Malaria Situation Research Articles

Epidemic situation of malaria in Qingdao City from 2012 to 2017

To investigate the epidemic situation and its epidemic characteristics of malaria in Qingdao City from 2012 to 2017, so as to provide the evidence for the prevention and control of malaria in this city. The data of cases and epidemiological characteristics of malaria in Qingdao City, 2012-2017 were collected from the China's disease prevention and control system infectious disease report information management system and parasitic disease prevention and control information management system, and analyzed. A total of 103 cases of malaria were reported in Qingdao City from 2012 to 2017, and all of them were imported. Among them, 98 (95.15%) were imported from Africa and 5 (4.85%) from Asia. There were 92 laboratory confirmed cases (89.32%) and 11 (10.68%) clinically diagnosed cases. The highest incidence occurred in 2016 (0.28/105) . According to the classification of cases, there were 87 falciparum malaria cases (84.47%), 13 vivax malaria cases (12.62%), and 3 ovale malaria cases (2.91%) . These patients were mainly young men, and the male to female ratio was 19.6∶1. There were malaria case reports in each month, and the peak onset season was not obvious. Newly diagnosed and confirmed units were mainly municipal medical institutions; the median of onset-definite diagnosis was 4 days. There was one death case, but there were no recurrence, reburning, and imported secondary cases. There were no local malaria cases in Qingdao City from 2012 to 2017. The prevention and control of imported malaria is the focus of the future work.

Malaria Situation in Latin America and the Caribbean: Residual and Resurgent Transmission and Challenges for Control and Elimination.

Despite recent progress toward malaria elimination in Latin America and the Caribbean, with an overall 62% decrease in incidence between 2000 and 2015, malaria remains endemic to 21 countries and territories in the region, where 120 million people are exposed to some risk of infection. Here we review recent epidemiologic trends, highlight current challenges, and briefly discuss the relative role of traditional and novel strategies for better malaria control and elimination across the continent.

Current Situation of Malaria in Africa.

Malaria infection is one of the major causes of deaths in the African continent. The high burden of malaria in Africa is due to P. falciparum, which adapts and cospecializes with Anopheles gambiae, the most effective and widespread malaria vector. Since 2000, the incidence of malaria has been reduced by 17% and malaria mortality rates by 26%. However, the rate of decline has stalled and even reversed in some regions since 2014. In 2017 as described by the latest World malaria report, 219 million malaria cases were reported, up from 2017 million cases reported in 2016 in 91 countries, and the global tally of malaria deaths reached 435,000 deaths, compared with 451,000 estimated deaths in 2016. Despite these achievements, the African region continues to account for about 92% of malaria cases and deaths worldwide. Therefore, it is important to master the current situation of malaria in Africa to see how to better plan its elimination. In this chapter, we present the current situation and prospective means to improve it, including a salutogenesis approach.

Situation of Malaria and Expansion of Key Interventions for Malaria Elimination in Bago Region, Myanmar, 2007-2015

Analysis of malaria trends is important for planning of malaria elimination. Therefore, we reviewed the malaria monthly reports and key interventions for malaria elimination in Bago Region of Myanmar between 2007 and 2015. Secondary data analysis revealed the trends in malaria morbidity, mortality, malaria positive rate (MPR), malaria species, annual parasite incidence (API) and annual blood examination rate (ABER). Key interventions included distribution of insecticide-treated net (ITN), long lasting insecticidal net (LLIN) and case detection. Over the 8-year period, malaria morbidity and mortality rates markedly reduced from 8 to 0.3 per 1,000 population and 1.4 to 0.1 per 100,000 population respectively. During 2010-2015, API and MPR correspondingly reduced. Together with the concomitant increase in ABER and townships with API lower than one per 1,000 population, confirmed cases of P. falciparum malaria markedly decreased from 91.1% in 2007 to 55.4% in 2015. Meanwhile, the ITN/LLIN scaling-up activities resulted in an increase in population coverage from 23.5% in 2011 to 69.3% in 2015. Data from the public sector showed declining trends in malaria morbidity and mortality and low API, increasing the chance of malaria elimination. Still, there is a possibility of residual malaria that may trigger a resurgence, and thus, it is worthwhile to promote surveillance systems, especially in private sector health care establishments.

