Posts or Comments 05 July 2022

Archive for "ITNs"



Antenatal Care (ANC) &Behavior Change &Communication &ITNs Bill Brieger | 20 Nov 2021

Factors affecting adoption of malaria-preventive behaviors among populations at high risk of malaria in Cote d’Ivoire

Save the Children designs programs to protect children and families from malaria. An important aspect of the design process is learning about the factors that influence community members’ behaviors related to the prevention of the disease. Here we learn about behavioral factors that must be considered to design effective programs. This information is being presented at the 2021 American Society of Tropical Medicine and Hygiene Annual Meeting. See Author List below.

Understanding the drivers of malaria-related behavior helps national malaria control programs and implementing partners to plan national malaria strategies and to tailor interventions accordingly. This study examined the factors affecting adoption of malaria behaviors and those that drive or inhibit them among populations at high risk of malaria in Cote d’Ivoire.

This study was a multi-method, qualitative study with an exploratory approach using focus group discussions (FGDs), in-depth interviews (IDIs) and life stories. The study was conducted in 12 health districts across 10 health regions of Cote d’Ivoire in both urban and rural areas. FGDs and life stories were conducted with pregnant women and mothers of children under 5 and men (heads of household). IDIs were conducted with a number of stakeholders including: departmental district directors; midwives, nurses, community health workers, leaders of women’s groups, community leaders, and the local media.

The findings from this study show that incorrect knowledge about LLINs, LLIN dislike and discomfort, housing structure and size, sleeping arrangements for children under 5, and lack of LLIN recycling strategies were among the root causes for incorrect, non-use and/or inconsistent use of LLINs. In terms of ANC attendance, the main reported barriers were influence of their beliefs and norms, cost, perceived poor services provided, bad experiences from gynecological examinations, and the distance of health facilities in rural areas. Additionally, the lack of information on the benefits of SP for prevention of malaria in pregnancy and the use of traditional medicine were the main barriers for SP in pregnancy. Cost, poor services by health care providers and stock outs were the main barriers to diagnosis and treatment for children U5.  The main factor that influenced the adoption of preventive measures was free LLIN distribution through ANC viists and mass distribution campaigns.

Findings from this study are useful to inform the revision of the Social Behavior Change Communication Strategy in Cote d’Ivoire. Additionally, they can inform key messaging and the design of interventions in a context where malaria is the main cause of morbidity and mortality and children under 5 and pregnant women are the most affected.

AUTHOR LIST:

Jacob Y. Agniman1, Manasse N. Kassi1, Yssouf Ouattara1, Edouard C. Balogoun1, Serge B. Assi2, Philomène A. Beda1, Michel N’da-Ezoa3, Aristide E. Kouadio1, Joel Koffi1, Apollinaire N. Kouadio1, Paul Bouey4, Sara Canavati4, Eric Swedberg4 — 1Save the Children, Abidjan, Côte D’Ivoire, 2Le Programme Nationale de Lutte contre le Paludisme (PNLP), Abidjan, Côte D’Ivoire, 3Socio-Anthropologue de la Santé, Abidjan, Côte D’Ivoire, 4Save the Children, Washington, DC, United States

Antenatal Care (ANC) &Communication &Health Systems &ITNs Bill Brieger | 20 Nov 2021

Education and knowledge help fighting malaria, but health systems strengthening in Cote d’Ivoire

Save the Children recognizes the importance of strong health systems to deliver malaria interventions. Here they arsharing a wealth of information on these efforts at the 2021 American Society of Tropical Medicine and Hygiene Annual Meeting. Here is an abstract from one of their malaria efforts. See Author List below.

Since 2010, Cote d’Ivoire has made significant progress in the fight against malaria; however, since 2016 progress has stagnated and malaria incidence is steadily increasing. The aims of this study were to assess knowledge, attitudes and practices among heads of households, pregnant women and caretakers of children under 5 years of age (U5) and IPTp-SP compliance.

A mixed-methods study was conducted in rural and urban areas in 20 health districts of Cote d’Ivoire. A total of 1,812 households composed of 8,813 members were surveyed using a structured questionnaire. Qualitative data were gathered through twenty focus group discussions. Data triangulation was used during analysis.

Fever was the main malaria symptom reported by heads of households (38.5%) followed by headache (25.5%). Additionally, many FGD participants also reported sadness as a symptom of malaria. The primary cause of malaria was mosquito bites, followed by fatigue, the sun, and salty water, 70.7%, 15.1% and 10.9%, 3.3% respectively. The main prevention methods reported were sleeping under an ITN (60.4%), spraying the house (25.9%), taking medication (5.8%), and using a fan (7.9%). In FGDs, additional means of prevention were discussed including sanitation of the environment, personal hygiene, and stopping alcohol consumption.

The majority of women with at least one child reported having attended at least three ANC visits in their last pregnancy (85.1%). The cost of ANC was a main factor affecting attendance.  Overall, 78.2% of them received SP and of these women, 98.1% said they received it during their ANC visits. However, only 55.4% received 3 doses or more of SP and 76.79% received SP free of charge. The reasons for not taking SP were stock outs, side effects, bitter taste, and preference for injections.

