scholarly journals Assessing the Intrinsic and Extrinsic Drivers and Targeting the Observed Resilience of Malaria in Northwestern and Southern Tanzania: A Protocol for a Cross-Sectional Exploratory Study

2020 ◽  
Author(s):  
Mercy G Chiduo ◽  
Celine I. Mandara ◽  
Susan F. Rumisha ◽  
Frank Chaky ◽  
Filbert T. Francis ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Control Strategies ◽  
Group Discussion ◽  
Bed Nets ◽  
Malaria Surveillance ◽  
Previous Night ◽  
High Coverage ◽  
Cross Sectional ◽  
Malaria Burden ◽  
Using Data

Abstract Background Despite high coverage and successes in malaria control strategies, some areas of Tanzania have indicated stagnantion or revesal of malaria burden. In malaria research, most studies are designed to assess drivers of malaria transmission focusing only on one dimension, single location while very few studies assess multiple components and their interactions. This article describes the protocol used to assess intrinsic and extrinsic drivers of persistent malaria transmission (hotsposts) in four regions from northwestern (Geita and Kigoma) and southern (Ruvuma and Mtwara) Tanzania.Results: Preliminary results show that 6,297 HHs and 28,361 individuals with median age of 16yrs (IQR= 7-35yrs) were registered from the 16 villages. Over 49% of individuals used bed-nets in the previous night before the survey and 43.9% of HHs had bed-nets covering two members per household. For parasitological survey, 25.8% of registered individuals (n=7,313) were selected from 2,527 HHs (40.1%) and invited for assessment and sampling. The positivity rate (PR) by mRDTs was 33.3% (range = 21.9% to 41.1%); while by microscopy, the PR was 20.6% and varied from 8.0% to 29.0%. Socio-anthropology interviews were conducted with a total of 1,687 heads/representatives of HHs. For qualitative surveys 32 Focus group discussion (two from each village) and 16 key informant interviews (two per district) were conducted. Thirty-one health facilities were visited for health system survey; 19.4% (n=6) were hospitals; 41.9% (n=13) health centres and 38.7% (n=12) dispensaries. For entomological survey, 8,891 adult mosquitoes were collected, whereby Anopheles gambiae complex, An. funestus group and other mosquitoes accounted for 12.0%, 49.7% and 38.3%, respectively.Conclusion: An analysis plan using data from the five components surveyed has been proposed and results from this study are expected to determine factors potentially responsible for persistence of malaria (hotspots) in the study areas. Rather than the traditional methodology of focusing on one metric, the approach will triangulate observations from all five components, highlighting understanding of potential drivers while studying their complex interactions and map spatial heterogeneity. This study will provide an important framework and data which will guide future studies and malaria surveillance in Tanzania and other malaria endemic countries.

scholarly journals Assessing the intrinsic and extrinsic drivers and targeting the observed resilience of malaria in northwestern and southern Tanzania: A protocol for a cross-sectional exploratory study

2020 ◽  
Author(s):  
Mercy G. Chiduo ◽  
Celine I. Mandara ◽  
Susan F. Rumisha ◽  
Frank Chaky ◽  
Filbert T. Francis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health System ◽  
Malaria Transmission ◽  
Control Strategies ◽  
Rapid Test ◽  
Malaria Prevention ◽  
Health Facilities ◽  
Malaria Surveillance ◽  
High Coverage ◽  
Cross Sectional