Effects of climate change on malaria morbidity and mortality in Taraba State, Nigeria

The study investigated the effects of climatic changes on malaria parasite prevalence, morbidity and mortality in Taraba State, Nigeria. Using a retrospective study design, the study relied on secondary data covering a period from 2005 to 2014, obtained from Meteorological Station Jalingo and Health facilities. Mean annual rainfall, temperature and relative humidity from 2005 to 2014 were 1 886 mm, 24.2 °C and 70%, respectively. Per 1 000 people, mean malaria morbidity was 228.9 and mortality 0.311. Years with peak malaria morbidities (2006, 2011 and 2014) had lowest annual rainfalls (1 488–1 677 mm). Monthly, malaria morbidity had a significantly negative linear relationship with rainfall (r = −0.536, p < 0.0001) and relative humidity (r = −0.509, p < 0.001), and a significantly positive linear relationship with temperature (r = 0.305, p = 0.001). Within the decade, malaria morbidity and mortality increased by 0.298% and 0.0007%, respectively. This study provides information on the malaria situation in Taraba State that could be useful to the National Malaria Control Programs and public health service providers in formulating policies that might promote the mitigation of malaria in Nigeria.

Epidemic status of malaria in Zhenjiang City from 2004 to 2017

To analyze the epidemic situation and epidemiological characteristics of malaria in Zhenjiang City from 2004 to 2017, so as to provide the evidence for formulating the reasonable strategies and measures for malaria prevention and control. The epidemiological data of malaria in Zhenjiang City from 2004 to 2017 were collected and analyzed for the epidemic situation, epidemiological characteristics, species of Plasmodium, blood test status for febrile patients. A total of 182 malaria cases were reported in Zhenjiang City between 2004 and 2017, 123 cases (67.58%) were infected with P. vivax, and 55 cases (30.22%) were infected with P. falciparum. Among all the reported cases, 41 (22.53%) were local cases, 66 (36.26%) were imported cases from other provinces in China, 75 (41.21%) were imported cases from abroad. Most of the cases were male (133 cases), and 59.89% of them concentrated in the age groups of 20-50 years. These cases were mainly farmers (24.73%, 45/182) and workers (24.18%, 44/182), and most of the cases occurred from July to September. From 2004 to 2017, the blood tests were conducted for 258 879 febrile patients, with a positive detection rate of 0.007% in the local population and 0.724% in floating population, and there was a statistically significant difference between them (P<0.01). Since 2011, no indigenous cases have been reported in Zhenjiang City, and therefore, the control of imported malaria from abroad has become the key of malaria prevention and control in this city.

Analysis of Malaria Control Situation in Magelang Regency and Obstacles to Maintain Malaria Elimination Status

Magelang Regency received malaria elimination certificate in April 2014, however, the epidemic signal was received back in April 2015. Malaria epidemic had occurred for two months and until the end of December, indigenous cases could still be found. The purpose of this study was to find out description of situation regarding malaria, malaria control, and obstacles to malaria control in Magelang Regency. Rapid assessment method was conducted by adopting the methodology in the protocol and methods for malaria situation analysis from WHO (2003) and by using desk review as the reference for the research process in malaria control method in a region with similar condition to Magelang regency. Data collection was performed through interview and observation. This study found that in April 2015, the number of indigenous cases was 2 which was increased to 37 cases in May and the peak prevalence was 56 cases in June. Previously, import cases were found in March. Up until December, malaria cases were dominated by indigenous cases (97%). Village regulation regarding malaria migration surveillance was still not available in most receptive villages. In area which had eliminate malaria, there should be regulation that govern malaria migration surveillance. Therefore, the Regent should advise the village chief through a circulatory letter to form a new regulation regarding malaria migration surveillance in order to reduce outbreak potential.

Epidemiological analysis of malaria in Shandong Province in 2017

To understand the malaria epidemiological characteristics of Shandong Province in 2017, so as to provide the evidences for formulating targeted prevention and control strategy and measures. The data of malaria cases of Shandong Province in 2017 were collected from the Information Management System for Infectious Diseases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological characteristics of malaria situation and the diagnosis and treatment of malaria cases were analyzed. There were 209 malaria cases reported in 2017, all of them were imported cases, and 205 cases (98.09%) were imported from African countries. Among them, 155 cases (74.16%) were falciparum malaria cases. Totally 16 cities had cases reported in 2017, and 154 cases (73.68%) were reported in 6 cities (Yantai, Jining, Weihai, Dezhou, Qingdao, and Tai'an). The malaria cases distributed in 17 cities, and there were 110 cases distributed in 4 cities, namely Yantai, Tai'an, Weihai, and Qingdao, which accounted for 56.41% of the total cases in Shandong Province. Both the median time from onset to seeing a doctor and the median time from seeing a doctor to being diagnosed were one day. Totally 12.92% of the cases went to visit a doctor 7 days later after they had symptoms and 10.53% of the cases were diagnosed 7 days later after the first visit to a doctor. At present, the prevention and control of the imported malaria is the focus of malaria control in Shandong Province. According to the central tendency of the malaria situation, the health education and propaganda among the high risk groups and the training on the diagnosis and treatment among medical workers should be strengthened, so as to prevent the risk of reappearance of local cases in the past malaria endemic regions, and to ensure the goal of malaria elimination been achieved on schedule.