Our study revealed that knowledge of prevention measures (ITNs) and causes of malaria (mosquito bites) were high and in line with the targets of the National BCC Strategy 2021-2025. However, even though the majority of pregnant women would like to take SP, they were blocked by the health system unable to provide them with the drugs and others had to pay for them. These problems within the health system are likely to contribute to the high malaria incidence in Cote d’Ivoire.

AUTHOR LIST

Edouard C. Balogoun1, Manasse Kassi1, Philomène A. Beda1, Jacob Y. Agniman1, Serge B. Assi2, Florence Kadjo-Kouadio3, Michel N’da-Ezoa4, Aristide E. Kouadio1, Joel Koffi1, Apollinaire N. Kouadio1, Paul Bouey5, Sara Canavati5, Eric Swedberg5 — 1Save the Children, Abidjan, Côte D’Ivoire, 2Le Programme Nationale de Lutte contre le Paludisme (PNLP), Abidjan, Côte D’Ivoire, 3Médecin Spécialiste de Santé, Abidjan, Côte D’Ivoire, 4Socio-Anthropologue de la Santé, Abidjan, Côte D’Ivoire, 5Save the Children, Washington, DC, United States

ITNs &Mosquitoes Bill Brieger | 19 Nov 2021

Mosquito net knowledge, ownership, use, acceptability and preferences

Save the Children addresses various ways to protect children and families from malaria. Here we learn about Mosquito net knowledge, ownership, use, acceptability and preferences among primary caregivers of children under 5 years of age, pregnant women and household heads in Cote d’Ivoire. This information is being presented at the 2021 American Society of Tropical Medicine and Hygiene Annual Meeting. See Author List below.

Strengthening vector control measures among populations at higher risk of malaria, such as pregnant women and children under 5 years of age (U5s), is crucial to malaria control. Cote d’Ivoire has set itself a number of targets for malaria control by 2025. These include: at least 90% of the population are aware of national malaria prevention measures and at least 80% of the general population, pregnant women and children U5 sleep under an LLIN. One of the specific aims of this study was to assess mosquito net knowledge, ownership, use, acceptability and preferences of primary caregivers of children U5, pregnant women and household heads.

A mixed-methods study was conducted in rural and urban areas in 20 health districts of Cote d’Ivoire. A total of 1,812 households composed of 8,813 members were surveyed using a structured questionnaire. Only households who had one or more children under five years of age and/or a pregnant woman were included in the study. Qualitative data were gathered through twenty focus group discussions. Data triangulation of the qualitative and quantitative data was used during analysis.

Sixty percent of participants cited mosquito nets as the main malaria preventive measure. The majority of participants (95.6%) received information on the use of mosquito nets and over half of them received it from mass distribution campaign agents (51.1%). Although 79.5% of households owned at least one mosquito net, less than half (46.47%) owned one mosquito net for two people. The majority (98.2%) of participants received a free mosquito net. Nets were reportedly received mainly through mass distribution campaigns (54.99%) and ANC visits (39.0%). Self-reported mosquito net use by the head of households was 53.5%. This was higher for pregnant women and children U5, 76.2% and 83.2% respectively. However, only 53.0% of mosquito nets were suspended over a bed. Reasons for not using a mosquito nets were feeling of suffocation, heat, side effects, and poor condition of the mosquito net.

While mosquito net was reported as the main malaria preventive measure, mosquito net coverage and use remains below national targets. In addition, there was a noted gap between coverage and net use, potentially undermining the effectiveness of net-related interventions that could impact malaria control efforts in Cote d’Ivoire. The design, material, and condition of nets are important factors for user preferences that appear to drive net use.

AUTHOR LIST:

Edouard C. Balogoun1, Manasse N. Kassi1, Philomène A. Beda1, Serge B. Assi2, Jacob Y. Agniman1, Florence Kadjo-Kouadio3, Michel N’da-Ezoa4, Aristide E. Kouadio1, Joel Koffi1, Apollinaire N. Kouadio1, Paul Bouey5, Sara Canavati5, Eric Swedberg5 — 1Save the Children, Abidjan, Côte D’Ivoire, 2Le Programme Nationale de Lutte contre le Paludisme (PNLP), Abidjan, Côte D’Ivoire, 3Médecin spécialiste de Santé, Abidjan, Côte D’Ivoire, 4Socio-Anthropologue de la Santé, Abidjan, Côte D’Ivoire, 5Save the Children, Washington, DC, United States

Capacity Building &CHW &Community &Elimination &Health Education &Indoor Residual Spraying &IPTp &ITNs &Malaria in Pregnancy &World Malaria Day &Zero Malaria Bill Brieger | 25 Apr 2021

Twenty Years of Malaria Day Observances: Jhpiego at the Forefront

In 2001 the first Africa Malaria Day (AMD) was observed. The opportunity to mark progress and exhort increased efforts for the continent continued through 2007. Then in 2008, the concept of World Malaria Day (WMD) took over, though it could not be denied that the bulk of malaria morbidity, mortality and intervention still was focused on African countries. Other countries have made progress such as the recent certification of malaria elimination in Argentina and El Salvador, but twenty years after the first AMD/WMD, Africa is still leading the way for creative, sustained intervention against the disease, despite threats to resources from economic downturns and new pandemic diseases.

