scholarly journals Fever Cases Associated with Plasmodium falciparum Malaria Infection among Children Attending a Tertiary Health Facility in Imo State, Nigeria

2020 ◽  
pp. 7-14
Author(s):  
C. I. Okoro ◽  
F. C. Ihenetu ◽  
K. E. Dunga ◽  
K. Achigbu ◽  
C. C. Obasi ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Parasite Density ◽  
Malaria Prevalence ◽  
Sub Saharan Africa ◽  
World Health ◽  
Axillary Temperature ◽  
Mean Body Temperature ◽  
Imo State ◽  
Significant Difference ◽  
History Of

Background: Malaria is a major cause of fever in endemic countries, although the prevalence of malaria has been declining across Sub-Saharan Africa, the proportion of clinical presentation attributable to febrile illness due to malaria to febrile illnesses have remained high. It is therefore important to determine the proportion of fever cases attributable to malaria. Methods: A descriptive cross sectional study was conducted among children aged 1-72 months presenting at a tertiary facility in Imo state Nigeria from 1st March, 2014 to 31st October, 2015. Children between 1-72 months of age with documented fever at presentation or history of fever in the last 24 hours without signs of severe malaria and those without any history of anti-malarial drugs administration were considered eligible. Fever was regarded as axillary temperature of ≥37.5°C. For all subjects (febrile and afebrile), the presence of Plasmodium falciparum was assessed microscopically by a WHO Certified malaria microscopist. Malaria parasite density was grouped as 1-1000, 1001–10000, and >10,000 parasites/µl respectively according to World Health Organization guidelines for grouping malaria parasitamae while data was analysed using SPSS 20.1v. Results: Overall malaria prevalence of both febrile and afebrile at point of assessment but with history of fever in the last 24 hours was 24.3%. Prevalence by microscopy was 26% among the 289 children who were febrile as at point of examination. There was no significant difference (p>0.05) between malaria prevalence in males as against females. Age group 49-72 months had the highest prevalence (42.6%), while age groups 25-48 and 1-24 months recorded prevalence of 35.7% and 25%, respectively (P<0.05). About 22.5% of afebrile patients had positive Plasmodium parasitaemia. The Geo-mean (range) of parasitaemia was 1427(8-180,000) parasite/µl while mean body temperature ± SD was 37.0±0.9°C. About 8% of the children had high parasite density. Conclusion: Plasmodium falciparum although linked with majority of fever is not the cause of fever in all instances. Healthcare providers should make more effort to correctly diagnose non-malaria febrile cases so as to optimize clinical outcomes for the patients and minimize possible over diagnosis and overtreatment of malaria.

Pro- and anti-inflammatory response profile modulates Plasmodium falciparum malaria outcomes among subjects from Baiyeku, Ikorodu, Lagos, Nigeria.

2020 ◽  
Author(s):  
Daniel Osegi Okpokor ◽  
Olusola Ajibaye ◽  
Peter Mac Asaga ◽  
Ikechukwu Nwankwo ◽  
Anthony Danaan Dakul
Keyword(s):  
Plasmodium Falciparum ◽  
Inflammatory Cytokines ◽  
Parasite Density ◽  
World Health ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tnf Α ◽  
Significant Difference ◽  
Ifn Γ ◽  
Anti Inflammatory ◽  
Pro Inflammatory Cytokines

