scholarly journals Intermittent Preventive Treatment and Malaria of Parturient Women in Southeastern Gabon.

2021 ◽  
Author(s):  
Jean Claude Biteghe-Bi-Essone ◽  
Roméo Karl Imboumy-Limoukou ◽  
Jean Jordan Ekogha-Ovono ◽  
Sydney Maghendji-Nzondo ◽  
Jean Bernard LEKANA-DOUKI
Keyword(s):  
Malaria Control ◽  
Rural Areas ◽  
Intermittent Preventive Treatment ◽  
Age Groups ◽  
Preventive Treatment ◽  
Control Measures ◽  
Adherence Rate ◽  
Good Adherence ◽  
The Mean ◽  
Plasmodial Infection

Abstract Background: Evaluating malaria control strategies for pregnant women is essential. The objective of this study was to determine the factors influencing the frequency of prenatal consultations (PNC), the adherence to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) and its impact on the health of parturient women and their newborn babies living in semi-urban and rural areas of southeastern Gabon.Methods: This transversal study was performed at the Centre Hospitalier Régional Paul Moukambi de Koula-Moutou (CHRPMK). Information regarding age, frequency of prenatal consultations, obstetric history, use of malaria control measures, use of IPT-SP, malaria diagnostic of parturient women and their newborns, were collected with a questionnaire and from birth registers from January 1st 2018 to December 31st 2019.Results: In total, 2174 parturient women were included in the study. The mean age was 26.2 ± 6.99 years and 81.4% of parturient women attended at least four CPN. The proper attendance of PNC (at least 4 prenatal consultations) was linked with age (p< 0.001) and profession (aOR= 1.72 [1.27 - 2.37]; p< 0.001). The coverage rate of IPT-SP was 90% with a good adherence rate (at least three doses of IPT-SP) of 58.87%. The good adherence rate to IPT-SP was linked to profession (aOR= 1.65 [1.20 - 2.29]; p< 0.01) and age (p< 0.001). The mean weight of newborns was higher for babies whose mothers had received three doses of IPT-SP (p< 0,001) but the APGAR score was not influenced by the use of IPT-SP by the mother (p= 0.47). The prevalence of plasmodial infection was 3.10% (IC95%= [1.21 - 5]) and Plasmodium falciparum was responsible for 100% of infections. The prevalence of plasmodial infection was the same for all age groups (p> 0.06). No link was found between plasmodial infection, gravidity (p> 0.06) and domestic control measures (p≥ 0.05). A low birth weight was statistically linked to the mother’s plasmodial infection (OR= 9.42 [2.55 – 34.75]; p< 0.01). Furthermore, plasmodial infection was statistically linked to premature birth (OR= 69.25 [8.52 – 562.69]; p< 0.001).Conclusions: We observed a good attendance of women to prenatal counselling services in southeastern Gabon, though the adherence of IPT-SP is insufficient.

scholarly journals Incidence of Plasmodium falciparum malaria infection in 6-month to 45-year-olds on selected areas of Bioko Island, Equatorial Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicente Urbano Nsue Ndong Nchama ◽  
Ali Hamad Said ◽  
Ali Mtoro ◽  
Gertrudis Owono Bidjimi ◽  
Marta Alene Owono ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Control ◽  
Malaria Infection ◽  
Age Groups ◽  
Control Measures ◽  
Equatorial Guinea ◽  
Safety And Efficacy ◽  
Bioko Island ◽  
Malaria Vaccines

