (OR = 1.2; 95% CI 1.0–1.5) were independently associated with increased odds of RDT positivity. In contrast, male gender (OR=0.8; 95% CI 0.7–0.9), sleeping under an LLIN the previous night (OR = 0.9; 95% CI 0.7–0.9), having higher household net access (Ptrend < 0.001), and living in a household that received IRS in the last 12 months (OR = 0.8; 95% CI 0.7–0.9) were independently associated with reduced odds of RDT positivity. A significant effect modification of combining IRS and LLIN was also noted (OR = 0.7; 95% CI 0.6–0.8). Conclusions The findings suggest that vector control remains an important malaria prevention intervention: they underscore the need to maintain universal access to LLINs, the persistent promotion of LLIN use, and application of IRS. Additionally, enhanced behavioural change and preventive strategies targeting children aged 5–14 years and travellers are needed.

scholarly journals Risk Factors Associated with Malaria Infection Identified through Reactive Case Detection in Zanzibar, 2012-2019

2021 ◽  
Author(s):  
Humphrey Raphael Mkali ◽  
Erik J. Reaves ◽  
Shabbir M. Lalji ◽  
Abdul-wahid Al-mafazy ◽  
Joseph J. Joseph ◽  
...  
Keyword(s):  
Risk Factors ◽  
Malaria Infection ◽  
Universal Access ◽  
Indoor Residual Spraying ◽  
P Value ◽  
Case Detection ◽  
Reactive Case Detection ◽  
Factors Associated ◽  
Llin Use ◽  
History Of

Abstract BackgroundOver the past two decades, Zanzibar substantially reduced malaria burden. As malaria decreases, sustainable improvements in prevention and control interventions may increasingly depend on accurate knowledge of malaria risk factors to further target interventions. This study aimed to investigate the risk factors associated with malaria infection in Zanzibar. MethodsWe analyzed surveillance data from Zanzibar’s Malaria Case Notification system collected between August 2012 and December 2019. This system collects data from all malaria cases passively detected and reported by public and private health facilities, from household-based follow-up and reactive case detection activities linked to those primary cases. All members of households of the passively detected malaria cases were screened for malaria using a malaria rapid diagnostic test (mRDT); individuals with a positive mRDT result were treated with artemisinin-based combination therapy. Univariate and multivariate logistic regression analyses were done to investigate the association between mRDT positivity among the household members and explanatory factors (i.e., age, sex, history of fever, history of travel, rainfall, long-lasting insecticidal net [LLIN] density, LLIN use, household indoor residual spraying [IRS], and household location) with adjustment for seasonality ResultsThe findings show that younger age (p-value for trend<0.001), history of fever in the last two weeks (odds ratio [OR]=32.0; 95% CI: 29.1-35.3), history of travel outside Zanzibar in the last 30 days (OR=2.3; 95% CI: 2.1-2.6) and living in Unguja (OR=1.2; 95% CI: 1.1-1.3) were independently associated with increased odds of mRDT positivity. In contrast, male sex (OR=0.8; 95% CI: 0.7-0.9), having higher household LLIN density (p-value for trend<0.001), sleeping under an LLIN the previous night (OR=0.8; 95% CI: 0.7-0.9), and living in a household that received IRS in the last 12 months (OR=0.9; 95% CI: 0.8-0.9) were independently associated with reduced odds of mRDT positivity. A significant effect modification of combining IRS and LLIN was also noted (OR=0.7; 95% CI:0.6-0.8).ConclusionsThe findings suggest that vector control remains an important malaria prevention intervention: they underscore the need to maintain universal access to LLINs, the persistent promotion of LLIN use, and application of IRS. Additionally, enhanced behavioral change and preventive strategies targeting children aged 5-14 years and travelers are needed.

scholarly journals Epidemiology of Plasmodium falciparum Infections in a Semi-Arid Rural African Setting: Evidence of Reactive Case Detection in Northwestern Kenya

2021 ◽  
Author(s):  
Hannah R. Meredith ◽  
Amy Wesolowski ◽  
Diana Menya ◽  
Daniel Esimit ◽  
Gilchrist Lokoel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Malaria Transmission ◽  
Control Strategies ◽  
Age Groups ◽  
Individual Characteristics ◽  
Case Detection ◽  
Reactive Case Detection ◽  
Logistic Regression Models ◽  
Household Members ◽  
Associated Risk Factors