Determining malaria situation through linelist hospital attendance records in selected communities in Benue State, north-central Nigeria

Knowledge of malaria situation provides useful insights on which effective malaria control strategies can be predicated. The objective of this study was to retrospectively determine the malaria situation in the selected communities through hospital attendance records. In the absence of useable retrospective data, a line list record of hospital attendance was collated and used to provide baseline information on some malariological parameters. Point of service collation resulted in 490 confirmed malaria cases, only 69(14.1%) captured the rural settings while 421(85.9%) represented the urban areas. Rapid Diagnostic Test (RDT) was used for 464(94.7%), microscopy 4(0.8%) and RDT/microscopy accounted for 22(4.5%).Of the four species of human malaria recorded, Plasmodium falciparum peaked with 470(95.9%). Indoor Residual Spray (IRS) was not extensive (3.13%) and Insecticide Treated Nets (ITNs) ownership did not equate usage. Dataset highlights gaps in malaria disease control, the need for universal coverage, and the age long challenge of irregular reporting. Failure to tackle these challenges is a guaranty for unsuccessful elimination and ensures a resurgence of this formidable disease.Keywords: Malaria, morbidity; mortality; Plasmodium; Nigeria.

Malaria control and chemoprophylaxis policy in the Republic of Korea Armed Forces for the previous 20\xa0years (1997\u20132016)

BackgroundVivax malaria reemerged along the Demilitarized Zone (DMZ), Republic of Korea (ROK), in 1993. While it was hypothesized that vivax malaria would spread throughout the peninsula, nearly all cases were due to exposure near the DMZ. To reduce spillover of vivax malaria to the civilian community, the ROK Ministry of National Defense (MND) initiated malaria prevention policies including a large-scale chemoprophylaxis programme in malaria high-risk areas in 1997. The present study investigated the overall changes in the incidence of malaria among ROK soldiers and the mass chemoprophylaxis program from 1997 to 2016.ResultsPeak numbers of vivax malaria were reported in 2000, with most cases reported near the DMZ, before declining to the current levels. To combat the rapid increase in the number of malaria cases and its expansion throughout the ROK, the MND implemented mosquito control and personal protection programmes. The MND also implemented a large-scale vivax malaria chemoprophylaxis programme using hydroxychloroquine (400 mg weekly) in 1997, and primaquine (15 mg × 14 days) as terminal chemoprophylaxis in 2001. Additionally, an improved medical system enabled the rapid detection and treatment of malaria to reduce morbidity and decrease transmission of malaria from humans to mosquitoes. Following the full implementation of these programmes, the incidence of vivax malaria declined in both ROK Armed Forces and civilian populations. Subsequently, several changes in the ROK Armed Forces chemoprophylaxis programme were implemented, including the reduction of the period of hydroxychloroquine prophylaxis by 2 months (2008) and other changes in the chemoprophylaxis policy, e.g., only ROK Armed Forces personnel in moderate risk groups received terminal primaquine chemoprophylaxis (2011), and in 2016, the discontinuation of terminal primaquine chemoprophylaxis in moderate-risk area.ConclusionsThe resurgence of vivax malaria in the ROK Armed Forces personnel near the DMZ was successfully suppressed through the implementation of a mass malaria chemoprophylaxis programme initiated by the MND in 1997, as well as several other factors that may have contributed to the reduction of malaria transmission since 2000. Given the current malaria situation in the ROK and North Korea, it is necessary to reevaluate the ROK Armed Forces and civilian malaria control policies.

Review of Malaria Situation in Assam with Special Reference to Security Forces

Review of Malaria Situation in Assam with Special Reference to Security Forces

Public Health Interventions for Control of Malaria in the Population Living in the Terai Region of Nepal.

