Pub Date : 2024-11-18DOI: 10.1186/s12936-024-05184-7
Solomon Oguta, Brian Serumaga, Lameck Odongo, Donald Otika, Jackline Ayikoru, Raymond Otim, Jimmyy Opee, Baifa Arwinyo, Francis Pebolo Pebalo, Vincentina Achora, Sande Ojara, Benard Abola, Silvia Awor
Background: All pregnant mothers in Uganda are given sulfadoxine-pyrimethamine (SP, Fansidar®) for presumptive treatment of malaria in pregnancy from 14 weeks of gestation, every four weeks, until delivery. However, prenatal mothers still fall sick of malaria. This study aimed to assess the factors associated with malaria in pregnancy among antenatal care mothers at Gulu Regional Referral Hospital.
Methods: This was a cross-sectional study at Gulu Regional Referral Hospital antenatal clinic from July to August 2023. Consecutive sampling was used. An interviewer-administered questionnaire was used to collect sociodemographic characteristics, physical examination findings and blood samples taken for rapid diagnostic test (RDT) for malaria. A positive RDT was taken as the presence of malaria infection in pregnancy. Data was pre-processed in STATA®15, and logistic regression analysis was done in RStudio 4.2.2. Variables with p < 0.05 were taken as independently associated with malaria in pregnancy and reported as adjusted risk ratios (aRR).
Results: Three hundred fifty (350) pregnant women were recruited; 96% of them slept under mosquito nets daily, while more than half of them (51.7%) had not yet taken SP (IPTp) during their current pregnancy. Prevalence of anaemia (Hb < 11.0 g/dl) was 46.0%. Twenty-four per cent of the mothers were in the first trimester, 56.3% in the second and 19.7% in the third. The prevalence of malaria in pregnancy was 39.7% (95% CI 34.5-45.1%), equally distributed throughout the trimesters. Anaemia (aRR = 4.99, 95%CI 3.10-8.05, p < 0.001) and tertiary level of education (aRR = 0.29, 95% CI 0.14-0.62, p = 0.001) were significantly associated with malaria in pregnancy. Not sleeping under a mosquito net (aRR = 3.79, 95% CI 0.95-15.16, p = 0.059) may be a factor associated with malaria in pregnancy.
Conclusion: Four in every ten mothers had malaria infection, with anaemia being a risk factor, while a tertiary level of education was protective against malaria in pregnancy.
{"title":"Factors associated with malaria in pregnancy among antenatal care mothers at Gulu Regional Referral Hospital in northern Uganda.","authors":"Solomon Oguta, Brian Serumaga, Lameck Odongo, Donald Otika, Jackline Ayikoru, Raymond Otim, Jimmyy Opee, Baifa Arwinyo, Francis Pebolo Pebalo, Vincentina Achora, Sande Ojara, Benard Abola, Silvia Awor","doi":"10.1186/s12936-024-05184-7","DOIUrl":"https://doi.org/10.1186/s12936-024-05184-7","url":null,"abstract":"<p><strong>Background: </strong>All pregnant mothers in Uganda are given sulfadoxine-pyrimethamine (SP, Fansidar<sup>®</sup>) for presumptive treatment of malaria in pregnancy from 14 weeks of gestation, every four weeks, until delivery. However, prenatal mothers still fall sick of malaria. This study aimed to assess the factors associated with malaria in pregnancy among antenatal care mothers at Gulu Regional Referral Hospital.</p><p><strong>Methods: </strong>This was a cross-sectional study at Gulu Regional Referral Hospital antenatal clinic from July to August 2023. Consecutive sampling was used. An interviewer-administered questionnaire was used to collect sociodemographic characteristics, physical examination findings and blood samples taken for rapid diagnostic test (RDT) for malaria. A positive RDT was taken as the presence of malaria infection in pregnancy. Data was pre-processed in STATA<sup>®</sup>15, and logistic regression analysis was done in RStudio 4.2.2. Variables with p < 0.05 were taken as independently associated with malaria in pregnancy and reported as adjusted risk ratios (aRR).</p><p><strong>Results: </strong>Three hundred fifty (350) pregnant women were recruited; 96% of them slept under mosquito nets daily, while more than half of them (51.7%) had not yet taken SP (IPTp) during their current pregnancy. Prevalence of anaemia (Hb < 11.0 g/dl) was 46.0%. Twenty-four per cent of the mothers were in the first trimester, 56.3% in the second and 19.7% in the third. The prevalence of malaria in pregnancy was 39.7% (95% CI 34.5-45.1%), equally distributed throughout the trimesters. Anaemia (aRR = 4.99, 95%CI 3.10-8.05, p < 0.001) and tertiary level of education (aRR = 0.29, 95% CI 0.14-0.62, p = 0.001) were significantly associated with malaria in pregnancy. Not sleeping under a mosquito net (aRR = 3.79, 95% CI 0.95-15.16, p = 0.059) may be a factor associated with malaria in pregnancy.</p><p><strong>Conclusion: </strong>Four in every ten mothers had malaria infection, with anaemia being a risk factor, while a tertiary level of education was protective against malaria in pregnancy.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"346"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1186/s12936-024-05140-5
Carol B Colonia, Ana B Vásquez-Rodríguez, Neal Alexander, Fernando de la Hoz Restrepo
Background: This systematic review investigates the relationship between malaria incidence, climate variables, and deforestation in Colombia, Latin America, and the Caribbean from 2000 to 2020. Malaria, a significant public health issue in these regions, is influenced by ecological factors including climatic conditions and environmental changes, such as deforestation.
Methods: The review employs a comprehensive search strategy across PubMed, Web of Science, Embase, Scopus, Cochrane, and Scielo databases. It applies strict inclusion and exclusion criteria to ensure the relevance and quality of selected studies, focusing on analysing the relationship between climate variables, deforestation, and malaria incidence.
