Low malaria morbidity in a cohort of Senegalese children with free access to health structures

Valin, Nadia; Dieng, Allé Baba; Chippaux, Jean-Philippe; Hesran, Jean-Yves Le; Gaye, O; Garcia, André

doi:10.1051/parasite/2006131079

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…Prevalence of malaria in Senegal has always been reported either on a national basis or a regional level [ 18 – 20 ]. While it is important and necessary to report these figures at community or village level, such aggregated data at national and regional level may mask the spatial heterogeneity of the malaria prevalence.…”

Section: Discussionmentioning

confidence: 99%

Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission

Ndiath

Faye

Cissé

et al. 2014

Malar J

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BackgroundMalaria is major public health problem in Senegal. In some parts of the country, it occurs almost permanently with a seasonal increase during the rainy season. There is evidence to suggest that the prevalence of malaria in Senegal has decreased considerably during the past few years. Recent data from the Senegalese National Malaria Control Programme (NMCP) indicates that the number of malaria cases decrease from 1,500,000 in 2006 to 174,339 in 2010. With the decline of malaria morbidity in Senegal, the characterization of the new epidemiological profile of this disease is crucial for public health decision makers.MethodsSaTScan™ software using the Kulldorf method of retrospective space-time permutation and the Bernoulli purely spatial model was used to identify malaria clusters using confirmed malaria cases in 74 villages. ArcMAp was used to map malaria hotspots. Logistic regression was used to investigate risk factors for malaria hotspots in Keur Soce health and demographic surveillance site.ResultsA total of 1,614 individuals in 440 randomly selected households were enrolled. The overall malaria prevalence was 12%. The malaria prevalence during the study period varied from less than 2% to more than 25% from one village to another. The results showed also that rooms located between 50 m to 100 m away from livestock holding place [adjusted O.R = 0.7, P = 0.044, 95% C.I (1.02 - 7.42)], bed net use [adjusted O.R = 1.2, P = 0.024, 95% C.I (1.02 –1.48)], are good predictors for malaria hotspots in the Keur Soce health and demographic surveillance site. The socio economic status of the household also predicted on hotspots patterns. The less poor household are 30% less likely to be classified as malaria hotspots area compared to the poorest household [adjusted O.R = 0.7, P = 0.014, 95% C.I (0.47 – 0.91)].ConclusionThe study investigated risk factors for malaria hotspots in small communities in the Keur Soce site. The result showed considerable variation of malaria prevalence between villages which cannot be detected in aggregated data. The data presented in this paper are the first step to understanding malaria in the Keur Soce site from a micro-geographic perspective.

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Section: Discussionmentioning

confidence: 99%

Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission

Ndiath

Faye

Cissé

et al. 2014

Malar J

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“…Nevertheless, it is well known that despite the intensive presence of health workers in area (see www.ird.sn/activites/niakhar/), uncontrolled circulation of drugs existed and, at this time, concerned essentially chloroquine [40]. However, we performed repeated controls for the presence of chloroquine and its metabolites in urine.…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, if a child was treated, by our team, for malaria attack during the follow-up, his PD measurement was not included in the mean level of P. falciparum infection during the following three weeks. Secondly, although most of the time children received their treatment within our research program framework, the uncontrolled circulation of drugs in Niakhar remains an important problem (essentially chloroquine in this area [40]). To deal with this uncontrolled medicine intake, urine samples were collected 12 times during the follow-up to control for the presence of chloroquine and its metabolites in urine [69].…”

Section: Methodsmentioning

confidence: 99%

Genome Wide Linkage Study, Using a 250K SNP Map, of Plasmodium falciparum Infection and Mild Malaria Attack in a Senegalese Population

