Anopheles stephensi in Africa requires a more integrated response

Mnzava, Abraham; Monroe, April; Okumu, Fredros O.

doi:10.1186/s12936-022-04197-4

Cited by 59 publications

(37 citation statements)

References 35 publications

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“…stephensi expansion against the backdrop of changing climate is imperative for public health planning and risk mitigation. Its propensity to spread and establish outside of its current range is already underway, drawing the attention of the global health community [ 5 , 7 , 18 , 44 ]. As a malaria transmitting Anopheline capable of exploiting a similar niche to the urban adapted Aedes spp.…”

Section: Discussionmentioning

confidence: 99%

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquito Anopheles stephensi

Ryan

Lippi

Villena

et al. 2023

Malar J

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Background Anopheles stephensi is a malaria-transmitting mosquito that has recently expanded from its primary range in Asia and the Middle East, to locations in Africa. This species is a competent vector of both Plasmodium falciparum and Plasmodium vivax malaria. Perhaps most alarming, the characteristics of An. stephensi, such as container breeding and anthropophily, make it particularly adept at exploiting built environments in areas with no prior history of malaria risk. Methods In this paper, global maps of thermal transmission suitability and people at risk (PAR) for malaria transmission by An. stephensi were created, under current and future climate. Temperature-dependent transmission suitability thresholds derived from recently published species-specific thermal curves were used to threshold gridded, monthly mean temperatures under current and future climatic conditions. These temperature driven transmission models were coupled with gridded population data for 2020 and 2050, under climate-matched scenarios for future outcomes, to compare with baseline predictions for 2020 populations. Results Using the Global Burden of Disease regions approach revealed that heterogenous regional increases and decreases in risk did not mask the overall pattern of massive increases of PAR for malaria transmission suitability with An. stephensi presence. General patterns of poleward expansion for thermal suitability were seen for both P. falciparum and P. vivax transmission potential. Conclusions Understanding the potential suitability for An. stephensi transmission in a changing climate provides a key tool for planning, given an ongoing invasion and expansion of the vector. Anticipating the potential impact of onward expansion to transmission suitable areas, and the size of population at risk under future climate scenarios, and where they occur, can serve as a large-scale call for attention, planning, and monitoring.

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Section: Discussionmentioning

confidence: 99%

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquito Anopheles stephensi

Ryan

Lippi

Villena

et al. 2023

Malar J

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“…This vulnerability seems to be driven by multiple factors that have shaped the dynamics of the malaria epidemiological quartet of vector, agent, host and environment [12]. The emergence of novel malaria-transmitting mosquito Anopheles stephensi mosquito in SSA [13], has posed a new threat to malaria control measures. In addition, the recent emergence of independent malaria drug resistance in Rwanda [14], Tanzania [15], and Uganda [16] has caused challenges in malaria control using artemisinin combination therapies (ACTs).…”

Section: Discussionmentioning

confidence: 99%

Unusual Clinical Spectra of Childhood Severe Malaria During Malaria Epidemic in Eastern Uganda: A Prospective Study

