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2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Adama Gansané ◽  
Baltazar Candrinho ◽  
Aimable Mbituyumuremyi ◽  
Perpetua Uhomoibhi ◽  
Sagnon NFalé ◽  
...  

Abstract Background Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primarily through insecticidal-treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resistance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual-AI) ITNs that are effective at killing insecticide-resistant mosquitoes have recently been introduced. However, large-scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost-effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost-effectiveness of dual-AI ITNs, compared to standard pyrethroid-only ITNs, at reducing malaria transmission across a variety of transmission settings. Methods Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual-AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveillance occurring in select study districts include annual cross-sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual-AI ITNs to similar districts receiving standard pyrethroid-only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost-effectiveness analysis will assess incremental cost-effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid-only ITNs, based on incidence rate ratios calculated from routine data. Conclusions Evidence of the effectiveness and cost-effectiveness of the dual-AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision-making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual-AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact.


2022 ◽  
Vol 15 (1) ◽  
Author(s):  
Sundus Shafat Ahmad ◽  
Manju Rahi ◽  
Poonam Saroha ◽  
Amit Sharma

AbstractMalaria constitutes one of the largest public health burdens faced by humanity. Malaria control has to be an efficient balance between diagnosis, treatment and vector control strategies. The World Health Organization currently recommends indoor residual spraying and impregnated bed nets as two malaria vector control methods that have shown robust and persistent results against endophilic and anthropophilic mosquito species. The Indian government launched the National Framework for Malaria Elimination in 2016 with the aim to achieve the elimination of malaria in a phased and strategic manner and to sustain a nation-wide malaria-free status by 2030. India is currently in a crucial phase of malaria elimination and novel vector control strategies maybe helpful in dealing with various challenges, such as vector behavioural adaptations and increasing insecticide resistance among the Anopheles populations of India. Ivermectin can be one such new tool as it is the first endectocide to be approved in both animals and humans. Trials of ivermectin have been conducted in endemic areas of Africa with promising results. In this review, we assess available data on ivermectin as an endectocide and propose that this endectocide should be explored as a vector control tool for malaria in India. Graphical Abstract


2022 ◽  
Vol 21 (1) ◽  
Author(s):  
John B. Keven ◽  
Michelle Katusele ◽  
Rebecca Vinit ◽  
Daniela Rodríguez-Rodríguez ◽  
Manuel W. Hetzel ◽  
...  

Abstract Background A malaria control programme based on distribution of long-lasting insecticidal bed nets (LLINs) and artemisinin combination therapy began in Papua New Guinea in 2009. After implementation of the programme, substantial reductions in vector abundance and malaria transmission intensity occurred. The research reported here investigated whether these reductions remained after seven years of sustained effort. Methods All-night (18:00 to 06:00) mosquito collections were conducted using human landing catches and barrier screen methods in four villages of Madang Province between September 2016 and March 2017. Anopheles species identification and sporozoite infection with Plasmodium vivax and Plasmodium falciparum were determined with molecular methods. Vector composition was expressed as the relative proportion of different species in villages, and vector abundance was quantified as the number of mosquitoes per barrier screen-night and per person-night. Transmission intensity was quantified as the number of sporozoite-infective vector bites per person-night. Results Five Anopheles species were present, but vector composition varied greatly among villages. Anopheles koliensis, a strongly anthropophilic species was the most prevalent in Bulal, Matukar and Wasab villages, constituting 63.7–73.8% of all Anopheles, but in Megiar Anopheles farauti was the most prevalent species (97.6%). Vector abundance varied among villages (ranging from 2.8 to 72.3 Anopheles per screen-night and 2.2–31.1 Anopheles per person-night), and spatially within villages. Malaria transmission intensity varied among the villages, with values ranging from 0.03 to 0.5 infective Anopheles bites per person-night. Most (54.1–75.1%) of the Anopheles bites occurred outdoors, with a substantial proportion (25.5–50.8%) occurring before 22:00. Conclusion The estimates of vector abundance and transmission intensity in the current study were comparable to or higher than estimates in the same villages in 2010–2012, indicating impeded programme effectiveness. Outdoor and early biting behaviours of vectors are some of the likely explanatory factors. Heterogeneity in vector composition, abundance and distribution among and within villages challenge malaria control programmes and must be considered when planning them.