Below we go straight to Africa to share activities and observances of WMD 2021 from Jhpiego’s African Malaria Technical Officers. After reading through, please watch “Jhpiego Leaves No One Behind | World Malaria Day, 2021″ on YouTube.

“Saramed” from Guinea reports that Guinea, like other countries in the world, celebrates World Malaria Day under the theme: ” Zero Malaria, Draw a Line on Malaria “. We are currently conducting the following activities:

  • Lectures and debates on malaria in medical faculties and health schools;
  • Animation of debate programs on malaria in public and private radios and televisions of the country,
  • Advocacy and sensitization of religious and other influential people
  • Carrying out a package of activities (administration of IPT to pregnant women who have missed their ANC appointment, community distribution of LLINs, screening and treatment of confirmed cases, awareness raising on malaria) in high incidence localities.

These activities is in line with the WHO approach of “high burden, high impact”.

Noella Umulisa reports that the WMD celebration took place in Eastern Province, in Bugesera district in the Mareba sector. Due to COVID-19 pandemic ,only 100 persons were invited to the event.This year’s the national theme is “Zero Malaria starts with me”.

Key activities during the event included …

  • Visit of breeding sites under sentinel surveillance
  • Visit of indoor residual spraying (IRS) sites
  • Launching of the Awareness of the population using drones on the ongoing IRS campaign in this time of COVID-19
  • Song by CHWs
  • Certificate to Integrated Vector Management (IVM) Training of Trainers who will train others up to village level
  • Speech of the Director General ,the guest of honor.

From Burkina Faso, Yousseff Sawadogo and Moumouni Bonkoungou shared photos of the celebration that featured a giant Insecticide-Treated  Net, a speech by the US Ambassador, a malaria song composed by a nurse, an official speech by the President of the National Assembly, and national recognition given to one of the current Jhpiego staff members, Thiery Ouedraogo, who at one time also served as director of the national malaria control program. He was decorated by the country’s authorities as a knight of the order of merit.

Bright Orgi from Jhpiego’s TiPToP malaria in pregnancy project in Nigeria ?? shared photos from a series of compound meetings in the community to mark WMD 2021. The meetings focused on malaria prevention and treatment. Provided opportunities to rural communities to ask questions on malaria issues. Here we can see that observance of WMD must be taken to the people who actually suffer from malaria and need to be actively involved in its solution. Deo Cibinda from the Democratic Republic of the Congo share photos of a national celebration, seen to the left.

Finally, As Kristen Vibbert noted, “These are such amazing World Malaria Day stories. I’m so heartened to see all of these great country efforts to remind everyone of how the fight against malaria must continue despite the Covid-19 pandemic.”  Charles Wanga tweeted, “We know how to defeat #malaria. But that’s not enough. We must do more to save pregnant women and children from the deadly scourge. This #WorldMalariaDay and everyday, because@Jhpiego leaves no one behind in our fight to #EndMalaria for good in Africa, and everywhere”

Communication &Health Workers &IPTp &ITNs &Malaria in Pregnancy Bill Brieger | 16 Nov 2020

Provider Communication about IPTp and ITNs for Pregnant Women in Tanzania

Courtney Emerson and co-workers address the issues of Intermittent Preventive Treatment of Malaria with Sulfadoxine Pyrimethamine and Provision of Insecticide Treated Nets in Geita, Tanzania: Provider Communication and Opportunities at the virtual 69th Annual Meeting of American Society of Tropical Medicine and Hygiene. See their findings below.

Intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is a life-saving intervention to reduce morbidity and mortality among pregnant women and their infants. Additionally, provision and use of insecticide treated nets (ITNs) to prevent malaria is critical to improving pregnancy outcomes.

To assess implementation of malaria in pregnancy services and related health communications, we surveyed 1111 women who had delivered a live born infant in the preceding 12 months (recently pregnant women), as well as 1194 adults from randomly selected households without a recently pregnant woman in Geita Region, Tanzania in 2019. Most (88.2%) recently pregnant women reported receiving any IPTp dose; 45.5% received 3 doses. 72.3% of women received their first dose in the second trimester, as recommended by national guidelines, but only 14.4% received IPTp in the 4th month; 20.3% of women did not receive IPTp until third trimester.

There was a significant difference between ITN ownership and use among households (HH) with and without a recent pregnancy: ownership of at least one net was 95.2% vs 87.9%, respectively (p<0.0001), and use was 90% vs 77.8%, respectively (p<.0001). Despite this, few HHs had enough ITNs to cover all residents; on average, HHs had 1 ITN for every 3 rather than every 2 people, as recommended. Notably, only 21.2% and 26.2% of HH with and without a recent pregnancy had sufficient ITNS (p=0.005), despite 87.3% of recently pregnant women receiving an ITN during their last pregnancy.

