Malaria Infection Rates Research Articles

EFFECTS OF NON-COMPLIANCE TO LLIN AND IPT IN PREGNANCY ON MATERNAL AND NEONATAL MALARIA, AGE AND BIRTH WEIGHTS OF NEONATES AT UYO

Pregnant mothers and children under 5 years are most vulnerable to Plasmodium falciparum malaria in Nigeria. Non-compliance to LLIN and IPT, and resultant maternal and cord blood malaria on neonatal age and birth weights were studied in Uyo, Nigeria between September and October 2013. Peripheral and cord blood from 106 consenting pregnant women were examined for malaria parasites; and their usage of LLIN and IPT ascertained. Ages and weights of resulting neonates were recorded at birth. Results showed that maternal and neonatal malaria infection rates (IR) were 54.7% (Mean± SD=49.23±26.41) and 45.3% (Mean± SD=40.6±20.6), with indications that maternal immunity increases with parity. Generally 29.2% and 39.6% of all neonates were respectively delivered pre-term and underweight. About 53.8% and 51.9% of the women were non-compliant to LLIN and IPT, respectively; and 91.4% of LLIN non-compliant as well as 94.8% of IPT non-compliant were infected with malaria. We inferred that use of LLIN and IPT would have offered the women protection against malaria. Heat generation, fear of toxic reactions, and difficulty in setting-up LLIN as well as ‘not sick’, fear of abortion, and doubtful efficacy of IPT were among the reasons given by pregnant women for non-compliance. Sustained health education on the use of LLIN and IPT will help to reduce malaria infection and its consequences in Uyo.

Liver function biomakers in Malaria and Hepatitis B co-infection among patients with febrile illness

Introduction: Malaria and Hepatitis B Virus (HBV) co-infections present major threat to public health throughout tropical and Sub-Saharan Africa. This study was carried out to analyze the status of liver enzymes and serum protein in HBV and malaria co-infected patients in Murtala Muhammed Specialist Hospital (MMSH) Kano. Methods: Standard microscopy and rapid diagnostic test (RDT) were used separately to screen for mono and co-infections among 200 outpatients presented with fever. Their serum protein and liver enzymes were investigated. Results: Among the total subjects studied 25.5% were malaria positive. Females had higher rate of malaria infection (18%) than males (7.5%). Age group 15-24 had the highest malaria prevalence (11%). Thirteen (6.5%) subjects were HBV positive. Males had higher rate of infection (4.5%) than females (2.0%). Male subjects had higher prevalence of co-infection representing 4.5% and age groups 25-34 were observed to have highest co-infection rate of 1.5%. Biochemical parameters analyzed on all the categories of subjects shows significant difference in their mean values as compared to other groups (P<0.05). However no significant difference was observed in the value of ALP in all the groups. Statistical difference was also established in ALB values between the co-infection and malaria groups (P=0.037) and between malaria and control group (P=0.022). There is also a statistical difference in the mean value of total bilirubin among the groups P<0.05 and mean value of DB between HBV and control groups (P=0.022). Conclusion: The study showed that co-infection of malaria and HBV infection had no profound effect on the level of serum protein and liver enzyme activities in the serum.

Malaria and Hepatitis B co-infection in patients with febrile illnesses attending general outpatient unit of the Murtala Muhammed Specialist Hospital, Kano, Northwest Nigeria

Malaria and Hepatitis B Virus (HBV) infections are co-endemic throughout much of the tropical and sub-Saharan Africa and both present major threat to public health. A study on the prevalence of HBV and Malaria co-infection was carried out on 200 patients presenting with fever at the General Outpatient Department (GOPD) of the Murtala Muhammed Specialist Hospital (MMSH), Kano using Gold Standard microscopy and rapid diagnostic test (RDT). The effect of mono and co-infection on hematological parameters was also investigated. Fifty one (25.5%) out of the 200 patients studied were Malaria positive. Females had higher prevalence rate(18%) of Malaria infection than males with 7.5%. Age group 15-24 had the highest Malaria prevalence (11%) followed by age group 25-34 with 6.5%. Higher mean parasite density (1,200/il) was recorded among subjects with monoinfection of Malaria than mean parasite density (518/il) obtained among the co-infected. Mean parasite density was higher in female than male subjects. Thirteen (6.5%) subjects were HBV positive. Males had higher rate of infection with 4.5% prevalence than females with 2.0%. Nine individuals representing 4.5% of the total population had co-infection with higher prevalence (3%) among the males. Age groups 25-34 were observed to have high co-infection rate of 1.5% and the least prevalence was observed among the age group 15-24 with 0.5% prevalence for both males and females. Hematological evaluation carried out on all the categories of subjects shows significant difference in mean values of PCV (P=0.041), Hb (P=0.018) between the co-infection group and those with malaria infection and control groups. However, no significant difference (P>0.05) was observed in the values of WBC, PLT and Red cell indices among the co-infected and other test group. It was concluded that co-infection with the two ailments had no profound effect on hematologic parameters. Keywords : Co-Infection, Hepatitis B, Kano, Malaria, MMSH, Prevalence