Infectious diseases are a major problem for developing countries. Controlling and eradicating these diseases have remained a challenge because of the multitudes of social and environmental factors involved. However, a multi-sectoral and collective effort in dealing with these diseases has been shown to result in positive outcomes. This paper looks at the current situation of Malaria in Nepal and a population that is at high risk. It explains the impact that social and environmental determinants have on this target population. This review then critically examines the various possible public health interventions that could potentially help in the control of malaria in this high risk population, drawing from evidences and experiences reported from other countries with suggestions for adapting these interventions to the Nepali environment.

Obstetric and Haematological Determinants of Malaria Parasitaemia among Pregnant Women in Kano State, Nigeria

Malaria during pregnancy has serious health consequences, and poses substantial risk to the mother, her fetus, and the new born. This study was carried out to assess the relationships between malaria parasitaemia and some obstetric, haematological and clinical characteristics of pregnant women of various parities in the study area, with the hope to better understanding the local malaria situation. The laboratory techniques employed were: preparation of thick and thin blood smears, by Giemsa staining, for malaria parasite screening; measurement of blood haemoglobin, for detection of anaemia by Cyanmethaemoglobin method; alkaline pH electrophoresis of haemoglobin, for detection of haemoglobin variance. Parity was found to be significantly associated with malarial infection, with high prevalence seen in nulliparous and primiparous women, and the rate of infection decreasing with increasing parity. Likewise the sickle cell trait was found to influence the prevalence of malaria infection, with pregnant women who had the sickle cell condition (Hb SS) and those with normal haemoglobin (Hb AA) being more at risk for malaria infection than those individuals with the sickle cell trait (Hb AS and SC). A strong association was also found between anaemia and malaria parasitaemia, with individuals that were anaemic being more infected than those that were not anaemic. However, history of fever and previous chemoprophylaxis were not found to have any impact on the rate of malaria infection. Health education programs on the management of malaria in pregnancy should be intensified.&#x0D;

The detection of cryptic Plasmodium infection among villagers in Attapeu province, Lao PDR.

BackgroundAlthough the malaria burden in the Lao PDR has gradually decreased, the elimination of malaria by 2030 presents many challenges. Microscopy and malaria rapid diagnostic tests (RDTs) are used to diagnose malaria in the Lao PDR; however, some studies have reported the prevalence of sub-microscopic Plasmodium infections or asymptomatic Plasmodium carriers in endemic areas. Thus, highly sensitive detection methods are needed to understand the precise malaria situation in these areas.Methodology/Principal findingsA cross-sectional malaria field survey was conducted in 3 highly endemic malaria districts (Xaysetha, Sanamxay, Phouvong) in Attapeu province, Lao PDR in 2015, to investigate the precise malaria endemicity in the area; 719 volunteers from these villages participated in the survey. Microscopy, RDTs and a real-time nested PCR were used to detect Plasmodium infections and their results were compared. A questionnaire survey of all participants was also conducted to estimate risk factors of Plasmodium infection. Numbers of infections detected by the three methods were microscopy: P. falciparum (n = 1), P. vivax (n = 2); RDTs: P. falciparum (n = 2), P. vivax (n = 3); PCR: Plasmodium (n = 47; P. falciparum [n = 4], P. vivax [n = 41], mixed infection [n = 2]; 6.5%, 47/719). Using PCR as a reference, the sensitivity and specificity of microscopy were 33.3% and 100.0%, respectively, for detecting P. falciparum infection, and 7.0% and 100.0%, for detecting P. vivax infection. Among the 47 participants with parasitemia, only one had a fever (≥37.5°C) and 31 (66.0%) were adult males. Risk factors of Plasmodium infection were males and soldiers, whereas a risk factor of asymptomatic Plasmodium infection was a history of ≥3 malaria episodes.Conclusions/SignificanceThere were many asymptomatic Plasmodium carriers in the study areas of Attapeu province in 2015. Adult males, probably soldiers, were at high risk for malaria infection. P. vivax, the dominant species, accounted for 87.2% of the Plasmodium infections among the participants. To achieve malaria elimination in the Lao PDR, highly sensitive diagnostic tests, including PCR-based diagnostic methods should be used, and plans targeting high-risk populations and elimination of P. vivax should be designed and implemented.