Of recently pregnant women, 87% received advice on preventing malaria from a health worker. Of these, 82.7% were advised to sleep under an ITN, but only 66.4% were advised to take SP, and 52.1% to attend ANC regularly. Although uptake of any IPTp was high, there are critical messages that need to be more consistently communicated to pregnant women by ANC providers including the importance of attending ANC regularly during pregnancy. To improve outcomes among pregnant women, additional net distribution may be warranted due to the unexpectedly low access.

Authors and Affiliations

Courtney Nicole Emerson(1), Ryan Lash(1), Ruth Lemwayi(2), Melkior Assenga(2), Alen Kinyina(2), Annette Almeida(2), Samwel L. Nhiga(3), Lia Florey(4), Chonge Kitojo(5), Erik Reaves(6), Miriam Kombe(5), Peter Winch(7), Stephanie Suhowatsky(7), Mary Drake(2), Julie Gutman(1) 1.US Centers for Disease Control and Prevention, Atlanta, GA, United States, 2.Jhpiego, Dar es Salaam, United Republic of Tanzania, 3.National Malaria Control Program, Tanzania, Dar es Salaam, United Republic of Tanzania, 4.US Agency for International Development (USAID), Washington DC, DC, United States, 5.US Agency for International Development (USAID), Dar es Salaam, United Republic of Tanzania, 6.US Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania, 7.Jhpiego, Baltimore, MD, United States

 

IPTp &ITNs &Malaria in Pregnancy Bill Brieger | 16 Nov 2020

Scoping Review of the Key Determinants and Indicators of Malaria in Pregnancy, Madagascar (2010-2019)

This year the 69th Annual Meeting of American Society of Tropical Medicine and Hygiene is virtual.  Catherine Dentinger and colleagues (see authors below) gathered information to guide partner planning to combat malaria in pregnancy in Madagascar. Here are their findings.

Malaria in pregnancy (MIP) increases the risk of poor maternal and infant outcomes; to prevent this, the World Health Organization (WHO) recommends insecticide-treated net (ITN) use, intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), and prompt case management. In Madagascar, IPTp uptake remains low; 10% of targeted women receive 3 doses.

To determine if additional data are needed to improve MIP activities, we conducted a scoping review to identify barriers to antenatal care (ANC) and IPTp uptake. We searched PubMed, Google Scholar and USAID’s files (Development Experience Catalog) using the terms “Madagascar” and “pregnancy” and “malaria” and collected materials from stakeholders. We included English and French documents from 2010 to 2019 with quantitative or qualitative data regarding malaria during pregnancy.

Documents were reviewed and categorized as MIP background information, care seeking, and facility readiness. Of 69 project reports, surveys and published articles, 15 (22%) met the inclusion criteria; 4 (27%) were categorized as care seeking, 4 (27%) as background, and 7 (47%) as facility readiness.

Eight (53%) articles mentioned SP stock outs, 3 (20%) mentioned poor provider knowledge of IPTp guidelines despite recent training, and 5 (33%) discussed barriers to ANC including distance, wait times, poor service quality, cost, and unfriendly providers. One study found only 30% of targeted health workers received recommended supervision.  A 2015 survey of 52 health facilities revealed limited access to ANC due to financial and geographic barriers; 2018 surveys revealed similar findings. Self-treatment and care-seeking delays were reported even when distance was not a barrier.

Our review revealed well-documented barriers to MIP services that could be mitigated by reducing stock outs, improving access to healthcare by removing fees and providing services closer to women’s homes, and targeted behavior change. These findings can be used to guide coordinated donor and government efforts to address management, financial, and human resource gaps to improve MIP services.

Authors and Affiliations

Catherine Dentinger(1), Natasha Hansen(2), Susan Youll(2), Annett Cotte(1), Mary Lindsay(3), Chiarella Matten(4), Vololoniala Aimee Ravaoarinosy(5). 1.Centers for Disease Control and Prevention, Atlanta, GA, United States, States, 3.US Agency for International Development, Washington, DC, United States, 4.Institut Pasteur de Madagascar, Antananarivo, Madagascar, 5.National Malaria Control Program, Antananarivo, Madagascar 2.US Agency for International  Development, Washington DC, DC, United States

Asymptomatic &Children &coinfection &IPTp &ITNs &Malaria in Pregnancy &Plasmodium/Parasite &Reproductive Health &Schools &Seasonal Malaria Chemoprevention Bill Brieger | 15 Oct 2020

Malaria News Today 2020-10-15

Recent publications in Malaria Journal, The Lancet and eLife tackle several challenges to saving lives and malaria elimination. Problems include low access to bednets for children in Ethiopia, high prevalence of asymptomatic malaria in Ghanaian adults, risk of co-infection with other infectious diseases, and gaps in current interventions to prevent malaria in pregnancy and children. On the hopeful side, new targets for drug therapy are being identified. Read more on each by following the links below.