2021 ◽  
Vol 1 (2) ◽  
pp. 1-11
Author(s):  
Mubarick Asumah ◽  
Francis Akugri ◽  
Patricia Akanlu ◽  
Alice Taapena ◽  
Faustina Boateng

Author(s):  
Raymond Babila Nyasa ◽  
Muyang Florence Fomundam ◽  
Chounna Ndongmo Winston Patrick ◽  
Anong Nota Damian

Aims: In Cameroon, on August 2011 and October 2015 the Ministry of Public Health launched the national campaign for distribution of long-lasting insecticide-treated bed nets (LLINs) to all families as a means of effectively fighting malaria transmission. The study area Mbengwi Health District found in the North West Region of Cameroon benefitted from this distribution of LLINs, but the impact of this intervention has not been evaluated. This study was designed to assess the use of LLINs in selected households of rural and semi-urban communities in Mbengwi Health District. Study Design: A cross sectional study was conducted in households, between July 2017 to September 2017 in Mbengwi health district. Methodology: Two questionnaires were administered; one to the household head and the other to the occupants. Blood samples were obtained to diagnose and quantify malaria parasite and to determine hemoglobin concentrations (HB). A total of 93 households and 440 inhabitants of all sexes and age groups were surveyed. Results: Of the 440 participants, 49 were positive for malaria parasite giving an overall prevalence of 11.1%. From the questionnaires it was observed that 87 (93.5%) of the households owned LLINs, with up to 82 (94.3%) sleeping under the nets. All the owners of LLINs (87; 100%) obtained the nets from the government free of charge. There was no significant difference in bed-net ownership (p=0.978) and usage (p=0.664) between the rural and semi-urban communities. Malaria prevalence was significantly lower among users of LLINs (4.8%) than non-users (23.5%, p<0.001). Malaria parasite density negatively correlated significantly with HB (r= -0.097, p=0.041). Conclusion: Overall, there was a high degree ownership and usage of LLINs by households in both rural and semi-urban communities, which was associated with protection from malaria infection.


Author(s):  
Hanna S.I Kawulur ◽  
Hotma Martogi Lorensi Hutapea ◽  
Ivon Ayomi ◽  
Melda Suebu ◽  
Mardi Raharjo Pardi

Malaria is still a health problem in Indonesia, particularly in Eastern part of Indonesia. The use of LLIN insecticide bed nets is one of the efforts to reduce the malaria morbidity rate by protecting human from malaria vector bites. The Anopheles flavirostris, Anopheles barbirostris, and Anopheles subpictus mosquitoes are three of the species reported as malaria vectors in West-Southeast Maluku Regency. The aim of this research was to detect the kdr gene in An. flavirostris, An. barbirostris, and An.subpictus mosquitoes collected from Alusi Kelaan village, West-Southeast Maluku Regency. The research was conducted at the Papua Biomedical Research and Development Center, in June 2016. A total of six An. flavirostris, 42 An. barbirostris, and 24 An. subpictus were pooled separately for genomic DNA extraction. The sample used was the An. flavirostris, An. barbirostris, and An. subpictus that survived after the impregnated paper test. The kdr gene detection was carried out using quantitative PCR (qPCR) focused on points V1010 and L1014. The results showed that there were no kdr mutant strains in the An. flavirostris, An. barbirostris, and An. subpictus. These results indicated that the sensitivity of pyrethroid insecticides contained in LLIN mosquito nets to An. flavirostris, An. barbirostris, and An. subpictus mosquitoes was not decreased in West Southeast Maluku Regency.


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 ◽  
...  

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.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Abebe Asale ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Alayu Teshager ◽  
Aklilu Belay ◽  
...  

Abstract Background Use of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), community-based malaria education, prompt diagnosis and treatment are key programme components of malaria prevention and control in Ethiopia. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behaviour, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening). Methods The study was conducted in Jabi Tehnan district, Northwestern Ethiopia, from November 2019 to March 2020. A total of 3010 households from 38 villages were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters considering agro-ecological differences. A total of 1256 children under 10 years of age were screened for malaria parasites using microscopy to determine malaria prevalence. Furthermore, 5-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics. Results Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health-seeking behaviour remains a key behavioural challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average, households lost 2.53 working days per person-per malaria episode and they spent US$ 18 per person per episode. Out of the 1256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, with 50% of the total cases reported from households being from among individuals who were 15 years or older. The second most affected group was the age group between 5 and 14 years followed by children aged under 5, with 31% and 14% burden, respectively. Conclusion Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low. Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritized in the study area to bring about the desired behavioural changes.


BMC Genomics ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
M. Kefi ◽  
J. Charamis ◽  
V. Balabanidou ◽  
P. Ioannidis ◽  
H. Ranson ◽  
...  