The prevalence of malaria at first antenatal visit in Blantyre, Malawi declined following a universal bed net campaign.

BackgroundPreventing malaria during pregnancy is important for the health of mothers and newborns. Interventions, which include distribution of bed nets and administration of intermittent preventive treatment (IPT), typically occur at the first antenatal visit, usually in the second or third trimester of pregnancy. In 2012, during the course of ongoing clinical studies of malaria among pregnant women in Malawi, a universal bed net campaign was implemented by the Government. This study tested the hypothesis that a universal bed net campaign would decrease the prevalence of malaria among pregnant women at their first antenatal visit.MethodsSome 1661 women were recruited for two studies from 2009 to 2014. Quantitative PCR (qPCR) was conducted from dried blood spots collected at the first antenatal care visit (prior to administration of IPT or any study interventions) from women who were in their first or second pregnancy and less than 28 weeks gestation by clinical assessment.ResultsOverall, 320 of 1629 (19.6 %) women tested for malaria at their first antenatal visit were infected. Malaria infection rates declined from 28.4 % before the universal bed net campaign, to 18.5 % in 2012, to 15.0 % in the years following the universal bed net campaign. The odds of malaria infection at the time of first antenatal visit in 2012 and the years following the bed net campaign were significantly lower than in the years prior to the intervention (OR 0.6, 95 % CI 0.4–0.8; and OR 0.4, 95 % CI 0.3–0.6, respectively). A similar pattern was observed for the prevalence of clinical malaria. The inverse trend was observed for reported bed net use. However bed net use and malaria infection were not significantly associated on the individual level.ConclusionsMalaria infection in pregnant women is common even after a bed net campaign in Malawi, though prevalence rates declined. These early infections may cause maternal anaemia and placental malaria resulting in adverse maternal and fetal outcomes. Infection early in pregnancy may also contribute to malaria transmission as pregnant women represent a significant untreated reservoir of parasites. Universal bed net distribution appears to have moderate success in preventing malaria early in pregnancy and these findings support continued efforts to target women early in pregnancy and all women of childbearing age.

Avian malaria in Hawaiian forest birds: infection and population impacts across species and elevations

Wildlife diseases can present significant threats to ecological systems and biological diversity, as well as domestic animal and human health. However, determining the dynamics of wildlife diseases and understanding the impact on host populations is a significant challenge. In Hawai‘i, there is ample circumstantial evidence that introduced avian malaria (Plasmodium relictum) has played an important role in the decline and extinction of many native forest birds. However, few studies have attempted to estimate disease transmission and mortality, survival, and individual species impacts in this distinctive ecosystem. We combined multi‐state capture‐recapture (longitudinal) models with cumulative age‐prevalence (cross‐sectional) models to evaluate these patterns in Apapane, Hawai‘i Amakihi, and Iiwi in low‐, mid‐, and high‐elevation forests on the island of Hawai‘i based on four longitudinal studies of 3–7 years in length. We found species‐specific patterns of malaria prevalence, transmission, and mortality rates that varied among elevations, likely in response to ecological factors that drive mosquito abundance. Malaria infection was highest at low elevations, moderate at mid elevations, and limited in high‐elevation forests. Infection rates were highest for Iiwi and Apapane, likely contributing to the absence of these species in low‐elevation forests. Adult malaria fatality rates were highest for Iiwi, intermediate for Amakihi at mid and high elevations, and lower for Apapane; low‐elevation Amakihi had the lowest malaria fatality, providing strong evidence of malaria tolerance in this low‐elevation population. Our study indicates that hatch‐year birds may have greater malaria infection and/or fatality rates than adults. Our study also found that mosquitoes prefer feeding on Amakihi rather than Apapane, but Apapane are likely a more important reservoir for malaria transmission to mosquitoes. Our approach, based on host abundance and infection rates, may be an effective alternative to mosquito blood meal analysis for determining vector‐host contacts when mosquito densities are low and collection of blood‐fed mosquitoes is impractical. Our study supports the hypothesis that avian malaria has been a primary factor influencing the elevational distribution and abundance of these three species, and likely limits other native Hawaiian species that are susceptible to malaria.