Long-lasting insecticide-treated bed net ownership, utilization and associated factors among school-age children in Southern Ethiopia

Zerihun Zerdo and colleagues examined net use among children in malaria-prone areas of

Dara Mallo and Uba Debretsehay districts because malaria is one of the major causes of morbidity and mortality among school-age children (SAC) in sub-Saharan Africa. This study was part of a baseline assessment in a cluster-randomized controlled trial.

The ownership of at least one LLIN by households of school-aged children (SAC) was about 19.3% (95% CI 17.7–21.0%) but only 10.3% % (95% CI 7.7–13.7%) of these households had adequate access of bed nets to the household members. Ownership of bed net was lower than universal coverage of at least one bed net for two individuals. It is important to monitor replacement needs and educate mothers with low education level with their SAC on the benefit of consistent utilization of bed nets.

Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

Kotepui and Kotepui observed that Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. Therefore they examined co-infection in people living in endemic areas of both diseases. The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. and found 22 studies to include in a systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran’s Q statistic?<?0.001, I2: 95.8%).

No difference in age or gender and risk of Plasmodium spp. and HBV co-infection group was found. The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

High prevalence of asymptomatic malaria infections in adults, Ashanti Region, Ghana, 2018

Melina Heinemann and co-researchers noted that Ghana is among the high-burden countries for malaria infections and recently reported a notable increase in malaria cases. While asymptomatic parasitaemia is increasingly recognized as a hurdle for malaria elimination, studies on asymptomatic malaria are scarce, and usually focus on children and on non-falciparum species. Therefore asymptomatic adult residents from five villages in the Ashanti Region, Ghana, were screened for Plasmodium species by rapid diagnostic test (RDT) and polymerase chain reaction (PCR) during the rainy season. Samples tested positive were subtyped using species-specific real-time PCR.

Molecular prevalence of asymptomatic Plasmodium infection was 284/391 (73%); only 126 (32%) infections were detected by RDT. While 266 (68%) participants were infected with Plasmodium falciparum, 33 (8%) were infected with Plasmodium malariae and 34 (9%) with P. ovale. The sub-species P. ovale curtisi and P. ovale wallikeri were identified to similar proportions. Non-falciparum infections usually presented as mixed infections with P. falciparum.

Most adult residents in the Ghanaian forest zone are asymptomatic Plasmodium carriers. The high Plasmodium prevalence not detected by RDT in adults highlights that malaria eradication efforts must target all members of the population. Beneath Plasmodium falciparum, screening and treatment must also include infections with P. malariae, P. o. curtisi and P. o. wallikeri.

Scientists shed new light on mechanisms of malaria parasite motility

eLife reports a new insight on the molecular mechanisms that allow malaria parasites to move and spread disease within their hosts has just been published. The first X-ray structures of the molecular complex that allows malaria parasites to spread disease highlight a novel target for antimalarial treatments.

The movement and infectivity of the parasite Plasmodium falciparum, and ultimately its ability to spread malaria among humans, rely on a large molecular complex called the glideosome. The new findings provide a blueprint for the design of future antimalarial treatments that target both the glideosome motor and the elements that regulate it.

New Lancet Series: Malaria in early life

Malaria infections are harmful to both the pregnant mother and the developing fetus. Malaria is associated with a 3–4 times increased risk of miscarriage and a substantially increased risk of stillbirth, and it disproportionately affects children younger than 5 years. Falciparum malaria is responsible for more than 200 000 child deaths per year in Africa and vivax malaria causes excess mortality in children in Asia and Oceania. In a duet of papers, we review 1) the deleterious effects of malaria in pregnancy on the developing fetus and 2) the current strategies for prevention and treatment of malaria in children.

Paper 1 is “Deleterious effects of malaria in pregnancy on the developing fetus: a review on prevention and treatment with antimalarial drugs” by Makoto Saito, Valérie Briand, Aung Myat Min, and Rose McGready. The authors are concerned that one in ten maternal deaths in malaria endemic countries may result from Plasmodium falciparum infection, that malaria is associated with a 3–4 times increased risk of miscarriage and a substantially increased risk of stillbirth. While current treatment and prevention strategies reduce, but do not eliminate, malaria’s damaging effects on pregnancy outcomes. They conclude that there is a need for alternative strategies to prevent malaria in pregnancy.

Paper 2 is “Treatment and prevention of malaria in children” by Elizabeth A Ashley and Jeanne Rini Poespoprodjo. They examine the following interventions: Triple antimalarial combination therapies, the RTS,S/AS01 vaccine, seasonal malaria chemoprevention and preventing relapse in Plasmodium vivax infection with primaquine.

Anemia &coronavirus &COVID-19 &IPTp &IRS &ITNs &Larvicide &Malaria in Pregnancy &Morbidity &Mortality &Mosquitoes &Sahel Bill Brieger | 03 Oct 2020

Malaria News Today 2020-10-02/03

Recent news and abstracts include mosquito control using solar disruption of of larval habitats and plants that repel the insects around homes. The challenges of malaria related anemia in pregnancy is discussed. Malaria cases increase in Mali and Mozambique, but in the latter, deaths actually decrease. Malaria parasites have ways of making people more attractive to mosquito bites. Finally covid-19 has not disrupted malaria work as much as anticipated. Read more at the links in the sections below.