Abstract Background Available evidence indicates that the various stages of the malaria parasite life cycle elicit specific immune responses of which the relative levels of pro-inflammatory cytokines are key to disease progression, killing the parasite and mediating disease outcomes. This study will inform immunological interventions against malaria and thus malaria vaccine developments programs/efforts. Methods A total of four hundred and sixty-two participants were screened in a community survey for Plasmodium falciparum (P. falciparum) malaria in Baiyeku, Lagos, Nigeria. P. falciparum parasitaemia was determined by Microscopy using thick and thin blood films stained by Giemsa method using World Health Organization parasitology laboratory protocol whist the serum levels of IL-10, IFNγ and TNFα were determined by Enzyme linked immunosorbent assay [ELISA]. Data analysis was done by One-way Analysis of Variance (ANOVA), Chi square (X²) and Student’s T-test in statistical package for the social sciences (SPSS) version 24 was used to test statistical significance between the symptomatic groups and asymptomatic in relation to age, gender and BMI of the participants.Results A total of 70 (15.2 %) participants were microscopically positive for P. falciparum of which 70% were female, 30% were males while children aged 1-17 years were 65.7%. The geometric mean parasite density (GMPD) was significantly (p=0.001) higher among females than males. The GMPD of participants < 5 years was also significantly (p=0.001) higher than other age groups. About 46.8% of the participants were underweight (BMI < 18.5) also had the highest parasite intensity. The TNFα, IFNγ and IL-10 levels were significantly (p 0.05) higher in the infected than the uninfected participants. IFN-γ values were significantly (p=0.014) elevated among the symptomatic than the asymptomatic participants while there was no significant difference (P>0.053) in the levels of TNF-α and IL-10 (P>0.093) between the symptomatic and asymptomatic participants. Notably, the IL-10 levels were the most elevated amongst the participants with the highest parasite density.Conclusion The prevalence of P. falciparum obtained in this study area which is endemic for malaria is 15.2% suggesting a significant reduction of the disease over time. The awareness of the disease which is now more than before seems to contribute to the lowering of prevalence of the disease in the community. There was a positive relationship between TNF-alpha levels and body temperature. However, compared with the anti-inflammatory cytokine (IL-10) in this study, the levels of the pro-inflammatory cytokines (IFN-γ and TNF-α) were lower due to the negative action of the anti-inflammatory cytokines. IL-10 value increased as parasitemia increased (p=0.073). These findings suggest that higher levels of anti-inflammatory cytokines, especially IL-10 levels may contribute to pathogenesis of uncomplicated malaria.

scholarly journals Prevalence of Infection and Malaria Parasite Density among Under Five Children: A Case Study of Dunukofia Rural Community in Anambra State, Nigeria

2021 ◽  
pp. 23-29
Author(s):  
O. A. Okeke ◽  
C.C. Igboka ◽  
N. P. Udeh ◽  
I. O. Nnatuanya ◽  
V. N. Elosiuba ◽  
...  
Keyword(s):  
Rural Community ◽  
Parasite Density ◽  
Malaria Parasite ◽  
Malaria Prevalence ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
Malaria Parasites ◽  
Cross Sectional ◽  
Under Five ◽  
Significant Difference

Aim: Malaria still remains an overwhelming cause of morbidity and mortality among children under five years of age, especially in sub-Saharan Africa. The study was carried out to evaluate malaria prevalence amongst children less than five years old.  Study Design: A cross sectional study was carried out. The study adopted a retrospective descriptive survey using the hospital records and diagnostic cross sectional survey by examination of blood samples across three variables: gender, age group and mosquito net usage. Duration: The study was done in 2021 from the month of March to April in the rural community.  Methodology: Parasitological diagnosis was with Plasmodium falciparum histidine-rich protein 2-based malaria Rapid Diagnostic Test (RDT) and microscopy of giemsa-stained blood smears. Demographic information was collected using questionnaire. Results: Three hundred (300) children aged less than five years malaria infection status was investigate, 174 (58.00% ) of them were females while 126 (42.00%. ) were males. Twenty one percent (21.00%) of the respondents are <1 year, 23.33% (70) of them are between the ages of 2 to 3 years, while 55.67% (167) were 4 years and above. Current malaria prevalence was higher with microscopy (67.33%) than that of RDT (23.33%).  Also, previous RDT results showed that there was a higher prevalence (73.56%) of malaria parasites in females than males (58.73%). The microscopy results showed that males had a higher prevalence (38.10%) of malaria parasites than females (12.64%). Overall gender result also revealed that males had a higher prevalence (96.83%) of malaria parasites than females (86.21%). There was a significant difference in the prevalence result with gender (P<0.05). Females had higher parasite density (28.05±15.390) than males (23.22±19.171), there was no significant difference (P>0.05). It further revealed that children from 4 years and above had higher intensity (29.68±17.357) while those of 1 year and below had the least (14.89±16.069). However, there was no significant difference in the malaria parasite among the age groups of patients (P>0.05). Conclusion: Prevalence of malaria parasitaemia was still high in Dunukaofia, Anamba State, Nigeria despite various control measures and interventions put in place by WHO.

