scholarly journals Epidemiology of malaria in an area with pyrethroid-resistant vectors in south-western Burkina Faso: a pre-intervention study

2020 ◽  
Author(s):  
Anthony Somé ◽  
Issaka Zongo ◽  
Bertin N’cho Tchiekoi ◽  
Dieudonné D. Soma ◽  
Barnabas Zogo ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Rainy Season ◽  
Malaria Infection ◽  
Malaria Incidence ◽  
Control Strategies ◽  
Controlled Trial ◽  
Cross Sectional ◽  
Malaria Burden ◽  
Epidemiological Profile ◽  
Western Burkina Faso

AbstractBackgroundThe objective of this study was to update malaria epidemiological profile prior to the implementation of a randomized controlled trial aiming to evaluate the efficacy of new vector control tools in complementary to the use of long-lasting insecticidal nets in Burkina Faso.MethodsWe carried out active and passive cross-sectional surveys to estimate the prevalence and incidence of malaria infection from August 2016 to July 2017 in 27 villages of the Diebougou health district.ResultsWith the passive survey, we extracted data from 4814 patients included in the study from August 2016 to July 2017. Malaria incidence showed a seasonal distribution, with an overall incidence rate estimated at 414.3 per 1000 person-years. In the active cross sectional surveys, we enrolled 2839, 2594 and 2337 participants respectively in September 2016, December 2016 and June 2017. Prevalence of malaria infection were respectively 41.5%, 43.5% and 32.3% in September 2016, in December 2016 and June 2017. Multivariate analysis showed that girls seemed to have a lower risk of malaria infection (OR = 0.86; 95% CI = 0.79 - 0.95; p = 0.004). The risk of malaria infection was significantly lower in third survey (June 2017) at the beginning of the rainy season (OR = 0.69; 95% CI = 0.6 - 0.8; p < 0.001) compared to the first survey (September 2016) which was performed during the rainy season. Children aged 6 to 59 months had a higher risk of malaria infection compared to those aged 10 to 17 years (OR = 0.58; 95% CI = 0.51 - 0.66).ConclusionMalaria burden remains high in this region of Burkina Faso despite substantial efforts made in malaria control during this current decade. Children under 5 years old were subject of malaria burden in this setting. This results reinforce the urgent need to develop alternative control strategies to complement those already existing.

scholarly journals Seasonal Depiction of Malariometric Indices in Children under Five Years in a Sudanese Semi-urban Area of Burkina Faso

2019 ◽  
pp. 1-12
Author(s):  
San M. Ouattara ◽  
Alphonse Ouédraogo ◽  
Alfred B. Tiono ◽  
Benjamin Sombié ◽  
Amidou Diarra ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Rainy Season ◽  
Control Strategies ◽  
Geometric Mean ◽  
Dry Season ◽  
P Value ◽  
Cross Sectional ◽  
Under Five ◽  
Endemic Malaria ◽  
Transmission Period

Aims: Malariometric indices are essential for the assessment of both new therapies and control strategies. As part of the characterization of a new malaria clinical trial site, this study was carried out to assess malariometric indices during the two seasons of a Sudanese area of Burkina Faso, in children aged under five years. Study Design: Two community-based cross-sectional surveys were conducted as follow: the first during the rainy season of 2009 and the second during the following dry season. Socio-demographic and clinical data were recorded. A finger prick blood sample was collected to perform malaria blood films and to measure the hemoglobin level. Results: Malaria parasitemia prevalence was 55.2% (N = 677) in the rainy season with a geometric mean of parasite density (GMPD) of 3439 trophozoites/µl against 23.3% (N = 720) in the dry season with a GMPD of 1368 trophozoites/µl. Gametocytemia prevalence was 21.7% and 6.5% respectively in rainy and dry season while splenomegaly prevalence was 11.2% (N = 689) in rainy season against 4.2% (N = 752) in dry season. The prevalence of anemia (hemoglobin < 11.0 g/dl) was 90.0% in rainy season and 70.6% in dry season. All indices in rainy season were statistically higher than those in dry season (p-value < 0.0001). The odds of parasite carriage were 3 to 5 times higher in rainy season compared to dry season (95% CI for OR = [3.1, 5.0]). Conclusion: The site is located in a seasonal hyper-endemic malaria area and seems appropriate for the conduct of malaria drugs or vaccines studies. Though the gap between seasons is considerable, the residual level of parasite carriage during low transmission period is not negligible and may command the development of strategies targeting this specific period, to break the chain of transmission of the disease.