Improved Mosquito Control with Solar Power Machine that Causes Ripple Effect

Kristina Panos writes that mosquito haters of the world, rejoice! A few years ago we told you about the first version of this solar-powered mosquito repellent that works by disturbing the surface of standing water. Since then, the project has received worldwide attention, and [Pranav] is back with Solar Scare Mosquito version 2.0 in time for the the 2020 Hackaday Prize.

The idea’s still the same as before: let mosquitoes lay their eggs in the standing waters of tanks and swamps, then disturb the water with vibrations so the larvae on the surface can’t breathe. As smart as this simple idea is, version 2.0 is even smarter. It has a microphone that listens to the wing-beat frequencies of mosquitoes that like to hang around places like that. Inside there’s an Arduino MKR GSM to run the ripple-generating air pump, detect water from the sensor, and gather data from the microphone.

With a network of these devices all reporting data, [Pranav] envisions an early warning system for mosquito-borne epidemics that works by alerting the locals through their phones. Solar Scare Mosquito has come a long way since 2014.

Malaria cases spike in northern Mali

Malaria cases in northern Mali have spiked, according to medical workers, claiming 23 lives in the often lawless desert region last week alone. Mali’s ministry of health said this week that 59 people have died of malaria in the north since the start of the year, almost double the number of deaths over the same period last year.

Already struggling to curb coronavirus, the poor Sahel country is also fighting a brutal jihadist insurgency active in the north and centre of the country.

A powerful attractant: Malaria parasites lure blood-sucking mosquitoes

The malaria parasite’s gametocyte-stage has been demonstrated in the field to heavily manipulate the blood-seeking behaviour of vector mosquitoes through increasing the appeal of biting an infected host.

Plasmodium parasites, the causative agents of Malaria in humans and animals, are well known for manipulating both their human and mosquito hosts as a way of maximising the probability of interactions between them, thereby increasing the chance malaria parasites are transmitted from host to host. One way in which these devious parasites have been shown to increase the probability of host interaction is during their transmissible (gametocyte) stage.

This is achieved by inducing host red blood cells to produce volatile compounds that attract malarial vector species, such as mosquitos in the Anopheles family. The increase in production of volatile compounds, such as certain aldehydes and terpenes, by host red blood cells was shown back in 2017 to be specifically induced by a gametocyte-produced molecule called (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate, also known as HMBPP.

Malaria campaigns fight off Covid disruptions to deliver programmes

Almost all planned work against the disease has gone ahead this year, delivering nets, drugs and the world’s first malaria vaccine. More than 90% of anti-malaria campaigns planned this year across four continents are on track, despite disruptions caused by the coronavirus pandemic, according to new research.

The delivery of insecticide-treated nets and provision of antimalarial medicines in the majority of malaria-affected countries across Africa, Asia and the Americas were still going ahead, a high-level meeting organised by the RBM Partnership to End Malaria heard on Thursday.

Malaria associated with increased prevalence of anemia during pregnancy

Ken Downey Jr. and colleagues conducted a study in seven sub-Saharan African countries demonstrated an association between malaria and an increased prevalence of anemia among pregnant women, according to findings published in BMC Pregnancy and Childbirth.

“Pregnant women in sub-Saharan Africa suffer a double burden of malaria and HIV infections, and these infections interact with each other to cause anemia,” Ssentongo told Healio. “If not treated, the risk of the mother and the unborn baby dying is high. Multipronged strategies to prevent and treat malaria in HIV pregnant women are critical to ensure the survival of the mothers and their unborn babies.”Paddy Ssentongo, MD, MPH, a research assistant professor at Penn State University,

Mozambique: Malaria Cases Increase, Malaria Death Toll Declines

From January to August, 442 people in Mozambique are known to have died from malaria, according to Health Minister Armindo Tiago. Speaking at the launch of a National Home Spraying Campaign, Tiago said the malaria death toll, in the first eight months of the year, was significantly lower than that recorded in the same period in 2019, when 562 people died of the disease.

But although fewer people are dying of malaria, the number of malaria cases has actually increased – from 7.86 million cases in January-August 2019 to 8.36 million in the same months this year. The number of cases rose by 6.4 per cent, but the number of deaths fell by 21.4 per cent. Thus there is the drive to persuade families to change their behaviour.

The Plants That Keep Mosquitoes Away

Protect outdoor areas from mosquitoes and bugs to enjoy evenings outside. Including the following plants in a home garden can provide homeowners with some important weapons in the war against mosquitoes.

1. Citronella Plants: You may already be familiar with citronella plants, as they are known for emitting a strong smell that mosquitoes find objectionable. This group of plants contain citronellal, the active ingredient commonly found in mosquito repellents like citronella patio candles or sprays.

2. The Mint Family: Some members of the mint family have the power to repel mosquitoes, or at least take the sting out of their bites. Check Lemon Balm, Peppermint, Basil, Lavender, Sage, and Catnip.

