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1. Proactive community case management decreased malaria prevalence in rural Madagascar: results from a cluster randomized trial

Author

Rila Ratovoson, Andres Garchitorena, Daouda Kassie, Jemima A. Ravelonarivo, Voahangy Andrianaranjaka, Seheno Razanatsiorimalala, Avotra Razafimandimby, Fanjasoa Rakotomanana, Laurie Ohlstein, Reziky Mangahasimbola, Sandro A. N. Randrianirisoa, Jocelyn Razafindrakoto, Catherine M. Dentinger, John Williamson, Laurent Kapesa, Patrice Piola, Milijaona Randrianarivelojosia, Julie Thwing, Laura C. Steinhardt, Laurence Baril, Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM), U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Institut Pasteur du Cambodge, Université de Toliara, and This work was supported by the United States Agency for International Development (USAID) in Surveillance and Data for Management (SDM) project, Grant n°AID-687-G-13-00003. Financial support for this study was also provided by the US President’s Malaria Initiative (US PMI).

Subjects
Community case management, Santé publique, Madagascar, Prevalence, Humans, Rural, Child, Aged, Community Health Workers, Malaria detection, Contrôle de maladies, Infant, Newborn, General Medicine, Malaria, Épidémiologie, S50 - Santé humaine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, approches communautaires, Case Management, Zone rurale
Abstract

Background Malaria remains a leading cause of morbidity and mortality worldwide, with progress in malaria control stalling in recent years. Proactive community case management (pro-CCM) has been shown to increase access to diagnosis and treatment and reduce malaria burden. However, lack of experimental evidence may hinder the wider adoption of this intervention. We conducted a cluster randomized community intervention trial to assess the efficacy of pro-CCM at decreasing malaria prevalence in rural endemic areas of Madagascar. Methods Twenty-two fokontany (smallest administrative unit) of the Mananjary district in southeast Madagascar were selected and randomized 1:1 to pro-CCM (intervention) or conventional integrated community case management (iCCM). Residents of all ages in the intervention arm were visited by a community health worker every 2 weeks from March to October 2017 and screened for fever; those with fever were tested by a rapid diagnostic test (RDT) and treated if positive. Malaria prevalence was assessed using RDTs on all consenting study area residents prior to and following the intervention. Hemoglobin was measured among women of reproductive age. Intervention impact was assessed via difference-in-differences analyses using logistic regressions in generalized estimating equations. Results A total of 27,087 and 20,475 individuals participated at baseline and endline, respectively. Malaria prevalence decreased from 8.0 to 5.4% in the intervention arm for individuals of all ages and from 6.8 to 5.7% in the control arm. Pro-CCM was associated with a significant reduction in the odds of malaria positivity in children less than 15 years (OR = 0.59; 95% CI [0.38–0.91]), but not in older age groups. There was no impact on anemia among women of reproductive age. Conclusion This trial suggests that pro-CCM approaches could help reduce malaria burden in rural endemic areas of low- and middle-income countries, but their impact may be limited to younger age groups with the highest malaria burden. Trial registration NCT05223933. Registered on February 4, 2022

Published
2022

2. Family, social and cultural determinants of long-lasting insecticidal net (LLIN) use in Madagascar: secondary analysis of three qualitative studies focused on children aged 5–15 years

Author

Andry Andrianasolo, Ammy Fiadanana Njatosoa, Chiarella Mattern, Bakoly Rahaivondrafahitra, Christophe Rogier, Mauricette Andriamananjara, Aina Harimanana, Thomas Kesteman, Dolorès Pourette, Elliot Rakotomanana, Jocelyn Razafindrakoto, Emma Raboanary, Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université de Paris (UP), Unité de Recherche sur le Paludisme [Antananarivo, Madagascar], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Oxford University Clinical Research Unit [Hanoi] (OUCRU), Population Services International Madagascar [Antananarivo], Population Services International [Washington], Ministère de la Santé Publique [Antananarivo, Madagascar], U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Institut international des sciences sociales [Antananarivo] (IISS), Primum Vitare, The publication process of this paper has been funded by USAID through the Research, Innovation, Surveillance and Evaluation (RISE) programme., Institut de Recherche pour le Développement (IRD), and Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité)