In northwestern Kenya, Turkana County has been historically considered unsuitable for stable malaria transmission because of its unfavorable climate and predominantly semi-nomadic population; consequently, it is overlooked during malaria control planning. However, the area is changing, with substantial development, an upsurge in travel associated with resource extraction, and more populated settlements forming. Recently, numerous malaria outbreaks have highlighted the need to characterize malaria transmission and its associated risk factors in the region to inform control strategies. Reactive case detection of confirmed malaria cases at six health facilities across central Turkana was conducted from 2018 to 2019. Infections in household members of index cases were detected by malaria rapid diagnostic tests (RDTs) and PCR tests, and they were grouped according household and individual characteristics. The relationships between putative risk factors and infection were quantified by multilevel logistic regression models. Of the 3,189 household members analyzed, 33.6% had positive RDT results and/or PCR test results. RDT-detected infections were more prevalent in children; however, PCR-detected infections were similarly prevalent across age groups. Recent travel was rarely reported and not significantly associated with infection. Bed net coverage was low and net crowding was associated with increased risks of household infections. Infections were present year-round, and fluctuations in prevalence were not associated with rainfall. These findings indicate year-round, endemic transmission with moderate population immunity. This is in stark contrast to recent estimates in this area. Therefore, further investigations to design effective intervention approaches to address malaria in this rapidly changing region and other similar settings across the Horn of Africa are warranted.

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

Rabies Ecology in Bauchi State, Nigeria

2019 ◽  
Vol 2 (1) ◽  
pp. 5-12
Author(s):  
Bolajoko Muhammad-Bashir ◽  
Yakubu Joel Atuman
Keyword(s):  
Risk Factors ◽  
Cost Effective ◽  
The State ◽  
Control Measures ◽  
P Value ◽  
Public Health Implication ◽  
Factors Associated ◽  
Canine Rabies ◽  
Dog Ownership ◽  
Dog Owners

Despite availability of safer and cost-effective treatments and vaccines, rabies is still considered among the most fatal viral zoonotic disease worldwide. The epidemiology of rabies is directly associated with the ecology of the reservoirs which needs better understanding to underpin appropriate control measures. There are only few reported attempts made towards understanding the ecology of dog and rabies cases in Nigeria. Although dogs are tolerated and kept in Bauchi State, the risk factors associated with dog ownership in the state, remain to be studied. This study is aimed at determining the risk factors associated with dog ownership in Bauchi state and to evaluate the degree with which the presence or absence of the identified factors can increase or decrease risk of rabies cases in the state. A questionnaire-based survey was conducted amongst dog owners across the state. Basic descriptive analyses were carried out in Microsoft Excel 2016 and IBM SPSS 21 was used to determine the relative risk (RR) of rabies occurrence in households across the state when exposed to each of the identified risk factors where P-value was set at 0.05. A total of 80 questionnaires were completed and received from the respondents. The calculated RR, revealed that the practice of extensive system of management increases the risk of canine rabies amongst dogs of the state by 80% and knowledge of dog owners about canine rabies reduces the risk of canine rabies by 27%. This study confirmed that dogs are owned and tolerated but poorly managed under extensive management system in Bauchi state with increasing risks of rabies spread due to low vaccination coverage and lack of practical application of knowledge on the dangers of rabies amongst the populace. The public health implication of this situation and the need for concerted efforts for sustainable control of rabies in the state is discussed

scholarly journals Malaria infection prevalence and sensitivity of reactive case detection in Zanzibar

2020 ◽  
Vol 97 ◽  
pp. 337-346 ◽  
Author(s):  
Logan Stuck ◽  
Bakar S. Fakih ◽  
Abdul-wahid H. Al-mafazy ◽  
Natalie E. Hofmann ◽  
Aurel Holzschuh ◽  
...  
Keyword(s):  
Malaria Infection ◽  
Infection Prevalence ◽  
Case Detection ◽  
Reactive Case Detection

scholarly journals Adding proactive and reactive case detection into the integrated community case management system to optimise diagnosis and treatment of malaria in a high transmission setting of Cameroon: an observational quality improvement study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026678 ◽  
Author(s):  
Cavin Epie Bekolo ◽  
Thomas D’Arcy Williams
Keyword(s):  
Quality Improvement ◽  
Case Management ◽  
Diagnostic Testing ◽  
Sub Saharan Africa ◽  
Secondary Outcome ◽  
Case Detection ◽  
Community Case Management ◽  
Reactive Case Detection ◽  
Integrated Community Case Management ◽  
Index Cases