3. Flowers: Believe it or not, ornamental plants can actually do double duty and function as mosquito repellents. Even better, these plants love sun and are drought resistant. Marigolds, and their relative, tarragoncontain pyrethrum, an ingredient found in many insect repellents. Verbena is a lemon-scented, easy-to-grow perennial. Citrosum is also named “the mosquito plant,” and is one of the best plants in the game for repelling mosquitoes.

Costs &Diagnosis &Ecosystems &Elimination &Genetics &IPTp &ITNs &Microscopy &Mosquitoes &Severe Malaria Bill Brieger | 30 Sep 2020

Malaria News Today 2020-09-30: Diagnostics, Mosquito Genes and Neutrophils

Mosquito populations vary across nations and can be spurred by change in land use and deforestation as seen in Madagascar. Urine and saliva have potential in diagnostics but have lower sensitivity than blood tests. Not all insects have similar genes, and mosquitoes evolved a different gene to handle body segmentation. The DHS Program has released recent Malaria Indicator Surveys for Ghana and Uganda, but indicators are below targets. The emerging roles for neutrophils in malaria will be discussed at a webinar. Finally cost-effectiveness issues around RDTs is noted. More information can be obtained via the hyperlinks.

Variation in Anopheles distribution and predictors of malaria infection risk across regions of Madagascar

Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.

The presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. Ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity. Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.

Evaluating the potential of using urine and saliva specimens for malaria diagnosis in suspected patients in Ghana

This study aimed at detecting PfHRP2 and pLDH malaria antigens in urine and salivary specimens of suspected malaria patients using RDT kits, and identifying factors influencing the detection of these antigens. Malaria rapid test kit (SD Bioline RDT kit) was used to detect malaria antigens, PfHRP2 and pLDH, in blood, urine and saliva samples received from patients suspected of malaria. Subsequently, malaria parasitaemia was determined.

A total of 706 suspected malaria patients provided all three specimens. Prevalence of malaria by microscopy and RDT was 44.2% and 53.9%, respectively. Compared to blood, the sensitivities of urine and saliva were 35.2% and 57.0% respectively. Haemoglobin concentration?<?9.9 g/dL, body temperature?>?38.7 °C and occult blood influenced the detection of malaria antigens in both urine and saliva. Furthermore, the antigens were not detected in urine and saliva when parasitaemia was?<?60,000 parasites/µL and?<?40,000 parasites/µL, respectively.

Saliva, with or without blood contamination, was found to be more efficient that urine samples. Therefore these non-blood specimens have the potential to be used as non-invasive samples for malaria diagnosis. However, this approach is useful in severe to moderate anaemia, hyperthermia, parasitaemia?>?60,000 parasites/µL and samples contaminated with blood.

Mosquitos lost an essential gene for body segmentation with no ill effects

University of Maryland entomologists discovered that a gene critical for survival in other insects is missing in mosquitoes—the gene responsible for properly arranging the insects’ segmented bodies. The researchers also found that a related gene evolved to take over the missing gene’s job. Although laboratory studies have shown that similar genes can be engineered to substitute for one another, this is the first time that scientists identified a gene that naturally evolved to perform the same critical function as a related gene long after the two genes diverged down different evolutionary paths.

The work emphasizes the importance of caution in genetic studies that use model animals to make conclusions across different species. It also points to a new potential avenue for research into highly targeted mosquito control strategies. The research study was published in the September 30, 2020, issue of the journal Communications Biology. “Every single arthropod has a segmented body plan. And you would think it develops the same way in all of them. But what we found is that it doesn’t,” said Alys Jarvela. “That means different genes probably regulate male fertility in mosquitoes, and they might be unique to the mosquito, which could potentially provide a powerful avenue for controlling mosquitoes without harming other insects such as butterflies and bees,” Jarvela said.

Two New Malaria Indicator Surveys Available

Ghana 2019 MIS/DHS Infographic. Malaria prevalence going down from 27% in 2014 to 14% in 2019. Still below target in terms of ITN coverage of and in households.

Uganda 2018-19 MIS/DHS Infographic.  Wide regional variation in malaria prevalence from 1-5% in the southwest to 34% in the northeast. ITN use by children and pregnant women below 2/3rds, while only 2/5 pregnant women got 3 doses of IPT.

Emerging Roles for Neutrophils in Malaria

Aubrey Cunnington and an interdisciplinary translational research group studying host-pathogen interactions in severe infections, focussing on malaria in particular. See for example,  “A More Granular View of Neutrophils in Malaria

Neutrophils are abundant innate immune cells with crucial roles in immunity and vascular inflammation. Recent evidence indicates that neutrophils have a dual role in malaria, contributing to both pathogenesis and control of Plasmodium. We discuss emerging mechanisms behind these opposing functions and identify key outstanding questions.

Cost-effectiveness analysis of malaria rapid diagnostic test in the elimination setting

As more and more countries approaching the goal of malaria elimination, malaria rapid diagnostic tests (RDT) was recomended to be a diagnostic strategy to achieve and maintain the statute of malaria free, as it’s less requirements on equipment and expertise than microscopic examination. But there are very few economic evaluations to confirm whether RDT was cost-effective in the setting of malaria elimination. This research aimed to offer evidence for helping decision making on malaria diagnosis strategy.