scholarly journals Effect of Interventions to Reduce Malaria Incidence Among Military Personnel on Active Duty: Study Protocol for a Cluster Randomised Controlled Trial of the Impact of Etofenprox-treated Uniforms, Permethrin-treated Uniforms and DEET Insect Repellent

2021 ◽  
Author(s):  
Daniel Msellemu ◽  
Amanda Ross ◽  
Lucky Temu ◽  
Irene Moshi ◽  
Lorenz Hofer ◽  
...  
Keyword(s):  
Military Personnel ◽  
Malaria Infection ◽  
Malaria Incidence ◽  
Protective Efficacy ◽  
Controlled Trial ◽  
Active Duty ◽  
Insect Repellent ◽  
Insect Repellents ◽  
Cluster Randomised ◽  
The Impact

Abstract Background: While there is strong evidence that permethrin-treated clothing and topical insect repellents are protective against insect bites, there are few studies assessing the impact on malaria infection. This study will evaluate the impact of the protective efficacy of bite prevention methods on the incidence of malaria infection among military personnel in an operational setting. Permethrin-treated uniforms will be compared to etofenprox-treated uniforms, with both clothing treatments used in conjunction with DEET insect repellent. An additional study arm will test permethrin uniforms with placebo lotion to determine if there is any additional protective effect of using DEET with insecticide-treated clothing. Method: A cluster randomised double-blind placebo-controlled trial is planned to evaluate the effectiveness of the interventions on preventing malaria infections in soldiers on active duty at Mgambo National Service Camp in Tanga, Tanzania. The arms are (1) permethrin-treated uniform with 30% DEET liposome formula; (2) permethrin-treated uniform with placebo lotion; (3) candidate insect repellent system, i.e., etofenprox-treated uniform with 30% DEET liposome formula; and (4) placebo, i.e., untreated uniforms with placebo lotion. The primary outcome is the incidence of Plasmodium falciparum malaria infection detected by polymerase chain reaction (PCR) by active case detection using surveys every 2 weeks for 12 months. Rapid diagnostic tests will be used for diagnosis of participants with symptoms. The unit of randomisation will be combania: companies formed by recruits aged 18 to 25 years; combania do activities together and sleep in the same dormitory. Unequal randomisation will be used to optimise statistical power for the primary comparison between permethrin-treated uniforms with DEET and etofenprox-treated uniforms with DEET. Discussion: This trial will estimate the effects of permethrin with DEET compared to those of the new fabric treatment etofenprox with DEET and any additional effect of using DEET. The results will inform strategies to protect military personnel and civilians who have more outdoor or occupational malaria exposure than the general public. Trial registration: clinicaltrials.gov Registration number NCT02938975.

scholarly journals Performance of IRS on malaria prevalence and incidence using pirimiphos-methyl in the context of pyrethroids resistance in Koulikoro region, Mali

2020 ◽  
Author(s):  
Fousseyni Kané ◽  
Moussa Keïta ◽  
Boïssé Traoré ◽  
Sory Ibrahim Diawara ◽  
Sidy Bane ◽  
...  
Keyword(s):  
Rainy Season ◽  
Pyrethroid Resistance ◽  
Malaria Incidence ◽  
Malaria Prevalence ◽  
Control Area ◽  
Added Value ◽  
Rank Test ◽  
Cross Sectional ◽  
Pirimiphos Methyl ◽  
Set Up