Abstract Background Extensive malaria control measures have been implemented on Bioko Island, Equatorial Guinea over the past 16 years, reducing parasite prevalence and malaria-related morbidity and mortality, but without achieving elimination. Malaria vaccines offer hope for reducing the burden to zero. Three phase 1/2 studies have been conducted successfully on Bioko Island to evaluate the safety and efficacy of whole Plasmodium falciparum (Pf) sporozoite (SPZ) malaria vaccines. A large, pivotal trial of the safety and efficacy of the radiation-attenuated Sanaria® PfSPZ Vaccine against P. falciparum is planned for 2022. This study assessed the incidence of malaria at the phase 3 study site and characterized the influence of socio-demographic factors on the burden of malaria to guide trial design. Methods A cohort of 240 randomly selected individuals aged 6 months to 45 years from selected areas of North Bioko Province, Bioko Island, was followed for 24 weeks after clearance of parasitaemia. Assessment of clinical presentation consistent with malaria and thick blood smears were performed every 2 weeks. Incidence of first and multiple malaria infections per person-time of follow-up was estimated, compared between age groups, and examined for associated socio-demographic risk factors. Results There were 58 malaria infection episodes observed during the follow up period, including 47 first and 11 repeat infections. The incidence of malaria was 0.25 [95% CI (0.19, 0.32)] and of first malaria was 0.23 [95% CI (0.17, 0.30)] per person per 24 weeks (0.22 in 6–59-month-olds, 0.26 in 5–17-year-olds, 0.20 in 18–45-year-olds). Incidence of first malaria with symptoms was 0.13 [95% CI (0.09, 0.19)] per person per 24 weeks (0.16 in 6–59-month-olds, 0.10 in 5–17-year-olds, 0.11 in 18–45-year-olds). Multivariate assessment showed that study area, gender, malaria positivity at screening, and household socioeconomic status independently predicted the observed incidence of malaria. Conclusion Despite intensive malaria control efforts on Bioko Island, local transmission remains and is spread evenly throughout age groups. These incidence rates indicate moderate malaria transmission which may be sufficient to support future larger trials of PfSPZ Vaccine. The long-term goal is to conduct mass vaccination programmes to halt transmission and eliminate P. falciparum malaria.

scholarly journals Intermittent preventive treatment for malaria in pregnancy: Is directly observed therapy still necessary? A prospective cohort study in a tertiary hospital, Southern Nigeria

2020 ◽  
Vol 4 ◽  
pp. 34-39
Author(s):  
Ubong Akpan ◽  
Udeme Asibong ◽  
Zibrin Okhormbe ◽  
Mabel Ekott ◽  
Saturday Etuk
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Rural Areas ◽  
Venous Blood ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Tertiary Hospital ◽  
Control Group ◽  
Directly Observed Therapy ◽  
In Pregnancy

Objective: Malaria is a major cause of indirect maternal death. In the last two decades several efforts have been made to combat the menace of this disease especially among pregnant women and children in developing countries. Directly observed therapy (DOT) was recommended to enhance the uptake of intermittent preventive treatment (IPT) of malaria with sulfadoxine – pyrimethamine among pregnant women. Due to challenges involved in the practice of DOT especially with regards to shortage of man power and clean water in rural areas, there is need to evaluate impact of DOT on the effectiveness of treatment. Material and Methods: A cohort study was carried out among 320 healthy pregnant women receiving ante natal care with equal assignment of subjects. The study group (160) received two doses of IPT by DOT while 160 matched controls were given prescription for self- drug administration at home. Malaria tests were done using microscopy method and the hemoglobin values determined using centrifuge one month after the second dose of IPT. Umbilical cord blood samples were obtained for a repeat microscopy at delivery. Results: The results showed that there were no statistical significant differences in the venous blood parasitemia, placental parasitemia and anaemia between the DOT group and the control group (P = 0.215; P = 0.100; P = 0.966) respectively. Lower social class was the main predictor of anaemia in pregnancy (P = 0.032). Conclusion: The delivery of IPT through DOT may not influence uptake in some settings. Effort may need to be channeled into ante natal education and women empowerment.

scholarly journals Prevalence of asymptomatic malaria parasitaemia following mass testing and treatment in Pakro sub-district of Ghana

2019 ◽  
Author(s):  
Ignatius Cheng Ndong ◽  
Daniel Okyere ◽  
Juliana Yartey Enos ◽  
Benedicta Ayiedu Mensah ◽  
Alexander Kwadwo Nyarko ◽  
...  
Keyword(s):  
Malaria Control ◽  
Lower Cost ◽  
Health Centre ◽  
Scale Up ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Asymptomatic Malaria ◽  
Community Based ◽  
High Coverage ◽  
Asymptomatic Parasitaemia

