The Effect of Insecticide Treated Nets (ITNs) on Plasmodium falciparum Infection in Rural and Semi-Urban Communities in the South West Region of Cameroon

Apinjoh, Tobias O.; Anchang-Kimbi, Judith Kuoh; Mugri, Regina N.; Tangoh, Delphine A.; Nyingchu, Robert V.; Hanesh, F.; Tata, Rolland Bantar; Njumkeng, Charles; Njua-Yafi, Clarisse; Achidi, Eric A.

doi:10.1371/journal.pone.0116300

Cited by 65 publications

(124 citation statements)

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“…Incorporation of a cost effective PCR in routine malaria diagnosis could be necessary in the long-term for effective malaria diagnosis. Insecticide treated bednet (ITN) usage has been reported to be protective against malaria in malaria endemic countries including Cameroon [38]. Although ITNs usage in this study was relatively low (44.8 %) compared to ownership (79.7 %), participants who did not sleep under the bed net were more susceptible to malaria infection (Table 5).…”

Section: Discussionmentioning

confidence: 80%

Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon

et al. 2016

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BackgroundThe current roll-out of rapid diagnostic tests (RDTs) in many endemic countries has resulted in the reporting of fewer cases of malaria-attributed illnesses. However, lack of knowledge of the prevalence of other febrile illnesses and affordable diagnostic tests means that febrile patients are not managed optimally. This study assessed the prevalence of commonly treatable or preventable febrile illnesses in children between 6 months and 15 years using rapid diagnostic tests at the point-of-care.MethodsFebrile children were enrolled between February-April 2014 at a health facility after obtaining informed consent from parent. Eligible participants were aged 6 months-15 years with a history of fever in the last 24 h or axillary temperature ≥38 °C at consultation. All participants were tested using RDTs for malaria, typhoid, toxoplasmosis and rubella. Malaria parasites were further identified by microscopy and PCR. Clinical and household characteristics were recorded and association with pathogens determined.ResultsOf the 315 children enrolled, the mean age was 5.8 ± 3.8 years. Stomach pain (41.2 %) was the most reported symptom. Prior to attending the health facility, 70.8 % had taken antipyretics, 27.9 % antimalarials, 11.4 % antibiotics and 13.3 % antifungal drugs. Among 315 children with fever, based on RDTs, 56.8 % were infected with malaria, 4.4 % with typhoid, 3.2 % with acute toxoplasmosis, and 1.3 % with rubella (all positive for rubella were in the same family and not vaccinated). All non-malarial infections were co-infections and approximately 30 % of the fever cases went un-diagnosed. Malaria prevalence by microscopy and PCR was 43.4 and 70.2 % respectively. The sensitivity and specificity of RDTs for the diagnosis of malaria were 75.98 and 100 % respectively, with 0.73 measurement agreement between RDTs and microscopy while that of RDT and PCR were 81 and 100 % respectively with a K value of 0.72. The use of Insecticide Treated Bednets was 44 %. There was a significant association between ITN non-usage and malaria (p = 0. 029) as well as drinking water and presence of typhoid (p = 0.047). No association was observed between type of housing and malaria, or toxoplasmosis and raising cats.ConclusionThough malaria still remains the major cause of fever in children, using RDTs for other treatable febrile illnesses like typhoid and toxoplasmosis could facilitate the optimal management of febrile illnesses in children especially when these occur as co-infections with malariaElectronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1996-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 80%

Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon

et al. 2016

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“…[4,38] The free distribution of ITN (one per under-five child or pregnant woman) was a one-time activity and not sustained. [39] Many, especially the poor in rural communities could not afford to replace torn or expired ITNs, [23,40] while others used them for fishing so as to provide food for their families. [41] These caused Cameroon to be ranked lowest of 29 African countries in ITN ownership and to feature among African countries with little or no progress in malaria prevention after ITN scale-up.…”

Section: Vector Controlmentioning

confidence: 99%

“…[43] Cultural unacceptability and limited knowledge have Participation: An In-Depth Review contributed to low ownership and utilisation of ITNs. [40] Although all pregnant women in Ndop Health District in the North West knew malaria prevention measures, only 79.4% used them. [11] This was supported by 99% awareness in the Buea Health District in the South West Region where only 58% slept under ITNs, [39,40] highly determined by individual knowledge and perception.…”

Section: Vector Controlmentioning

confidence: 99%

“…[40] Although all pregnant women in Ndop Health District in the North West knew malaria prevention measures, only 79.4% used them. [11] This was supported by 99% awareness in the Buea Health District in the South West Region where only 58% slept under ITNs, [39,40] highly determined by individual knowledge and perception. [45] Accessibility to vector control methods was a major problem particularly in the rural areas.…”