et al. 2010

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Multiple factors are involved in the variability of host's response to P. falciparum infection, like the intensity and seasonality of malaria transmission, the virulence of parasite and host characteristics like age or genetic make-up. Although admitted nowadays, the involvement of host genetic factors remains unclear. Discordant results exist, even concerning the best-known malaria resistance genes that determine the structure or function of red blood cells. Here we report on a genome-wide linkage and association study for P. falciparum infection intensity and mild malaria attack among a Senegalese population of children and young adults from 2 to 18 years old. A high density single nucleotide polymorphisms (SNP) genome scan (Affimetrix GeneChip Human Mapping 250K-nsp) was performed for 626 individuals: i.e. 249 parents and 377 children out of the 504 ones included in the follow-up. The population belongs to a unique ethnic group and was closely followed-up during 3 years. Genome-wide linkage analyses were performed on four clinical and parasitological phenotypes and association analyses using the family based association tests (FBAT) method were carried out in regions previously linked to malaria phenotypes in literature and in the regions for which we identified a linkage peak. Analyses revealed three strongly suggestive evidences for linkage: between mild malaria attack and both the 6p25.1 and the 12q22 regions (empirical p-value = 5×10−5 and 9×10−5 respectively), and between the 20p11q11 region and the prevalence of parasite density in asymptomatic children (empirical p-value = 1.5×10−4). Family based association analysis pointed out one significant association between the intensity of plasmodial infection and a polymorphism located in ARHGAP26 gene in the 5q31–q33 region (p-value = 3.7×10−5). This study identified three candidate regions, two of them containing genes that could point out new pathways implicated in the response to malaria infection. Furthermore, we detected one gene associated with malaria infection in the 5q31–q33 region.

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“…The use of CQ, which has no effect on gametocyte carriage, but is associated with high coverage and early treatment, led to a 50% decrease in the incidence of presumptive malaria cases between August 1985 and July 1987 in Katana province of Zaire [ 21 ]. In the Niakhar area of Senegal, a weekly prospective follow up study of a cohort of 566 children with free access to health care for three months in the malaria transmission season led, in spite of the high level of CQ resistance, to no return to the dispensary in children who had receive this treatment and only one case of severe malaria [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in malaria morbidity following the introduction of artesunate plus amodiaquine combination in M'lomp village dispensary, south-western Senegal

Sarrassat

Senghor

Hesran

2008

Malar J

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Abstract

Background

In Thailand, South Africa and Zanzibar, a decrease in malaria morbidity was observed following the introduction of artemisinin-based combination therapy (ACT). In Senegal, therapeutic trials supervised the in vivo efficacy of artesunate plus amodiaquine from 1999 to 2005 at the M'lomp village dispensary. The trends in malaria morbidity in this village were evaluated from 2000 to 2002.

Methods

Each year, between July and December inclusive, fevers treated with antimalarials and slide-proven, uncomplicated malaria cases were collected from dispensary health records. Data were also collected in 1998, just prior to ACT introduction. Pearson's chi square tests and Student tests were used to compare two percentages or two means respectively (α = 0.05).

Results

Between 1998 and 2002, the total number of fevers treated with antimalarials and their repetitiveness progressively decreased: From 2824 to 945 fevers and from 17.6% to 9.7% (RR_1998–2002= 0.55; [0.44–0.69]; p < 0.0001) respectively. Considering uncomplicated malaria cases only, a decrease was observed in their total number between 2001 and 2002, from 953 to 570 cases. The incidence rate and repetitiveness also decreased. The incidence rate fell from 46.1% in 2001 to 37.5% in 2002 (p < 0.0001) and the repetitiveness decreased from 13.0% in 2000 to 6.6% in 2002 (RR_2000–2002= 0.51; [0.35–0.72]; p = 0.0001).

Conclusion

The percentage of uncomplicated malaria cases treated with ACT increased, from 18.9% in 2000 to 64.0% in 2002, making it tempting to conclude an impact on malaria morbidity. Nonetheless, the decline in incidence rate of uncomplicated malaria was slight and a lower recorded rainfall was reported in 2002 which could also explain this decline. The context in which ACT is introduced affects the impact on malaria morbidity. In M'lomp, in contrast to studies in Thailand, South Africa and Zanzibar, ACT coverage of malaria cases was low and no vector control measure was deployed. Moreover, the malaria transmission level is higher. In sub-Saharan countries, in order to optimize the impact on malaria morbidity, ACT deployment must be supported, on the one hand, by a strengthening of public health system to ensure a high ACT coverage and, on the other hand, by others measures, such vector control measures.

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Low malaria morbidity in a cohort of Senegalese children with free access to health structures

Cited by 4 publications

References 10 publications

Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission

Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission

Genome Wide Linkage Study, Using a 250K SNP Map, of Plasmodium falciparum Infection and Mild Malaria Attack in a Senegalese Population

Trends in malaria morbidity following the introduction of artesunate plus amodiaquine combination in M'lomp village dispensary, south-western Senegal

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