The results showed that RDT strategy was the most effective (245 cases) but also the most costly (United States Dollar [USD] 4.47 million) compared to using microscopy alone (238 cases, USD 3.63 million), and RDT followed by microscopy (221 cases, USD 2.75 million). There was no strategy dominated. One-way sensitivity analysis reflected that the result was sensitive to the change in labor cost and two-way sensitivity analysis indicated that the result was not sensitive to the proportion of falciparum malaria. The result of Monte Carlo simulation showed that RDT strategy had higher effects and higher cost than other strategies with a high probability. Compared to microscopy and RDT followed by microscopy, RDT strategy had higher effects and higher cost in the setting of malaria elimination.

Elimination &Eradication &Health Systems &Helminths/Worms &ITNs &Journalists/Media &Leishmaniasis &NGOs &Nigeria &NTDs &Partnership &Repellent &Research &Schistosomiasis &Technical Assistance &Treatment Bill Brieger | 29 Sep 2020

Malaria News Today 2020-09-28/29: media involvement, NGOs, monitoring and research

A variety of malaria and related issues have arisen over the past two days. A media coalition for malaria elimination formed in Ghana. A Nigerian NGO stresses the importance of addressing malaria on Nigeria’s 60th Independence Day (October 1). An innovative technology foundation is supporting various malaria and NTD treatment and diagnostic research efforts. Click on links below to read the details.

Media Coalition for malaria control and elimination launched

A Media Coalition comprising of selected journalists and editors, has been launched in Ghana under the umbrella of the “Zero Malaria Starts with Me” campaign to eliminate malaria by 2030. The Coalition, which aimed to enhance the quality and quantity of malaria coverage, and support broader advocacy efforts, was launched at a workshop in Accra organized by the National Malaria Control Programme (NMCP), in collaboration with the African Media and Malaria Research Network and Speak Up Africa, an advocacy and communication Organisation based in Senegal.

The workshop brought together media personnel from across the regions, who nominated their Regional Executives, with two National Co-Chairpersons coming from Greater Accra. The Members of the Coalition, made a firm declaration of their commitment towards the elimination of malaria in Ghana by the year 2030, by championing the fight, taking responsibility for their roles through proactive, regular, accurate, and high-quality media output of news on malaria.

Chinwe Chibuike Foundation Set To Flag-off Full Scale Malaria Eradication Program On Independence Day

A Nigeria indigenous and international non-governmental organization, envisioned to create a conducive environment towards the accessibility of healthcare facilities and improved educational opportunities, has joined the fight against the bizzare challenges of Malaria. The renowned Nigeria-USA humanitarian organization, Chinwe Chibuike Foundation is collaborating with other organizations to flagoff a full scale malaria eradication exercise tagged “Nigeria at 60 Malaria Eradication Project”, on the 1st of October 2020.

According to the founder and President of Chinwe Chibuike Foundation, Ms Gloria Chibuike, during an interview session with Pulse TV few days ago, she noted the forthcoming Nigeria At 60 Malaria Eradication Program will be different and of more impact, especially with the full scale approach and introduction a new Malaria repellant Band.

While emphasizing on the extensive features of the project, Ms Gloria described Malaria as one of the biggest problems in Africa at the moment, considering the increased number of recorded deaths and infection. She narrated that the discovery of the new malaria repellent band was timely and off-course very efficient, especially with testimonies from few persons who have already tried the brand.

Drugs and Diagnostics: Malaria and NTDs

The Global Health Innovative Technology (GHIT) Fund announced today a total of 1.37 billion yen (US$13 million*) to invest in seven partnerships to develop new lifesaving drugs and diagnostics for malaria, Buruli ulcer, Chagas disease, leishmaniasis, schistosomiasis, and soil-transmitted helminths (STH). This includes three newly funded projects and four that will receive continued funding. The RBM Partnership is planning on how to monitor and provide technical support for ITN programs. Click the links within each section to read details.

As of September 29, GHIT’s portfolio includes 50 ongoing projects: 26 discovery projects, 16 preclinical projects and eight clinical trials (Appendix 3). The total amount of investments since 2013 is 22.3 billion yen (US$211 million).

Support the Improvement of Operational Efficiency of ITN Campaigns

The Alliance for Malaria Prevention (AMP) is a workstream within the RBM Partnership to End Malaria. With malaria indicators stagnating and intense pressure to improve access and use of effective ITNs, WHO has renewed focus on stratifying vector control strategies in countries. Along with the introduction of new, more expensive ITNs, countries are now challenged to determine where they should deploy different ITN types to manage insecticide resistance within limited funding envelopes, as well as to identify more efficient ways to implement mass ITN distribution.

Countries that have accessed AMP technical assistance have significantly improved their capacity to modify and update strategies and tools to increase ITN access, use and accountability. They have also continued to identify further gaps and look for effective ways to address them. Now AMP planning to support update and finalization of ITN tracking tool, aligned with priorities across major partners (GF, PMI, RBM).

 

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