Variation in Malaria Transmission Intensity in Seven Sites Throughout Uganda

Okello, Paul Edward; Bortel, Wim Van; Byaruhanga, Anatol Maranda; Correwyn, Anne; Roelants, Patricia; Talisuna, Ambrose; D’Alessandro, Umberto; Coosemans, Marc

doi:10.4269/ajtmh.2006.75.219

Cited by 266 publications

(298 citation statements)

References 31 publications

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“…Laboratory confirmation is still limited in the region in terms of tools, skills and infrastructure although efforts are being taken to improve coverage (Kyabayinze et al, 2012;Yeka et al, 2012). For example, laboratory confirmation is routinely conducted in six sentinel sites across Uganda (Okello et al, 2006;Zinszer et al, 2015); however, the geographical and temporal coverage of the related dataset is considerably low with data freely available only for the period October 2006 to March 2013 for the longest time series. Our dataset covers a greater geographical area and spans for a larger period, allowing more robust estimations of malaria relations than the sentinel site set.A further limitation is related to the use of remote sensing products as a source for climate data.…”

Section: Discussionmentioning

confidence: 99%

Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda

Colón‐González¹,

Tompkins²,

Biondi³

et al. 2016

Geospat Health

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We investigate the short-term effects of air temperature, rainfall, and socioeconomic indicators on malaria incidence across Rwanda and Uganda from 2002 to 2011. Delayed and nonlinear effects of temperature and rainfall data are estimated using generalised additive mixed models with a distributed lag nonlinear specification. A time series cross-validation algorithm is implemented to select the best subset of socioeconomic predictors and to define the degree of smoothing of the weather variables. Our findings show that trends in malaria incidence agree well with variations in both temperature and rainfall in both countries, although factors other than climate seem to play an important role too. The estimated short-term effects of air temperature and precipitation are nonlinear, in agreement with previous research and the ecology of the disease. These effects are robust to the effects of temporal correlation. The effects of socioeconomic data are difficult to ascertain and require further evaluation with longer time series. Climate-informed models had lower error estimates compared to models with no climatic information in 77 and 60% of the districts in Rwanda and Uganda, respectively. Our results highlight the importance of using climatic information in the analysis of malaria surveillance data, and show potential for the development of climateinformed malaria early warning systems. IntroductionDespite the global contraction in range over the past century , malaria still imposes a significant health and socioeconomic burden to many countries (WHO, 2013). The World Health Organization estimates that about 3.4 billion people are at risk of malaria (WHO, 2013). Approximately 207 million cases and 627,000 deaths occurred in 2012 worldwide (WHO, 2013). About 90% of the total mortality occurs in sub-Saharan Africa, and 77% of that percentage happens in children under 5 years of age (WHO, 2013). Two countries significantly affected by malaria are Rwanda and Uganda. Malaria has long been considered the main cause of morbidity and mortality in both countries (NISR, MOH and ICF International, 2012; UBOS and ICF International, 2012). Over the period 2002 to 2011, more than five million malaria cases were reported in Rwanda to government health facilities. The number was significantly greater in Uganda with about 100 million reports of suspected malaria cases between 2002 and 2010.Trends in malaria incidence could be attributed to the complex interplay of a range of determinants including climatic, environmental, and socioeconomic factors (Kazembe et al., 2006;Lowe et al., 2013;Rulisa et al., 2013). Statistical models are useful tools that allow us: i) to understand how disease outcomes change as a function of variations in their key driver; and ii) to predict disease outcomes based on the dynamics of such drivers (James et al., 2013). This paper aims to investigate the ways in which malaria incidence varies as a function of short-term changes in air temperature and rainfall over the period [2002][2003][2004][2005][...

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Section: Discussionmentioning

confidence: 99%

Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda

Colón‐González¹,

Tompkins²,

Biondi³

et al. 2016

Geospat Health

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“…The study was conducted in Tororo District Hospital in eastern Uganda, a malaria hyperendemic area between November 4, 2011 and January 14, 2012. The entomological inoculation rate in this area was estimated at 562 infective bites per person per year in 2002, 1 and more recent reports indicate persistent very high incidence of malaria in childhood despite use of long-lasting insecticide-treated nets and ACT. 16 The study was carried out alongside the Tororo Child Cohort (TCC), a longitudinal antimalarial drug efficacy trial that began in 2007.…”

Section: Methodsmentioning

confidence: 99%

“…1 High malaria transmission areas are characterized by a high prevalence of parasitemia in the population and frequent malaria episodes, especially in children 5 years of age. Parasitological diagnosis using either microcopy or malaria rapid diagnostic tests is recommended before antimalarial treatment.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Two Malaria Rapid Diagnostic Tests (RDTS) for Initial Diagnosis and Treatment Monitoring in a High Transmission Setting in Uganda

Mbabazi

Hopkins

Osilo

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Malaria rapid diagnostic tests (RDTs) may improve fever management in areas without microscopy. We compared the accuracy of histidine-rich protein 2 (HRP2) and Plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as a gold standard, for initial diagnosis, treatment monitoring, and diagnosis of recurrent malaria in a cohort of children followed longitudinally in a high-transmission area in Uganda. For 305 initial fever episodes, sensitivity was 98% for HRP2 and 87% for pLDH, whereas specificity was 55% and 96%, respectively. The HRP2 gave 51% false-positive results on Day 28, whereas pLDH gave no false positives after Day 7. For 59 recurrent fever episodes during follow-up, sensitivity was 100% for HRP2 and 91% for pLDH, whereas specificity was 33% and 100%, respectively. The HRP2-based RDTs are useful for initial diagnosis of malaria caused by superior sensitivity; however, as a result of superior specificity, pLDH-based RDTs are more appropriate to monitor treatment and diagnose recurrent malaria.

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“…[15][16][17][18] The vast majority of people living in Uganda are at risk of malaria, and although malaria transmission is of varied intensity, as documented by the entomological inoculation rate, rates of malaria transmission in Uganda are among the highest in the world. 19 According to the WHO, 90% of the total Ugandan population reside in areas of high malaria transmission, almost exclusively via P. falciparum. 20 Fortunately, efforts to curtail the burden of malaria are underway.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age—Uganda, 2009

Menon

Yoon

2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda.

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Variation in Malaria Transmission Intensity in Seven Sites Throughout Uganda

Cited by 266 publications

References 31 publications

Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda

Assessing the effects of air temperature and rainfall on malaria incidence: an epidemiological study across Rwanda and Uganda

Accuracy of Two Malaria Rapid Diagnostic Tests (RDTS) for Initial Diagnosis and Treatment Monitoring in a High Transmission Setting in Uganda

Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age—Uganda, 2009

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