Abstract Background: Global efforts to scale-up malaria control interventions are gaining steam. These include the use of Long-Lasting Insecticide Nets, Intermittent Preventive Treatment and Test, Treat and Track (T3) using ACTs. Intermittent preventive treatment of children (IPTc) in Ghana has demonstrated a parasite load reduction of 90%. However, unanswered questions include – whether mass treatment of population sub-groups such as IPTc could be scaled-up to whole populations as in mass testing, treatment and tracking (MTTT)? What is needed to implement MTTT at scale? Can MTTT reduce asymptomatic parasitaemia levels in children under 15? And whether MTTT of populations complemented by community-based management of malaria (CBMm) using volunteers could be an effective strategy for malaria control at a lower cost. Methods: A population of 5,000 asymptomatic individuals in seven communities in the Pakro sub-district of Ghana participated in this study. A register was developed for each community following a census. MTTT engaged trained community-based health volunteers (CBHVs) who conducted house-to-house testing using RDTs every four months and treated positive cases with ACTs. Between interventions, CBMm was done on symptomatic cases. Results: MTTT Coverage was 98.8% in July 2017 and 79.3% in July 2018. Of those tested, asymptomatic infection with malaria parasites reduced from 1,795 (36.3%) in July 2017 to 1,303 (32.9%) in July 2018. Implementing MTTT significantly averted asymptomatic parasitaemia by 24% from July 2017 to July 2018 after adjusting for age, ITN use and temperature (OR=0.76, CI=0.67, 0.85 p ≤ 0.001). In comparison, treatment of symptomatic patients at the Health Centre reduced parasitaemia by 9% over the same period which was however, not statistically significant (OR=0.91, CI=0.67, 1.38 p = 0.672). A total of 223 (5.1%) cases were averted in children under 15 years (X² = 9.7, p < 0.002). An important observation was a decrease in hospital attendance, which negatively affected the internally generated funds (IGF) scheme of the participating health facilities. Conclusion: This study has demonstrated that implementing MTTT was feasible and could reduce prevalence of malaria asymptomatic parasitaemia in children under 15 years of age. Furthermore, the use of CBHVs could ensure high coverage at lower cost.

scholarly journals Reaching the unreached: Effectiveness and Satisfaction with Community-Directed Distribution of Suphadoxine-Pyrimethamine for preventing Malaria in Pregnancy in rural South-East, Nigeria

2020 ◽  
Author(s):  
Ijeoma Nkem Okedo-Alex ◽  
Ifeyinwa Chizoba Akamike ◽  
Chihurumnanya Alo ◽  
Adaoha Pearl Agu ◽  
Chinyere Benedicta Nzeh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Large Scale ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Antenatal Clinic ◽  
Post Intervention ◽  
Birth Attendants ◽  
Itn Use

Abstract Background Innovative community strategies to increase Intermittent Preventive Treatment with Suphadoxine-Pyrimethamine (IPTp-SP) coverage is advocated particularly in rural areas, where health infrastructures are weakest and malaria transmission highest. This study was a proof-of-concept implementation research to determine satisfaction with and effectiveness of community-directed distribution of IPTp-SP on uptake among pregnant women in Ebonyi State, Nigeria.Methods This before-after study was carried out in 2019 in a rural community in Ebonyi State Nigeria. The intervention involved advocacy visits, community-wide sensitizations on malaria prevention, house to house directly observed IPTp-SP administration and follow-up visits by trained community-selected Community Directed Distributors (CDDs). Monthly coverage IPTp-SP coverage was assessed over five months using SPSS version 20.Results During the study, 229, 232, 217, 121 and 34 women received 1-5 IPT doses respectively. The uptake of ≥3 IPTp doses increased from 31.4% to 71.6% (P<0.001). Sleeping under Insecticide Treated Net (ITN) the night before the survey increased from 62.4% to 84.3% (P<0.001) while reporting of fever during pregnancy decreased from 64.9% to 17.0% (P<0.001). Although antenatal clinic utilization increased in the primary health center serving the community, traditional birth attendants and patent medicine vendors in the community remained more patronized. Post-intervention, most mothers rated CDD services well (93.6%), were satisfied (97.6%) and preferred community IPTp administration to facility administration (92.3%).Conclusions Community-directed distribution of IPTp-SP improved uptake of IPTp-SP and ITN use. Mothers were satisfied with the services. We recommend sustained large-scale implementation of community-directed distribution of IPTp with active community engagement.

