Malaria Situation Research Articles

Trends in Malaria in Odisha, India-An Analysis of the 2003-2013 Time-Series Data from the National Vector Borne Disease Control Program.

BackgroundAlthough Odisha is the largest contributor to the malaria burden in India, no systematic study has examined its malaria trends. Hence, the spatio-temporal trends in malaria in Odisha were assessed against the backdrop of the various anti-malaria strategies implemented in the state.MethodsUsing the district-wise malaria incidence and blood examination data (2003–2013) from the National Vector Borne Disease Control Program, blood examination-adjusted time-trends in malaria incidence were estimated and predicted for 2003–2013 and 2014–2016, respectively. An interrupted time series analysis using segmented regression was conducted to compare the disease trends between the pre (2003–2007) and post-intensification (2009–2013) periods. Key-informant interviews of state stakeholders were used to collect the information on the various anti-malaria strategies adopted in the state.ResultsThe state annual malaria incidence declined from 10.82/1000 to 5.28/1000 during 2003–2013 (adjusted annual decline: -0.54/1000, 95% CI: -0.78 to -0.30). However, the annual blood examination rate remained almost unchanged from 11.25% to 11.77%. The keyinformants revealed that intensification of anti-malaria activities in 2008 led to a more rapid decline in malaria incidence during 2009–2013 as compared to that in 2003–2007 [adjusted decline: -0.83 (-1.30 to -0.37) and -0.27 (-0.41 to -0.13), respectively]. There was a significant difference in the two temporal slopes, i.e., -0.054 (-0.10 to -0.002, p = 0.04) per 1000 population per month, between these two periods, indicating almost a 200% greater decline in the post-intensification period. Although, the seven southern high-burden districts registered the highest decline, they continued to remain in that zone, thereby, making the achievement of malaria elimination (incidence <1/1000) unlikely by 2017.ConclusionThe anti-malaria strategies in Odisha, especially their intensification since 2008, have helped improve its malaria situation in recent years. These successful measures need to be sustained and perhaps intensified further for eliminating malaria from Odisha.

Epidemiology and Clinical Burden of Malaria in the War-Torn Area, Orakzai Agency in Pakistan.

BackgroundMilitary conflict has been a major challenge in the detection and control of emerging infectious diseases such as malaria. It poses issues associated with enhancing emergence and transmission of infectious diseases by destroying infrastructure and collapsing healthcare systems. The Orakzai agency in Pakistan has witnessed a series of intense violence and destruction. Military conflicts and instability in Afghanistan have resulted in the migration of refugees into the area and possible introduction of many infectious disease epidemics. Due to the ongoing violence and Talibanization, it has been a challenge to conduct an epidemiological study.Methodology/Principal FindingsAll patients were sampled within the transmission season. After a detailed clinical investigation of patients, data were recorded. Baseline venous blood samples were taken for microscopy and nested polymerase chain reaction (nPCR) analysis. Plasmodium species were detected using nested PCR (nPCR) and amplification of the small subunit ribosomal ribonucleic acid (ssrRNA) genes using the primer pairs. We report a clinical assessment of the epidemic situation of malaria caused by Plasmodium vivax (86.5%) and Plasmodium falciparum (11.79%) infections with analysis of complications in patients such as decompensated shock (41%), anemia (8.98%), hypoglycaemia (7.3%), multiple convulsions (6.7%), hyperpyrexia (6.17%), jaundice (5%), and hyperparasitaemia (4.49%).Conclusions/SignificanceThis overlooked distribution of P. vivax should be considered by malaria control strategy makers in the world and by the Government of Pakistan. In our study, children were the most susceptible population to malaria infection while they were the least expected to use satisfactory prevention strategies in such a war-torn deprived region. Local health authorities should initiate malaria awareness programs in schools and malaria-related education should be further promoted at the local level reaching out to both children and parents.

Assessment of Current Malaria Status in Light of the Ongoing Control Interventions, Socio-Demographic and Environmental Variables in Jiga Area, Northwest Ethiopia.

