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

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.

Malaria Prevalence in Asymptomatic and Symptomatic Children Living in Rural, Semi-Urban and Urban Areas in Eastern Gabon.

Background Malaria remains a major public health issue in the world despite a decline in the disease burden. However, though symptomatic malaria is diagnosed and treated, asymptomatic infections remain poorly known and support transmission. This study assessed the prevalence of symptomatic and asymptomatic plasmodial infections in three areas in Gabon to monitor and evaluate the impact of malaria. Methods A cross-sectional study was conducted at the Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF). Febrile children and without fever, aged 6 months to 15 years from three localities (Franceville, Makokou, Lastoursville) in south-eastern Gabon were included in this study. The Plasmodium Spp infection was determined by microscopy and/or rapid diagnostic tests (RDT) followed by PCR according to the Snounou method. The data were recorded in Excel, and the statistical analyzes were performed using the software R version R 64x 3.5.0. Results Two thousand three hundred and eighty-one (2381) children were screened and included in this analysis. The mean age was significantly higher in asymptomatic children compared to symptomatic children. Hematological parameters varied significantly according to regions and clinical signs. The overall prevalence of Plasmodium infection was 40% (952/2381). In the urban area (Franceville) the prevalence of plasmodial infection was not significantly different between symptomatic and asymptomatic children. In contrast, a high prevalence of symptomatic plasmodial infection was found in infected children in rural and semi-rural areas. Among the three plasmodial species (Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale) identified, Plasmodium falciparum was the most widespread, and its prevalence was not significantly different between symptomatic and asymptomatic children in the three localities. In rural and semi-rural areas, a higher or lower prevalence of Plasmodium malariae was demonstrated in asymptomatic children. Conclusion This study showed that the prevalence of plasmodial infection varied according to the regions and clinical signs. The main species was Plasmodium falciparum, but in asymptomatic children the prevalence of Plasmodium malariae was high in rural areas. To help fight malaria more effectively asymptomatic infections should be taken into account and treated.

Placental Malaria: Histological Findings and Immune Cell Infiltrates in Submicroscopic Infections

Most research on placental malaria is focused on microscopic infection by Plasmodium falciparum; there are very few studies on submicroscopic infection. This study aimed to assess alterations of placental tissue associated with placental malaria, to describe the immune cell populations in the placental tissue, and to explore the relationships between the histopathological changes and cell infiltrates. A descriptive, prospective and cross-sectional study was carried out. Women were recruited at hospital obstetric facilities in three municipalities in Northwest Colombia. The histopathological analysis was performed in a total of 132 placentas including 66 placentas with submicroscopic plasmodial infection and 66 that were negatives. Immunohistochemistry was performed on a subset of 75 placentas to determine the distribution of immune cells. Based on histology, there were more immune cells in placentas with submicroscopic plasmodial infection compared with those without infection. The quantity of syncytial knots and calcifications was greater with submicroscopic plasmodial infection, but the quantity of abruption and thrombi was greater in placentas without infection. By immunohistochemistry, we observed a significant increase of CD56+ and CD68+ cells in the infected placentas. Submicroscopic plasmodial infection in the placenta causes tissue alterations and increased immune cell infiltrates. Submicroscopic plasmodial infection is very common in Colombia and can represent a serious threat to mothers and newborns.

Dexamethasone increased the survival rate in Plasmodium berghei-infected mice

The present study aimed to evaluate the effects of dexamethasone on the redox status, parasitemia evolution, and survival rate of Plasmodium berghei-infected mice. Two-hundred and twenty-five mice were infected with Plasmodium berghei and subjected to stimulation or inhibition of NO synthesis. The stimulation of NO synthesis was performed through the administration of L-arginine, while its inhibition was made by the administration of dexamethasone. Inducible NO synthase (iNOS) inhibition by dexamethasone promoted an increase in the survival rate of P. berghei-infected mice, and the data suggested the participation of oxidative stress in the brain as a result of plasmodial infection, as well as the inhibition of brain NO synthesis, which promoted the survival rate of almost 90% of the animals until the 15th day of infection, with possible direct interference of ischemia and reperfusion syndrome, as seen by increased levels of uric acid. Inhibition of brain iNOS by dexamethasone caused a decrease in parasitemia and increased the survival rate of infected animals, suggesting that NO synthesis may stimulate a series of compensatory redox effects that, if overstimulated, may be responsible for the onset of severe forms of malaria.

Malaria in children and women of childbearing age: infection prevalence, knowledge and use of malaria prevention tools in the province of Nyanga, Gabon

Background There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children under 5 years old living in malaria-endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in Nyanga Province. Methods A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the malaria infection in five departments of Nyanga Province. Plasmodial infection was diagnosed in children ≤ 5 years of age and women aged 15-49 years using rapid diagnostic tests. A questionnaire was administered randomly to women aged 15–49 years and to the parents or guardians of children aged ≤ 5 years in 535 households during a 2-week period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge of malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments. Results Data from a total of 1,307 participants were included in this study, including 631 women of childbearing age (61 of them pregnant) and 676 children. Practically the entire (97.7%) interviewed population had heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the reported rate of reported bed-net use was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departmental capitals of Nyanga Province had a significant level of malaria infection except for Mayumba where no plasmodial infection was found. Conclusion High malaria prevalence is found in the departmental capital cities of Nyanga Province. This study reveals that respondents have a high knowledge of the malaria symptoms, its mode of transmission and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for other types of interventions.