Abstract Background: Koulikoro Health District is one of three districts of Mali where the indoor residual spray (IRS) has been implemented from 2008 to 2016. With widespread of resistance to pyrothroid, IRS was shifted from pyrethroid to pirimiphos-methyl from 2014 to 2016. We assessed the added value of IRS to LLINs on the prevalence of parasitemia and malaria incidence among children under 10 years old. Methods: A comparative study was carried out to assess the effects of pirimiphos-methyl based IRS on malaria prevalence and incidence among children from 6 months to 10 years old in selected pyrethroid resistance villages of two health districts in Mali: one where IRS was implemented in combination with LLINs (intervention area) and one with LLINs-only (control area). Two cross-sectional surveys were carried out at the beginning (June) and end of the rainy season (October) to assess seasonal changes in malaria parasitemia by microscopy. A passive detection case (PCD) was set-up in each study village for 9 months to estimate the incidence of malaria using RDT. Results: There was an increase of 220% in malaria prevalence from June to October in the control area (14% to 42%) versus only 53% in the IRS area (9.2% to 13.2%).Thus, the proportional rise in malaria prevalence from the dry to the rainy season in 2016 was 4 times greater in the control area compared to the IRS area. The overall malaria incidence rate was 2.7 per 100 person-months in the IRS area compared with 6.8 per 100 person-month in the control areas. The Log-rank test of Kaplan-Meier survival analysis showed that children living in IRS area remain much longer free from malaria (Hazard ratio (HR)=0.45, CI 95% = 0.37-0.54) than children of the control area (P < 0.0001).Conclusions: IRS using pirimiphos-methyl has been successful in reducing substantially both the prevalence and the incidence of malaria in children under 10 years old in the area of pyrethroid resistance of Koulikoro, Mali. Pirimiphos-methyl is a better alternative than pyrethroids for IRS in areas with widespread of pyrethroid resistance.

scholarly journals Effectiveness of The Innovative 1,7-Malaria Reactive Community-based Testing and Response (1, 7-mRCTR) Approach on Malaria Burden Reduction in Southeastern Tanzania

2020 ◽  
Author(s):  
Yeromin P. Mlacha ◽  
Duoquan Wang ◽  
Prosper P. Chaki ◽  
Tegemeo Gavana ◽  
Zhengbin Zhou ◽  
...  
Keyword(s):  
Malaria Infection ◽  
Health Workers ◽  
Malaria Incidence ◽  
Pilot Project ◽  
Malaria Prevalence ◽  
Health Facilities ◽  
Community Based ◽  
Malaria Burden ◽  
Tailored Approach ◽  
The Village

Abstract Background: In 2015, a China-UK-Tanzania tripartite pilot project was implemented in south-eastern Tanzania to explore a new model for reducing malaria burden and possibly scaling-out the approach into other malaria endemic countries. The 1,7-malaria Reactive Community-based Testing and Response (1,7-RCTR) which is a locally-tailored approach for reporting febrile malaria cases in endemic villages was developed to stop transmission and plasmodium life-cycle. The (1,7-RCTR) utilizes existing health facility data and locally trained community health workers to conduct community-level testing and treatment. Methods: The pilot project was implemented from September 2015 to June 2018. Matched malaria incidence pairs of control and intervention wards were chosen. The latter arm was selected for the 1,7-mRCTR approach leaving control wards relying on existed programs. The 1,7-mRCTR activities included community testing and treatment of malaria infection. Malaria case-to-suspect ratios at health facilities (HF) were aggregated by villages, weekly to identify the village with the highest ratio. Community-based mobile test stations (cMTS) were used for conducting mass testing and treatment. Random household surveys were done in the control and intervention wards before (baseline) and after (endline) the program. The primary outcome was the baseline and endline difference of malaria prevalence in the control and intervention wards measured by the interaction term of ‘time’ (post vs. pre) and group in a logistic model. We also studied the malaria incidence reported at the health facilities during the intervention.Results: Overall 85 rounds of 1,7-mRCT conducted in the intervention wards significantly reduced the odds of malaria infection by 66% (adjusted OR 0.34, 95%CI 0.26,0.44, p<0001) beyond the effect of the standard programs. Malaria prevalence in the intervention wards declined by 81% (from 26% (95% CI, 23.7, 7.8), at baseline to 4.9% (95% CI, 4.0,5.9) at endline). Villages receiving the 1,7-mRCT had a case ratio decreased by over 15.7% (95%CI, -33, 6) compared to baseline.Conclusion: The 1,7-mRCTR approach reduced significantly the malaria burden in the areas of moderate and high transmission in southern Tanzania. This locally-tailored approach could accelerate malaria control and elimination efforts. The results provide the impetus for further evaluation of the effectiveness and scaling up of this type of approach in other high malaria burden countries in Africa, including Tanzania.