Results: Twenty-four articles were included in this review, fourteen of which assessed the relationship between climatic variables and malaria and ten between deforestation and malaria. The analysis reveals a nuanced understanding of malaria dynamics. A significant finding is the seasonal effect of climatic variables on malaria incidence. The study notes that increased rainfall is positively correlated with malaria incidence. Similarly, warmer temperatures are associated with increased malaria risks, and malaria rates can change by 10% to 80% for every degree of temperature increase, after adjusting for altitude. The impact of deforestation on malaria is complex, with positive and negative correlations observed, depending on the remaining forest cover.
Conclusions: The review highlights the multifaceted nature of malaria transmission, emphasizing the need for integrated approaches that consider both environmental and health perspectives. It underscores the importance of understanding the complex relationships between malaria incidence, climate variables, and deforestation.
{"title":"Malaria, relationship with climatic variables and deforestation in Colombia, Latin America and the Caribbean from 2000 to 2020: a systematic review.","authors":"Carol B Colonia, Ana B Vásquez-Rodríguez, Neal Alexander, Fernando de la Hoz Restrepo","doi":"10.1186/s12936-024-05140-5","DOIUrl":"https://doi.org/10.1186/s12936-024-05140-5","url":null,"abstract":"<p><strong>Background: </strong>This systematic review investigates the relationship between malaria incidence, climate variables, and deforestation in Colombia, Latin America, and the Caribbean from 2000 to 2020. Malaria, a significant public health issue in these regions, is influenced by ecological factors including climatic conditions and environmental changes, such as deforestation.</p><p><strong>Methods: </strong>The review employs a comprehensive search strategy across PubMed, Web of Science, Embase, Scopus, Cochrane, and Scielo databases. It applies strict inclusion and exclusion criteria to ensure the relevance and quality of selected studies, focusing on analysing the relationship between climate variables, deforestation, and malaria incidence.</p><p><strong>Results: </strong>Twenty-four articles were included in this review, fourteen of which assessed the relationship between climatic variables and malaria and ten between deforestation and malaria. The analysis reveals a nuanced understanding of malaria dynamics. A significant finding is the seasonal effect of climatic variables on malaria incidence. The study notes that increased rainfall is positively correlated with malaria incidence. Similarly, warmer temperatures are associated with increased malaria risks, and malaria rates can change by 10% to 80% for every degree of temperature increase, after adjusting for altitude. The impact of deforestation on malaria is complex, with positive and negative correlations observed, depending on the remaining forest cover.</p><p><strong>Conclusions: </strong>The review highlights the multifaceted nature of malaria transmission, emphasizing the need for integrated approaches that consider both environmental and health perspectives. It underscores the importance of understanding the complex relationships between malaria incidence, climate variables, and deforestation.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"347"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1186/s12936-024-05170-z
Paula Calderón-Ruiz, Gabriel Velez-Tobón, Sebastian Bolívar-Hernández, Luz Mila Murcia-Montaño, Alberto Tobón-Castaño
Background: In Colombia, published studies on the treatment of uncomplicated Plasmodium vivax malaria with chloroquine-primaquine are scarce. The aim of this study was to evaluate the therapeutic response to two treatment regimens at the 28-day follow-up and the occurrence of adverse events in patients with P. vivax malaria.
Methods: A quasi-experimental clinical trial was conducted at 3 sites in the Department of Amazonas. Patients received supervised or unsupervised anti-malarial treatment (chloroquine plus primaquine), and the primary effectiveness endpoint was the clinical and parasitological response. Safety was assessed through adverse event surveillance.
Results: A total of 103 patients were included: 53 in the 7-day primaquine group (Group I) and 50 in the group receiving primaquine for 14 days (Group II). Among the patients in group I, an adequate treatment response of 100% and 89.5% was found in patients who received supervised and unsupervised treatment, respectively. In Group II, adequate responses of 100% and 95% were reported for patients who received supervised and unsupervised treatment, respectively. No adverse events were detected.
Conclusions: The response to combined treatment with chloroquine plus primaquine continues to be adequate for treating P. vivax malaria in the Colombian Amazon region; however, a response to unsupervised treatment in the region is recommended.
{"title":"Chloroquine-primaquine therapeutic response and safety in patients with uncomplicated Plasmodium vivax malaria in the Colombian Amazon region.","authors":"Paula Calderón-Ruiz, Gabriel Velez-Tobón, Sebastian Bolívar-Hernández, Luz Mila Murcia-Montaño, Alberto Tobón-Castaño","doi":"10.1186/s12936-024-05170-z","DOIUrl":"https://doi.org/10.1186/s12936-024-05170-z","url":null,"abstract":"<p><strong>Background: </strong>In Colombia, published studies on the treatment of uncomplicated Plasmodium vivax malaria with chloroquine-primaquine are scarce. The aim of this study was to evaluate the therapeutic response to two treatment regimens at the 28-day follow-up and the occurrence of adverse events in patients with P. vivax malaria.</p><p><strong>Methods: </strong>A quasi-experimental clinical trial was conducted at 3 sites in the Department of Amazonas. Patients received supervised or unsupervised anti-malarial treatment (chloroquine plus primaquine), and the primary effectiveness endpoint was the clinical and parasitological response. Safety was assessed through adverse event surveillance.</p><p><strong>Results: </strong>A total of 103 patients were included: 53 in the 7-day primaquine group (Group I) and 50 in the group receiving primaquine for 14 days (Group II). Among the patients in group I, an adequate treatment response of 100% and 89.5% was found in patients who received supervised and unsupervised treatment, respectively. In Group II, adequate responses of 100% and 95% were reported for patients who received supervised and unsupervised treatment, respectively. No adverse events were detected.</p><p><strong>Conclusions: </strong>The response to combined treatment with chloroquine plus primaquine continues to be adequate for treating P. vivax malaria in the Colombian Amazon region; however, a response to unsupervised treatment in the region is recommended.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"348"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1186/s12936-024-05182-9
Octavio René García-Flores, Mayra Eugenia Avilés-Ramírez, Sabrina Vianey Castillo-Paniagua, Edgar Misael Pérez-Jiménez, José Carlos Gasca-Aldama, María Virgilia Soto-Abraham, Juan Carlos Bravata-Alcántara, Juan Manuel Bello-López, Giorgina Barbara Piccoli, Enzo Vásquez-Jiménez
Background: The course of kidney function and outcomes of severe malaria infection in pregnant women is poorly understood. The indications for renal replacement therapy in pregnant patients with AKI are similar to the general population. This is the case of a pregnant patient with severe Plasmodium falciparum infection that caused cerebral malaria, acute kidney injury (AKI) who required renal replacement therapy and kidney biopsy during her hospitalization.
