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2. Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide- treated nets?

Author

Wotodjo, Amélé Nyedzie, Doucoure, Souleymane, Gaudart, Jean, Diagne, Nafissatou, Diene Sarr, Fatoumata, Faye, Ngor, Tall, Adama, Raoult, Didier, Sokhna, Cheikh, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Unité d'Epidémiologie des Maladies Infectieuses, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Laboratoire de Parasitologie, Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, and Gaudart, Jean

Subjects
Plasmodium, [MATH.MATH-PR] Mathematics [math]/Probability [math.PR], Mosquito Control, Time Factors, Fevers, lcsh:Medicine, Disease Vectors, Pathology and Laboratory Medicine, Mosquitoes, Anti-Infective Agents, [STAT.AP] Statistics [stat]/Applications [stat.AP], Recurrence, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Surveys and Questionnaires, Outcome Assessment, Health Care, Medicine and Health Sciences, Longitudinal Studies, Child, lcsh:Science, [MATH.MATH-ST] Mathematics [math]/Statistics [math.ST], Protozoans, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [STAT.AP]Statistics [stat]/Applications [stat.AP], [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [STAT.ME] Statistics [stat]/Methodology [stat.ME], Malarial Parasites, Middle Aged, Artemisinins, Senegal, Insects, Infectious Diseases, Child, Preschool, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [STAT.ME]Statistics [stat]/Methodology [stat.ME], [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Research Article, Adult, Arthropoda, Adolescent, Immunology, [MATH.MATH-DS]Mathematics [math]/Dynamical Systems [math.DS], [MATH.MATH-DS] Mathematics [math]/Dynamical Systems [math.DS], Young Adult, Signs and Symptoms, Diagnostic Medicine, Parasite Groups, parasitic diseases, Parasitic Diseases, Animals, Adults, Humans, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Insecticide-Treated Bednets, Aged, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, lcsh:R, Organisms, Immunity, Biology and Life Sciences, Infant, Tropical Diseases, Invertebrates, [SDE.ES]Environmental Sciences/Environmental and Society, Parasitic Protozoans, Insect Vectors, Malaria, Health Care, [MATH.MATH-PR]Mathematics [math]/Probability [math.PR], Species Interactions, Cross-Sectional Studies, Socioeconomic Factors, Age Groups, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, People and Places, Parasitology, Population Groupings, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDE.ES] Environmental Sciences/Environmental and Society, Health Statistics, Morbidity, Apicomplexa
Abstract

International audience; BACKGROUND: The malaria burden has decreased significantly in recent years in Africa through the widespread use of artemisinin-based combination therapy (ACT) and long-lasting insecticide-treated nets (LLINs). However, the occurrence of malaria resurgences, the loss of immunity of exposed populations constitute among other factors, serious concerns about the future of malaria elimination efforts. This study investigated the evolution of malaria morbidity in Dielmo (Senegal) before and after the implementation of LLINs.METHODS: A longitudinal study was carried out in Dielmo over eight years, from July 2007 to July 2015. In July 2008, LLINs were offered to all villagers, and in July 2011 and August 2014 the LLINs were renewed. A survey on LLINs use was done each quarter of the year. Thick smears stained with Giemsa, a rapid diagnostic test (RDT) and quantitative polymerase chain reaction (PCR) methods were performed for all cases of fever to assess malaria clinical attacks. Malaria cases were treated with ACT since June 2006.RESULTS: Malaria morbidity has decreased significantly since the implementation of LLINs in Dielmo, together with ACT. However, malaria resurgences have occurred twice during the seven years of LLINs use. These resurgences occurred the first time during the third year after the introduction of LLINs (aIRR (adjusted incidence-rate ratio) [95%CI] = 5.90 [3.53; 9.88] p< 0.001) and a second time during the third year after the renewal of LLINs (aIRR [95%CI] = 5.60 [3.34; 9.39] p< 0.001). Sixty-nine percent (69%) of the nets tested for their long-lasting insecticidal activity remained effective after 3 years of use.CONCLUSION: Good management of malaria cases by the use of ACT as first-line treatment against malaria in addition to the use of LLINs has significantly reduced malaria in Dielmo and allowed to reach the phase of pre-elimination of the disease. However, the occurrence of malaria resurgences raised serious concerns about malaria elimination, which would require additional tools in this village.

Published
2017

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