ABSTRACTBackgroundDespite high coverage and successes in malaria control strategies, some areas of Tanzania have indicated stagnantion or revesal of malaria burden. In malaria research, most studies are designed to assess drivers of malaria transmission focusing only on one dimension, single location while very few studies assess multiple components and their interactions at once. This article describes the protocol used to assess intrinsic and extrinsic drivers of persistent malaria transmission (hotsposts) in four regions from northwestern (Geita and Kigoma) and southern (Ruvuma and Mtwara) Tanzania.MethodsThis cross-sectional study was conducted between July and November 2017 in eight districts (two from each region). Based on the health facilities records, two villages were selected from each district. The study assessed five components individually and their linkages: socio-economic and malaria risk factors, parasitological, entomological, socio-anthropological and health system factors. Households (HHs) and household members were enumerated, socio-economic status and risk factors associated with malaria transmission were assessed. A total of 120 HHs were sampled from each village where malaria testing using rapid test and microscopy were done and blood spots on filter papers for genetic studies were collected. Heads of HHs were interviewed to capture information on knowledge, attitude, practice and beliefs towards malaria and its control. Assessment of adult mosquitoes in 25 HHs in each village and complimented with assessment of immature mosquitoes through larvae was conducted. The performance of the health system was assessed with respect to Information on availability, accessibility, affordability and quality of malaria prevention and case management services were collected from these health facilities.DiscussionThe proposed analysis plan and results from this study are expected to determine factors potentially responsible for persistence of malaria (hotspots) in the study areas. Rather than the traditional methodology of focusing on one metric, the approach proposed here triangulates observations from all five components, highlighting understanding of potential drivers while studying their complex interactions and map spatial heterogeneity. This study will provide an important framework and data which will guide future studies and malaria surveillance in Tanzania and other malaria endemic countries.

scholarly journals Ownership, utilization, and motivations for use or non-use of bed nets among community members at risk of malaria along the Thai-Myanmar border

2021 ◽  
Author(s):  
Kasama Pooseesod ◽  
Daniel M. Parker ◽  
Natthani Meemon ◽  
Saranath Lawpoolsri ◽  
Pratap Singhasivanon ◽  
...  
Keyword(s):  
At Risk ◽  
Bed Nets ◽  
High Risk Population ◽  
Bed Net ◽  
Mosquito Density ◽  
Previous Night ◽  
High Coverage ◽  
Cross Sectional ◽  
Net Use ◽  
Heat Perception

Abstract Background With the goal for malaria elimination in Thailand set for 2024, increased coverage and utilization of bed net, especially insecticide-treated net (ITN) or long-lasting insecticidal net (LLIN) is a key strategy. This study aims to provide the necessary information about bed net ownership and utilization among the population at risk of malaria living along the Thai-Myanmar border in Tak province. Methods A cross-sectional study was conducted using a mixed-method approach in 331 households from 5 hamlets in the villages of the Thai-Myanmar border. The research tools included a questionnaire, bed net inspection, and semi-structured interviews. Log-binomial regression was used to explore the sociodemographic factors associated with bed net utilization. The qualitative analysis employed a thematic analysis approach. Results This survey found that 98.5% of households had at least one bed net per household, and 74.3% had at least one ITN/LLIN. However, only 30.8% of households reached the standard policy set by the Minister of Public Health of one ITN/LLINs per two persons. Most residents used bed net (92.1% used in the previous night and 80.9% used every day). For those using bed nets, however, 61.9% used ITNs or LLINs the night before and 53.1% used them every day. Nonetheless, the usage rates of bed nets (any type) in the previous night among children and pregnant women were high, reaching 95.3% and 90.0%, respectively. Three explanatory variables including “not stay overnight in the forest”, “preference of free bed nets”, and “sufficient numbers of bed nets to cover all sleeping spaces”, showed statistically significant association with bed net use every day. The major reasons for the regular use of bed nets in both household and the forest were to prevent mosquito biting. The reasons for not using bednets in the household were discomfort feelings from heat, perception of unnecessity due to low mosquito density, whereas the reason for not using bednets in the forest was inconvenience. Conclusion Despite that overall coverage and usage of bed nets was high, only one third reached the standard level specified by the policy. Overnight in the forest, the dissatisfaction with the quality of free bed nets, insufficient number of bed nets, discomfort from heat, perception of no benefits of bed nets due to low mosquito density, and inconvenience were factors influencing bed net use. Maintaining high coverage and utility rate of bed nets should be a priority for the malaria high-risk population.