scholarly journals 1241. PfSPZ Vaccine Administered by Direct Venous Inoculation to Prevent Plasmodium falciparum Malaria is as Safe as Normal Saline – a Meta-analysis of 12 Randomized Controlled Clinical Trials

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S639-S640
Author(s):  
L W Preston Church
Keyword(s):  
Plasmodium Falciparum ◽  
Random Effects ◽  
Normal Saline ◽  
Meta Analysis ◽  
Laboratory Data ◽  
Plasmodium Falciparum Malaria ◽  
Sub Saharan Africa ◽  
Sensitivity Analyses ◽  
Double Blind ◽  
Significant Difference

Abstract Background Sanaria’s PfSPZ Vaccine prevents Plasmodium falciparum (Pf) infection transmitted in the field and by controlled human malaria infection. Safety of PfSPZ Vaccine has been demonstrated in 12 randomized, double-blind, placebo-controlled trials (RCT) varying in regimen from 3 to 5 doses over 4 to 20 weeks and in size from 18 to 332 subjects in adults in the US and EU and 5-month to 65-year-olds in 5 countries in sub-Saharan Africa. This study was conducted to analyze solicited adverse event (AE) and laboratory data by random effects meta-analysis. Methods PfSPZ Vaccine is composed of radiation-attenuated, aseptic, purified, cryopreserved Pf sporozoites (SPZ) administered by direct venous inoculation (DVI). Normal saline (NS) is always the placebo. Data from all completed RCTs were included as either age &gt; 18 years (n=598) or age 5 months to 17 years (n=641). Any subject receiving at least one dose was included. A random-effects model was used to study vaccine safety and I2 to evaluate heterogeneity. Analysis was performed for any systemic solicited AE and for the most frequently observed AEs and laboratory abnormalities. Sensitivity analyses were performed by removal of trials with zero events to evaluate potential bias. Results When examined individually, only 1 trial had a significant difference between PfSPZ Vaccine and NS for any AE (myalgias in adults). In the adult meta-analysis, there was no difference in the random effects risk ratios (RR) for having any vaccine-related AEs (1.40, 95% confidence interval (CI) 0.88-2.28), or for fever (0.75, 0.24-2.35), headache (1.23, 0.74-2.02), fatigue (0.72, 0.19-2.54), or myalgia (1.09, 0.26-4.68). In the pediatric meta-analysis there was no difference between the RR for PfSPZ Vaccine and NS for any AE (0.84, 0.59-1.18) or for fever (1.09, 0.44-2.69). No significant differences in the most common grade 2 or higher laboratory abnormalities – declines in hemoglobin, neutrophil or platelet count – were detected. Sensitivity analysis did not change the results. Conclusion There was no difference in risk for AEs or lab abnormalities between PfSPZ Vaccine and NS, indicating that PfSPZ Vaccine administered by DVI was extremely safe and well tolerated in 5-month- to 65-year-olds. Disclosures LW Preston Church, MD, FIDSA, Sanaria Inc. (Employee)

scholarly journals Hepatitis B and C viruses’ infection and associated factors among pregnant women in the Amhara region, Ethiopia: implications for prevention of vertical transmission.