Following substantial decline in malaria burden in Ethiopia, the country is planning to eliminate malaria in certain low transmission settings by 2020. To evaluate the attainability of this goal in-depth examination of malaria parasite carriage at community level is necessary. This study was, therefore, aimed at assessing the current situation of malaria in relation to ongoing control interventions in Jiga area, Jabi Tehnan District in northwest Ethiopia. A cross-sectional household (HH) survey was conducted in November-December 2013. Out of 2,574 HHs (11,815 people) in the entire Jabi Tehnan District, 392 (accommodating 1911 people) were randomly selected from three purposely selected villages. One randomly selected member from each selected HH was tested for malaria using rapid diagnostic test (mRDT). All participants tested for malaria (n = 392) were afebrile (axillary temperature <37.5°C). Eleven individuals (2.8%, 95% confidence interval (CI):1.2–4.4%) were found to be mRDT positive. Most HHs (95.9%, 95% CI: 93.5–97.5%) had at least 1 long-lasting insecticidal net (LLIN). Insecticide residual spraying (IRS) coverage the last six months was 85.5% (95% CI: 82.0–88.9%). Malaria prevalence remains unexpectedly high despite high HH coverage of control interventions.

Analysis of epidemic situation of malaria in Longlin Various Nationalities Autonomous County in Guangxi from 1951 to 2014

To analyze the data of epidemic situation of malaria in Longlin Various Nationalities Autonomous County, Guangxi Zhuang Autonomous Region, China from 1951 to 2014 and discuss the distribution characteristics and epidemic law, so as to provide the evidences for developing the prevention and control strategies of the disease. The data about the epidemic situation of malaria in Longlin Various Nationalities Autonomous County were collected and analyzed statistically with Excel 2007. Totally 93 460 malaria cases were reported from 1951 to 2014 in the county. There were two morbidity peaks of malaria during this period, namely 1950s and 1970s, and the annual average incidence rates were 3 237.94/100 000 and 1 572.12/100 000, respectively, but it began to flatten after 1980s. Before 2000, the local cases were the main type, however, there were no endogenous cases since 2008. In 1950s, falciparum malaria was the main type of the disease, and the cases with falciparum malaria, tertian malaria and quartan malaria were accounted for 45.01% (2 392/5 314), 33.72% (1 792/5 314) and 19.55% (1 039/5 314), respectively; while in 1960s, the proportion of cases with tertian malaria increased, that of the cases with quartan malaria decreased, and there were no quartan malaria cases reported since 1980s. There were imported malaria cases reported since 1990s, and a total of 51 cases were found in this period, among which, 50 cases (98.04%) were tertian malaria, and the main infection sources were the cases from epidemic areas in other provinces of China. After 2000, the imported malaria cases with falciparum malaria increased, with a proportion of 60.00% (21/35), and the infection sources were mainly from Africa and Southeast Asia. The local endemic of malaria in Longlin Various Nationalities Autonomous County has been effectively controlled, but the situation of imported malaria is still severe in this county. Therefore, strengthening the surveillance of floating population, especially the workers backing from overseas, is still the key of malaria prevention and control in the future.

Malaria prevalence in Bata district, Equatorial Guinea: a cross-sectional study.

BackgroundMalaria has traditionally been a leading public health problem in Equatorial Guinea. After completion, in September 2011, of the integrated set of interventions against malaria launched by the Global Fund Malaria Programme in the mainland area, the epidemiological situation of malaria remains unknown. The aim of this study was to investigate the prevalence rate of malaria and associated factors based on the rapid diagnosis test (RDT) in Bata district, in order to provide evidence that will reinforce the National Malaria Control Programme.MethodsFrom June to August 2013, a representative cross sectional survey using a multistage, stratified, cluster-selected sample was carried out in urban zones and rural villages from Bata district. Data on socio-demographic, health status and malaria-related behaviours was collected. Malaria diagnosis was performed by RDT. Bivariate and multivariable statistical methods were employed to assess malaria prevalence and its association with different factors.ResultsPrevalence of malaria was higher in rural settings (58.9 %; CI 95 % 55.2–62.5 %) than in the sampled urban communities (33.9 %; CI 95 % 31.1–36.9 %). Presence of anaemia was also high, especially in rural sites (89.6 vs. 82.8 %, p < 0.001). The analyses show that a positive RDT result was significantly associated with age group, the most affected age range being 13 months–14 years old. Other significant covariates were ethnic group (only in urban sites), number of adults living in the house (only in rural villages) previous history of fever, anaemia (only in urban sites) and sleeping under a bed net. Moreover, those who never slept under a bed net were two times more likely to have malaria.ConclusionThe prevalence of malaria was high in Bata district, especially in rural villages. The National Programme to fight malaria in Equatorial Guinea should take into account the differences found between rural and urban communities and age groups to target appropriately those worst affected. The findings of this study will assist in planning and undertaking regional policy and other preventive initiatives.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0986-7) contains supplementary material, which is available to authorized users.