Surveillance-based estimation of the malaria disease burden in a low endemic state of Punjab, India, targeted for malaria elimination

2021 ◽  
Author(s):  
Jaspreet Kaur ◽  
Taruna Kaura ◽  
Ayush Sharma ◽  
Ashish Kumar ◽  
M K Pangotra ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Control Strategies ◽  
The State ◽  
Primary Data ◽  
Effective Control ◽  
Malaria Surveillance ◽  
Weighted Estimates ◽  
Malaria Burden ◽  
Routine Surveillance ◽  
Malaria Trends

Abstract Background The state of Punjab in India qualifies for malaria elimination because the number of cases reported through routine surveillance is in decline. However, surveillance system prevalence mainly provides malaria trends. Therefore, a prospective epidemiological study was designed to estimate the malaria burden in the state. Methods District-wise annual parasite incidence (API) was used for identification of three strata, representing high, moderate and low API zones. A total of 0.9 million people from nine districts was under malaria surveillance for 1 y. The weighted estimates of API for the three regions was calculated and combined to give an estimate of API for the total population of the state. Results Based upon the primary data generated, malaria cases from high, moderate and low malaria-endemic areas were estimated to be 3727, 904 and 106, respectively. Further, the total number of malaria cases in the state was estimated to be 4737 (95% CI 4006 to 5469) cases per annum. Conclusion Actual burden of malaria in the state of Punjab, India, is about seven to eight times higher than that reported by routine surveillance activities. However, the state still qualifies for malaria elimination but needs vigorous efforts to strengthen the active surveillance and reporting system along with implementation of effective control strategies to achieve malaria elimination.

scholarly journals Control measures of malaria transmission in Rwanda based on SEIR SEI mathematical model

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Emmanuel Hakizimana ◽  
Jean Marie Ntaganda
Keyword(s):  
Mathematical Model ◽  
Optimal Control ◽  
Malaria Transmission ◽  
Optimal Control Problems ◽  
Control Strategies ◽  
Control Measures ◽  
Bed Nets ◽  
Infected People ◽  
Insecticide Treated Bed Nets ◽  
Malaria Model

This research paper investigated the dynamics of malaria transmission in Rwanda using the nonlinear forces of infections which are included in SEIR-SEI mathematical model for human and mosquito populations. The mathematical modeling of malaria studies the interaction among the human and mosquito populations in controlling malaria transmission and eventually eliminating malaria infection. This work investigates the optimal control strategies for minimizing the rate of malaria transmission by applying three control variables through Caputo fractional derivative. The optimal control problems for malaria model found the control parameters which minimize infection. The numerical simulation showed that the number of exposed and infected people and mosquito population are decreased due to the control strategies. Finally, this work found out that the transmission of malaria in Rwanda can be minimized by using the combination of controls like Insecticide Treated bed Nets (ITNs), Indoor Residual Spray (IRS) and Artemisinin based Combination Therapies (ACTs).

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

2020 ◽  
Author(s):  
Jane Namuganga ◽  
Adrienne Epstein ◽  
Joaniter Nankabirwa ◽  
Arthur Mpimbaza ◽  
Moses Kiggundu ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Critical Role ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Fold Increase ◽  
Bed Nets ◽  
Malaria Burden ◽  
Vector Control Intervention ◽  
Using Data ◽  
The Impact

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.

scholarly journals Determinants of Ownership and Utilization of Insecticide-Treated Bed Nets for Malaria Control in Eastern Ethiopia

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sibhatu Biadgilign ◽  
Ayalu Reda ◽  
Haji Kedir
Keyword(s):  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Mosquito Net ◽  
Previous Night ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Mortality And Morbidity ◽  
Sub Saharan ◽  
Insecticide Treated Bed Nets

Background. Malaria remains a major cause of mortality and morbidity in the world, and particularly in sub-Saharan Africa.Objectives. The aim of this study was to determine ownership and utilization of ITNs among households with children under five in the previous night.Methods. A community based cross-sectional study was conducted in Gursum district in Eastern Ethiopia. A total of 335 households were surveyed using a pretested structured questionnaire administered though house-to-house interviews.Results. Household ownership for at least one mosquito net and use of nets were 62.4% (95% CI 57.2–67.6%) and 21.5% (95% CI 17.1–25.9%), respectively. Households who received or were told about ITN in the last 6 months were three times more likely to have used it than those who were not (OR 3.25; 95% CI 1.5–7.10). Households whose heads were engaged as a farmer (adjusted OR 0.137; 95% CI: 0.04–0.50) and housewife (OR 0.26; 95% CI: 0.08–0.82) were less likely to use ITN than those of other occupations.Conclusion. The findings indicate low ITN ownership and utilization among the households. Intensive health education and community mobilization effort should be employed to increase the possession and proper utilization of insecticide treated bed nets.