The impact of livestock on the abundance, resting behaviour and sporozoite rate of malaria vectors in southern Tanzania.

BackgroundIncreases in the coverage of long-lasting insecticidal nets (LLINs) have significantly reduced the abundance of Anopheles gambiae sensu stricto in several African settings, leaving its more zoophagic sibling species Anopheles arabiensis as the primary vector. This study investigated the impact of livestock ownership at the household level on the ecology and malaria infection rate of vectors in an area of Tanzania where An. arabiensis accounts for most malaria transmission.MethodsMosquito vectors were collected resting inside houses, animal sheds and in outdoor resting boxes at households with and without livestock over three years in ten villages of the Kilombero Valley, Tanzania. Additionally, the abundance and sporozoite rate of vectors attempting to bite indoors at these households was assessed as an index of malaria exposure.ResultsThe mean abundance of An. gambiae s.l. biting indoors was similar at houses with and without livestock. In all years but one, the relative proportion of An. arabiensis within the An. gambiae s.l. species complex was higher at households with livestock. Livestock presence had a significant impact on malaria vector feeding and resting behaviour. Anopheles arabiensis were generally found resting in cattle sheds where livestock were present, and inside houses when absent. Correspondingly, the human blood index of An. arabiensis and An. funestus s.l. was significant reduced at households with livestock, whereas that of An. gambiae s.s. was unaffected.Whilst there was some evidence that sporozoite rates within the indoor-biting An. gambiae s.l population was significantly reduced at households with livestock, the significance of this effect varied depending on how background spatial variation was accounted for.ConclusionsThese results confirm that the presence of cattle at the household level can significantly alter the local species composition, feeding and resting behaviour of malaria vectors. However, the net impact of this livestock-associated variation in mosquito ecology on malaria exposure risk was unclear. Further investigation is required to distinguish whether the apparently lower sporozoite rates observed in An. gambiae s.l. at households with livestock is really a direct effect of cattle presence, or an indirect consequence of reduced risk within areas where livestock keepers choose to live.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-014-0536-8) contains supplementary material, which is available to authorized users.

The impact of urbanization on malaria infection rate and parasite density in children in the municipality of Yopougon, Abidjan (Côte d'Ivoire)

From September 23-30, 2005, we conducted a cross-sectional study in six townships of Yopougon, a municipality of Abidjan. These townships were grouped in three levels of urbanization (village, precarious township, and residential township). The main objective of this survey was to determine the impact of urbanization on the malaria infection (parasite) rate and parasite density, and their consequences on the heterogeneity of malaria transmission in urban Abidjan. Specifically we compared these rates in all three urbanization levels, selecting two townships for each level to take environmental specificities observed from previous data into account. The study included 400 households per township. All children younger than 5 years in these households were included. Thick and thin blood smears were taken for each child on slides, and each slide was examined by microscope after staining. The malaria infection rate was 21.8%, indicating mesoendemic malaria. Its distribution varied significantly between the three urbanization levels. Malaria parasite densities also varied significantly between them. These results confirm the involvement of urbanization in the heterogeneity of malaria transmission in the city of Abidjan.

Anopheles arabiensis seasonal densities and infection rates in relation to landscape classes and climatic parameters in a Sahelian area of Senegal.