2020 ◽  
Author(s):  
Mulat Dagnew ◽  
Yihenew Million ◽  
Mucheye Gizachew ◽  
Setegn Eshetie ◽  
Gashaw Yitayew ◽  
...  
Keyword(s):  
Public Health ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Associated Factors ◽  
Sub Saharan Africa ◽  
World Health ◽  
Amhara Region ◽  
History Of

Abstract Background Hepatitis virus infection is a major public health burden and silent killer disease in sub-Saharan Africa, including Ethiopia. Despite the recommendations of the World Health Organization, screening for hepatitis B virus (HBV) and hepatitis C virus (HCV) in pregnant women is not done routinely in public health institutions. Therefore, this study aimed to determine the burden of HBV and HCV and its associated factors among pregnant women in the Amhara region, Ethiopia. Methods A total of 1121 pregnant women were enrolled in the study. Data on sociodemographic and associated factors were collected using a structured questionnaire. Blood was collected from the pregnant women, and serum samples were tested for HBsAg and anti-hepatitis C virus antibody (anti-HCV) using ELISA. The status of HIV-infected pregnant women was collected from the records of their charts. SPSS version 20 was used for data analysis, and a binary logistic regression model was used to assess the relationship between factors associated with HBV and HCV infection. Results The seroprevalence of HBsAg and anti-HCV antibody were 4.6% and 1.6, respectively. The co-infection rate of HBV/HCV was 1.4% (1/69). Ten out of 52 HBV positive cases (19.2%) were co-infected with HIV. Only 20 (1.8%) pregnant women had the HBV vaccine. Interestingly, pregnant women with a history of multiple sexual partners (AOR = 3.2,95% CI,1.7–7.6), blood transfusion (AOR = 7.6,95% CI,2.9–16.9), family history of HBV (AOR = 3.5, 95% CI,1.7–7.6), being HIV-positive (AOR = 2.5, 95% CI,1-5.9), and tattooing (AOR = 2, 95% CI, 1-3.8) were significant predictors of HBV infection. Conclusions HBV and HCV infections were intermediate among pregnant women; risk factors were responsible for the majority of cases. Infants born from these infected mothers are at risk of infection. This calls for integration of HBV prevention into the PMTC of HIV. Thus, the provision of health education on HBV and HCV transmission, vaccination, and screening of all pregnant women routinely is essential for PMTCT.

Pro- and anti-inflammatory immune response profiling prevents severe malaria among Nigerians infected with Plasmodium falciparum: the future for malaria vaccines and therapeutics.

2020 ◽  
Author(s):  
DANIEL OSAGIE OKPOKOR ◽  
ASAGA MAC PETER ◽  
Ajibaye Olusola ◽  
Anthony Danaan Dakul
Keyword(s):  
Plasmodium Falciparum ◽  
Immune Responses ◽  
Severe Malaria ◽  
Inflammatory Cytokines ◽  
Parasite Density ◽  
Malaria Parasite ◽  
World Health ◽  
Tnf Α ◽  
Anti Inflammatory ◽  
Pro Inflammatory Cytokines

Abstract Background Available evidence indicates that the various stages of the malaria parasite life cycle have specific immune responses. The pro-inflammatory cytokines tend to play an important role in preventing malaria and killing the parasites. Furthermore, the relative levels of pro-and anti-inflammatory cytokines are essential mediators of malaria anemia production and outcomes. Natural human immune responses to malaria recognize extracellular sporozoites and merozoites, both of which have surface-exposed antigens, and which are currently being developed for various vaccines. Methods A total of four hundred sixty- two (462) participants were tested for Plasmodium falciparum. The procedure employed were parasite staining using World Health Organization parasitology laboratory protocol [Microscopy] of Giemsa staining and Enzyme linked immunosorbent assay [ELISA]. Results The subjects in this study showed high levels of INF-γ and TNF-α which decreases with increased malaria severity and high parasite density. These results suggest that INF-γ cytokine and TNF-α may contribute to protection against severe malaria anaemia and parasite clearance. Conversely, infected participants showed higher levels of IL-10, which decreases with severe malaria parasite, furthermore IL-10 levels correlated with parasite density. These findings suggest that higher levels of anti-inflammatory cytokines, especially IL-10 levels may contribute to pathogenesis of complicated malaria by inhibiting the INF-γ and TNF-α production. Conclusion Molecular biological and other serological analysis are needed to elucidate the implication of these cytokines and other pro-inflammatory cytokines as IL-17, IL-21 and IL-22 in the responses to malaria and consequently their involvement in malaria vaccine construct/development as well as other therapeutics for the treatment and elimination of the malaria parasite in our environment.

