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.

scholarly journals Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Desalegn Nega ◽  
Adugna Abera ◽  
Bokretsion Gidey ◽  
Sindew Mekasha ◽  
Abnet Abebe ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Open Data ◽  
Diagnostic Techniques ◽  
Malaria Prevalence ◽  
Asymptomatic Malaria ◽  
Cross Sectional Survey ◽  
Axillary Temperature ◽  
Cross Sectional ◽  
Control And Prevention ◽  
Asymptomatic Individuals

Abstract Background Encouraged by the previous success in malaria control and prevention strategies, the 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 at targeted settings. Methods A community-based cross-sectional survey was conducted at 20 malaria-elimination targeted Districts selected from five Regional states and one city administration in Ethiopia. The GPS-enabled smartphones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. CareStart™ Malaria PAN (pLDH) Rapid Diagnostic Tests (RDTs) were used for blood testing at the 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 proportion of symptomatic cases (axillary temperature > 37.5oc) in the survey was 9.2% (2760/29993). Among the 2510 symptomatic individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. The 75.2% (255/339) of all malaria positives were asymptomatic. Of the total asymptomatic malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age. Conclusion The study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country. The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts. Particularly, the high prevalence of asymptomatic individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques is suggested to know more real magnitude of residual malaria in the elimination-targeted areas.

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

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 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 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 Plasmodium falciparum is evolving to escape malaria rapid diagnostic tests in Ethiopia

2021 ◽  
Author(s):  
Sindew M. Feleke ◽  
Emily N. Reichert ◽  
Hussein Mohammed ◽  
Bokretsion G. Brhane ◽  
Kalkidan Mekete ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Diagnostic Tests ◽  
Population Expansion ◽  
Selective Advantage ◽  
Rapid Diagnostic Tests ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Diagnostic Strategies ◽  
Malaria Rapid Diagnostic Tests ◽  
Molecular Inversion Probe

AbstractIn Africa, most rapid diagnostic tests (RDTs) for falciparum malaria recognize histidine-rich protein 2 antigen. Plasmodium falciparum parasites lacking histidine-rich protein 2 (pfhrp2) and 3 (pfhrp3) genes escape detection by these RDTs, but it is not known whether these deletions confer sufficient selective advantage to drive rapid population expansion. By studying blood samples from a cohort of 12,572 participants enroled in a prospective, cross-sectional survey along Ethiopia’s borders with Eritrea, Sudan and South Sudan using RDTs, PCR, an ultrasensitive bead-based immunoassay for antigen detection and next-generation sequencing, we estimate that histidine-rich protein 2-based RDTs would miss 9.7% (95% confidence interval 8.5–11.1) of P. falciparum malaria cases owing to pfhrp2 deletion. We applied a molecular inversion probe-targeted deep sequencing approach to identify distinct subtelomeric deletion patterns and well-established pfhrp3 deletions and to uncover recent expansion of a singular pfhrp2 deletion in all regions sampled. We propose a model in which pfhrp3 deletions have arisen independently multiple times, followed by strong positive selection for pfhrp2 deletion owing to RDT-based test-and-treatment. Existing diagnostic strategies need to be urgently reconsidered in Ethiopia, and improved surveillance for pfhrp2 deletion is needed throughout the Horn of Africa.

Use of diagnostic tests by dermatologists, podiatrists and family practitioners in the United States: pilot data from a cross-sectional survey

Mycoses ◽  
2007 ◽  
Vol 50 (6) ◽  
pp. 463-469 ◽  
Author(s):  
Rebecca L. Koshnick ◽  
Kia K. Lilly ◽  
Katherine St Clair ◽  
Mary T. Finnegan ◽  
Erin M. Warshaw
Keyword(s):  
United States ◽  
Diagnostic Tests ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pilot Data ◽  
Family Practitioners

scholarly journals From malaria control to elimination in South Africa: The researchers’ perspectives

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Khumbulani W. Hlongwana ◽  
Joyce Tsoka-Gwegweni
Keyword(s):  
South Africa ◽  
Community Involvement ◽  
Malaria Elimination ◽  
Surveillance Systems ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Cross Border ◽  
Malaria Episodes ◽  
Structured Questionnaire