BackgroundThe influence of environmental and climatic factors on malaria vector bionomics and transmission is an important topic in the context of climatic change particularly at macro-geographical level. Sahelian areas could be particularly affected due to heterogeneous features including high inter-annual variability in rainfall and others associated parameters. Therefore, baseline information on the impact of environmental and climatic factors on malaria transmission at micro-geographical level is required for vector risk management and implementation of control strategies.MethodsMalaria vectors were collected indoors by pyrethrum spray catches in 14 villages belonging to 4 different landscape classes (wooded savanna, shrubby savanna, bare soils and steppe) in the sylvo-pastoral area of Senegal. Plasmodium falciparum infection rates were determined using an indirect enzyme-linked immunosorbent assay (ELISA).ResultsAn. arabiensis was the predominant species in all landscape classes and was the only species collected at the end of the rainy season excepted in villages located in bare soils where it cohabited with An. coluzzii. Mean temperature and relative humidity showed similar variations in all the landscape classes covered whereas rainfall was more heterogeneous in terms of pattern, frequency and amount. The mean densities of An. arabiensis displayed high seasonal differences with peaks observed in August or September. A positive non-significant correlation was observed between An. arabiensis densities for rainfall and humidity whereas a negative non-significant correlation was reported for temperature. Plasmodium falciparum-infected mosquitoes were detected only in wooded savanna and bare soils villages.ConclusionsThese observations suggest key roles played by landscape classes and rainfall in malaria vector densities, infection rates and malaria transmission that could be more pronounced in villages situated in wooded savanna and bare soils. Due to the close relationship between environmental and meteorological parameters in this Sahelian region, additional studies on the impact of these parameters are required to further ascertain their association with entomological parameters involved in malaria transmission. From the public health point of view, such information could be useful for human population settlements as well as for monitoring and modelling purposes giving early warning system for implementation of interventions in these unstable transmission zones.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0711-0) contains supplementary material, which is available to authorized users.

Does malaria epidemiology project Cameroon as 'Africa in miniature'?

Cameroon, a west-central African country with a ~ 20 million population, is commonly regarded as 'Africa in miniature' due to the extensive biological and cultural diversities of whole Africa being present in a single-country setting. This country is inhabited by ancestral human lineages in unique eco-climatic conditions and diverse topography. Over 90 percent Cameroonians are at risk of malaria infection, and ~ 41 percent have at least one episode of malaria each year. Historically, the rate of malaria infection in Cameroon has fluctuated over the years; the number of cases was about 2 million in 2010 and 2011. The Cameroonian malaria control programme faces an uphill task due to high prevalence of multidrug-resistant parasites and insecticide-resistant malaria vectors. Above all, continued human migration from the rural to urban areas as well as population exchange with adjoining countries, high rate of ecological instabilities caused by deforestation, poor housing, lack of proper sanitation and drainage system might have resulted in the recent increase in incidences of malaria and other vector-borne diseases in Cameroon. The available data on eco-environmental variability and intricate malaria epidemiology in Cameroon reflect the situation in the whole of Africa, and warrant the need for in-depth study by using modern surveillance tools for meaningful basic understanding of the malaria triangle (host-parasite-vector-environment).

How the malaria vector Anopheles gambiae adapts to the use of insecticide-treated nets by African populations.

BackgroundInsecticide treated bed nets have been recommended and proven efficient as a measure to protect African populations from malaria mosquito vector Anopheles spp. This study evaluates the consequences of bed nets use on vectors resistance to insecticides, their feeding behavior and malaria transmission in Dielmo village, Senegal, were LLINs were offered to all villagers in July 2008.MethodsAdult mosquitoes were collected monthly from January 2006 to December 2011 by human landing catches (HLC) and by pyrethroid spray catches (PCS). A randomly selected sub-sample of 15–20% of An. gambiae s.l. collected each month was used to investigate the molecular forms of the An. gambiae complex, kdr mutations, and Plasmodium falciparum circumsporozoite (CSP) rate. Malaria prevalence and gametocytaemia in Dielmo villagers were measured quarterly.ResultsInsecticide susceptible mosquitoes (wild kdr genotype) presented a reduced lifespan after LLINs implementation but they rapidly adapted their feeding behavior, becoming more exophageous and zoophilic, and biting earlier during the night. In the meantime, insecticide-resistant specimens (kdr L1014F genotype) increased in frequency in the population, with an unchanged lifespan and feeding behaviour. P. falciparum prevalence and gametocyte rate in villagers decreased dramatically after LLINs deployment. Malaria infection rate tended to zero in susceptible mosquitoes whereas the infection rate increased markedly in the kdr homozygote mosquitoes.ConclusionDramatic changes in vector populations and their behavior occurred after the deployment of LLINs due to the extraordinary adaptative skills of An. gambiae s. l. mosquitoes. However, despite the increasing proportion of insecticide resistant mosquitoes and their almost exclusive responsibility in malaria transmission, the P. falciparum gametocyte reservoir continued to decrease three years after the deployment of LLINs.

