Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

Control Measures ◽

Bed Nets ◽

Model Parameters ◽

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana have been investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation model with its associated rate parameters was developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Model parameters were estimated using data captured on the District Health Information Management System in Ghana from 2008 to 2017.The impact of insecticide treated bed nets and indoor residual spraying on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone. To fit the model, Approximate Bayesian Computational sampling approach was adopted. Results Increasing the coverage levels of both long lasting insecticide treated bed nets or indoor residual spraying activities without a corresponding increase in their proper use or patronage does not impact highly on averting predicted incidence of malaria in Ghana. Improving on the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones. Conclusions Projected goals set in the National Strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high efficacy.

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

10.21203/rs.2.22332/v2 ◽

2020 ◽

Author(s):

Timothy Awine ◽

Sheetal P Silal

Keyword(s):

Malaria Control ◽

Malaria Incidence ◽

Protective Efficacy ◽

Control Measures ◽

Bed Nets ◽

Model Parameters ◽

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana were investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation models with their associated rate parameters were developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Models were fitted using data from the District Health Information Management System in Ghana from 2008 to 2017 and historical intervention coverage levels. To calibrate the models, Approximate Bayesian Computational sampling approach with a distance based rejection criteria was adopted. A leave-one-out approach was used to validate model parameters and the most sensitive evaluated using a multivariate regression sensitivity analysis. The impact of insecticide treated bed nets and their usage and indoor residual spraying as well as their protective efficacy on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the malaria control strategy for 2014-2020. Results Increasing the coverage levels of both long lasting insecticide treated bed nets and indoor residual spraying activities without a corresponding increase in their recommended usage does not impact highly on averting predicted incidence of malaria. Improving upon the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones.Conclusions Projected goals set in the national strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely to be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy. Key words: model, malaria, interventions, long lasting insecticide bednets, indoor residual spraying

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: a population level mathematical modelling approach

Malaria Journal ◽

10.1186/s12936-020-03496-y ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Timothy Awine ◽

Sheetal P. Silal

Keyword(s):

Malaria Control ◽

Protective Efficacy ◽

World Health ◽

Bed Nets ◽

Model Parameters ◽

Ecological Zones ◽

Abstract Background This paper investigates the impact of malaria preventive interventions in Ghana and the prospects of achieving programme goals using mathematical models based on regionally diverse climatic zones of the country. Methods Using data from the District Health Information Management System of the Ghana Health Service from 2008 to 2017, and historical intervention coverage levels, ordinary non-linear differential equations models were developed. These models incorporated transitions amongst various disease compartments for the three main ecological zones in Ghana. The Approximate Bayesian Computational sampling approach, with a distance based rejection criteria, was adopted for calibration. A leave-one-out approach was used to validate model parameters and the most sensitive parameters were evaluated using a multivariate regression analysis. The impact of insecticide-treated bed nets and their usage, and indoor residual spraying, as well as their protective efficacy on the incidence of malaria, was simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the Ghana malaria control strategy for 2014–2020. Results Increasing the coverage levels of both long-lasting insecticide-treated bed nets and indoor residual spraying activities, without a corresponding increase in their recommended utilization, does not impact highly on averting predicted incidence of malaria. Improving proper usage of long-lasting insecticide-treated bed nets could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all ecological zones of Ghana. Conclusions Projected goals set in the national strategic plan for malaria control 2014–2020, as well as World Health Organization targets for malaria pre-elimination by 2030, are only likely to be achieved if a substantial improvement in treated bed net usage is achieved, coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy.