Low and Declining Risk for Malaria in Visitors to Indonesia: A Review of Local Indonesian and European Travelers' Data and a Suggestion for New Prophylactic Guidelines

The world's malaria map is constantly changing and with it the risk for travelers to contract malaria. While some efforts to appreciate the malaria situation for indigenous populations in Indonesia have been made recently, there is only sparse data in the literature on the risk for travelers to Indonesia. Data were collected from the Indonesian Ministry of Health (MoH), the World Health Organization (WHO), the Indonesian official statistics website Badan Pusat Statistik (BPS), and from the different European national surveillance bodies. Finally, a comparison between recent official guidelines for prevention of malaria in travelers from Germany, the United States, the UK, and from WHO was done. Data from Denmark, Germany, Sweden and Switzerland show a steady decline of imported cases of malaria from Indonesia from 1997 to 2013, with a leveling off during the last few years. In our study material, the Plasmodium falciparum incidence 2009 to 2013 was 0.35 cases per 100,000 visits and the Plasmodium vivax incidence 1.3 cases per 100,000 visits, with a 95% confidence interval of 0.1-0.9 and 0.7-2.2, respectively. Indonesian data also show a decline of malaria cases-the Annual Parasite Index (API) for all species of malaria has decreased from 4.68 cases per 1,000 inhabitants in 1990 to 1.38 cases per 1,000 inhabitants in 2013. Based on these data updated recommendations for malaria prophylaxis in travelers to Indonesia are suggested.

Malaria ecology along the Thailand-Myanmar border.

BackgroundMalaria in Southeast Asia frequently clusters along international borders. For example, while most of Thailand is malaria free, the border region shared with Myanmar continues to have endemic malaria. This spatial pattern is the result of complex interactions between landscape, humans, mosquito vectors, and malaria parasites. An understanding of these complex ecological and socio-cultural interactions is important for designing and implementing malaria elimination efforts in the region. This article offers an ecological perspective on the malaria situation along the Thailand–Myanmar border.DiscussionThis border region is long (2000 km), mountainous, and the environment ranges from thick forests to growing urban settlements and wet-rice fields. It is also a biologically diverse region. All five species of malaria known to naturally infect humans are present. At least three mosquito vector species complexes, with widely varying behavioural characteristics, exist in the area. The region is also a hub for ethnic diversity, being home to over ten different ethnolinguistic groups, several of which have been engaged in conflict with the Myanmar government now for over half a century. Given the biological and ethnic diversity, as well as the complex socio-political context, malaria control and elimination in the region is challenging.ConclusionDespite these complexities, multipronged approaches including collaborations with multiple local organizations, quick access to diagnosis and treatment, prevention of mosquito bites, radical cure of parasites, and mass drug administration appear to be drastically decreasing Plasmodium falciparum infections. Such approaches remain crucial as the region moves toward elimination of P. falciparum and potentially Plasmodium vivax.

Malaria Diagnosis Across the International Centers of Excellence for Malaria Research: Platforms, Performance, and Standardization.

Diagnosis is “the act of identifying a disease, illness, or problem by examining someone or something.” When an individual with acute fever presents for clinical attention, accurate diagnosis leading to specific, prompt treatment often saves lives. As applied to malaria, not only individual patient diagnosis is important but also assessing population-level malaria prevalence using appropriate diagnostic methods is essential for public health purposes. Similarly, identifying (diagnosing) fake antimalarial medications prevents the use of counterfeit drugs that can have disastrous effects. Therefore, accurate diagnosis in broad areas related to malaria is fundamental to improving health-care delivery, informing funding agencies of current malaria situations, and aiding in the prioritization of regional and national control efforts. The International Centers of Excellence for Malaria Research (ICEMR), supported by the U.S. National Institute of Allergy and Infectious Diseases, has collaborated on global efforts to improve malaria diagnostics by working to harmonize and systematize procedures across different regions where endemicity and financial resources vary. In this article, the different diagnostic methods used across each ICEMR are reviewed and challenges are discussed.

Sero-epidemiological evaluation of Plasmodium falciparum malaria in Senegal.