Seasonal genetic partitioning in the neotropical malaria vector, Anopheles darlingi.

BackgroundAnopheles darlingi is the main malaria mosquito vector in the Amazonia region. In spite of being considered a riverine, forest-dwelling species, this mosquito is becoming more abundant in peri-urban areas, increasing malaria risk. This has been associated with human-driven environmental changes such as deforestation.MethodsMicrosatellites were used to characterize A. darlingi from seven localities along the Madeira River, Rondônia (Brazil), collected in the early and late periods of the rainy season.ResultsTwo genetically distinct subpopulations were detected: one (subpopulation A) was associated with the late rainfall period and seems to be ecologically closer to the typical forest A. darlingi; the other (subpopulation B) was associated with the early rainfall period and is probably more adapted to drier conditions by exploiting permanent anthropogenic breeding sites. Results suggest also a pattern of asymmetric introgression, with more subpopulation A alleles introgressed into subpopulation B. Both subpopulations (and admixed mosquitoes) presented similar malaria infection rates, highlighting the potential for perennial malaria transmission in the region.ConclusionsThe co-occurrence of two genetically distinct subpopulations of A. darlingi adapted to different periods of rainfall may promote a more perennial transmission of malaria throughout the year. These findings, in a context of strong environmental impact due to deforestation and dam construction, have serious implications for malaria epidemiology and control in the Amazonian region.

English

Malaria transmitted by female anopheles mosquitoes is a major cause of death in many developing countries of the world. In Nigeria, malaria prevalence is as high as 80 to 85% and is the most common cause of outpatient visits to health facilities. The malaria situation in Nigeria is very burdensome and it impedes human development. The degree of malaria infestation varies from region to region in Nigeria. This spatial attribute of malaria infestation across regions necessitate the needs for malaria mapping among researchers. Also, the rate of malaria infection across space depends on dynamic processes involving complex climatic, environmental, physical, and social variables operating differently in space. This complexity makes the analysis of the spatial pattern of malaria infection in Nigeria important. Such analysis can explain the variations, providing a basis for policy intervention. It is against this background that this paper examines the spatial patterns of malaria infestation in Nigeria. Malaria data for fifteen years (1993 to 2007) were collected from the World Health Organisation (WHO) Data Bank, Roll Back Malaria/Epidemiological Unit of both the Federal and State Ministries of Health for twenty-three states in Nigeria. The pattern of spatial variation in the rate of malaria infection was analyzed using principal component analysis (PCA). The results indicate that seasonal variations play significant roles in malaria infection in Nigeria. It also shows high concentration of malaria infections in some few states. This paper therefore recommends that deliberate effort should be made to increase the distribution of treated mosquito nets and drugs in the affected states and an increment in the financial allocation to the affected states by the Federal Ministry of Health with a few to reducing the effect of the disease in the affected states. Key words: Assessment, spatial, patterns, malaria, infection, Nigeria.

An epidemiological study on clinical profile of malaria in Rampachodavaram and Maredumilli the tribal belt of east Godavari, Andhra Pradesh, India

ObjectiveTo observe the distribution of malaria infection in the tribal area of East Godavari District of Andhra Pradesh, India. MethodsThe data for the present study was collected from 6 342 and 765 patients who were admitted at tribal hospital and hill forest camps respectively during the study period. The data was collected from the malaria suspected patients admitted in paediatric and adult critical care wards of a tertiary hospital and in interior hill and forest camps in and around the Rampachodavaram. The detailed medical case sheet proforma were prepared and data has been analyz. It was found that RDT's can be helpful to screen Plasmodium falciparum (P. falciparum) inendemic areas and remote tribal belt. ResultsA total number of 6 342 and 765 patients were admitted at tribal hospital and hill forest camps respectively during the study period. Among 6 342 of individuals tested, 4 387 individuals were reported for malaria positive. Out of the 4 387 slides examined, 59.0% were positive P. falciparum infection, 19.4% slides showed positive Plasmodium vivax infection and 21.5% had mixed infection. The total P. falciparum burden was estimated as 80.5%. In hill forest camps, out of 765 admitted patients, 650 patients who had clinical history showed suggestive of malaria were examined for malaria parasites. ConclusionsThe maximum numbers of malaria infection (4 387) were reported from the tribal based hospital. Malaria is responsible for major health concern in this region, particularly in rainy season. P. falciparum was the major parasite type causing malaria, and most of the complications were due to Plasmodium vivax. Compared to rest of the hills and forest areas, where most of the tribal people reside has the heavy load of malaria mainly P. falciparum. One important finding from the present study was the sex-difference observed in the admission rate. The rate of malaria infection was significantly high for male (53.5%), followed by female (46.5%) and children (33%).