Recent global updates in malaria control and situation in Sub-Saharan Africa region

Recent global updates in malaria control and situation in Sub-Saharan Africa region

Epidemiological Situation of Malaria in Rakhine State, Myanmar during 2000-2014

Rakhine State is the state with highest number of malaria cases in Myanmar. The objective of the study was to investigate the malaria situation in Rakhine State during 2000-2014. Data on malaria monthly reports from all townships during 2000-2014 were reviewed and analyzed. The malaria morbidity rate in Rakhine State was observed to decrease from 40.0 per 1,000 population in 2000 to 13.5 per 1,000 in 2014. Marked reduction in mortality and case-fatality rates were also observed. Although the morbidity and mortality rates were reduced in all townships, some townships had maintained high malaria positivity rate and low annual blood examination rate. Ten percent of cases in under 5-year children indicated the endemicity and local transmission of malaria. Malaria cases treated by community volunteers were increased from 1.7% in 2011 to 27.9% in 2014. The majority of malaria cases were caused by Plasmodium falciparum. Reduction in malaria morbidity and mortality might be due to early detection and treatment of cases. Efforts to detect and treat cases earlier should be a high priority in townships with high malaria positive rate and low annual blood examination rate in order to reduce the burden of malaria infection in Myanmar.

Analysis of overseas imported malaria and implication for prevention and control strategy in Shijiazhuang City from 2012 to 2015

Objective To analyze the overseas imported malaria situation of Shijiazhuang City from 2012 to 2015, so as to provide the evidence for exploring the prevention and control strategy. Methods The data of overseas imported malaria were collected and analyzed with the descriptive method including Plasmodium species, population characteristics, epidemic focus distribution, onset time, diagnosis and treatment in Shijiazhuang City from 2012 to 2015, and the time from the onset to first medical visit, time from first medical visit to being diagnosed, and time from onset to being diagnosed of different Plasmodium species were analyzed respectively with the statistical analysis method. Results A total of 92 overseas imported malaria cases were reported in Shijiazhuang City from 2012 to 2015, including 88 cases from African countries (falciparum malaria taking 53.41%), and 4 cases from Southeast Asian and other countries (vivax malaria taking 50%). Eighty-nine cases were distributed in 28 counties (districts) of 6 cities in Hebei Province, except 2 persons with foreign nationalities and 1 with Anhui Province census register. The male and young adults were dominant. The median time from the onset to seeing a doctor was one day and the median time from seeing a doctor to being diagnosed was five days. Most cases were reported by the Fifth Hospital of Shijiazhuang which was the sentinel hospital. Totally 42.39% of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100% of them received the standard treatment after diagnosis. Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Shijiazhuang City. It is necessary to further strengthen the long-term cooperation mechanism between the medical institutions and the entry-exit inspection and quarantine department. The technician training should be strengthened to avoid the severe cases and death cases.

A review of spatial epidemiology with malaria surveillance and control in China

The monitoring and control of malaria depends largely on the spatial analysis technology and mathematical models. Visualization of malaria situation is the most popular way to present how malaria transmits. In this paper, the malaria epidemic situation and the application of spatial epidemiology of malaria in China are summarized, so as to provide the systematic epidemiological information for malaria elimination in China.

Diagnostic Efficacy of Microscopy, Rapid Diagnostic Test and Polymerase Chain Reaction for Malaria Using Bayesian Latent Class Analysis

Introduction: The diagnostic techniques for malaria are undergoing a change depending on the availability of newer diagnostics and annual parasite index of infection in a particular area. At the country level, guidelines are available for selection of diagnostic tests; however, at the local level, this decision is made based on malaria situation in the area. The tests are evaluated against the gold standard, and if that standard has limitations, it becomes difficult to compare other available tests. Bayesian latent class analysis computes its internal standard rather than using the conventional gold standard and helps comparison of various tests including the conventional gold standard. Materials and Methods: In a cross-sectional study conducted in a tertiary care hospital setting, we have evaluated smear microscopy, rapid diagnostic test (RDT), and polymerase chain reaction (PCR) for diagnosis of malaria using Bayesian latent class analysis. Results: We found the magnitude of malaria to be 17.7% (95% confidence interval: 12.5%–23.9%) among the study subjects. In the present study, the sensitivity of microscopy was 63%, but it had very high specificity (99.4%). Sensitivity and specificity of RDT and PCR were high with RDT having a marginally higher sensitivity (94% vs. 90%) and specificity (99% vs. 95%). On comparison of likelihood ratios (LRs), RDT had the highest LR for positive test result (175) and the lowest LR for negative test result (0.058) among the three tests. Conclusion: In settings like ours conventional smear microscopy may be replaced with RDT and as we move toward elimination and facilities become available PCR may be roped into detect cases with lower parasitaemia.

Elimination of Plasmodium falciparum malaria in Tajikistan

Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards speedy reduction of P. vivax incidence in Tajikistan.