BackgroundIn Senegal, a significant decrease of malaria transmission intensity has been noted the last years. Parasitaemia has become lower and, therefore, more difficult to detect by microscopy. In the context of submicroscopic parasitaemia, it has become relevant to rely on relevant malaria surveillance tools to better document malaria epidemiology in such settings. Serological markers have been proposed as an essential tool for malaria surveillance. This study aimed to evaluate the sero-epidemiological situation of Plasmodium falciparum malaria in two sentinel sites in Senegal.MethodsCross-sectional surveys were carried out in Velingara (south Senegal) and Keur Soce (central Senegal) between September and October 2010. Children under 10 years old, living in these areas, were enrolled using two-level, random sampling methods. P. falciparum infection was diagnosed using microscopy. P. falciparum antibodies against circumsporozoite protein (CSP), apical membrane protein (AMA1) and merozoite surface protein 1_42 (MSP1_42) were measured by ELISA method. A stepwise logistic regression analysis was done to assess factors associated with P. falciparum antibodies carriage.ResultsA total of 1,865 children under 10 years old were enrolled. The overall falciparum malaria prevalence was 4.99% with high prevalence in Velingara of 10.03% compared to Keur Soce of 0.3%. Symptomatic malaria cases (fever associated with parasitaemia) represented 17.37%. Seroprevalence of anti-AMA1, anti-MSP1_42 and anti-CSP antibody was 38.12, 41.55 and 40.38%, respectively. The seroprevalence was more important in Velingara and increased with age, active malaria infection and area of residence.ConclusionThe use of serological markers can contribute to improved malaria surveillance in areas with declining malaria transmission. This study provided useful baseline information about the sero-epidemiological situation of malaria in Senegal and can contribute to the identification of malaria hot spots in order to concentrate intervention efforts.Trial registration number: PACTR201305000551876 (http://www.pactr.org).

Socio-economic, epidemiological and geographic features based on GIS-integrated mapping to identify malarial hotspots.

BackgroundMalaria is a major health problem in the tropical and subtropical world. In India, 95% of the population resides in malaria endemic regions and it is major public health problem in most parts of the country. The present work has developed malaria maps by integrating socio-economic, epidemiology and geographical dimensions of three eastern districts of Uttar Pradesh, India. The area has been studied in each dimension separately, and later integrated to find a list of vulnerable pockets/villages, called as malarial hotspots.MethodsThe study has been done at village level. Seasonal variation of malaria, comparison of epidemiology indices and progress of the medical facility were studied. Ten independent geographical information system (GIS) maps of socio-economic aspects (population, child population, literacy, and work force participation), epidemiology (annual parasitic index (API) and slides collected and examined) and geographical features (settlement, forest cover, water bodies, rainfall, relative humidity, and temperature) were drawn and studied. These maps were overlaid based on computed weight matrix to find malarial hotspot.ResultsIt was found that the studied dimensions were inter-weaving factors for malaria epidemic and closely affected malaria situations as evidenced from the obtained correlation matrix. The regions with water logging, high rainfall and proximity to forest, along with poor socio-economic conditions, are primarily hotspot regions. The work is presented through a series of GIS maps, tables, figures and graphs. A total of 2,054 out of 8,973 villages studied were found to be malarial hotspots and consequently suggestions were made to the concerned government malaria offices.ConclusionWith developing technology, information tools such as GIS, have captured almost every field of scientific research especially of vector-borne diseases, such as malaria. Malarial mapping enables easy update of information and effortless accessibility of geo-referenced data to policy makers to produce cost-effective measures for malaria control in endemic regions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0685-4) contains supplementary material, which is available to authorized users.

Malaria situation in India with special reference to tribal areas.

Background & objectives:In India, malaria is a major public health problem in States having predominantly tribal population. The objective of this analysis was to find out the incidence of malaria in various States/districts having varied proportions of tribal population using National Vector Borne Disease Control Programme (NVBDCP) data.Methods:States and districts were classified into three categories based on proportions of Scheduled Tribes (ST) population as <10, 10-29.9 and 30 per cent + ST population. Five year average (2008-2012) of all important malaria indicators collected by NVBDCP was taken to normalize the effect of annual fluctuations in malaria incidence.Results:State level analysis revealed that ten States/UTs with 30 per cent or more tribal population comprising only three per cent of total population, contributed 14 per cent of total malaria, 21 per cent Plasmodium falciparum and 29 per cent of deaths due to malaria. Similarly, district level analysis showed that districts with 30 per cent or more tribal population comprising about eight per cent country's population contributed to 46 per cent of total malaria cases, 70 per cent P. falciparum and 47 per cent malarial deaths in the country.Interpretation & conclusions:Our analysis showed that the neglect of the ethnic communities in tribal areas would be detrimental to the overall reduction of morbidity and mortality due to malaria. The fight against the increasing burden of malaria in tribal belt requires adoption of multiple approaches and socio-economic development of the tribal communities.