ObjectiveIntegrated community case management (iCCM) of childhood illness is a powerful intervention to reduce mortality. Yet, only 29% and 59% of children with fever in sub-Saharan Africa had access to malaria testing and treatment between 2015 and 2017. We report how iCCM+ based on incorporating active case detection of malaria into iCCM could help improve testing and treatment.DesignA community-led observational quality improvement study.SettingThe rural community of Bare-Bakem in Cameroon.ParticipantsChildren and adults with fever between April and June 2018.InterventionA modified iCCM programme (iCCM+) comprising a proactive screening of febrile children <5 years old for malaria using rapid diagnostic testing to identify index cases and a reactive screening triggered by these index cases to detect secondary cases in the community.Primary and secondary outcome measuresThe proportion of additional malaria cases detected by iCCM+ over iCCM.ResultsWe screened 501 febrile patients of whomPlasmodiuminfection was confirmed in 425 (84.8%) cases. Of these cases, 102 (24.0%) were index cases identified in the community during routine iCCM activity and 36 (8.5%) cases detected passively in health facilities; 38 (8.9%) were index cases identified proactively in schools and 249 (58.6%) were additional cases detected by reactive case detection—computing to a total of 287 (67.5%) additional cases found by iCCM+ over iCCM. The likelihood of finding additional cases increased with increasing family size (adjusted odd ratio (aOR)=1.2, 95% CI: 1.1 to 1.3) and with increasing age (aOR=1.7, 95% CI: 1.5 to 1.9).ConclusionMost symptomatic cases of malaria remain undetected in the community despite the introduction of CCM of malaria. iCCM+ can be adopted to diagnose and treat more of these undiagnosed cases especially when targeted to schools, older children and larger households.

scholarly journals Assessment of risk factors associated with vitamin D status among children of an urban and a rural areas of Bangladesh

2020 ◽  
Vol 46 (2) ◽  
pp. 134-141
Author(s):  
Anamika Saha ◽  
Md Salim Shakur ◽  
Runa Laila ◽  
Salomee Shakur ◽  
Md Sohel Shomik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Urban Children ◽  
Outpatient Department ◽  
P Value ◽  
Rural Children ◽  
Vitamin D Status ◽  
Factors Associated

Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported. Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated. Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study. Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency. Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended. Bangladesh Med Res Counc Bull 2020; 46(2): 134-141

Risk Factors Associated with VOD with RIC and MAC Hematopoietic Stem Cell Transplant and the Early Estimation of VOD

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4315-4315
Author(s):  
Shoichi Nagakura ◽  
Tetsuyuki Kiyokawa ◽  
Michihiro Hidaka ◽  
Takahiro Yano ◽  
Kazutaka Sunami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Goodness Of Fit ◽  
Time Course ◽  
Laboratory Data ◽  
P Value ◽  
Cell Transplant ◽  
Data Set ◽  
Hematopoietic Stem ◽  
Post Transplant ◽  
Factors Associated

Abstract BACKGROUND: Despite recent increase of reduced intensity conditioning (RIC) transplantation, mortality rates after RIC and myeloabrative conditioning (MAC) HSCT remain high and hepatic veno-occlusive disease (VOD) cannot accurately predicted. OBJECTIVE: To determine the value of risk factors associated with the development of VOD after allergenic HSCT with RIC and MAC. Estimating VOD based on clinical factors may further improve results of allogenic HSCT. PATIENTS AND METHODS: A retrospective review of 415 consecutive allogenic HSCT was performed with attention to VOD, pre-transplant factors and laboratory data in five hematopoietic cell transplantation centers between 2000 and 2005. Patients underwent transplantation with MAC (n=247) or RIC (n=168). Main outcomes and risk factors were analyzed in multivariable analyses (a logistic regression model) with RIC and MAC. Three kind of laboratory data set, pre-transplant (day −10), post-transplant (day 20) and differences from pre-transplant to post-transplantation were analyzed. RESULTS: VOD occurred in 65 of 415(15.7%) transplant recipients; 40 of 247(16.1%) with MAC and 25 of 168(14.9%) with RIC. Multivariate analyses identified risk factors with the development of VOD with MAC (albumin level, creatinine level) and with RIC (HCT-CI, number of prior chemotherapy regimen, ALT) in pre-transplant laboratory data set. The risk factors of VOD were identified in post-transplant and differences (Table). The Akaike’s information criterion (AIC) of risk factors with differences was better than with the post-transplant. CONCLUSION: Our results provided risk factors of VOD with MAC and RIC. The estimation of VOD before transplantation may be useful for the selection of conditioning regimens. Differences of laboratory data with the time course of transplant may be useful for the early diagnosis of VOD. MAC Pre-transpant data Post-transplant data Differences data OR P-Value OR P-Value OR P-Value Age - - 0.945 0.0090 - - Alb 0.290 0.0125 - - - - Cr 10.204 0.0307 1.786 0.0039 1.984 0.0139 TPro - - 0 358 0.0019 - - TBi I - - 1.385 0.0027 1.314 0.0037 Ara-C - - 5.000 0.0139 goodness of fit AIC 106.727 126.499 86.931 RIC Pre-transpant data Post-transplant data Differences data OR P-Value OR P-Value OR P-Value Sex - - 3.401 0.0446 - - HCTCI 3.922 0.0050 2.000 0.0123 - - ImpScore 2.000 0.0314 - - - - TPro - - 0.366 0.0091 - - TBi I - - 1.675 0.0042 2.273 0.0004 ALT 0.969 0.0432 - - - - CY - - - - 5.682 0.0447 goodness of fit AIC 61.552 91.09 52.808