Section: Vector Controlmentioning

confidence: 99%

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Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Mbako¹

2017

CAJPH

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Abstract:Despite 66 percent reduction in mortality between 2000 and 2015, malaria remains a major global public health problem, affecting mostly Sub-Saharan Africa. Cameroon remains endemic to malaria, with about 41 percent suffering at least one episode of malaria, annual overall mortality of 30 to 35 percent and 67 percent childhood mortality. Cameroon government's subsidy on artemisinin combination therapy (ACT) for uncomplicated malaria, intermittent preventive treatment for pregnant women (IPTp), free distribution of insecticide treated bed nets (ITNs) to pregnant women and under-fives have been more of a top-down approach, with the affected communities mainly at the receiving end. Challenges of failed adherence to test results, drug and insecticide resistance, substandard and self-medication, low ITN ownership and utilisation have been identified, especially in the rural areas. This study reviews malaria prevention in Cameroon and proposes community based context-specific complementary interventions strategies that will promote community participation in prevention and mitigate the effects of poverty towards achievement of the sustainable development goals targets for malaria. The study involved an in-depth review of secondary data from electronic and non-electronic documents. Electronic search was done in Global Health, PubMed, governmental and non-governmental organisation websites, journals and google scholar. Non-electronic documents from the University of Leeds and World Health Organisation (WHO), Geneva libraries were also used. A conceptual framework on integrated community-based approach on intervention to prevent neglected tropical diseases and infectious diseases of poverty was adapted and used, while different intervention strategies were analysed. A total of 96 publications were eligible for inclusion. Analysis of the factors influencing malaria prevention in Cameroon, reveals that current measures alone are insufficient. Therefore, a combination of multiple delivery strategies using an integrated community-based approach is likely to be more effective in breaking the transmission cycle than single programme interventions. Concurrent implementation of community mobilisation through social groups and Village Development Committees, education on house screening, training of mothers and caregivers and health promotion through environmental management were recommended as the best and most feasible strategies to complement current interventions in Cameroon.

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“…Malaria prevalence in Cameroon is a major public health problem at both the regional (larger) and urban-rural (smaller) geographic scales, with an estimated 1.6 million confirmed cases reported in health facilities and 18,738 cases at the community level and 8000 (6000-10,000) estimated deaths in 2016 [3]. Generally, malaria intervention policies and control strategies in both the regional and urban-rural scales in Cameroon, have been reported to focus on the use of insecticide treated bed-nets (ITNs), indoor residual spray (IRS),larval control, diagnostic testing, treatments, disease surveillance, and national campaigns [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Small-area spatial statistical analysis of malaria clusters and hotspots in Cameroon;2000–2015

et al. 2018

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BackgroundMalaria prevalence in Cameroon is a major public health problem both at the regional and urban-rural geographic scale. In 2016, an estimated 1.6 million confirmed cases, and 18,738 cases were reported in health facilities and communities respectively, with about 8000 estimated deaths. Several studies have estimated malaria prevalence in Cameroon using the analytical techniques at the regional scale. We aimed at identifying malaria clusters and hotspots at the urban-rural geographic scale from the Demographic and Health Survey (DHS) data for households between 2000 and 2015 using ArcGIS for intervention programs.MethodsTo identify malaria hotspots and analyze the pattern of distribution, we used the optimized hotspots toolset and spatial autocorrelation respectively in ArcGIS 10.3 for desktop. We also used Pearson’s Correlation analysis to identify associative environmental factors using the R-software 3.4.1.ResultsThe spatial distribution of malaria showed statistically significant clustered pattern for the year 2000 and 2015 with Moran’s indexes 0.126 (P < 0.001) and 0.187 (P < 0.001) respectively. Meanwhile, the years 2005 and 2010 with Moran’s indexes 0.001 (P = 0.488) and 0.002 (P = 0.318) respectively, had a random malaria distribution pattern. There exist varying degrees of malaria clusters and statistically significant hotspots in the urban-rural areas of the 12 administrative regions. Malaria cases were associated with population density and some environmental covariates; rainfall, enhanced vegetation index and composite lights (P < 0.001).ConclusionThis study identified urban-rural areas with high and low malaria clusters and hotspots. Our maps can be used as supportive tools for effective malaria control and elimination, and investments in malaria programs and research, malaria prevention, diagnosis and treatment, surveillance, should pay more attention to urban-rural geographic scale.

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The Effect of Insecticide Treated Nets (ITNs) on Plasmodium falciparum Infection in Rural and Semi-Urban Communities in the South West Region of Cameroon

Cited by 65 publications

References 44 publications

Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon

Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Small-area spatial statistical analysis of malaria clusters and hotspots in Cameroon;2000–2015

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