Background: Global decline in malaria episodes over the past decade gave rise to a debate to target malaria elimination in eligible countries. However, investigation regarding researchers’ perspectives on barriers and facilitating factors to effective implementation of a malaria elimination policy in South Africa (SA) is lacking.Aim: The aim of this study was to investigate the malaria researchers’ knowledge, understandings, perceived roles, and their perspectives on the factors influencing implementation of a malaria elimination policy in SA.Setting: Participants were drawn from the researchers who fulfilled the eligibility criteria as per the protocol, and the criteria were not setting-specific.Methods: The study was a descriptive cross-sectional survey conducted through an emailed self-administered semi-structured questionnaire amongst malaria researchers who met the set selection criteria and signed informed consent.Results: Most (92.3%) participants knew about SA’s malaria elimination policy, but only 45.8% had fully read it. The majority held a strong view that SA’s 2018 elimination target was not realistic, citing that the policy had neither been properly adapted to the country’s operational setting nor sufficiently disseminated to all relevant healthcare workers. Key concerns raised were lack of new tools, resources, and capacity to fight malaria; poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance.Conclusion: Malaria elimination is a noble idea, with sharp divisions. However, there is a general agreement that elimination requires: (a) strong cross-border initiatives; (b) deployment of adequate resources; (c) sustainable multistakeholder support and collaboration; (d) good surveillance systems; and (e) availability and use of all effective intervention tools.

Prevalence and Epidemiological Characteristics of Asymptomatic Malaria Based on Ultrasensitive Diagnostics: A Cross-sectional Study

2018 ◽  
Vol 69 (6) ◽  
pp. 1003-1010 ◽  
Author(s):  
Seble Girma ◽  
James Cheaveau ◽  
Abu Naser Mohon ◽  
Dewdunee Marasinghe ◽  
Ruth Legese ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Cross Sectional Study ◽  
Rapid Diagnostic Tests ◽  
World Health ◽  
Asymptomatic Malaria ◽  
Global Public Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Qrt Pcr ◽  
Epidemiological Characteristics

Abstract Background As the global public-health objectives for malaria evolve from malaria control towards malaria elimination, there is increasing interest in the significance of asymptomatic infections and the optimal diagnostic test to identify them. Method We conducted a cross-sectional study of asymptomatic individuals (N = 562) to determine the epidemiological characteristics associated with asymptomatic malaria. Participants were tested by rapid diagnostic tests (CareStart, Standard Diagnostics [SD] Bioline, and Alere ultrasensitive RDT [uRDT]), loop-mediated isothermal amplification (LAMP), and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine malaria positivity. Hemoglobin values were recorded, and anemia was defined as a binary variable, according to World Health Organization guidelines. Results Compared to reference qRT-PCR, LAMP had the highest sensitivity (92.6%, 95% confidence interval [CI] 86.4–96.5), followed by uRDT Alere Malaria (33.9%, 95% CI 25.5–43.1), CareStart Malaria (14.1%, 95% CI 8.4–21.5), microscopy (5.0%, 95% CI 1.8–10.5), and SD Bioline (5.0%, 95% CI 1.8–10.5). For Plasmodium falciparum specimens only, the sensitivity for uRDT Alere Malaria was 50.0% (95% CI 38.8–61.3) and SD Bioline was 7.3% (95% CI 2.7–15.3). Based on multivariate regression analysis with qRT-PCR as the gold standard, for every 3.2% increase in the prevalence of asymptomatic malaria, hemoglobin decreased by 1 gram per deciliter (prevalence ratio 0.968, 95% CI 0.940–0.997; P = .032). Deletions (4.8%) in hrp2 were noted. Conclusions While uRDT Alere Malaria has superior sensitivity to rapid diagnostic tests and microscopy in detecting asymptomatic malaria, LAMP is superior still. Ultrasensitive diagnostics provide the accurate prevalence estimates of asymptomatic malaria required for elimination.

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