Molecular epidemiology of drug-resistant Plasmodium falciparum in Benguela province, Angola.

BackgroundThe malaria situation has been worsening in Angola, partly due to armed conflict until the recent past and drug-resistant Plasmodium falciparum. Malaria transmission is heterogeneous within the country, and data on drug-resistant malaria in different parts of the country are incomplete. The aim of the present study was to evaluate resistance to 4-aminoquinolines and antifolate drugs in P. falciparum isolates collected in Benguela province, central Angola, using molecular markers.MethodsFingerprick capillary blood was collected from asymptomatic children aged less than 15 years old during a household survey in and around Balombo town in 2010–2011. Samples were screened for P. falciparum by nested PCR. Molecular markers (P. falciparum dihydrofolate reductase [pfdhfr], P. falciparum dihydropteroate synthase [pfdhps], P. falciparum chloroquine resistance transporter [pfcrt], and P. falciparum multidrug-resistance gene 1 [pfmdr1]) were sequenced to determine the key codons associated with drug resistance.ResultsA total of 60 blood samples were positive for P. falciparum. Most isolates with successful PCR amplification had mutant pfdhfr alleles, with either double mutant AICNI (69%) or triple mutant AIRNI (21%) haplotypes. A16V, S108T, and I164L substitutions were not found. Many of the isolates were carriers of either SGKAA (60%) or AGKAA (27%) pfdhps haplotype. K540E substitution was absent. There were only two pfcrt haplotypes: wild-type CVMNK (11%) and mutant CVIET (89%). Wild-type pfmdr1 NYSND haplotype was found in 19% of the isolates, whereas single mutant pfmdr1 YYSND and NFSND haplotypes occurred in 48% and 11%, respectively. Double mutant pfmdr1 haplotypes (YFSND and YYSNY) occurred rarely.ConclusionsThe results suggest that the high prevalence of mutant pfcrt CVIET haplotype is in agreement with low clinical efficacy of chloroquine observed in earlier studies and that the double pfdhfr mutant AICNI and single pfdhps mutant SGKAA are currently the predominant haplotypes associated with antifolate resistance in Benguela province. The hallmark of clinical resistance observed in East Africa, i.e. triple pfdhfr mutant haplotype (AIRNI) and double pfdhps mutant haplotype (SGEAA), was absent. These molecular findings need to be further evaluated in parallel with clinical studies, in particular with the efficacy of intermittent preventive treatment using sulphadoxine-pyrimethamine in pregnant women and artesunate-amodiaquine for uncomplicated malaria.

Antibody response against three Plasmodium falciparum merozoite antigens in Mamuju District, West Sulawesi Province, Indonesia.

BackgroundMalaria endemicity in the archipelago of Indonesia varies substantially across regions. Following the government’s plan for a malaria elimination programme in Indonesia, baseline malaria surveys were conducted in Mamuju District, West Sulawesi Province, Indonesia to re-assess the malaria situation prior to the establishment of an evidence-based malaria elimination programme in the area. The present study aims to determine the antibody response to three merozoite antigens among the inhabitants of the district.MethodsAntibodies were measured following elution from filter-paper blood spots collected during cross-sectional surveys in the dry and wet season in 2010. Enzyme-linked immunosorbent assays using three merozoite antigens, MSP2, EBA175 and PfRh2a were conducted. A positivity threshold was determined by samples from unexposed individuals and the difference in antibody level against each antigen and correlation of antibody level in different age groups and seasons were statistically analysed.ResultsA total of 497 subjects, 248 in dry and 249 in wet season, aged between 0.6 and 78 years were included. The prevalence of positive antibody responses to MSP2, EBA175 and PfRh2a antigens in dry season were 27.82, 27.42 and 25.81%, respectively. In wet season, the antibody prevalences were 64.26, 64.66 and 61.45%. The antibody levels to the three antigens were all higher in older age groups and also significantly higher in the wet season. The antibody levels also correlated positively with the Plasmodium falciparum infection status of the subjects.ConclusionMSP2, EBA175 and PfRh2a induce antibody responses among the subjects in Mamuju District, and the prevalence is significantly higher in wet season. The level of antibody also correlates significantly with age and malaria positivity. The overall results indicate the antigens might be used as a target for vaccines against P. falciparum infection and as markers for malaria exposure.