WOMEN AND MALARIA—SPECIAL RISK AND APPROPRIATE CONTROL STRATEGY

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 117-117
Author(s):  
R. Rueben
Keyword(s):  
Pregnant Women ◽  
Malaria Transmission ◽  
Falciparum Malaria ◽  
Malaria Control ◽  
Rural Areas ◽  
Control Strategies ◽  
Current Control ◽  
Control Measures ◽  
Control Programs ◽  
Utility Distribution

The factors that make pregnant women particularly vulnerable to morbidity and mortality with falciparum malaria and their relationship to current control strategies are reviewed. Pregnant women, particularly during their first pregnancy, are at greatest risk of severe falciparum malaria in areas of high and continuous malaria transmission and under conditions of unstable malaria in which they do not develop protective immunity. The author recommends chemoprophylaxis with chloroquine for pregnant women living in holoendemic and hyperendemic areas of Africa and Papua, New Guinea. Chloroquine is safe, but drug resistance has increasingly limited its utility, distribution is a formidable problem. In rural areas where poorly developed health care system are better developed and malaria transmission is less intense, the emphasis should be on early diagnosis and treatment. Women are potentially the key to the implementation of malaria control programs, yet recent studies indicate that underprivileged women frequently do not attend malaria clinics and are often missed in projects with passive surveillance. Additional research and community interventions are needed to enable women with malaria to obtain treatment and to involve them in malaria control measures at the village level.

scholarly journals Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy

2018 ◽  
Vol 44 (2) ◽  
pp. 134-144 ◽  
Author(s):  
Anna Cristina Calçada Carvalho ◽  
Claudete Aparecida Araújo Cardoso ◽  
Terezinha Miceli Martire ◽  
Giovanni Battista Migliori ◽  
Clemax Couto Sant’Anna
Keyword(s):  
Age Groups ◽  
Clinical Manifestations ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Control Measures ◽  
World Health ◽  
Rapid Progression ◽  
Childhood And Adolescence ◽  
Pediatric Tuberculosis ◽  
Health Organization

ABSTRACT Tuberculosis continues to be a public health priority in many countries. In 2015, tuberculosis killed 1.4 million people, including 210,000 children. Despite the recent progress made in the control of tuberculosis in Brazil, it is still one of the countries with the highest tuberculosis burdens. In 2015, there were 69,000 reported cases of tuberculosis in Brazil and tuberculosis was the cause of 4,500 deaths in the country. In 2014, the World Health Organization approved the End TB Strategy, which set a target date of 2035 for meeting its goals of reducing the tuberculosis incidence by 90% and reducing the number of tuberculosis deaths by 95%. However, to achieve those goals in Brazil, there is a need for collaboration among the various sectors involved in tuberculosis control and for the prioritization of activities, including control measures targeting the most vulnerable populations. Children are highly vulnerable to tuberculosis, and there are particularities specific to pediatric patients regarding tuberculosis development (rapid progression from infection to active disease), prevention (low effectiveness of vaccination against the pulmonary forms and limited availability of preventive treatment of latent tuberculosis infection), diagnosis (a low rate of bacteriologically confirmed diagnosis), and treatment (poor availability of child-friendly anti-tuberculosis drugs). In this review, we discuss the epidemiology, clinical manifestations, and prevention of tuberculosis in childhood and adolescence, highlighting the peculiarities of active and latent tuberculosis in those age groups, in order to prompt reflection on new approaches to the management of pediatric tuberculosis within the framework of the End TB Strategy.

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