Case presentation: A 29-year-old pregnant woman from Equatorial Guinea was admitted to the hospital with haemolytic anaemia, hyperbilirubinaemia and thrombocytopenia. During hospitalization, a thick blood smear was performed where parasitaemia by P. falciparum were observed and confirmed by real-time PCR assay. The patient developed cerebral malaria secondary to an ischaemic-type cerebral vascular event, hypotension and severe. After confirming diagnosis of P. falciparum infection, artesunate, artemether/lumefantrine and primaquine were started. Kidney biopsy revealed an active tubulointerstitial nephritis with acute tubular lesion and pigment tubulopathy with negative immunofluorescence. After CVVHDF, the patient received intermittent haemodialysis until the recovery of kidney function. After discharge, follow-up was carried until the successful resolution of the pregnancy by cesarean delivery and not shown deterioration in kidney function or proteinuria.
Conclusion: In this case, intensive dialysis was started and dialysis intensity progressively reduced when kidney function improved. Due to the evolution of kidney function, a kidney biopsy was performed which showed tubulointerstitial nephritis as a manifestation of the infection. While the kidney biopsy was of interest for discriminating between tubular and glomerular involvement, the availability of placental biomarkers (sflt1-PlGF) would have been of help for ruling out preeclampsia and placental damage. The multidisciplinary approach to AKI during pregnancy should be the rule, with diligent care of maternal-fetal well-being during pregnancy and monitoring of kidney function after delivery.
背景:人们对孕妇严重疟疾感染后的肾功能变化和预后知之甚少。患有 AKI 的孕妇肾脏替代治疗的适应症与普通人群相似。这是一例严重恶性疟原虫感染导致脑疟疾和急性肾损伤(AKI)的孕妇患者,她在住院期间需要进行肾替代治疗和肾活检:一名来自赤道几内亚的 29 岁孕妇因溶血性贫血、高胆红素血症和血小板减少症入院。住院期间进行了血液浓涂片检查,观察到恶性疟原虫寄生虫血症,并通过实时 PCR 检测进行了确诊。患者继发缺血性脑血管事件、低血压和严重的脑疟疾。确诊为恶性疟原虫感染后,患者开始服用青蒿琥酯、蒿甲醚/本芴醇和伯氨喹。肾活检显示,患者患有活动性肾小管间质性肾炎,伴有急性肾小管病变和色素性肾小管病变,免疫荧光呈阴性。CVVHDF 后,患者接受了间歇性血液透析,直至肾功能恢复。出院后,进行了随访,直到剖宫产成功结束妊娠,且未发现肾功能或蛋白尿恶化:结论:在这个病例中,开始进行强化透析,当肾功能改善后,透析强度逐渐降低。由于肾功能的变化,患者接受了肾活检,结果显示肾小管间质性肾炎是感染的一种表现形式。肾活检有助于区分肾小管和肾小球受累,而胎盘生物标记物(sslt1-PlGF)则有助于排除子痫前期和胎盘损伤。妊娠期 AKI 的多学科治疗方法应成为一项规则,在妊娠期间应努力关注母婴健康,并在分娩后监测肾功能。
{"title":"Kidney involvement in Plasmodium falciparum infection in a pregnant patient.","authors":"Octavio René García-Flores, Mayra Eugenia Avilés-Ramírez, Sabrina Vianey Castillo-Paniagua, Edgar Misael Pérez-Jiménez, José Carlos Gasca-Aldama, María Virgilia Soto-Abraham, Juan Carlos Bravata-Alcántara, Juan Manuel Bello-López, Giorgina Barbara Piccoli, Enzo Vásquez-Jiménez","doi":"10.1186/s12936-024-05182-9","DOIUrl":"https://doi.org/10.1186/s12936-024-05182-9","url":null,"abstract":"<p><strong>Background: </strong>The course of kidney function and outcomes of severe malaria infection in pregnant women is poorly understood. The indications for renal replacement therapy in pregnant patients with AKI are similar to the general population. This is the case of a pregnant patient with severe Plasmodium falciparum infection that caused cerebral malaria, acute kidney injury (AKI) who required renal replacement therapy and kidney biopsy during her hospitalization.</p><p><strong>Case presentation: </strong>A 29-year-old pregnant woman from Equatorial Guinea was admitted to the hospital with haemolytic anaemia, hyperbilirubinaemia and thrombocytopenia. During hospitalization, a thick blood smear was performed where parasitaemia by P. falciparum were observed and confirmed by real-time PCR assay. The patient developed cerebral malaria secondary to an ischaemic-type cerebral vascular event, hypotension and severe. After confirming diagnosis of P. falciparum infection, artesunate, artemether/lumefantrine and primaquine were started. Kidney biopsy revealed an active tubulointerstitial nephritis with acute tubular lesion and pigment tubulopathy with negative immunofluorescence. After CVVHDF, the patient received intermittent haemodialysis until the recovery of kidney function. After discharge, follow-up was carried until the successful resolution of the pregnancy by cesarean delivery and not shown deterioration in kidney function or proteinuria.</p><p><strong>Conclusion: </strong>In this case, intensive dialysis was started and dialysis intensity progressively reduced when kidney function improved. Due to the evolution of kidney function, a kidney biopsy was performed which showed tubulointerstitial nephritis as a manifestation of the infection. While the kidney biopsy was of interest for discriminating between tubular and glomerular involvement, the availability of placental biomarkers (sflt1-PlGF) would have been of help for ruling out preeclampsia and placental damage. The multidisciplinary approach to AKI during pregnancy should be the rule, with diligent care of maternal-fetal well-being during pregnancy and monitoring of kidney function after delivery.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"345"},"PeriodicalIF":2.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-16DOI: 10.1186/s12936-024-05172-x
Betwel J Msugupakulya, Nicolaus S Mhumbira, Dawson T Mziray, Masoud Kilalangongono, Mohamed Jumanne, Halfan S Ngowo, Najat F Kahamba, Alex J Limwagu, Meleji L Mollel, Prashanth Selvaraj, Anne L Wilson, Fredros O Okumu
Background: Larval source management (LSM) is re-emerging as a critical malaria intervention to address challenges associated with core vector control tools, such as insecticide-treated nets (ITNs), and to accelerate progress towards elimination. Presently, LSM is not widely used in rural settings and is instead more commonly applied in urban and arid settings. A systematic entomological assessment was conducted in rural communities of southeastern Tanzania, where insecticide-treated nets (ITNs) are widely used, to explore opportunities for deploying LSM to improve malaria control.