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach

10.21203/rs.2.22332/v3 ◽

2020 ◽

Author(s):

Timothy Awine ◽

Sheetal P Silal

Keyword(s):

Malaria Control ◽

Protective Efficacy ◽

Bed Nets ◽

Model Parameters ◽

District Health ◽

Ecological Zones ◽

Abstract Background: This paper investigates the impact of malaria preventive interventions in Ghana and the prospects of achieving program goals using mathematical models based on regionally diverse climatic zones of the country. Methods: Using data from the District Health Information Management System of the Ghana Health Service from 2008 to 2017 and historical intervention coverage levels, ordinary non-linear differential equations models were developed incorporating transistions between various disease compartments for the three main ecological zones in Ghana. The Approximate Bayesian Computational sampling approach, with a distance based rejection criteria, was adopted for calibration. A leave-one-out approach was used to validate model parameters and the most sensitive evaluated using a multivariate regression analysis. The impact of insecticide treated bed nets and their usage and indoor residual spraying as well as their protective efficacy on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the Ghana malaria control strategy for 2014-2020. Results: Increasing the coverage levels of both long lasting insecticide treated bed nets and indoor residual spraying activities without a corresponding increase in their recommended utilisation does not impact highly on averting predicted incidence of malaria. Improving proper usage of long lasting insecticide treated bed nets could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all ecological zones of Ghana. Conclusions: Projected goals set in the national strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely to be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy.

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach

10.21203/rs.2.22332/v4 ◽

2020 ◽

Author(s):

Timothy Awine ◽

Sheetal P Silal

Keyword(s):

Malaria Control ◽

Protective Efficacy ◽

World Health ◽

Bed Nets ◽

Model Parameters ◽

Ecological Zones ◽

Abstract Background This paper investigates the impact of malaria preventive interventions in Ghana and the prospects of achieving programme goals using mathematical models based on regionally diverse climatic zones of the country. Methods Using data from the District Health Information Management System of the Ghana Health Service from 2008 to 2017, and historical intervention coverage levels, ordinary non-linear differential equations models were developed. These models incorporated transitions amongst various disease compartments for the three main ecological zones in Ghana. The Approximate Bayesian Computational sampling approach, with a distance based rejection criteria, was adopted for calibration. A leave-one-out approach was used to validate model parameters and the most sensitive parameters were evaluated using a multivariate regression analysis. The impact of insecticide-treated bed nets and their usage, and indoor residual spraying, as well as their protective efficacy on the incidence of malaria, was simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the Ghana malaria control strategy for 2014-2020. Results Increasing the coverage levels of both long-lasting insecticide-treated bed nets and indoor residual spraying activities, without a corresponding increase in their recommended utilization, does not impact highly on averting predicted incidence of malaria. Improving proper usage of long-lasting insecticide-treated bed nets could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all ecological zones of Ghana. Conclusions Projected goals set in the national strategic plan for malaria control 2014-2020, as well as World Health Organization targets for malaria pre-elimination by 2030, are only likely to be achieved if a substantial improvement in treated bed net usage is achieved, coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy.

Transgenic Mosquitoes Fight against Malaria: A Review

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v7i1.24695 ◽

2019 ◽

Vol 7 (1) ◽

pp. 59-65 ◽

Cited By ~ 1

Author(s):

Amit Kumar Shrivastava ◽

Laxmi Shrestha ◽

Shraddha Prakash ◽

Roshan Kumar Mehta

Keyword(s):

Malaria Control ◽

Control Program ◽

Bed Nets ◽

Mosquito Vector ◽

Gene Drive ◽

Malaria Control Program ◽

Malaria Burden ◽

Transgenic Mosquitoes

Malaria control with transgenic mosquitoes will be challenging; however, recent advances suggest that it may be a possibility in the foreseeable future. Progress towards discovering refractory genes for rodent malaria and gene drive systems for Drosophila provide hope that similar advances may be made for human malaria in mosquito vector species. That said, the African malaria burden has proved exceptionally difficult to diminish by all means tried thus far; and it is unlikely that transgenic mosquitoes will provide an all-in-one solution. Transgenic mosquitoes should be considered within the context of an integrated vector management strategy which should also include insecticide-treated bed-nets, indoor residual spraying with insecticides and treatment of infected individuals with antimalarial drugs. Integrated strategies will be a necessity for any successful african malaria control program and transgenic mosquitoes should be considered as a potential ingredient in the future goal of continent-wide disease control.