scholarly journals Asymptomatic Intestinal Parasitic Infestations among Children Under Five Years in Selected Communities in the Ho Municipality, Ghana

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
G.E. Kpene ◽  
S.Y. Lokpo ◽  
J.G. Deku ◽  
E. Agboli ◽  
P.K. Owiafe
Keyword(s):  
Risk Factors ◽  
Rural Communities ◽  
Intestinal Parasites ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated ◽  
Asymptomatic Children ◽  
Children Under 5

BACKGROUND፡ The study investigated intestinal parasitic infestations (IPIs) and possible risk factors associated with asymptomatic children under five (5) years in five (5) selected communities in the Ho Municipality.METHODS: The study design was cross- sectional, with a simple random sampling technique involving 150 asymptomatic children under 5 years from 5 selected communities (Klave, Hoe, Freetown, Dave and Godokpe) in the Ho Municipality. A questionnaire was used to obtain socio-demographics and other relevant parameters. Direct wet preparation, formol-ether concentration and Modified ZN staining techniques were used for the identification of intestinal parasites from participants’ stool samples. The Fisher’s exact test and binary logistic regression analysis were used to determine the difference in IPIs proportions and assess the risk factors associated with IPIs respectively.RESULTS: The overall IPIs cases was 14% (21/150). Cryptosporidium spp was most predominant [5.3% (8/150)], followed by Entamoeba spp [3.3% (5/150)], Cyclospora cayetenensis [2.7% (4/150)], Ascaris lumbricoides [1.3% (2/150)], Giardia lamblia [0.7% (1/150)] and Strongyloides stercoralis [0.7% (1/150)]. Children in rural communities (23.4%) recorded significantly higher case rate compared to those in urban communities (9.8%0), (p=0.04). Lower educational attainment of mother [OR=0.55, 95% CI (0.37 – 0.83), p-value = 0.015] andresidence in rural communities [OR = 0.53, 95% CI (0.33 –0.88)], p-value = 0.025] were significantly associated with IPIs.CONCLUSION: Asymptomatic IPIs are quite prevalent among children under 5 years in the Ho Municipality. The study thus recommends active sensitization programs for parents/guardians on preventive measures and school health programs should be instituted in rural communities.

scholarly journals Faktor Resiko Penyakit Infeksi Menular Seksual (IMS)

2018 ◽  
Vol 9 (3) ◽  
pp. 419
Author(s):  
Maria Tuntun
Keyword(s):  
Risk Factors ◽  
High School ◽  
Design Research ◽  
P Value ◽  
Age Group ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Cross Sectional Design ◽  
Age Range

<p>Sexually transmitted infections (STIs) are venereal diseases that can be transmitted by 30 types of pathogens through sexual intercourse. The purpose of this study is to find out the risk factors for STI disease in dr. H Hospital. Abdul Moeloek Lampung Province in 2012 - 2016. Type of descriptive analytic research with a cross-sectional design. Research place in RSUD dr. H. Abdul Moeloek Lampung Province, in November-December 2017. The population in this study were patients with STIs recorded in the medical record book of 2012-2016 as many as 191 people and a sample of 186 people. The results of the study obtained 4 types of STIs caused by bacteria, namely gonorrhea, syphilis, condyloma, and bartolinitis. The age range of STI patients is 12-62 years, and the most in the 12-25 year age group is 93 people (50%). The most STI sufferers are men, 100 people (53.8%), with the highest education is high school, which is 121 people (65.1%), more STI patients who work are 102 people (54.8%), and STI sufferers who more from Bandar Lampung, 103 people (55.4%). Risk factors associated with the type of STI are gender (p-value=0.012) and work (p-value=0.012), while age (p-value=0.718), education (p-value=0.368), and residence address (p-value=0.088) there is no relationship with the type of STI.</p>

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