Methods: Aquatic habitat surveys were conducted in 2022 and 2023 to understand habitat usage by different mosquito vectors, covering five villages during the rainy season and seven villages during the dry season. Additionally, samples of adult mosquitoes were collected to assess the role of various Anopheles species in malaria transmission in the area, and to explore opportunities for species sanitation using targeted LSM.
Results: Adult mosquito surveys showed that in this area, the total entomological inoculation rates (EIR) for indoor collections were 20.1 and 6.5 infectious bites per person per year for outdoors. Anopheles funestus and Anopheles arabiensis were the only Anopheles vectors identified. Anopheles funestus was responsible for over 97.6% of the malaria transmission indoors and 95.4% outdoors. The concurrent larval surveys found that habitats with late instar An. arabiensis and An. funestus comprised only a small subset of 11.2%-16.5% of all water bodies in the rainy season, and 9.7%-15.2% in the dry season. In terms of size, these habitats covered 66.4%-68.2% of the total habitat areas in the wet season, reducing to 33.9%-40.6% in the dry season. From the rainy season to the dry season, the surface area of habitats occupied by An. arabiensis and An. funestus decreased by 92.0% to 97.5%, while the number of habitats occupied by An. arabiensis and An. funestus decreased by 38.0% to 57.3%. Anopheles funestus preferred large, permanent habitats with clear water and vegetation year-round, while An. arabiensis showed contrasting seasonal preferences, favouring sunlit still waters in the rainy season and larger, opaque habitats in the dry season.
Conclusion: These findings suggest that An. funestus, which is the dominant malaria vector in the area, mediating over 95% of malaria transmission, preferentially occupies only a small subset of uniquely identifiable aquatic habitats in both wet and dry seasons. This presents an opportunity to expand LSM in rural settings by carefully targeting An. funestus habitats, which might be effective and logistically feasible as a complementary approach alongside existing interventions. Further research should assess the impact of targeted LSM for species sanitation compared to blanket LSM.
{"title":"Field surveys in rural Tanzania reveal key opportunities for targeted larval source management and species sanitation to control malaria in areas dominated by Anopheles funestus.","authors":"Betwel J Msugupakulya, Nicolaus S Mhumbira, Dawson T Mziray, Masoud Kilalangongono, Mohamed Jumanne, Halfan S Ngowo, Najat F Kahamba, Alex J Limwagu, Meleji L Mollel, Prashanth Selvaraj, Anne L Wilson, Fredros O Okumu","doi":"10.1186/s12936-024-05172-x","DOIUrl":"10.1186/s12936-024-05172-x","url":null,"abstract":"<p><strong>Background: </strong>Larval source management (LSM) is re-emerging as a critical malaria intervention to address challenges associated with core vector control tools, such as insecticide-treated nets (ITNs), and to accelerate progress towards elimination. Presently, LSM is not widely used in rural settings and is instead more commonly applied in urban and arid settings. A systematic entomological assessment was conducted in rural communities of southeastern Tanzania, where insecticide-treated nets (ITNs) are widely used, to explore opportunities for deploying LSM to improve malaria control.</p><p><strong>Methods: </strong>Aquatic habitat surveys were conducted in 2022 and 2023 to understand habitat usage by different mosquito vectors, covering five villages during the rainy season and seven villages during the dry season. Additionally, samples of adult mosquitoes were collected to assess the role of various Anopheles species in malaria transmission in the area, and to explore opportunities for species sanitation using targeted LSM.</p><p><strong>Results: </strong>Adult mosquito surveys showed that in this area, the total entomological inoculation rates (EIR) for indoor collections were 20.1 and 6.5 infectious bites per person per year for outdoors. Anopheles funestus and Anopheles arabiensis were the only Anopheles vectors identified. Anopheles funestus was responsible for over 97.6% of the malaria transmission indoors and 95.4% outdoors. The concurrent larval surveys found that habitats with late instar An. arabiensis and An. funestus comprised only a small subset of 11.2%-16.5% of all water bodies in the rainy season, and 9.7%-15.2% in the dry season. In terms of size, these habitats covered 66.4%-68.2% of the total habitat areas in the wet season, reducing to 33.9%-40.6% in the dry season. From the rainy season to the dry season, the surface area of habitats occupied by An. arabiensis and An. funestus decreased by 92.0% to 97.5%, while the number of habitats occupied by An. arabiensis and An. funestus decreased by 38.0% to 57.3%. Anopheles funestus preferred large, permanent habitats with clear water and vegetation year-round, while An. arabiensis showed contrasting seasonal preferences, favouring sunlit still waters in the rainy season and larger, opaque habitats in the dry season.</p><p><strong>Conclusion: </strong>These findings suggest that An. funestus, which is the dominant malaria vector in the area, mediating over 95% of malaria transmission, preferentially occupies only a small subset of uniquely identifiable aquatic habitats in both wet and dry seasons. This presents an opportunity to expand LSM in rural settings by carefully targeting An. funestus habitats, which might be effective and logistically feasible as a complementary approach alongside existing interventions. Further research should assess the impact of targeted LSM for species sanitation compared to blanket LSM.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"344"},"PeriodicalIF":2.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1186/s12936-024-05175-8
Ruth A Ashton, Kochelani Saili, Chama Chishya, Handrinah Banda Yikona, Annie Arnzen, Erica Orange, Chanda Chitoshi, John Chulu, Titus Tobolo, Frank Ndalama, Irene Kyomuhangi, Willy Ngulube, Hawela Moonga, Jacob Chirwa, Laurence Slutsker, Joseph Wagman, Javan Chanda, John Miller, Kafula Silumbe, Busiku Hamainza, Thomas P Eisele, Joshua Yukich, Megan Littrell
Background: Attractive targeted sugar bait (ATSB) stations containing bait (to attract) and ingestion toxicant (to kill) sugar-foraging mosquitoes are hypothesized to reduce malaria transmission by shortening the lifespan of Anopheles vectors.
