scholarly journals High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

2020 ◽  
Author(s):  
jaishree raman ◽  
Laura Gast ◽  
Ryleen Balawanth ◽  
Sofonias Tessema ◽  
Basil Brooke ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Malaria Prevalence ◽  
Rapid Diagnostic Tests ◽  
Insecticide Susceptibility ◽  
Potential Vector ◽  
Breeding Sites ◽  
Highly Sensitive ◽  
Kwazulu Natal

Abstract Background: KwaZulu-Natal, one of South Africa’s three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission. Methods: Malaria prevalence as well as malaria knowledge, attitudes and practices among community members and mobile migrant populations within uMkhanyakude district, KwaZulu-Natal were assessed during a community-based malaria prevalence survey. All consenting participants were tested for malaria by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Finger-prick filter-paper blood spots were also collected from all participants for downstream parasite genotyping analysis. Entomological investigations were conducted around the surveyed households, with potential breeding sites geolocated and larvae collected for species identification and insecticide susceptibility testing. A random selection of households were assessed for indoor residual spray quality by cone bioassay. Results: A low malaria prevalence was confirmed in the study area, with only 2% (67/2979) of the participants found to be malaria positive by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Malaria prevalence however differed markedly between the border market and community (p < 0001), with the majority of the detected malaria carriers (65/67) identified as asymptomatic Mozambican nationals transiting through the informal border market from Mozambique to economic hubs within South Africa. Genomic analysis of the malaria isolates revealed a high degree of heterozygosity and limited genetic relatedness between the isolates supporting the hypothesis of limited local malaria transmission within the province. New potential vector breeding sites, potential vector populations with reduced insecticide susceptibility and areas with sub-optimal vector intervention coverage were identified during the entomological investigation. Conclusion: If KwaZulu-Natal is to successfully halt local malaria transmission and prevent the re-introduction of malaria, greater efforts needs to be placed on detecting and treating malaria carriers at both formal and informal border crossings with transmission blocking antimalarials, while ensuring optimal coverage of vector control interventions is achieved.

scholarly journals High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

2020 ◽  
Author(s):  
Jaishree Raman ◽  
Laura Gast ◽  
Ryleen Balawanth ◽  
Sofonias Tessema ◽  
Basil Brooke ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Malaria Prevalence ◽  
Rapid Diagnostic Tests ◽  
Insecticide Susceptibility ◽  
Potential Vector ◽  
Breeding Sites ◽  
Highly Sensitive ◽  
Kwazulu Natal

Abstract Background KwaZulu-Natal, one of South Africa’s three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission. Methods Malaria prevalence as well as malaria knowledge, attitudes and practices among community members and mobile migrant populations within uMkhanyakude district, KwaZulu-Natal were assessed during a community-based malaria prevalence survey. All consenting participants were tested for malaria by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Finger-prick filter-paper blood spots were also collected from all participants for downstream parasite genotyping analysis. Entomological investigations were conducted around the surveyed households, with potential breeding sites geolocated and larvae collected for species identification and insecticide susceptibility testing. A random selection of households were assessed for indoor residual spray quality by cone bioassay. Results A low malaria prevalence was confirmed in the study area, with only 2% (67/2979) of the participants found to be malaria positive by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Malaria prevalence however differed markedly between the border market and community (p < 0001), with the majority of the detected malaria carriers (65/67) identified as asymptomatic Mozambican nationals transiting through the informal border market from Mozambique to economic hubs within South Africa. Genomic analysis of the malaria isolates revealed a high degree of heterozygosity and limited genetic relatedness between the isolates supporting the hypothesis of limited local malaria transmission within the province. New potential vector breeding sites, potential vector populations with reduced insecticide susceptibility and areas with sub-optimal vector intervention coverage were identified during the entomological investigation. Conclusion If KwaZulu-Natal is to successfully halt local malaria transmission and prevent the re-introduction of malaria, greater efforts needs to be placed on detecting and treating malaria carriers at both formal and informal border crossings with transmission blocking anti-malarials, while ensuring optimal coverage of vector control interventions is achieved.

scholarly journals High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

2020 ◽  
Author(s):  
Jaishree Raman ◽  
Laura Gast ◽  
Ryleen Balawanth ◽  
Sofonias Tessema ◽  
Basil Brooke ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Malaria Incidence ◽  
Malaria Prevalence ◽  
Rapid Diagnostic Tests ◽  
Potential Vector ◽  
Breeding Sites ◽  
Highly Sensitive ◽  
Kwazulu Natal