scholarly journals Antenatal care attendance and risk of low birthweight in Burkina Faso: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mamadou Bountogo ◽  
Ali Sié ◽  
Alphonse Zakané ◽  
Guillaume Compaoré ◽  
Thierry Ouédraogo ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Antenatal Care ◽  
Burkina Faso ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Median Number ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Health Card ◽  
Logistic Regression Models

Abstract Background Low birthweight is a major contributor to infant mortality. We evaluated the association between antenatal care (ANC) attendance and low birthweight among newborns in 5 regions of Burkina Faso. Methods We utilized data from the baseline assessment of a randomized controlled trial evaluating azithromycin distribution during the neonatal period for prevention of infant mortality. Neonates were eligible for the trial if the weighed at least 2500 g at enrollment and were 8–27 days of age. Data on ANC attendance and birthweight was extracted from each child’s carnet de santé, a government-issued health card on which pregnancy and birth-related data are recorded. We used linear and logistic regression models adjusting for potentially confounding variables to evaluate the relationship between ANC attendance (as total number of visits and ≥ 4 antenatal care visits) and birthweight (continuously and categorized into < 2500 g versus ≥2500 g). Results Data from 21,223 births were included in the analysis. The median number of ANC visits was 4 (interquartile range 3 to 5) and 69% of mothers attended at least 4 visits. Mean birthweight was 2998 g (standard deviation 423) and 8.1% of infants were low birthweight (< 2500 g). Birthweight was 63 g (95% CI 46 to 81 g, P < 0.001) higher in newborns born to mothers who had attended ≥4 ANC visits versus < 4 visits. The odds of low birthweight among infants born to mothers with ≥4 ANC visits was 0.71 (95% CI 0.63 to 0.79, P < 0.001) times the odds of low birthweight among infants born to mothers who attended < 4 ANC visits. Conclusions We observed a statistically significant association between ANC attendance and birthweight, although absolute differences were small. Improving access to ANC for all women may help improve birth outcomes. Trial registration The parent trial is registered at clinicaltrials.gov: NCT03682653; first registered 24 September 2018.

scholarly journals A Decline and Age Shift in Malaria Incidence in Rural Mali following Implementation of Seasonal Malaria Chemoprevention and Indoor Residual Spraying

2021 ◽  
Vol 104 (4) ◽  
pp. 1342-1347
Author(s):  
Drissa Coulibaly ◽  
Boureima Guindo ◽  
Amadou Niangaly ◽  
Fayçal Maiga ◽  
Salimata Konate ◽  
...  
Keyword(s):  
Incidence Rate Ratio ◽  
Malaria Incidence ◽  
Control Strategies ◽  
Indoor Residual Spraying ◽  
Older Children ◽  
Insecticide Treated Nets ◽  
African Countries ◽  
Cross Sectional ◽  
Seasonal Malaria Chemoprevention ◽  
Age Shift

ABSTRACTMany African countries have reported declines in malaria incidence, attributed to the implementation of control strategies. In Mali, artemisinin-based combination therapy (ACT) was introduced in 2004, and long-lasting insecticide-treated nets (LLINs) have been partially distributed free of charge since 2007. In the Malian town of Bandiagara, a study conducted from 2009 to 2013 showed a stable incidence of malaria compared with 1999, despite the implementation of ACTs and LLINs. Since 2016, seasonal malaria chemoprevention has been scaled up across the country. In addition to these strategies, the population of Bandiagara benefited from indoor residual spray implementation in 2017 and 2018 and continued universal bed net coverage. This study aimed to measure the incidence of malaria in Bandiagara, given this recent scaling up of control strategies. A cohort of 300 children aged 6 months to 15 years was followed up from October 2017 to December 2018. We performed monthly cross-sectional surveys to measure anemia and the prevalence of malaria infection by microscopy. The overall incidence of symptomatic malaria was 0.5 episodes/person-year. Malaria incidence in children up to 5 years old significantly declined since 2012 and since 1999 (incidence rate ratio estimates: 6.7 [95% CI: 4.2–11.4] and 13.5 [95% CI: 8.4–22.7]), respectively. The average prevalence of malaria parasitemia was 6.7%. Malaria incidence was higher in children older than 5 years than in those younger than 5 years, highlighting the need to extend malaria control efforts to these older children.