Seroprevalence of Malaria Parasite Infection among Pregnant Women Attending Two Tertiary Health Facilities in Akure Ondo State Nigeria

The sequel outcomes and increased rates of maternal morbidity are partly consequences of the prevalence of malaria infections in pregnant women. This study was designed to investigate the prevalence of malaria parasite infection in pregnant mothers in State Specialist Hospital Akure. A total of 616 pregnant women aged 15-46 years who attended the major referral health facility for routine ante-natal purposes between February and April, 2012 were included in this exercise. Giemsa stained thick blood smears of the patients were examined for the presence of asexual stages of Plasmodium parasite. The Packed Celled Volume (PCV), genotype and blood group of the mothers were also determined using the haematocrit, electrophoresis and agglutination methods respectively. Descriptive statistics was used to determine the percentage of infections. Chi-square analysis was used to compare maternal data. Statistical comparison of malaria parasite and PCV was significant p 0.05) indicating that genotype of mothers in this present study have no influence in the distribution and prevalence of malaria. Out of 616 pregnant women examined, 597 (96.92%) had malaria parasite infection while 19 (3.08%) were not infected. The total prevalence rate 96.92% observed in the sampled population examined was very high though majority were infected at low parasitaemia is indicative of the endemicity of the disease in Akure metropolis. The difference in the mean PCV of malaria infected and non-infected mothers coupled with the high rate of malaria infection suggested the involvement of malaria in maternal anaemia.

Influence of Malaria Prevention on Malaria Parasitaemia during Pregnancy

Malaria infection control remains a challenge in Africa. According to the World Health Organization, an estimated 660,000 deaths occurred from malaria infection in 2010, with Sub-Saharan Africa accounting for 90% of the mortality. The aim of this study is to assess the prevalence of peripheral malaria parasitaemia and the methods of malaria prevention commonly used among pregnant women. The study is a cross sectional survey of pregnant women attending an antenatal booking clinic in a secondary health care center in Southwest Nigeria. In addition to obtaining information about patients' knowledge of malaria infection and protection, obstetric history, general and obstetric examinations were completed, and blood film and capillary tube samples were obtained through a finger prick. Thick and thin blood films were stained and examined for identification and quantification of malaria parasite, and the capillary tube blood sample was processed for haematocritestimation. Results of 502 participants were used in the analysis; 38 (7.6%) women were positive for malaria parasite on microscopy. Peripheral malaria parasitaemia was more common among primigravidae25 (65.8%) compared with multigravidae 13(34.2%) (p-value< 0.001). The mean parasite density was higher among primigravidae, 6824.39parasites/µl compared to multigravidae, 606.69 parasites/µl. A total of 337 (67.1%) of the participants had haematocrits less than 11g/dl. Malaria prevention methods used by the participants included untreated nets 204 (40.7%), insecticide sprays and coils 211 (42.0%), and insecticide treated nets (ITNs) 87 (17.3%). Among the participants with peripheral malaria parasitaemia, one (2.6%) used ITNs compared with 21 (55.3%) and 16 (42.1%) who used insecticides and untreated nets respectively (p-value 0.032). Further analysis showed higher odds of peripheral malaria parasitaemia among those who used insecticides, and untreated nets relative to ITNs (odds ratio8.763, 95% CI 1.136 - 67.592, and odds ratio 6.993, 95% CI 0.899 - 54.411). Fewer pregnant women use ITN compared with other methods such as insecti- cides and untreated nets despite the protective benefits against malaria infection in pregnancy. Therefore, further exploration regarding improved accessibility and increased effectiveness of utilization is necessary to decrease malaria infection rates, es- pecially among pregnant women.