The impact of stopping and starting indoor residual spraying on malaria burden in 14 districts of Uganda

10.21203/rs.3.rs-126095/v1 ◽

2020 ◽

Author(s):

Jane Namuganga ◽

Adrienne Epstein ◽

Joaniter Nankabirwa ◽

Arthur Mpimbaza ◽

Moses Kiggundu ◽

...

Keyword(s):

Malaria Incidence ◽

Critical Role ◽

Scale Up ◽

Fold Increase ◽

Bed Nets ◽

Malaria Burden ◽

Vector Control Intervention ◽

Using Data ◽

Abstract The scale-up of malaria control efforts has led to marked reductions in malaria burden over the past twenty years, but progress has slowed. Implementation of indoor residual spraying (IRS) of insecticide, a proven vector control intervention, has been limited and difficult to sustain partly because questions remain on its added impact over widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities in Uganda, a country with high bet net coverage yet high malaria burden, we estimate the impact of starting and stopping IRS. We show that stopping IRS resulted in a 5-fold increase in malaria incidence within 10 months, but reinstating IRS led to an over 5-fold decrease within 8 months. In areas where IRS was initiated and sustained, malaria incidence dropped by 85% after year 4. IRS could play a critical role in achieving global malaria targets, particularly in areas where progress has stalled.

Push by a net, pull by a cow: can zooprophylaxis enhance the impact of insecticide treated bed nets on malaria control?

Parasites & Vectors ◽

10.1186/1756-3305-7-52 ◽

2014 ◽

Vol 7 (1) ◽

pp. 52 ◽

Cited By ~ 26

Author(s):

Hanako Iwashita ◽

Gabriel O Dida ◽

George O Sonye ◽

Toshihiko Sunahara ◽

Kyoko Futami ◽

...

Keyword(s):

Malaria Control ◽

Bed Nets ◽

The impact of stopping and starting indoor residual spraying on malaria burden in Uganda

Nature Communications ◽

10.1038/s41467-021-22896-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Jane F. Namuganga ◽

Adrienne Epstein ◽

Joaniter I. Nankabirwa ◽

Arthur Mpimbaza ◽

Moses Kiggundu ◽

...

Keyword(s):

Malaria Incidence ◽

Critical Role ◽

Scale Up ◽

Fold Increase ◽

Bed Nets ◽

Malaria Burden ◽

Vector Control Intervention ◽

Using Data ◽

AbstractThe scale-up of malaria control efforts has led to marked reductions in malaria burden over the past twenty years, but progress has slowed. Implementation of indoor residual spraying (IRS) of insecticide, a proven vector control intervention, has been limited and difficult to sustain partly because questions remain on its added impact over widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities in Uganda, a country with high bed net coverage yet high malaria burden, we estimate the impact of starting and stopping IRS on changes in malaria incidence. We show that stopping IRS was associated with a 5-fold increase in malaria incidence within 10 months, but reinstating IRS was associated with an over 5-fold decrease within 8 months. In areas where IRS was initiated and sustained, malaria incidence dropped by 85% after year 4. IRS could play a critical role in achieving global malaria targets, particularly in areas where progress has stalled.

Burden of Malaria in three Endemic Districts of Bhutan: Road to Malaria Elimination

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol04-i01/548 ◽

2019 ◽

Vol 4 (01) ◽

Cited By ~ 1

Author(s):

Vishal Chhetri ◽

Tobgyel Dukpa ◽

Rinzin Namgay ◽

Kesang Wangchuk ◽

Hari Prasad Pokrel

Keyword(s):