scholarly journals Effect of interventions to reduce malaria incidence among military personnel on active duty: study protocol for a cluster randomised controlled trial of the impact of etofenprox-treated uniforms, permethrin-treated uniforms and DEET insect repellent

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel Msellemu ◽  
Amanda Ross ◽  
Lucky Temu ◽  
Irene Moshi ◽  
Lorenz Hofer ◽  
...  
Keyword(s):  
Military Personnel ◽  
Malaria Infection ◽  
Malaria Incidence ◽  
Controlled Trial ◽  
Active Duty ◽  
Insect Repellent ◽  
Insect Repellents ◽  
Link Type ◽  
Cluster Randomised ◽  
The Impact

Abstract Background While there is strong evidence that bite protection methods such as permethrin-treated clothing and topical insect repellents are protective against insect bites, there are few studies assessing the impact on malaria infection. This study will estimate the protective efficacy of treated uniforms and DEET insect repellent on the incidence of malaria infection among military personnel in an operational setting. Permethrin-treated uniforms used with DEET lotion will be compared to etofenprox-treated uniforms with DEET lotion. The effect of DEET lotion will be estimated by comparing permethrin-treated uniforms with DEET or placebo lotion. Method A cluster randomised double-blind placebo-controlled trial is planned to evaluate the effectiveness of the interventions on preventing malaria infections in soldiers on active duty at Mgambo National Service Camp in Tanga, Tanzania. The arms are (1) permethrin-treated uniform with 30% DEET liposome formula; (2) permethrin-treated uniform with placebo lotion; (3) candidate insect repellent system, i.e. etofenprox-treated uniform with 30% DEET liposome formula; and (4) placebo, i.e. untreated uniforms with placebo lotion. The primary outcome is the incidence of Plasmodium falciparum malaria infection detected by polymerase chain reaction (PCR) by active case detection using surveys every 2 weeks for 12 months. Rapid diagnostic tests will be used for the diagnosis of participants with symptoms. The unit of randomisation will be combania: companies formed by recruits aged 18 to 25 years; combania do activities together and sleep in the same dormitory. Unequal randomisation will be used to optimise statistical power for the primary comparison between permethrin-treated uniforms with DEET and etofenprox-treated uniforms with DEET. Discussion This trial will provide the estimate of the effects of permethrin with DEET compared to those of the new fabric treatment etofenprox with DEET and any additional effect of using DEET. The results will inform strategies to protect military personnel and civilians who have more outdoor or occupational malaria exposure than the general public. Trial registration ClinicalTrials.govNCT02938975.

scholarly journals Prevalence and Risk Factors of Schistosoma Mansoni Infection Among Preschool-Aged Children From Panamasso Village, Burkina Faso

2021 ◽  
Author(s):  
Mamoudou Cisse ◽  
Ibrahim Sangare ◽  
Arthur D. Djibougou ◽  
Marc C. Tahita ◽  
Souleymane Gnissi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Burkina Faso ◽  
Control Strategies ◽  
Point Of Care ◽  
Geometric Mean ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Water Contact ◽  
Cross Sectional ◽  
Preschool Aged Children