scholarly journals Low Malaria Transmission in Rosso, an Irrigated Rice-Growing Area in Mauritania

Parasitologia ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 257-268
Author(s):  
Mohamed Aly Ould Lemrabott ◽  
Khadijetou Mint Lekweiry ◽  
Jemila Deida ◽  
Oum Kelthoum Mamadou Djigo ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Mosquito Species ◽  
Epidemiological Data ◽  
Bed Nets ◽  
Entomological Surveillance ◽  
High Coverage ◽  
Travel History ◽  
Breeding Sites ◽  
Senegal River ◽  
Behavioural Aspects

The construction of dams along the Senegal River resulted in an increase in irrigated land areas and changes in the epidemiology and transmission of water-related diseases. The objective of this study was to update epidemiological data on malaria in Rosso, one of the major Mauritanian cities along the Senegal River. Febrile patients (n = 318) were screened for malaria using a rapid diagnostic test (RDT) for malaria and microscopic examination of blood smears. Diagnosis was later confirmed by polymerase chain reaction (PCR). The mean age of 318 febrile patients was 25.1 (range 1–80 years). Only 7 (2.2%) and 2 (0.6%) had a positive RDT and thick smear, respectively. PCR confirmed the diagnosis in two Plasmodium vivax-infected patients. Most participants (198/318, 62.3%) had no recent travel history outside Rosso. The majority of the febrile patients (90%, 284/311) owned at least one insecticide-treated net (ITN). The frequency of the use of ITNs was not significantly associated with season (rainy vs. dry seasons; p = 0.9) or with the number of ITNs per household (rs = 0.07; n = 285; p = 0.19). Of 285 individuals with ITNs, only two (0.7%) with no travel history were PCR-positive for malaria. Despite the presence of mosquito breeding sites related to rice irrigation, malaria transmission in Rosso remained very low, possibly due to the high coverage and frequent use of bed nets. Regular entomological surveillance for possible changes in the prevalence of Anopheles mosquito species and their behavioural aspects should be implemented.

scholarly journals Analysis of Control Interventions against Malaria in communities with Limited Resources

2021 ◽  
Vol 29 (2) ◽  
pp. 71-91
Author(s):  
E.A. Bakare ◽  
B.O. Onasanya ◽  
S. Hoskova-Mayerova ◽  
O. Olubosede
Keyword(s):  
Optimal Control ◽  
Malaria Transmission ◽  
Control Strategies ◽  
Indoor Residual Spraying ◽  
Control Measures ◽  
Limited Resources ◽  
Effective Control ◽  
Bed Nets ◽  
Multiple Control ◽  
Potential Impact

Abstract The aim of this paper is to analyse the potential impact of multiple current interventions in communities with limited resources in order to obtain optimal control strategies and provide a basis for future predictions of the most effective control measures against the spread of malaria. We developed a population-based model of malaria transmission dynamics to investigate the effectiveness of five different interventions. The model captured both the human and the mosquito compartments. The control interventions considered were: educational campaigns to mobilise people for diagnostic test and treatment and to sleep under bed nets; treatment through mass drug administration; indoor residual spraying(IRS) with insecticide to reduce malaria transmission; insecticide treated net (ITN) to reduce morbidity; and regular destruction of mosquito breeding sites to reduce the number of new mosquito and bites/contact at dusks and dawn. Analysis of the potential impact of the multiple control interventions were carried out and the optimal control strategies that minimized the number of infected human and mosquito and the cost of applying the various control interventions were determined.

scholarly journals A cohort study to identify risk factors for malaria in Burkinabe children: implications for other high burden high impact countries

2020 ◽  
Author(s):  
Jean Baptiste Yaro ◽  
Alphonse Ouedraogo ◽  
Z Amidou Ouedraogo ◽  
Amidou Diarra ◽  
Malik Lankouande ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Burkina Faso ◽  
Malaria Transmission ◽  
Economic Status ◽  
Control Measures ◽  
Previous Night ◽  
Transmission Season ◽  
Malaria Burden ◽  
Increased Risk