Abstract Background: KwaZulu-Natal, one of South Africa’s three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission. Methods: Malaria prevalence as well as malaria knowledge, attitudes and practices among community members and mobile migrant populations within uMkhanyakude district, KwaZulu-Natal were assessed during a community-based malaria prevalence survey. All consenting participants were tested for malaria by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Finger-prick filter-paper blood spots were also collected from all participants for downstream parasite genotyping analysis. Entomological investigations were conducted around the surveyed households, with potential breeding sites geolocated and larvae collected for species identification and insecticide susceptibility testing. A random selection of households were assessed for indoor residual spray quality by cone bioassay. Results: A low malaria incidence was confirmed in the study area, with only 2% (67/2979) of the participants found to be malaria positive by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Malaria incidence however differed markedly between the border market and community (p < 0001), with the majority of the detected malaria carriers (65/67) identified as asymptomatic Mozambican nationals transiting through the informal border market from Mozambique to economic hubs within South Africa. Genomic analysis of the malaria isolates revealed a high degree of heterozygosity and limited genetic relatedness between the isolates supporting the hypothesis of limited local malaria transmission within the province. New potential vector breeding sites, potential vector populations with reduced insecticide susceptibility and areas with sub-optimal vector intervention coverage were identified during the entomological investigation. Conclusion: If KwaZulu-Natal is to successfully halt local malaria transmission and prevent the re-introduction of malaria, greater efforts needs to be placed on detecting and treating malaria carriers at both formal and informal border crossings with transmission blocking antimalarials, while ensuring optimal coverage of vector control interventions is achieved.

scholarly journals Baseline Malaria Prevalence at the Targeted Pre-elimination Districts in Ethiopia

2020 ◽  
Author(s):  
Desalegn Nega ◽  
Adugna Abera ◽  
Bokretsion Gidey ◽  
Sindew Mekasha ◽  
Abnet Abebe ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Open Data ◽  
Malaria Prevalence ◽  
Rapid Diagnostic Tests ◽  
Cross Sectional Survey ◽  
Axillary Temperature ◽  
Cross Sectional ◽  
Low Transmission ◽  
Total Prevalence

Abstract Background: Encouraged by the success in malaria control and prevention strategies, several malaria endemic countries have adopted elimination strategies worldwide. Accordingly, Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination for measuring future intervention success in elimination goal. Methods: Community based cross-sectional survey was conducted at twenty malaria elimination targeted districts selected from five regional states and one city administration in Ethiopia. The GPS enabled smart phones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. Care Start™ Malaria HRP-2/PLDH Rapid Diagnostic Tests (RDTs) were used for blood testing at field level. Armpit digital thermometers were used to measure axillary temperature.Result: Overall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at district levels ranged from 0.0% to 4.7%. The total prevalence of febrile cases (axillary temperature >37.5oc) in the survey was 9.2% (2760/29993). Among the 2,510 febrile individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. Among all study participants, 0.88% (255/28973) malaria positives were afebrile and 0.29% (84/28973) were febrile individuals. The 75.2% (255/339) of all malaria positives were afebrile. Of the total afebrile malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age. Conclusion: The 1.17% malaria prevalence that ranges 0 to 4% in some districts by rapid diagnostic tests should be given due consideration by the elimination program. Especially the higher prevalence of afebrile individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques than this conventional method is suggested to know more real magnitude of residual malaria in the elimination targeted low transmission areas and break the chain of transmission.

scholarly journals Baseline Malaria Prevalence at the Targeted Pre-elimination Districts in Ethiopia

2021 ◽  
Author(s):  
Desalegn Nega ◽  
Adugna Abera ◽  
Bokretsion Gidey ◽  
Sindew Mekasha ◽  
Abnet Abebe ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Open Data ◽  
Malaria Prevalence ◽  
Rapid Diagnostic Tests ◽  
Cross Sectional Survey ◽  
Axillary Temperature ◽  
Cross Sectional ◽  
Low Transmission ◽  
Total Prevalence

Abstract Background: Encouraged by the success in malaria control and prevention strategies, several malaria endemic countries have adopted elimination strategies worldwide. Accordingly, Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination for measuring future intervention success in elimination goal. Methods: Community based cross-sectional survey was conducted at twenty malaria elimination targeted districts selected from five regional states and one city administration in Ethiopia. The GPS enabled smart phones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. Care Start™ Malaria HRP-2/PLDH Rapid Diagnostic Tests (RDTs) were used for blood testing at field level. Armpit digital thermometers were used to measure axillary temperature.Result: Overall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at district levels ranged from 0.0% to 4.7%. The total prevalence of febrile cases (axillary temperature >37.5oc) in the survey was 9.2% (2760/29993). Among the 2,510 febrile individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. Among all study participants, 0.88% (255/28973) malaria positives were afebrile and 0.29% (84/28973) were febrile individuals. The 75.2% (255/339) of all malaria positives were afebrile. Of the total afebrile malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age. Conclusion: The 1.17% malaria prevalence that ranges 0 to 4% in some districts by rapid diagnostic tests should be given due consideration by the elimination program. Especially the higher prevalence of afebrile individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques than this conventional method is suggested to know more real magnitude of residual malaria in the elimination targeted low transmission areas and break the chain of transmission.