scholarly journals Evaluating Malaria Prevalence Using Clinical Diagnosis Compared with Microscopy and Rapid Diagnostic Tests in a Tertiary Healthcare Facility in Rivers State, Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
M. N. Wogu ◽  
F. O. Nduka
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Rural Areas ◽  
Randomized Study ◽  
Malaria Prevalence ◽  
Sub Saharan Africa ◽  
World Health ◽  
High Morbidity ◽  
Cross Sectional ◽  
Sensitivity Specificity

The World Health Organization’s policy on laboratory test of all suspected malaria cases before treatment has not yielded significant effects in several rural areas of Sub-Saharan Africa due to inadequate diagnostic infrastructure, leading to high morbidity and mortality rates. A cross-sectional randomized study was conducted to evaluate the validity of clinical malaria diagnosis through comparison with microscopy and rapid diagnostic test kits (RDTs) using 1000 consenting outpatients of a tertiary hospital in Nigeria. Physicians conducted clinical diagnosis, and blood samples were collected through venous procedure and analyzed for malaria parasites using Giemsa microscopy and RDT kits. Microscopy was considered the diagnostic “gold standard” and all data obtained were statistically analyzed using Chi-square test with aPvalue <0.05 considered significant. Malaria prevalence values of 20.1%, 43.1%, and 29.7% were obtained for clinical diagnosis, microscopy, and RDTs, respectively (P<0.05). Values of 47.2%, 95.9%, and 77.8% were obtained for sensitivity, specificity, and diagnostic accuracy, respectively, in clinical diagnosis, while RDTs had sensitivity, specificity, and diagnostic accuracy values of 73.7%, 97.3%, and 88.3%, respectively, when compared to microscopy (P<0.05). Clinical diagnosed malaria cases should be confirmed with a parasite-based laboratory diagnosis and more qualitative research is needed to explore why clinicians still use clinical diagnosis despite reported cases of its ineffectiveness.

scholarly journals Anaemia and severe malarial anaemia burden in febrile Gabonese children: a nine-year health facility based survey

2013 ◽  
Vol 7 (12) ◽  
pp. 983-989 ◽  
Author(s):  
Marielle Karine Bouyou-Akotet ◽  
Denise Patricia Mawili Mboumba ◽  
Eric Kendjo ◽  
Fanckie Mbadinga ◽  
Nestor Obiang-Bekale ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Diagnosis ◽  
Malaria Prevalence ◽  
Severe Anaemia ◽  
Falciparum Infection ◽  
Sub Saharan Africa ◽  
Nutritional Deficiencies ◽  
Infection Prevalence ◽  
Severe Malarial Anaemia ◽  
Sub Saharan

Introduction: Anaemia remains a major cause of poor health in children and pregnant women living in sub-Saharan Africa. Malaria is one of the main causes of anaemia in endemic countries. At the time of decreasing Plasmodium falciparum infection prevalence among children, it was essential to analyze the evolution of anaemia and severe malarial anaemia (SMA), the most frequent clinical manifestation of severe malaria, in Gabon. Methodology: Yearly recorded haemoglobin levels of febrile children aged below11 years, who benefitted from microscopic malaria diagnosis, were retrospectively analyzed to determine the evolution of anaemia and SMA prevalence throughout a nine-year period between 2000 and 2008. Results: Anaemia prevalence remained high both in P. falciparum-infected children (between 87.6% and 90.7%) and in uninfected children (between 73.5% and 82.6%). Although the risk of developing severe anaemia ranged between 1.9 [0.9-3.8] in 2000 and 3.0 [1.3-6.5] in 2007, SMA prevalence did not significantly change during the study period, varying from 6.0% to 8.0%. From 2001, the frequency of SMA was comparable between children younger than five years of age and children older than five years of age. Conclusions: The decreasing malaria prevalence previously observed in Gabon between 2000 and 2008 was not associated with a significant reduction of anaemia and SMA burden among children. Furthermore, other factors such as nutritional deficiencies, which may not be negligible, must be investigated in this vulnerable population

scholarly journals The return of chloroquine susceptible Plasmodium falciparum in Sub-Saharan Africa: a protocol for systematic review