Malaria in children and women of childbearing age: infection prevalence, knowledge and use of malaria prevention tools in the province of Nyanga, Gabon

Background There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children under five years old living in malaria-endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in Nyanga Province. Methods A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the malaria infection in five departments of Nyanga Province. Plasmodial infection was diagnosed in children ≤5 years of age and women aged 15-49 years using rapid diagnostic tests. A questionnaire was administered randomly to women aged 15-49 years and to the parents or guardians of children aged ≤5 years in 535 households during a 2-week period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge of malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments.Results Data from a total of 1,307 participants were included in this study, including 631 women of childbearing age (61 of them pregnant) and 676 children. Practically the entire (97.7%) interviewed population had heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the reported rate of reported bed-net use was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departmental capitals of Nyanga Province had a significant level of malaria infection except for Mayumba where no plasmodial infection was foundConclusion High malaria prevalence is found in the departmental capital cities of Nyanga Province. This study reveals that respondents have a high knowledge of the malaria symptoms, its mode of transmission and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for other types of interventions.

Malaria in children and women of childbearing age: infection prevalence, knowledge and use of malaria prevention tools in the province of Nyanga, Gabon

Background: There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children under five year old living in malaria endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in the Nyanga Province. Methods: A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the malaria infection in five departments of the Nyanga Province. Plasmodial infection was diagnosed in children ≤ 5 years of age and women aged 15-49 years using rapid diagnostic tests. A questionnaire was administered randomly to women aged 15-49 years and to the parents or guardians of children aged ≤ 5 years in 535 households during a two weeks period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge on malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments.Results: Data from a total of 1,307 participants were included in this study, including 631 women of childbearing age (including 61 pregnant women) and 676 children. Practically the entire (97.7%) interviewed population had already heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the reported rate of reported bednet use was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departmental capitals of the Nyanga province had a significant level of malaria infection except for the Mayumba where no plasmodial infection was foundConclusion: High malaria prevalence is found in the departmental capital cities of the Nyanga province. This study reveals that respondents have a high knowledge of the malaria symptoms, its mode of transmission and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for other types of interventions.

Malaria in children and women of childbearing age: prevalence and knowledge in the province of Nyanga, Gabon

Background: There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children aged under 5 years old living in malaria endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in the Nyanga Province. Methods: A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the infection in five departments of the Nyanga Province. Malaria infection was confirmed using rapid diagnostic tests. A questionnaire was administered randomly to 535 households during a two weeks period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge on malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments. Results: Data was collected on 1,307 participants were included in this study, 631 women of childbearing age (including 61 pregnant women) and 676 children. Practically the entire (97.7%) interviewed population had already heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the bed net coverage rate was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departments of Nyanga province had significant level of malaria infection except for the Mayumba department where no plasmodial infection was found. The overall prevalence of the plasmodial infection was significantly higher in children and pregnant women compared to adults in the cities of Tchibanga and Moabi. Conclusion: Malaria is highly prevalent in the province of Nyanga. Our findings show that children under five and pregnant women are more vulnerable to malaria in this area of the country. This study reveals that respondents have a high knowledge of mode of transmission, malaria symptoms and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for continuous strategic interventions particularly health awareness and educational programs

Malaria in children and women of childbearing age: prevalence and knowledge in the province of Nyanga, Gabon

Background: There is little information on the social perception of malaria and the use of preventative measures in Gabon, especially in rural areas. Adequate knowledge of malaria prevention and control can help in reducing the burden of malaria among vulnerable groups, particularly pregnant women and children aged under 5 years old living in malaria endemic settings. This study was designed to assess the prevalence of malaria and the knowledge and attitude towards this disease in households in the Nyanga Province. Methods: A cross-sectional study was conducted to assess malaria knowledge, prevention practices and prevalence of the infection in five departments of the Nyanga Province. Malaria infection was confirmed using rapid diagnostic tests. A questionnaire was administered randomly to 535 households during a two weeks period in March 2018. Overall, the respondents’ socio-demographic characteristics, knowledge on malaria, malaria prevention practices and malaria prevalence were evaluated and compared across the five departments. Results: Data was collected on 1,307 participants were included in this study, 631 women of childbearing age (including 61 pregnant women) and 676 children. Practically the entire (97.7%) interviewed population had already heard about malaria and attributed the cause of malaria to a mosquito bite (95.7%). This survey revealed that the bed net coverage rate was 73.3%. The study observed an average malaria parasite prevalence of 13.9%. All departments of Nyanga province had significant level of malaria infection except for the Mayumba department where no plasmodial infection was found. The overall prevalence of the plasmodial infection was significantly higher in children and pregnant women compared to adults in the cities of Tchibanga and Moabi. Conclusion: Malaria is highly prevalent in the province of Nyanga. Our findings show that children under five and pregnant women are more vulnerable to malaria in this area of the country. This study reveals that respondents have a high knowledge of mode of transmission, malaria symptoms and preventive measures. Despite this high level of knowledge of the disease and its preventive measures, the incidence of malaria remains relatively high in this rural community highlighting the need for continuous strategic interventions particularly health awareness and educational programs