Methods: A two-arm cluster-randomized controlled trial (cRCT) was conducted in Western Province Zambia. Seventy clusters of 250-350 households were assigned (1:1) by restricted randomization to an intervention arm (ATSB) or control arm (no ATSB) in the context of standard of care vector control (insecticide-treated nets and/or indoor residual spraying). Two ATSB stations (Westham Sarabi, 0.11% dinotefuran w/w) were maintained on exterior walls of eligible household structures for a 7-month deployment period (December-June) during the high malaria transmission season. The primary outcome was clinical malaria incidence among two consecutive seasonal cohorts of children aged 1-14 years, followed-up monthly from January-June in 2022 and 2023. Secondary outcome was Plasmodium falciparum prevalence among individuals aged over six months. Analysis compared clinical malaria incidence and prevalence between arms among the intention-to-treat population.
Results: ATSB coverage, assessed by cross-sectional survey, was 98.3% in March-April 2022 and 89.5% in March-April 2023. 4494 children contributed any follow-up time to the cohort, with 2313 incident malaria cases in the intervention arm (1.28 per child per six-month transmission season), and 2449 in the control arm (1.38 per child-season). The incidence rate ratio between the two arms was 0.91 (95% CI 0.72-1.15, p = 0.42). 2536 individuals participated in cross-sectional surveys, with prevalence of P. falciparum 50.7% in the intervention arm and 53.5% in the control arm. The odds ratio between the two arms was 0.89 (95% CI 0.66-1.18, p = 0.42). Secondary covariable-adjusted and subgroup analyses did not substantially alter the findings. No serious adverse events associated with the intervention were reported.
Conclusions: Two ATSB stations deployed per eligible structure for two consecutive transmission seasons did not result in a statistically significant reduction in clinical malaria incidence among children aged 1-14 years or in P. falciparum prevalence in rural western Zambia. Further studies are needed to assess the efficacy of ATSB stations in different settings and with different deployment strategies.
Trial registration: The trial is registered with Clinicaltrials.gov (NCT04800055).
{"title":"Efficacy of attractive targeted sugar bait stations against malaria in Western Province Zambia: epidemiological findings from a two-arm cluster randomized phase III trial.","authors":"Ruth A Ashton, Kochelani Saili, Chama Chishya, Handrinah Banda Yikona, Annie Arnzen, Erica Orange, Chanda Chitoshi, John Chulu, Titus Tobolo, Frank Ndalama, Irene Kyomuhangi, Willy Ngulube, Hawela Moonga, Jacob Chirwa, Laurence Slutsker, Joseph Wagman, Javan Chanda, John Miller, Kafula Silumbe, Busiku Hamainza, Thomas P Eisele, Joshua Yukich, Megan Littrell","doi":"10.1186/s12936-024-05175-8","DOIUrl":"10.1186/s12936-024-05175-8","url":null,"abstract":"<p><strong>Background: </strong>Attractive targeted sugar bait (ATSB) stations containing bait (to attract) and ingestion toxicant (to kill) sugar-foraging mosquitoes are hypothesized to reduce malaria transmission by shortening the lifespan of Anopheles vectors.</p><p><strong>Methods: </strong>A two-arm cluster-randomized controlled trial (cRCT) was conducted in Western Province Zambia. Seventy clusters of 250-350 households were assigned (1:1) by restricted randomization to an intervention arm (ATSB) or control arm (no ATSB) in the context of standard of care vector control (insecticide-treated nets and/or indoor residual spraying). Two ATSB stations (Westham Sarabi, 0.11% dinotefuran w/w) were maintained on exterior walls of eligible household structures for a 7-month deployment period (December-June) during the high malaria transmission season. The primary outcome was clinical malaria incidence among two consecutive seasonal cohorts of children aged 1-14 years, followed-up monthly from January-June in 2022 and 2023. Secondary outcome was Plasmodium falciparum prevalence among individuals aged over six months. Analysis compared clinical malaria incidence and prevalence between arms among the intention-to-treat population.</p><p><strong>Results: </strong>ATSB coverage, assessed by cross-sectional survey, was 98.3% in March-April 2022 and 89.5% in March-April 2023. 4494 children contributed any follow-up time to the cohort, with 2313 incident malaria cases in the intervention arm (1.28 per child per six-month transmission season), and 2449 in the control arm (1.38 per child-season). The incidence rate ratio between the two arms was 0.91 (95% CI 0.72-1.15, p = 0.42). 2536 individuals participated in cross-sectional surveys, with prevalence of P. falciparum 50.7% in the intervention arm and 53.5% in the control arm. The odds ratio between the two arms was 0.89 (95% CI 0.66-1.18, p = 0.42). Secondary covariable-adjusted and subgroup analyses did not substantially alter the findings. No serious adverse events associated with the intervention were reported.</p><p><strong>Conclusions: </strong>Two ATSB stations deployed per eligible structure for two consecutive transmission seasons did not result in a statistically significant reduction in clinical malaria incidence among children aged 1-14 years or in P. falciparum prevalence in rural western Zambia. Further studies are needed to assess the efficacy of ATSB stations in different settings and with different deployment strategies.</p><p><strong>Trial registration: </strong>The trial is registered with Clinicaltrials.gov (NCT04800055).</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"343"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent reports from Thailand reveal a substantial surge in Plasmodium knowlesi cases over the past decades, with a more than eightfold increase in incidence by 2023 compared to 2018. This study investigates temporal changes in genetic polymorphism associated with the escalating transmission of P. knowlesi malaria in Thailand over time using the prominent vaccine candidate, pkmsp1 as a marker.