2020 ◽  
Author(s):  
George M Bwire ◽  
Ritah Mutagonda ◽  
Amisa Tindamanyile ◽  
Tosi Mwakyandile ◽  
Belinda Jackson Njiro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Falciparum ◽  
Grey Literature ◽  
Malaria Prevention ◽  
Sub Saharan Africa ◽  
Chloroquine Resistance ◽  
World Health ◽  
Current Status ◽  
First Line ◽  
Restricted Use

Abstract Background: Following withdrawal and/or restricted use of chloroquine (CQ) as first line malaria treatment in many countries, studies have reported an increased number of CQ susceptible Plasmodium falciparum in several countries with subsequent dropping of CQ resistance. Since the future of malaria control and elimination is still uncertain with rising resistance in currently available antimalarials such as artemisinin based combination therapy (ACT), a review on current resistance profile of CQ in P. falciparum is of paramount importance.Methods: A systematic search in PubMed/MEDLINE, EMBASE, COCHRANE central, Google Scholar and Web of science will be done. We will consult thesis repositories to identify additional studies and search the websites of key healthcare organizations (World Health Organization (WHO), public health agencies). Similarly, a grey literature search will be done with help of Google. Data from 2000 and onwards published in English will be included and the reporting will be done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses Protocol (PRISMA-P).Discussion: This article provides a detailed account of this systematic review protocol that will be used to report the current status of CQ resistance in P. falciparum following its restricted use and/ or withdrawal as the first-line treatment of uncomplicated malaria. Mutations in P. falciparum chloroquine transporter (pfcrt) gene and P. falciparum multidrug resistance (pfmdr1) gene, predict the clinical outcomes following treatment using CQ. On the other hand, countries with restricted use of CQ observed CQ-susceptible P. falciparum reemergence and are now predominant. Subject to its susceptibility profile that will be generated from this review, CQ may still be considered for malaria prevention in some population groups such as children with sickle cell disease and pregnant women. Additionally, CQ may be reintroduced in future, ideally in combination with other antimalarial drugs, especially in areas where disappearance of chloroquine resistance is evident while safe and affordable alternatives antimalarials are limited.Systematic review registration: PROSPERO registration number CRD42020154844

scholarly journals Relationship between changing malaria burden and low birth weight in sub-Saharan Africa: A difference-in-differences study via a pair-of-pairs approach

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Siyu Heng ◽  
Wendy P O'Meara ◽  
Ryan A Simmons ◽  
Dylan S Small
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Confidence Interval ◽  
Malaria Prevalence ◽  
Sub Saharan Africa ◽  
World Health ◽  
Difference In Differences ◽  
Malaria Burden ◽  
Percentage Points ◽  
Sub Saharan