Abstract Background: Progress in controlling malaria has stalled in recent years. Today the malaria burden is increasingly concentrated in a few countries, including Burkina Faso, where malaria is not declining. We carried out a cohort study to identify risk factors for malaria infection in children in south-west Burkina Faso, an area with high insecticide-treated net (ITN) coverage and insecticide-resistant vectors.Methods: Incidence of Plasmodium falciparum infection was measured in 252 children aged 5 to 15 years, using active and passive detection, during the 2017 transmission season, following clearance of infection. Demographic, socioeconomic, environmental and entomological risk factors, including use of ITNs and insecticide resistance were monitored.Results: During the six-month follow-up period, the overall incidence of P. falciparum infection, was 2.78 episodes per child (95% CI= 2.66-2.91) by microscopy, and 3.11 (95% CI= 2.95-3.28) by polymerase chain reaction. The entomological inoculation rate (EIR) was 80.4 infective bites per child over the six-month malaria transmission season. At baseline, 80.6% of children were reported as sleeping under an ITN the previous night, although at the last survey, 23.3% of nets were in poor condition and considered no longer protective. No association was found between the rate of P. falciparum infection and either EIR (Incidence Rate Ratio, IRR: 1.00, 95% CI: 1.00–1.00, p=0.08) or mortality in WHO tube tests when vectors were exposed to 0.05% deltamethrin (IRR: 1.05, 95% CI: 0.73–1.50, p=0.79). Travel history (IRR: 1.52, 95% CI: 1.45–1.59, p<0.001) and higher socio-economic status were associated with an increased risk of P. falciparum infection (IRR: 1.05, 95% CI: 1.00–1.11, p=0.04).Conclusions: Incidence of P. falciparum infection remains overwhelmingly high in the study area. Our findings suggest that because of the exceptionally high levels of malaria transmission in the study area, malaria elimination cannot be achieved solely by mass deployment of ITNs and additional control measures are needed.

scholarly journals Prevalence of asymptomatic malaria infections in selected military camps in Tanzania

2020 ◽  
Vol 21 (1) ◽  
pp. 1-11
Author(s):  
Akili Kalinga ◽  
Reginald A. Kavishe ◽  
Deus S Ishengoma ◽  
Gibson Kagaruki ◽  
Clement Mweya ◽  
...  
Keyword(s):  
Malaria Parasite ◽  
Geometric Mean ◽  
Parasite Prevalence ◽  
Cross Sectional Study ◽  
Asymptomatic Malaria ◽  
Malaria Surveillance ◽  
Cross Sectional ◽  
Malaria Burden ◽  
Military Recruits ◽  
Significant Difference

Background: Despite a decrease in malaria burden reported between 2000 and 2015, an increasing trend of malaria transmission has been recently reported in some endemic countries including Tanzania. Periodic monitoring to identify pocket areas for asymptomatic Plasmodium falciparum infection   is vital for malaria elimination efforts. The objective of this study was to determine prevalence of asymptomatic malaria infections among military recruits in selected camps in Tanzania. Methods: A cross-sectional study was conducted in 2015 at four military camps (Bulombora, Mgambo, Ruvu, and Rwamkoma) of National Service located in regions with varying malaria endemicity in Tanzania.  Finger prick blood samples collected from asymptomatic military recruits who had been at the camps for over two months were simultaneously tested using microscopy and malaria rapid diagnostic tests (mRDTs) to detect malaria parasite infections. Results: Malaria parasite prevalence among asymptomatic recruits was 20.3% and 19.4% by microscopy and mRDT respectively. There was moderate agreement (Kappa=0.724) between microscopy and mRDT test results. A significant difference (p<0.001) of malaria parasite prevalence among the four study camps was observed; ranging from 1.9% in Bulombora to 39.4% in Rwamkoma. The geometric mean parasite density was 11,053 asexual parasites/µl and most recruits (56.8%) had 200 to 1999 asexual parasites/µl. P. falciparum was the predominant (99.2%) malaria parasite species. Conclusion: Our study found high prevalence of asymptomatic malaria infections among military recruits in the selected camps, and this varied from one camp to another. The study has highlighted that public residence institutions such as military camps can be potential hotspots for malaria infection and therefore should not be skipped in routine national malaria surveillance system for monitoring trends of infections

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