Methods: Twenty-five P. knowlesi samples collected in 2018-2023 were sequenced for the 42-kDa region of pkmsp1 and compared with 24 retrieved sequences in 2000-2009, focusing on nucleotide diversity, natural selection, recombination rate, and population differentiation.
Results: Seven unique haplotypes were identified in recent samples, compared to 15 in earlier samples. Nucleotide and haplotype diversity were lower in recent samples (π = 0.016, Hd = 0.817) than in earlier samples (π = 0.018, Hd = 0.942). Significantly higher synonymous substitution rates were observed in both sample sets (dS-dN = 2.77 and 2.43, p < 0.05), indicating purifying selection and reduced genetic diversity over time. Additionally, 8 out of 17 mutation points were located on predicted B-cell epitopes, suggesting an adaptive response by the parasites to evade immune recognition. Population differentiation analysis using the fixation index (Fst) revealed high genetic differentiation between parasite populations in central and southern Thailand or Malaysia. Conversely, the relatively lower Fst value between southern Thailand and Malaysia suggests a closer genetic relationship, possibly reflecting historical gene flow.
Conclusion: This study highlights a decline in genetic diversity and evidence of purifying selection associated with the recently increased incidence of P. knowlesi malaria in Thailand. The minor genetic differentiation between P. knowlesi populations from southern Thailand and Malaysia suggests a shared recent ancestry of these parasites and underscores the need for coordinated efforts between the two countries for the elimination of P. knowlesi.
{"title":"Declining genetic polymorphism of the C-terminus Merozoite Surface Protein-1 amidst increased Plasmodium knowlesi transmission in Thailand.","authors":"Parsakorn Tapaopong, Sittinont Chainarin, Abdulrohman Mala, Arnuwat Rannarong, Nikom Kangkasikorn, Teera Kusolsuk, Wanlapa Roobsoong, Liwang Cui, Wang Nguitragool, Jetsumon Sattabongkot, Sirasate Bantuchai","doi":"10.1186/s12936-024-05162-z","DOIUrl":"10.1186/s12936-024-05162-z","url":null,"abstract":"<p><strong>Background: </strong>Recent reports from Thailand reveal a substantial surge in Plasmodium knowlesi cases over the past decades, with a more than eightfold increase in incidence by 2023 compared to 2018. This study investigates temporal changes in genetic polymorphism associated with the escalating transmission of P. knowlesi malaria in Thailand over time using the prominent vaccine candidate, pkmsp1 as a marker.</p><p><strong>Methods: </strong>Twenty-five P. knowlesi samples collected in 2018-2023 were sequenced for the 42-kDa region of pkmsp1 and compared with 24 retrieved sequences in 2000-2009, focusing on nucleotide diversity, natural selection, recombination rate, and population differentiation.</p><p><strong>Results: </strong>Seven unique haplotypes were identified in recent samples, compared to 15 in earlier samples. Nucleotide and haplotype diversity were lower in recent samples (π = 0.016, Hd = 0.817) than in earlier samples (π = 0.018, Hd = 0.942). Significantly higher synonymous substitution rates were observed in both sample sets (d<sub>S</sub>-d<sub>N</sub> = 2.77 and 2.43, p < 0.05), indicating purifying selection and reduced genetic diversity over time. Additionally, 8 out of 17 mutation points were located on predicted B-cell epitopes, suggesting an adaptive response by the parasites to evade immune recognition. Population differentiation analysis using the fixation index (F<sub>st</sub>) revealed high genetic differentiation between parasite populations in central and southern Thailand or Malaysia. Conversely, the relatively lower F<sub>st</sub> value between southern Thailand and Malaysia suggests a closer genetic relationship, possibly reflecting historical gene flow.</p><p><strong>Conclusion: </strong>This study highlights a decline in genetic diversity and evidence of purifying selection associated with the recently increased incidence of P. knowlesi malaria in Thailand. The minor genetic differentiation between P. knowlesi populations from southern Thailand and Malaysia suggests a shared recent ancestry of these parasites and underscores the need for coordinated efforts between the two countries for the elimination of P. knowlesi.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"342"},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017-2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers' perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them.
Methods: This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children's caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran's formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively.
Results: The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values < 0.001). Under-five malaria cases were also significant (p = 0.025). The odds of the perceived net impact influencing utilisation were 4.956 times greater. Non-usage was due to heat, quality concerns, limited access, breathing difficulties, health conditions such as asthma, and misconceptions about net treatment.
Conclusion: The study revealed a strong belief in insecticide-treated net efficacy. However, some challenges such as access, durability, and misinformation of insecticide-treated nets were discovered. These challenges affected utilisation of insecticide-treated nets in agreement with some literature reviewed. The insights found in this study will help policymakers in addressing health interventions for the reduction of malaria cases in Malawi.