Efficiency of histidine rich protein II-based rapid diagnostic tests for monitoring malaria transmission intensities in an endemic area

2018 ◽  
Author(s):  
Titilope Modupe Dokunmu ◽  
Grace Iyabo Olasehinde ◽  
David Oladoke Oladejo ◽  
Oladeji Olanrewaju ◽  
Abisola Akinbobola ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Diagnostic Tests ◽  
Endemic Area ◽  
Rapid Diagnostic Tests

scholarly journals The Utility of Malaria Rapid Diagnostic Tests as a Tool in Enhanced Surveillance for Malaria Elimination in Vanuatu

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0167136 ◽  
Author(s):  
Wesley Donald ◽  
Cielo Pasay ◽  
Jean-Olivier Guintran ◽  
Harry Iata ◽  
Karen Anderson ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Rapid Diagnostic Tests ◽  
Malaria Rapid Diagnostic Tests

scholarly journals The Role of Antigen Rapid Diagnostic Test in COVID-19 Diagnosis

2021 ◽  
Vol 1 (1) ◽  
pp. 108-111
Author(s):  
Ronni Mol Joji ◽  
Mohammad Shahid
Keyword(s):  
Diagnostic Tests ◽  
Point Of Care ◽  
Rapid Diagnostic Tests ◽  
World Health ◽  
Complementary Role ◽  
Reverse Transcription Quantitative Pcr ◽  
Highly Sensitive ◽  
Health Organization ◽  
Random Screening

Since the emergence of a novel infection due to the SARS-CoV-2 virus (COVID-19), the World Health Organization has urged countries to develop diagnostic tests to combat the pandemic. Molecular assays were developed following the release of the gene sequence of the virus in January 2020. Reverse transcription-quantitative PCR (RT-qPCR) is taken as the gold standard for the diagnosis of COVID-19. However, due to its limitations, highly sensitive methods for detecting antigens (antigen rapid diagnostic tests) have been developed that would help in a timely and accurate diagnosis. Antigen rapid diagnostic tests (Ag-RDTs) can help guide patient management at the point of care by random screening, re-testing, and timely decision-making in the field of public health. When the affordability and validity of the diagnostic assay are involved, no assay can show 100% correct results. Further studies need to be done to better understand the response of the Ag-RDTs in different settings. Nevertheless, Ag-RDTs can play a complementary role in the response and case management of COVID-19.

scholarly journals Situation of Asymptomatic Malaria among Iranian Native and Af-ghan and Pakistani Immigrants in a Malarious Area under the Na-tional Malaria Elimination Program of Iran

2020 ◽  
Author(s):  
Setareh ASKARI ◽  
Mehdi NATEGHPOUR ◽  
Afsaneh MOTEVALLI HAGHI ◽  
Leila FARIVAR ◽  
Ahmad RAEISI ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Rapid Diagnostic Tests ◽  
Asymptomatic Malaria ◽  
Sectional Study ◽  
Cross Sectional ◽  
Microscopical Method ◽  
Pakistani Immigrants ◽  
Pcr Techniques

Background: This study was designed to detect, if there are asymptomatic malaria infections amongst native and immigrant population from Afghanistan and Pakistan countries in Sistan & Baluchistan Province of Iran, where is under the national malaria elimination program. Methods: This cross-sectional study was performed among native individuals and resident immigrants in the southeastern province of Sistan & Baluchistan from May 2016 to Jul 2017. A total of 271 individuals were considered in this cross- sectional study based on microscopical method, Rapid Diagnostic Tests (RDTs) and PCR techniques. Out of 271 native and immigrant participants 140 (52%) and 131 (48%) were male and female, respectively. Results: None of the prepared samples was diagnosed as malaria positive case when was considered via above mentioned three techniques. Conclusion: Neither native nor immigrant individuals had asymptomatic malaria, hinting that national malaria elimination program is performed according to planned schedule in the studied areas

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