Marked Decline in Malaria Prevalence among Pregnant Women and Their Offspring from 1996 to 2010 on the South Kenyan Coast

Expanded malaria control in Kenya since the early 2000s has resulted in marked reduction in hospital admissions for malaria; however, no studies have reported changes in malaria infection rates in the same population over this period. Randomly selected archived blood samples from four cohorts of pregnant women and their children from 1996 to 2010 in Kwale District, Coast Province, Kenya, were examined for Plasmodium falciparum (Pf), P. malariae, P. ovale, and Plasmodium vivax by quantitative polymerase chain reaction (PCR) and microscopy. Maternal delivery Pf prevalence by PCR declined from 40% in 2000-2005 to 1% in 2009-2010, concordant with increased bed net and malaria chemoprophylaxis use. Individual risk of Pf infection in children from birth to 3 years in serial longitudinal cohort studies declined from almost 100% in 1996-1999 to 15% in 2006-2010. Declines in P. malariae and P. ovale infections rates were also observed. These results show a profound reduction in malaria transmission in coastal Kenya.

Exploring the impact of targeted distribution of free bed nets on households bed net ownership, socio-economic disparities and childhood malaria infection rates: analysis of national malaria survey data from three sub-Saharan Africa countries

BackgroundThe last decade has witnessed increased funding for malaria control. Malaria experts have used the opportunity to advocate for rollout of such interventions as free bed nets. A free bed net distribution strategy is seen as the quickest way to improve coverage of effective malaria control tools especially among poorest communities. Evidence to support this claim is however, sparse. This study explored the effectiveness of targeted free bed net distribution strategy in achieving equity in terms of ownership and use of bed nets and also reduction of malaria prevalence among children under-five years of age.MethodsNational malaria indicator survey (MIS) data from Angola, Tanzania and Uganda was used in the analysis. Hierarchical multilevel logistic regression models were used to analyse the relationship between variables of interest. Outcome variables were defined as: childhood test-confirmed malaria infections, household ownership of any mosquito net and children’s use of any mosquito nets. Marginal effects of having free bed net distribution on households with different wealth status were calculated.ResultsAngolan children from wealthier households were 6.4 percentage points less likely to be parasitaemic than those in poorest households, whereas those from Tanzania and Uganda were less likely to test malaria positive by 7 and 11.6 percentage points respectively (p < 0.001). The study estimates and present results on the marginal effects based on the impact of free bed net distribution on children's malaria status given their socio-economic background. Poorest households were less likely to own a net by 21.4% in Tanzania, and 2.8% in Uganda, whereas both poorer and wealthier Angolan households almost achieved parity in bed net ownership (p < 0.001). Wealthier households had a higher margin of using nets than poorest people in both Tanzania and Uganda by 11.4% and 3.9% respectively. However, the poorest household in Angola had a 6.1% net use advantage over children in wealthier households (p < 0.001).ConclusionThis is the first study to use nationally representative data to explore inequalities in bed net ownership and related consequences on childhood malaria infection rates across different countries. While targeted distribution of free bed nets improved overall bed net ownership, it did not overcome ownership inequalities as measured by household socioeconomic status. Use of bed nets was disproportionately lower among poorest children, except for Angola where bed net use was higher among poorest households when compared to children in wealthier households. The study highlights the need for malaria control world governing bodies and policy makers to continue working on finding appropriate strategies to improve access to effective malaria control tools especially by the poorest who often times bears the brunt of malaria burden than their wealthier counterparts.

Hamatological parameters and malaria parasite infection among pregnant women in Northwest Nigeria