{"title":"Perception of caregivers on ITNs utilisation and its effectiveness among children under 5 years of age in Chikwawa district, Malawi.","authors":"Enock Benito, Praveen Suthar, Godfrey Banda, Parthasarthi Ganguly, Wamaka Msopole","doi":"10.1186/s12936-024-05167-8","DOIUrl":"10.1186/s12936-024-05167-8","url":null,"abstract":"<p><strong>Background: </strong>In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017-2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers' perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them.</p><p><strong>Methods: </strong>This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children's caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran's formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively.</p><p><strong>Results: </strong>The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values < 0.001). Under-five malaria cases were also significant (p = 0.025). The odds of the perceived net impact influencing utilisation were 4.956 times greater. Non-usage was due to heat, quality concerns, limited access, breathing difficulties, health conditions such as asthma, and misconceptions about net treatment.</p><p><strong>Conclusion: </strong>The study revealed a strong belief in insecticide-treated net efficacy. However, some challenges such as access, durability, and misinformation of insecticide-treated nets were discovered. These challenges affected utilisation of insecticide-treated nets in agreement with some literature reviewed. The insights found in this study will help policymakers in addressing health interventions for the reduction of malaria cases in Malawi.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"341"},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-11DOI: 10.1186/s12936-024-05177-6
Bily Nebié, Constantin M Dabiré, Remy K Bationo, Dieudonné D Soma, Moussa Namountougou, Siaka Sosso, Roger C H Nebié, Roch K Dabiré, Eloi Palé, Pierre Duez
Background: Essential oils of Cymbopogon citratus and Hyptis suaveolens are known for their insecticidal properties, but remain ineffective against mosquitoes resistant to synthetic insecticides. In order to improve insecticidal properties of these plants, this study aimed to investigate the chemical composition and insecticidal activity against Anopheles gambiae mosquitoes of essential oil obtained by co-distillation of dry leaves of C. citratus and H. suaveolens.
Methods: Essential oils were extracted by hydrodistillation from dry leaves of C. citratus and H. suaveolens, separately, then from the mixture of the dry leaves of the two plants in mass ratio 50/50. Each pure essential oil and the mixture obtained either by co-distillation or by combining pure essential oils in volume ratio 50/50 were then analysed by GC/MS. All essential oils and Deltamethrin 0.05% (positive control) were tested on two species of mosquitoes of the genus Anopheles gambiae according to the World Health Organization standard methods.
Results: Essential oil obtained by co-distillation mainly contained piperitone (40.80%), 1,8-cineole (24.64%), p-menth-4(8)-ene (13.20%), limonene (6.09%) and α-pinene (4.73%). However, the mixture of pure essential oils of these two plants mostly contained geranial (20.74%), neral (16.42%), 1,8-cineole (19.79%), sabinene (6.03%) and β-pinene (3.87%). The essential oil of C. citratus mainly contained geranial (41.49%), neral (32.83%), β-myrcene (13.66%) and geraniol (3.49%) while the major constituents of essential oil of H. suaveolens were 1,8-cineole (39.58%), sabinene (12.06%), β-pinene (7.73%), α-terpinolene (6.72%) and (E)-caryophyllene (7.49%). At the dose of 1%, all essential oils, except that of H. suaveolens, induced about 100% of mortality on the sensitive species of An. gambiae. However, on the resistant species at the same dose, the essential oil obtained by co-distillation induced the highest mortality (53.44%). The essential oils of C. citratus, H. suaveolens and the mixture of the two pure essential oils caused respectively 2.47, 15.28 and 18.33% of mortality. The synthetic insecticide caused 100 and 14.84% of mortality respectively on the sensitive and resistant species of An. gambiae.
Conclusion: Essential oil obtained by co-distillation showed good insecticidal efficacy against a resistant species of An. gambiae and might constitute a new solution to fight against mosquitoes resistant to synthetic insecticides.
背景:柠檬香蒲(Cymbopogon citratus)和苏合香(Hyptis suaveolens)的精油以其杀虫特性而闻名,但对耐合成杀虫剂的蚊子仍然无效。为了改善这些植物的杀虫特性,本研究旨在调查通过对柠檬香蒲和苏合香蒲的干叶进行共蒸馏而获得的精油的化学成分和对冈比亚按蚊的杀虫活性:通过水蒸馏法分别从 C. citratus 和 H. suaveolens 的干叶中提取精油,然后再从这两种植物干叶的混合物中以 50/50 的质量比提取精油。然后用气相色谱/质谱法分析每种纯精油和通过共蒸馏或以 50/50 的体积比混合纯精油得到的混合物。根据世界卫生组织的标准方法,对所有精油和 0.05% 的溴氰菊酯(阳性对照)在冈比亚按蚊属的两种蚊子身上进行了测试:共蒸馏得到的精油主要含有胡椒酮(40.80%)、1,8-蒎烯(24.64%)、对薄荷-4(8)-烯(13.20%)、柠檬烯(6.09%)和α-蒎烯(4.73%)。然而,这两种植物的纯精油混合物主要含有香叶醇(20.74%)、矿物油(16.42%)、1,8-蒎烯(19.79%)、沙比利烯(6.03%)和β-蒎烯(3.87%)。C. citratus 的精油主要含有香叶醇(41.49%)、萘(32.83%)、β-月桂烯(13.66%)和香叶醇(3.49%)。而 H. suaveolens 精油的主要成分是 1,8-蒎烯(39.58%)、沙比利烯(12.06%)、β-蒎烯(7.73%)、α-松油醇烯(6.72%)和(E)-石竹烯(7.49%)。在 1%的剂量下,除 H. suaveolens 外,所有精油都能诱导冈比亚蚂蚁敏感种 100%死亡。然而,在相同剂量下,通过共蒸馏获得的精油对抗性物种的致死率最高(53.44%)。C. citratus、H. suaveolens 的精油和两种纯精油的混合物分别导致 2.47%、15.28% 和 18.33% 的死亡率。合成杀虫剂对冈比亚蚂蚁的敏感种和抗性种分别造成 100% 和 14.84% 的死亡:通过共蒸馏得到的精油对冈比亚蚁的抗药性物种有很好的杀虫效果,可能是对付对合成杀虫剂有抗药性的蚊子的一种新方法。