Abstract BackgroundSchistosomiasis remains a major public health concern in sub-Saharan Africa. Although schistosomiasis is well documented in school-aged children in Burkina Faso, prevalence data among preschool-aged children (PSAC) are limited and outdated, and its risk factors in this group remain poorly documented. The main objective of this study was to assess the prevalence and risk factors associated with Schistosoma (S.) mansoni infection among PSAC from Panamasso village, western Burkina Faso.MethodologyA cross-sectional study was carried out among 228 children under 6 years old from Panamasso village. Sociodemographic and water contact data were collected using a structured questionnaire. Kato-Katz and formol-ether concentration techniques were used to detect S. mansoni eggs in stool samples. Urine samples were subjected to a point-of-care circulating cathodic antigen (POC-CCA) cassette test and a centrifugation method to check for both S. mansoni and S. haematobium infection, respectively. Potential risk factors for S. mansoni infection were explored using multivariable logistic regression.ResultsThe mean age of children was 40.2 ± 15.0 months. The prevalence of S. mansoni infection as determined by Kato-Katz, formol-ether concentration, and POC-CCA was 42.1%, 39.5% and 80.7%, respectively. Based on the combined results of the three methods, the overall prevalence of S. mansoni infection was 81.1%. No case of S. haematobium infection was found. The geometric mean intensity of S. mansoni infection was 107.2 eggs per gram of faeces with 54.2%, 33.3%, and 12.5% of the children having light, moderate, and heavy infections, respectively. Girls (AOR = 2.9, 95% CI: 1.3-6.1), a household located within 500 m from the pond (AOR = 3.0, 95% CI: 1.0-8.6), or between 500 and 1000 m from the pond (AOR = 3.0, 95% CI: 1.2-7.2), and child’s history of going to the pond (AOR = 5.0, 95% CI: 1.7-14.3) were the variables significantly associated with S. mansoni infection. ConclusionS. mansoni was the sole species infecting a high proportion of PSAC in the study area. A mass drug administration program with praziquantel is therefore urgently required for those below 6 year-old. Other control strategies should include increased community-awareness and provision of safe water.

A decline and age shift in malaria incidence in rural Mali following implementation of seasonal malaria chemoprevention and indoor residual spraying

2020 ◽  
Author(s):  
Drissa Coulibaly ◽  
Boureima Guindo ◽  
Amadou Niangaly ◽  
Fayçal Maiga ◽  
Salimata Konate ◽  
...  
Keyword(s):  
Malaria Infection ◽  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
Age Group ◽  
Older Children ◽  
Insecticide Treated Nets ◽  
African Countries ◽  
Cross Sectional ◽  
Seasonal Malaria Chemoprevention ◽  
Age Shift

Abstract BackgroundDeclines in malaria incidence attributed to the implementation of control strategies have been reported in many African countries. The declines are often accompanied by a shift in clinical burden to older children. In Mali, artemisinin-based combination therapy (ACT) was introduced in 2004, and Long-lasting insecticide-treated nets (LLINs) have been partially distributed free of charge since 2007. In Bandiagara, a study conducted from 2009 to 2013 showed a stable incidence of malaria compared to 1999 despite the use of ACTs and LLINs. Since 2016, seasonal malaria chemoprevention (SMC) has been scaled up across the country. In addition to these strategies, the population of Bandiagara benefited the universal bed net coverage and indoor residual spray (IRS) implementation in 2017 and 2018.This study aimed to measure the incidence of malaria in the context of recent scaling-up of control strategies.MethodsA cohort of 300 children aged 6 months to 15 years was followed from October 2017 to December 2018 in Mali. Monthly cross-sectional surveys were done to measure the prevalence of malaria infection by microscopy and anaemia. The study outcomes included the monthly prevalence of malaria infection and the incidence of symptomatic malaria.ResultsThe incidence of symptomatic malaria was 0.5 episodes/person-year. The average prevalence of malaria parasitaemia was 6.7%. The incidence was higher in the oldest age group than the youngest one (0.6 episodes/person-year in children above 10 years vs 0.29 in 6 months to 5 years age group).ConclusionsThis study showed a reduction of malaria incidence compared to 1999 and 2009-2013. An age shift in the susceptibility to malaria was also observed; older children experienced more clinical malaria than younger ones. These findings suggest to extend malaria control efforts to older children.

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