Namayanja

Eregu

Ongodia

et al. 2023

Preprint

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Background In sub-Saharan Africa (SSA), malaria remains a public health problem despite recent reports of declining incidence. Severe malaria is a multiorgan disease with wide-ranging clinical spectra and outcomes that have been reported to vary by age, geographical location, transmission intensity over time. There are reports of recent malaria epidemics or resurgences, but few data, if any, focus on the clinical spectrum of severe malaria during epidemics. We describe the clinical spectrum and outcomes of childhood severe malaria during the disease epidemic in Eastern Uganda. Methodology: This prospective cohort study from October 1, 2021, to September 30, 2022, was nested within the Malaria Epidemiological, Pathophysiological and Intervention studies in Highly Endemic Eastern Uganda (TMA2016SF-1514-MEPIE Study) at Mbale Regional Referral Hospital, Uganda. Children aged 60 days to 12 years who at admission tested positive for malaria and fulfilled the clinical WHO criteria for surveillance of severe malaria were enrolled on the study. Follow-up was performed until day 28. Data were collected using a customised proforma on social demographic characteristics, clinical presentation, treatment, and outcomes. Laboratory analyses included complete blood counts, malaria RDT (SD BIOLINE Malaria Ag P.f/Pan, Ref. 05FK60-40-1) and blood slide, lactate, glucose, blood gases and electrolytes. In addition, urinalysis using dipsticks (Multistix® 10 SG, SIEMENS, Ref.2300) at the bedside was done. Data were analysed using STATA V15.0. The study had prior ethical approval. Results A total of 300 participants were recruited. At admission, the median age was 4.6 years (range two months − 11.8 years). Many children, 164/300 (57.7%,) were under five years, and 171/300 (57.0%) were males. The common clinical features were prostration 236/300 (78.7%), jaundice in 205/300 (68.3%), severe malarial anaemia in 158/300 (52.7%), blackwater fever 158/300 (52.7%) and multiple convulsions 51/300 (17.0%). Prolonged hospitalisation was found in 56/251 (22.3%) and was associated with hypoxaemia OR 6.3 (95% CI: 2.1, 18.1), P = 0.001. The overall mortality was 19/300 (6.3%). Day 28 follow-up was achieved in 247/300 (82.3%). Conclusion During a 2022 malaria epidemic in Eastern Uganda, the common clinical features for childhood severe malaria were prostration 236/300 (78.7%), jaundice 205/300 (68.3%), severe malarial anaemia 158/300 (52.7%), blackwater fever 158/300 (52.7%) and multiple convulsions 51/300 (17.0%).

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“…stephensi expansion against the backdrop of changing climate is imperative for public health planning and risk mitigation. Its propensity to spread and establish outside of its current range is already underway, drawing the attention of the global health community [5,7,17,32]. As a malaria transmitting Anopheline capable of exploiting a similar niche to the urban adapted Aedes spp.…”

Section: Discussionmentioning

confidence: 99%

“…Malarial transmission throughout sub-Saharan Africa is historically attributable to a few key mosquito vectors, most notably those in the Anopheles gambiae species complex [1,4]. However, in 2019 the WHO issued a notice to alert public health authorities to the recent expansion of invasive Anopheles stephensi into the Horn of Africa, identifying this new vector species as a major potential threat to malaria control in the region [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquitoAnopheles stephensi

Ryan

Lippi

Villena

et al. 2022

Preprint

View full text Add to dashboard Cite

Background:Anopheles stephensiis a malaria-transmitting mosquito that has recently expanded from its primary range in Asia and the Middle East, to locations in Africa. This species is a competent vector of bothP. falciparum(PF) andP. vivax(PV) malaria. Perhaps most alarming, the characteristics ofAn. stephensi, such as container breeding and anthropophily, make it particularly adept at exploiting built environments in areas with no prior history of malaria risk. Methods: In this paper we created global maps of thermal transmission suitability and people at risk (PAR) for malaria transmission byAn. stephensi, under current and future climate. Temperature-dependent transmission suitability thresholds derived from recently published species-specific thermal curves were used to threshold gridded, monthly mean temperatures under current and future climatic conditions. These temperature driven transmission models were coupled with gridded population data for 2020 and 2050, under climate-matched scenarios for future outcomes, to compare with baseline predictions for 2020 populations. Results: Using the Global Burden of Disease regions approach, we found that heterogenous regional increases and decreases in risk did not mask the overall pattern of massive increases of PAR for malaria transmission suitability with An. stephensi presence. General patterns of poleward expansion for thermal suitability were seen for both PF and PV transmission potential. Conclusions: Understanding the potential suitability forAn. stephensitransmission in a changing climate provides a key tool for planning, given an ongoing invasion and expansion of the vector. Anticipating the potential impact of onward expansion to transmission suitable areas, and the size of population at risk under future climate scenarios, and where they occur, can serve as a large-scale call for attention, planning, and monitoring.

show abstract

Anopheles stephensi in Africa requires a more integrated response

Cited by 59 publications

References 35 publications

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquito Anopheles stephensi

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquito Anopheles stephensi

Unusual Clinical Spectra of Childhood Severe Malaria During Malaria Epidemic in Eastern Uganda: A Prospective Study

Mapping current and future thermal limits to suitability for malaria transmission by the invasive mosquitoAnopheles stephensi

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