{"title":"Investigation on chemical composition and insecticidal activity against Anopheles gambiae of essential oil obtained by co-distillation of Cymbopogon citratus and Hyptis suaveolens from Western Burkina Faso.","authors":"Bily Nebié, Constantin M Dabiré, Remy K Bationo, Dieudonné D Soma, Moussa Namountougou, Siaka Sosso, Roger C H Nebié, Roch K Dabiré, Eloi Palé, Pierre Duez","doi":"10.1186/s12936-024-05177-6","DOIUrl":"10.1186/s12936-024-05177-6","url":null,"abstract":"<p><strong>Background: </strong>Essential oils of Cymbopogon citratus and Hyptis suaveolens are known for their insecticidal properties, but remain ineffective against mosquitoes resistant to synthetic insecticides. In order to improve insecticidal properties of these plants, this study aimed to investigate the chemical composition and insecticidal activity against Anopheles gambiae mosquitoes of essential oil obtained by co-distillation of dry leaves of C. citratus and H. suaveolens.</p><p><strong>Methods: </strong>Essential oils were extracted by hydrodistillation from dry leaves of C. citratus and H. suaveolens, separately, then from the mixture of the dry leaves of the two plants in mass ratio 50/50. Each pure essential oil and the mixture obtained either by co-distillation or by combining pure essential oils in volume ratio 50/50 were then analysed by GC/MS. All essential oils and Deltamethrin 0.05% (positive control) were tested on two species of mosquitoes of the genus Anopheles gambiae according to the World Health Organization standard methods.</p><p><strong>Results: </strong>Essential oil obtained by co-distillation mainly contained piperitone (40.80%), 1,8-cineole (24.64%), p-menth-4(8)-ene (13.20%), limonene (6.09%) and α-pinene (4.73%). However, the mixture of pure essential oils of these two plants mostly contained geranial (20.74%), neral (16.42%), 1,8-cineole (19.79%), sabinene (6.03%) and β-pinene (3.87%). The essential oil of C. citratus mainly contained geranial (41.49%), neral (32.83%), β-myrcene (13.66%) and geraniol (3.49%) while the major constituents of essential oil of H. suaveolens were 1,8-cineole (39.58%), sabinene (12.06%), β-pinene (7.73%), α-terpinolene (6.72%) and (E)-caryophyllene (7.49%). At the dose of 1%, all essential oils, except that of H. suaveolens, induced about 100% of mortality on the sensitive species of An. gambiae. However, on the resistant species at the same dose, the essential oil obtained by co-distillation induced the highest mortality (53.44%). The essential oils of C. citratus, H. suaveolens and the mixture of the two pure essential oils caused respectively 2.47, 15.28 and 18.33% of mortality. The synthetic insecticide caused 100 and 14.84% of mortality respectively on the sensitive and resistant species of An. gambiae.</p><p><strong>Conclusion: </strong>Essential oil obtained by co-distillation showed good insecticidal efficacy against a resistant species of An. gambiae and might constitute a new solution to fight against mosquitoes resistant to synthetic insecticides.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"339"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-11DOI: 10.1186/s12936-024-05159-8
Jean Paul Hategekimana, Clarisse Marie Claudine Simbi, Theoneste Ntakirutimana, Laetitia Nyirazinyoye
Background: Malaria remains a significant concern for children under five in malaria-endemic regions. Rwanda's successful efforts in malaria treatment reduced nationwide cases, but high mortality persists in the Eastern and Southern provinces. This study aimed to investigate the clinical features of severe malaria and to identify the death risk factors among under-five children in Eastern province Hospitals.
Methods: This cross-sectional study assessed severe malaria-related mortality and associated factors among children aged under five years in hospitals of Eastern Province, Rwanda, from 2017 to 2021. Data were collected from hospital records, and descriptive statistics and logistic regression were used for data analysis.
Results: Factors associated with severe malaria-related mortality included coma (aOR: 10, 95% CI: 1.2-82.5, p = 0.03), Vomiting (aOR: 5.2, 95% CI: 1.0-26.0, p = 0.04), four or more days of illness before consultation (aOR: 30.9, 95% CI: 8.7-109.9, p < 0.01). On the other hand, a low parasitaemia level (aOR: 0.01, 95% CI: 0.0-0.1, p < 0.01).
Conclusion: In conclusion, coma, vomiting, and healthcare delays increased mortality in children with severe malaria. Prompt treatment, proper assessments, protocol adherence, and caregiver education on early symptom recognition are crucial for improving outcomes.
{"title":"Factors associated with severe malaria-related mortality among hospitalized children under five years of age in Eastern Province of Rwanda: a cross-sectional study using hospital records from 2017 to 2021.","authors":"Jean Paul Hategekimana, Clarisse Marie Claudine Simbi, Theoneste Ntakirutimana, Laetitia Nyirazinyoye","doi":"10.1186/s12936-024-05159-8","DOIUrl":"10.1186/s12936-024-05159-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant concern for children under five in malaria-endemic regions. Rwanda's successful efforts in malaria treatment reduced nationwide cases, but high mortality persists in the Eastern and Southern provinces. This study aimed to investigate the clinical features of severe malaria and to identify the death risk factors among under-five children in Eastern province Hospitals.</p><p><strong>Methods: </strong>This cross-sectional study assessed severe malaria-related mortality and associated factors among children aged under five years in hospitals of Eastern Province, Rwanda, from 2017 to 2021. Data were collected from hospital records, and descriptive statistics and logistic regression were used for data analysis.</p><p><strong>Results: </strong>Factors associated with severe malaria-related mortality included coma (aOR: 10, 95% CI: 1.2-82.5, p = 0.03), Vomiting (aOR: 5.2, 95% CI: 1.0-26.0, p = 0.04), four or more days of illness before consultation (aOR: 30.9, 95% CI: 8.7-109.9, p < 0.01). On the other hand, a low parasitaemia level (aOR: 0.01, 95% CI: 0.0-0.1, p < 0.01).</p><p><strong>Conclusion: </strong>In conclusion, coma, vomiting, and healthcare delays increased mortality in children with severe malaria. Prompt treatment, proper assessments, protocol adherence, and caregiver education on early symptom recognition are crucial for improving outcomes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"340"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}