Abstract
BackgroundIn some African cities, urban malaria is a threat to the health and welfare of city dwellers. To improve the control of the disease, it is critical to identify neighbourhoods where the risk of malaria transmission is the highest. This study aims to evaluate the heterogeneity of malaria transmission risk in one city (Bouaké) in a West African country (Côte d’Ivoire) that presents several levels of urbanization.MethodsTwo cross-sectional studies were conducted in three neighbourhoods (Dar-es-Salam, Kennedy and N’gattakro) in Bouaké during both the rainy and dry seasons. Data on insecticide-treated net (ITN) use and blood samples were collected from children aged between 6 months and 15 years to determine the parasite density and the prevalence of Plasmodium falciparum and the level of IgG against the Anopheles gSG6-P1 salivary peptide, used as the biomarker of Anopheles bite exposure.ResultsThe specific IgG levels to the gSG6-P1 salivary peptide in the rainy season were significantly higher compared to the dry season in all neighbourhoods studied (all p < 0.001). Interestingly, these specific IgG levels did not differ between neighbourhoods during the rainy season, whereas significant differences in IgG level were observed in the dry season (p = 0.034). ITN use could be a major factor of variation in the specific IgG level. Nevertheless, no difference in specific IgG levels to the gSG6-P1 salivary peptide was observed between children who declared “always” versus “never” sleeping under an ITN in each neighbourhood. In addition, the prevalence of P. falciparum in the whole population and immune responders was significantly different between neighbourhoods in each season (p < 0.0001).ConclusionThis study highlights the high risk of malaria exposure in African urban settings and the high heterogeneity of child exposure to the Anopheles vector between neighbourhoods in the same city. The Anopheles gSG6-P1 salivary peptide could be a suitable biomarker to accurately and quantitatively assess the risk of malaria transmission in urban areas.
Highlights
In some African cities, urban malaria is a threat to the health and welfare of city dwellers
immunoglobulin G (IgG) level against gSG6‐P1 salivary peptide according to neighbourhoods To explore if different bio-ecological environments between neighbourhoods would influence individual exposure to Anopheles bites (Fig. 1), the specific IgG response in children was compared between the three neighbourhoods studied during the rainy and dry seasons, classically known for the periods of high and low exposure to Anopheles vectors, respectively
The first analysis showed that the level of specific IgG varied according to seasons and was higher in the rainy season compared to the dry season in all neighbourhoods
Summary
In some African cities, urban malaria is a threat to the health and welfare of city dwellers. This study aims to evaluate the heterogeneity of malaria transmission risk in one city (Bouaké) in a West African country (Côte d’Ivoire) that presents several levels of urbanization. In Bouaké, the second largest city of Côte d’Ivoire, several shallows have been transformed for rice farming and vegetable farming. This factor increases mosquito proliferation, in particular Anopheles gambiae, the major malaria vector in Africa, which is adapted to this urban environment and ensures a continuous transmission of malaria in several of the city’s neighbourhoods [2]. Even though malaria transmission in urban settings is generally considered low compared to rural areas, city dwellers could be considered at high risk of severe malaria because of their low acquired immunity specific to malaria, highlighting the particular health problem of urban malaria [6, 7]
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