ObjectiveTo evaluate some hematological and anthropometric parameters, malaria infection at different trimesters in pregnancy. MethodsFifty pregnant women (6 in first trimester, 28 in second trimester and 16 in third trimester) between ages of 15–40 years with ten age-matched non-pregnant women used as control were enrolled in the study. Consent were obtained from the subjects after which semi-structured questionnaires were administered to obtain data on demographic and socio-economic variables, reproductive and medical history. Anthropometric variables, and hematology were carried out using standard procedures. ResultsAnthropometric characteristics showed no significant difference in weight, height and BMI when compared with non-pregnant control. Hematological values indicated higher values for non-pregnant women but not statistically significant. Prevalence of malaria infection in pregnant women showed that 40% of pregnant women examined were infected compared to 30% non-pregnant with those with first pregnancy (primagravid) recording the highest infection (47.62%) with pregnant women within age 15–18 years least infected (16.7%). Pregnant women in the third trimester had the highest (50%) malaria infection and there was increase in prevalence with increase education status and those with first pregnancy (primagravid) recorded the highest infection (47.62%). Treatment used when infected showed 36.8% and 42.9% used malaria drug and both drug/herbs respectively. ConclusionsHigher prevalence rate of malaria infection in pregnant women with the highest prevalence recorded in those with first conception (primigravidae). There is a need for continuous monitoring of hematological parameters and malaria parasite infection for better outcome of pregnancy.

Malaria infection and feather growth rate predict reproductive success in house martins

Carry-over effects take place when events occurring in one season influence individual performance in a subsequent season. Blood parasites (e.g. Plasmodium and Haemoproteus) have strong negative effects on the body condition of their hosts and could slow the rate of feather growth on the wintering grounds. In turn, these winter moult costs could reduce reproductive success in the following breeding season. In house martins Delichon urbica captured and studied at a breeding site in Europe, we used ptilochronology to measure growth rate of tail feathers moulted on the winter range in Africa, and assessed infection status of blood parasites transmitted on the wintering grounds. We found a negative association between haemosporidian parasite infection status and inferred growth rate of tail feathers. A low feather growth rate and blood parasite infections were related to a delay in laying date in their European breeding quarters. In addition, clutch size and the number of fledglings were negatively related to a delayed laying date and blood parasite infection. These results stress the importance of blood parasites and feather growth rate as potentially mechanisms driving carry-over effects to explain fitness differences in wild populations of migratory birds.

The Impacts of Water Borne Diseases on Rural Development in Sudan: Study of Malaria in Gezira Irrigated Agricultural Scheme

Gezira irrigated scheme is globally one of the biggest agricultural productive units administratively managed. It has seen deteriorating productivity for the past two decades. There cries that it should be privatized. That was seriously taken by the government in an economic liquidation of its assets. However, in this study we discuss analyze other aspects than the previously mentioned aspects of production parameters. We focus of health economics and how gradual negligence led to the prevalence of waterborne diseases. That degenerated farmers' abilities to produce. The present study was carried out in the Gezira scheme to measure the impact of water borne diseases, e.g., Malaria and Bilharzias on rural development in Gezira scheme. The study was established on the assumption that water borne diseases have a drastic effect on the farmer income due to his absence from work because of the above mentioned two diseases. A simple random multistage stratified sample was taken from farmers in the villages of the scheme (180) farmers to represent the research community. The study is based on the field information that was gathered by the questionnaire. The other secondary information was collected from scientific research works, Ministry of health documents and the relevant institutions in order to identify the impact of these diseases on rural farmer in Gezira scheme. Used variables were of farmers socioeconomic parameters, e.g., age, level of education, annual income, the extent of his awareness of these diseases and the number of infections he has had and the type of treatment he uses. Other variables were health environment and centers, drinking water and the role of the responsible authorities control and treatment of the diseases.Statistical packages for social sciences were used to display and interpret the data. Chi-square was used to identify significant or non-significant relations. The study established that there are diseases that spread in the Gezira region, sometimes culminating to an epidemic level and that farmers do not get enough health care. That affects their health conditions and destroys their ability for productive lives. Additionally, income from agricultural production is less than medical treatment expenses for most them. Despite of the economic impacts, the role of the state in the control of these diseases in the region is weak.Chi-square analysis confirmed that there are significant relations between Malaria infection and income level and that have effects on agricultural activities of the farmer. Moreover, that there are relations between Malaria infection and the disease communicators. As for disease control, there is positive relation with available places of treatment and the role of state in control and treatment and the level of income from farming work and the cost of treatment of the diseases. However, there is also non-significant relation between Malaria infection and mortality rate due to infections. The same applies for Malaria infections and health care. Meanwhile, Malaria infection was correlated with the cost of health services. The study has proposed number of recommendations. The most important of them are the establishment of cooperative health organization for the farmers in each division of the scheme region to work for the control and treatment of these diseases. Also more attention should be given to the social, economic, cultural and manpower development of farmer of the Gezira scheme, being the real asset of rural development.