Abstract Background Insecticide-treated bed nets and indoor residual spraying comprise the major control measures against Anopheles gambiae sl, the dominant vector in sub-Saharan Africa. The primary site of contact with insecticide is through the mosquitoes’ legs, which represents the first barrier insecticides have to bypass to reach their neuronal targets. Proteomic changes and leg cuticle modifications have been associated with insecticide resistance that may reduce the rate of penetration of insecticides. Here, we performed a multiple transcriptomic analyses focusing on An. coluzzii legs. Results Firstly, leg-specific enrichment analysis identified 359 genes including the pyrethroid-binder SAP2 and 2 other chemosensory proteins, along with 4 ABCG transporters previously shown to be leg enriched. Enrichment of gene families included those involved in detecting chemical stimuli, including gustatory and ionotropic receptors and genes implicated in hydrocarbon-synthesis. Subsequently, we compared transcript expression in the legs of a highly resistant strain (VK7-HR) to both a strain with very similar genetic background which has reverted to susceptibility after several generations without insecticide pressure (VK7-LR) and a lab susceptible population (NG). Two hundred thirty-two differentially expressed genes (73 up-regulated and 159 down-regulated) were identified in the resistant strain when compared to the two susceptible counterparts, indicating an over-expression of phase I detoxification enzymes and cuticular proteins, with decrease in hormone-related metabolic processes in legs from the insecticide resistant population. Finally, we analysed the short-term effect of pyrethroid exposure on An. coluzzii legs, comparing legs of 1 h-deltamethrin-exposed An. coluzzii (VK7-IN) to those of unexposed mosquitoes (VK7-HR) and identified 348 up-regulated genes including those encoding for GPCRs, ABC transporters, odorant-binding proteins and members of the divergent salivary gland protein family. Conclusions The data on An. coluzzii leg-specific transcriptome provides valuable insights into the first line of defense in pyrethroid resistant and short-term deltamethrin-exposed mosquitoes. Our results suggest that xenobiotic detoxification is likely occurring in legs, while the enrichment of sensory proteins, ABCG transporters and cuticular genes is also evident. Constitutive resistance is primarily associated with elevated levels of detoxification and cuticular genes, while short-term insecticide-induced tolerance is linked with overexpression of transporters, GPCRs and GPCR-related genes, sensory/binding and salivary gland proteins.


2021 ◽  
Author(s):  
Bolanle Olapeju ◽  
Habtamu Tamene ◽  
Minyahil Ayele ◽  
Simon Heliso ◽  
Tsega Berhanu ◽  
...  

Abstract BackgroundEthiopia’s National Malaria Control and Elimination Program aims to diagnose all suspected malaria cases within 24 hours of fever onset and provide prompt treatment for confirmed cases. This study explored psychosocial factors associated with no-, delayed- and prompt- care-seeking among female caregivers of children under five with fever in rural Ethiopia.MethodsHousehold surveys were conducted from 2016–2019 among female caregivers (N = 2453) of children under five years old in Oromia; Amhara; Southern Nations, Nationalities, and Peoples Region (SNNPR); and Tigray. Prompt and delayed care-seeking were defined as seeking treatment within ≤ 24 hours or > 24 hours of symptom onset respectively. Contextual factors explored included sociodemographic factors, household supply of bed nets, exposure to health messages, and household vulnerability (a measure of financial access to food, shelter, schooling, and medical treatment). Ideational factors included psychosocial factors related to care-seeking (knowledge, self-efficacy, response efficacy, beliefs, involvement in decision-making, and household social support).ResultsThe prevalence of fever among children under five was 18% (ranging from 9% in Tigray to 34% in SNNPR. Overall, 45% of caregivers of children with fever sought care promptly, while 23% delayed care-seeking and 32% sought no care. Prompt care-seeking rates were higher among caregivers with positive attitudes toward prompt care-seeking (48%), involved in decision-making (48%) or perceived equitable gender norms in the community (65%). Caregivers with a high care-seeking ideation had increased odds of prompt care-seeking (aOR: 2.65; 95% CI: 1.74–4.02). Significant contextual factors included residence in the Oromia region (aOR: 2.99; 95% CI:1.40–6.41), caregivers age 35–49 years (aOR: 0.49; 95% CI: 0.26–0.95), residence in vulnerable households (aOR: 2.01; 95% CI: 1.28–3.18).ConclusionsAmong this rural Ethiopian population, prompt care-seeking was low but positively influenced by both ideational and contextual psychosocial factors occurring at the caregiver level. Multi-sectoral interventions at the individual, community, and health facility levels are needed to improve prompt care-seeking. These include social behavior change interventions to improve ideation, complemented by health facility interventions to ensure provision of high-quality services and structural interventions to increase educational attainment in these rural settings.


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