Malaria control in Nepal 1963-2012: challenges on the path towards elimination.

BackgroundMalaria is still a priority public health problem of Nepal where about 84% of the population are at risk. The aim of this paper is to highlight the past and present malaria situation in this country and its challenges for long-term malaria elimination strategies.MethodsMalariometric indicator data of Nepal recorded through routine surveillance of health facilities for the years between 1963 and 2012 were compiled. Trends and differences in malaria indicator data were analysed.ResultsThe trend of confirmed malaria cases in Nepal between 1963 and 2012 shows fluctuation, with a peak in 1985 when the number exceeded 42,321, representing the highest malaria case-load ever recorded in Nepal. This was followed by a steep declining trend of malaria with some major outbreaks. Nepal has made significant progress in controlling malaria transmission over the past decade: total confirmed malaria cases declined by 84% (12,750 in 2002 vs 2,092 in 2012), and there was only one reported death in 2012. Based on the evaluation of the National Malaria Control Programme in 2010, Nepal recently adopted a long-term malaria elimination strategy for the years 2011–2026 with the ambitious vision of a malaria-free Nepal by 2026. However, there has been an increasing trend of Plasmodium falciparum and imported malaria proportions in the last decade. Furthermore, the analysis of malariometric indicators of 31 malaria-risk districts between 2004 and 2012 shows a statistically significant reduction in the incidence of confirmed malaria and of Plasmodium vivax, but not in the incidence of P. falciparum and clinically suspected malaria.ConclusionsBased on the achievements the country has made over the last decade, Nepal is preparing to move towards malaria elimination by 2026. However, considerable challenges lie ahead. These include especially, the need to improve access to diagnostic facilities to confirm clinically suspected cases and their treatment, the development of resistance in parasites and vectors, climate change, and increasing numbers of imported cases from a porous border with India. Therefore, caution is needed before the country embarks towards malaria elimination.

Implementation of malaria dynamic models in municipality level early warning systems in Colombia. Part I: description of study sites.

As part of the Integrated National Adaptation Pilot project and the Integrated Surveillance and Control System, the Colombian National Institute of Health is working on the design and implementation of a Malaria Early Warning System framework, supported by seasonal climate forecasting capabilities, weather and environmental monitoring, and malaria statistical and dynamic models. In this report, we provide an overview of the local ecoepidemiologic settings where four malaria process-based mathematical models are currently being implemented at a municipal level. The description includes general characteristics, malaria situation (predominant type of infection, malaria-positive cases data, malaria incidence, and seasonality), entomologic conditions (primary and secondary vectors, mosquito densities, and feeding frequencies), climatic conditions (climatology and long-term trends), key drivers of epidemic outbreaks, and non-climatic factors (populations at risk, control campaigns, and socioeconomic conditions). Selected pilot sites exhibit different ecoepidemiologic settings that must be taken into account in the development of the integrated surveillance and control system.

Characterization of malaria transmission during military crisis in urban area of Bouake, Central Cote d’Ivoire

Background: During the past 10 years, Cote d’Ivoire has experienced a serious military and political crisis that disrupted the environment of towns and villages. From the change of the initial environment emerge new landscapes favourable to tropical diseases vectors and pests. To investigate the real situation of malaria in a war zone, a survey was conducted from April 2008 to March 2009 in the urban area of Kennedy in Bouake, central Cote d’Ivoire. Methods & Materials: Entomological data were collected from the human landing catches and parasitological data were obtained from blood smear and thick film in children aged 0 to 15 years, following a clinical examination. Results: The Culicidae fauna collected is characterized by three main malaria vectors, An. gambiae, A. funestus, An nili. However, An. gambiae and An. funestus transmitted Plasmodium with means sporozoite rates of 2.8% and 12.5%, respectively. The aggressive rates of both vectors were 29 and 0.7 b/m/n respectively. The endemicity of the study area estimated by the entomological inoculation rate (EIR) was 296 infected bites/man/year (ib/m/y) for An. gambiae and 33 ib/m/y for An. funestus. Mean prevalence of Plasmodium falciparum was estimated to 83% and Plasmodium falciparum is responsible for 100% of infections. Conclusion: During the political contributed to modify transmission ecology of Plasmodium in urban Bouake as malaria vectors found previously in rural areas were collected in this high urbanized area of Kennedy in Bouake.