Large Scale ◽

Malaria Incidence ◽

Care Service ◽

Health Care Service ◽

Bed Nets ◽

Vector Surveillance ◽

Male Population ◽

Mortality And Morbidity ◽

Insecticide Treated Bed Nets

Introduction: Bhutan is considered as a low endemic country for malaria. In the last decade, Bhutan has successfully reduced the number of malaria cases with the support from Global Fund and WHO. Sarpang, Samtse and Samdrup Jongkhar districts located in the Southern foothills of Bhutan records the most cases. Method: This retrospective study was undertaken with the available census record maintained in health centers of the three endemic districts and VDCP. Results: There were 892 confirmed malaria cases in 2009 and 41 cases in 2017 in three endemic districts. The slide positivity rate (SPR) declined from 2.2% in 2009 to 0.1% in 2017. The distribution of disease was significantly higher (p<0.05) amongst the male population with the increasing trend of Plasmodium vivax infection. The study found predominance of P. vivax in Samtse (93%), and Sarpang (62%) and Plasmodium falciparum in Samdrup Jongkhar (61%). The last four years (2014-2017) data showed that maximum cases detected were imported, followed by indigenous and introduced malaria; with 50%, 44% and 6%, respectively. The mortality and morbidity due to malaria has magnificently declined in the last decade. Conclusion: The large-scale implementation of vector control interventions, such as insecticide-treated bed nets, indoor residual spraying, free health care service and active vector surveillance has achieved a marked reduction in malaria incidence. Cross border malaria is still a huge challenge for elimination of malaria in Bhutan. Thus, imported malaria is an increasing problem due to high receptivity, and vulnerability.

Evaluating the Efficacy, Impact and Feasibility of Community-based House Screening as a Complementary Malaria Control Intervention in Southern Africa: a Study Protocol for a Household Randomized Trial.

10.21203/rs.3.rs-458248/v1 ◽

2021 ◽

Author(s):

Peter Onyango Sangoro ◽

Ulrike Fillinger ◽

Kochelani Saili ◽

Theresia Estomih Nkya ◽

Rose Marubu ◽

...

Keyword(s):

Vector Control ◽

Malaria Transmission ◽

Malaria Control ◽

Malaria Incidence ◽

Clinical Malaria ◽

Sub Saharan Africa ◽

Substantial Impact ◽

Transmission Season ◽

Abstract Background: Concerted effort to control malaria has had a substantial impact on transmission of the disease in the past two decades. In areas where reduced malaria transmission is being sustained through insecticide-based vector control interventions, primarily long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), non-insecticidal complementary tools will likely be needed to push towards malaria elimination. Once interruption in local disease transmission is achieved, insecticide-based measures can be scaled down gradually and eventually phased out, saving on costs of sustaining control programmes and mitigating any unintended negative health and environmental impacts posed by insecticides. These non-insecticidal methods could eventually replace insecticidal methods of vector control. House screening, a non-insecticidal method, has a long history in malaria control, but is still not widely adopted in sub-Saharan Africa. This study aims to add to the evidence-base for this intervention in low transmission settings by assessing the efficacy, impact and feasibility of house screening in areas where LLINs are conventionally used for malaria control. Methods: A two-armed, household randomized clinical trial will be conducted in Mozambique, Zambia and Zimbabwe to evaluate whether combined use of house screens and LLINs affords better protection against clinical malaria in children between 6 months and 13 years compared to the sole use of LLINs. Eight hundred households will be enrolled in each study area, where 400 households will be randomly assigned the intervention, house screening and LLINs while the control households will be provided with LLINs only. Clinical malaria incidence will be estimated by actively following up one child from each household for 6 months over the malaria transmission season. Cross-sectional parasite prevalence will be estimated by testing all participating children for malaria parasites at the beginning and end of each transmission season using rapid diagnostic tests.CDC light traps and pyrethrum spray catches (PSC) will be used to sample adult mosquitoes and evaluate the impact of house screening on indoor mosquito density, species distribution and sporozoite rates.Discussion: This study will contribute epidemiological data on the impact of house screening on malaria transmission and assess the feasibility of its implementation on a programmatic scale. Trial registration: This trial was retrospectively registered on 11th August 2020. Registration number PACTR202008524310568.