Background:According to the World Health Organization (WHO), in 2018, an estimated 228 million malaria cases occurred worldwide with most cases occurring in sub-Saharan Africa. Scale-up of vector control tools coupled with increased access to diagnosis and effective treatment has resulted in a large decline in malaria prevalence in some areas, but other areas have seen little change. Although interventional studies demonstrate that preventing malaria during pregnancy can reduce the rate of low birth weight (i.e. child’s birth weight <2500 g), it remains unknown whether natural changes in parasite transmission and malaria burden can improve birth outcomes.Methods:We conducted an observational study of the effect of changing malaria burden on low birth weight using data from 18,112 births in 19 countries in sub-Saharan African countries during the years 2000–2015. Specifically, we conducted a difference-in-differences study via a pair-of-pairs matching approach using the fact that some sub-Saharan areas experienced sharp drops in malaria prevalence and some experienced little change.Results:A malaria prevalence decline from a high rate (Plasmodium falciparum parasite rate in children aged 2-up-to-10 (i.e. PfPR2-10) > 0.4) to a low rate (PfPR2-10 < 0.2) is estimated to reduce the rate of low birth weight by 1.48 percentage points (95% confidence interval: 3.70 percentage points reduction, 0.74 percentage points increase), which is a 17% reduction in the low birth weight rate compared to the average (8.6%) in our study population with observed birth weight records (1.48/8.6 ≈ 17%). When focusing on first pregnancies, a decline in malaria prevalence from high to low is estimated to have a greater impact on the low birth weight rate than for all births: 3.73 percentage points (95% confidence interval: 9.11 percentage points reduction, 1.64 percentage points increase).Conclusions:Although the confidence intervals cannot rule out the possibility of no effect at the 95% confidence level, the concurrence between our primary analysis, secondary analyses, and sensitivity analyses, and the magnitude of the effect size, contribute to the weight of the evidence suggesting that declining malaria burden can potentially substantially reduce the low birth weight rate at the community level in sub-Saharan Africa, particularly among firstborns. The novel statistical methodology developed in this article–a pair-of-pairs approach to a difference-in-differences study–could be useful for many settings in which different units are observed at different times.Funding:Ryan A. Simmons is supported by National Center for Advancing Translational Sciences (UL1TR002553). The funder had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

scholarly journals Prevalence of Plasmodium falciparum Chloroquine Resistance Transporter (Pfcrt76T) Mutation Associated with Antimalarial Drug Resistance in Two Different Epidemiological Setting (Banfora and Saponé) in Burkina Faso Few Years after the Implementation of Artemisnine Based Combination Therapy (ACTs)

2020 ◽  
pp. 1-11
Author(s):  
Séni Nikiema ◽  
Samuel Sindié Sermé ◽  
Salif Sombié ◽  
Amidou Diarra ◽  
Noelie Bere Henry ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Burkina Faso ◽  
Public Health Problem ◽  
Antimalarial Drugs ◽  
Sub Saharan Africa ◽  
Chloroquine Resistance ◽  
Chloroquine Resistance Transporter ◽  
Significant Difference ◽  
Sub Saharan ◽  
Biology Laboratory

Introduction: In spite of considerable progress, malaria remains a public health problem in many areas, particularly in sub-Saharan Africa. One major complexity of malaria disease is caused by the development and the spread of vector and parasite resistance to insecticides and antimalarial drugs respectively. The Pfcrt76T gene mutation has been validated as a marker conferring resistance to chloroquine and other antimalarial drugs. The extension of Plasmodium falciparum resistance to commonly used antimalarial drugs (chloroquine, sulfadoxine-pyrimethamine) led to the adoption and the use of artemisinin-based combinations in Burkina Faso since 2005. Aims: The present study was initiated to assess the prevalence of the Pfcrt76T mutation in two different malaria epidemiological setting after a decade of introduction of artemisinin-based combination therapies (ACTs) in Burkina Faso.  Methodology:  The study population consisted of 181 uncomplicated malaria patients recruited in Banfora and Saponé health districts in 2012 and 2013. Blood samples were collected from finger prick on filter paper, dried and sent to the Molecular Biology Laboratory at Centre National de Recherche et de Formation sur le Paludisme (CNRFP) for molecular analyzes. DNA of Plasmodium falciparum was extracted with DNA extraction kit (Qiagen®) and the Pfcrt76T mutation was determined based on Polymerase Chain Reaction / Restriction Fragment Length Polymorphism technique (RFLP). Results:  The results of this study showed that the frequency of the pfcrt76T mutant allele (33.7%) was statistically lower than the Pfcrt76K wild-type allele (57.4%) in the study area. Moreover, the prevalence of Pfcrt76T mutation was neither associated with the patient age nor with the parasite density while a significant difference was observed between the two epidemiological setting, Banfora and Saponé. Conclusion: The findings of this study has shown a drop in the prevalence of mutant parasites Pfcrt76T in both the study area eight years after the introduction of ACTs compared to previous studies.

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