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.

Battling Malaria in Rural Zambia with Modern Technology: A Qualitative Study on the Value of Cell Phones, Geographical Information Systems, Asymptomatic Carriers and Rapid Diagnostic Tests to Identify, Treat and Control Malaria.

During the last decade much progress has been made in reducing malaria transmission in Macha, Southern Province, Zambia. Introduction of artemisinin combination therapies as well as mass screenings of asymptomatic carriers is believed to have contributed the most. When an endemic malaria situation is moving towards a non-endemic situation the resident population loses acquired immunity and therefore active case detection and efficient surveillance is crucial to prevent epidemic outbreaks. Our purpose was to evaluate the impact of cell phone surveillance and geographical information systems on malaria control in Macha. Furthermore, it evaluates what screening and treatment of asymptomatic carriers and implementation of rapid diagnostic tests in rural health care has led to. Ten in-depth semi-structured interviews, field observations and data collection were performed at the Macha Research Trust and at surrounding rural health centers. This qualitative method was inspired by rapid assessment procedure. The cell phone surveillance has been easily integrated in health care, and its integration with Geographical Information Systems has provided the ability to follow malaria transmission on a weekly basis. In addition, active case detection of asymptomatic carriers has been fruitful, which is reflected in it soon being applied nationwide. Furthermore, rapid diagnostic tests have provided rural health centers with reliable malaria diagnostics, thereby decreasing excessive malaria treatments and selection for drug resistance. This report reflects the importance of asymptomatic carriers in targeting malaria elimination, as well as development of effective surveillance systems when transmission decreases. Such an approach would be cost-efficient in the long run through positive effects in reduced child mortality and relief in health care.

Understanding of Malaria and Its Therapeutic Regimens–The Way Forward

Aim: Malaria is a very serious deadly disease that has attracted the attention of many researchers all over the world. Because a lot of work has been done in the area of malariology, there is need to understand its advance pattern and therapeutic regimens. Methods: Past and recent literatures on malaria were searched for information on history, global situation, classification, biology, pathology, pathogenesis, diagnosis, treatment and control of malaria to assess the progress made so far in the area of malariology. Results: Malaria is an ancient disease recognized by Hippocrates over 2413 years ago, caused by Plasmodium species, first identified by Charles-laveran 123 years ago affect 300–500 millions human worldwide, responsible for 3 deaths in every 30 seconds. The knowledge of classification, biology, pathology, pathogenesis, diagnosis and treatment of malaria is a tremendous achievement towards the control of the disease. Conclusion: But complete elimination of malaria perhaps will still take another time, since lots need to be known about the molecular biology of antigenic shift and drift, nature and mechanisms of action of the parasite toxin, in order to have basis for definite vaccine development. By so doing, radical cure and total eradication of malaria can be achieved.

Situation of Malaria in Kolkata Municipal Corporation area: A Secondary Data Analysis Report 2011.

A descriptive study was designed based on secondary data of Kolkata Municipal Corporation (KMC).Objectives:To estimate present status and trend of Malaria in KMC area; to determine time, place, person distribution of Malaria; to identify high-risk areas to mitigate future outbreak, and to recommend control strategies of Malaria.Materials and Methods:Three different sets of data were analyzed and the final estimate was obtained from the address confirmed database.Discussion:All the wards were high risk in boroughs 4 and 5. The Annual Blood Examination Rate (ABER) of KMC area declined to 5.29%. The falciparum percentage (Pf%) of KMC area was 8.91% in 2011. The ABER of Borough 14 was 1 but the Pf% was 14.6. “Sen Factor” may be calculated to plan the activities among the wards when the resources are limited.Conclusion:The ABER of Kolkata needs to be improved and Insecticide Treated Nets/ Long Lasting Insecticidal Nets must be considered to control the situation in addition to other regular vector-control measures and Behavior Change Communication activities. Cumulated ABER can be calculated for urban area to get an estimate of fever cases.