Subjects
Male, medicine.medical_specialty, Mosquito Control, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, LLIN use, 030231 tropical medicine, [SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology, Ethnic group, Qualitative property, [SHS]Humanities and Social Sciences, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Environmental health, parasitic diseases, medicine, Madagascar, Humans, lcsh:RC109-216, 030212 general & internal medicine, Children over five, Insecticide-Treated Bednets, Child, Disease burden, Research, Public health, [SHS.ANTHRO-SE]Humanities and Social Sciences/Social Anthropology and ethnology, medicine.disease, 3. Good health, Malaria, Infectious Diseases, Geography, Child, Preschool, Mosquito net, Female, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Thematic analysis, Sociocultural factors, Qualitative research
Abstract

BackgroundAlthough it is accepted that long-lasting insecticidal net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; the malaria prevalence is highest in this age group. The purpose of this research is to summarize recent qualitative studies describing LLIN use among the Malagasy people with a focus on children aged 5–15 years.MethodsQualitative data from three studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analysed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews.ResultsA total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN lower use by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and, therefore, are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs.ConclusionsPerceptions, social practices and regional beliefs regarding LLINs and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.

Published
2021

3. School-Based Serosurveys to Assess the Validity of Using Routine Health Facility Data to Target Malaria Interventions in the Central Highlands of Madagascar

Author

Odile Mercereau-Puijalon, Tsikiniaina Rasoloharimanana, Laura C. Steinhardt, Thomas Kesteman, Emma Rakotomalala, Christophe Rogier, Aina Harimanana, Seheno Razanatsiorimalala, Sixte Zigirumugabe, Elisabeth Ravaoarisoa, Anny M Randriamoramanana, Milijaona Randrianarivelojosia, Inès Vigan-Womas, Judith Hedje, Ryan E. Wiegand, Patrice Piola, Annett H. Cotte, Jessica Butts, Ronald Perraut, Jean Marius Rakotondramanga, Arsène Ratsimbasoa, Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, G4 malaria group [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Université d'Antananarivo, Unité d'Epidémiologie [Antananarivo, Madagascar] (IPM), U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], U.S.President's Malaria Initiative (PMI), AGENCY FOR INTERNATIONAL DEVELOPMENT WASHINGTON USA, Partenaires IRSTEA, Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Fondation Mérieux, Unité d'immunologie des maladies infectieuses [Antananarivo, Madagascar] (IPM), Département Parasites et Insectes vecteurs - Department of Parasites and Insect Vectors, Institut Pasteur [Paris] (IP), Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Ministère de la Santé Publique - Ministry of Public Health [Antananarivo, Madagascar], Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Unité d'Épidémiologie et de Santé Publique [Phnom Penh], Institut Pasteur du Cambodge, This work was supported by the US President’s Malaria Initiative program (grant number AID-687-G-13-00003 Surveillance and Data for Management Project)., We express our gratitude to the population of the districts and communes investigated and especially to the children, parents, guardians, and teachers who participated to the study. We also thank those who facilitated the survey, that is heads of communes and fokontany, local administration authorities, and health authorities from Ministry of Health and National Malaria Control Program. We also thank the survey teams., Institut Pasteur [Paris], and Ministère de la Santé Publique [Antananarivo, Madagascar]

Subjects
030231 tropical medicine, Indoor residual spraying, malaria, serology, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Serology, 03 medical and health sciences, 0302 clinical medicine, stratification, Health facility, Seroepidemiologic Studies, Environmental health, parasitic diseases, school-based surveys, Madagascar, Immunology and Allergy, Medicine, Seroprevalence, Humans, 030212 general & internal medicine, Seroconversion, 2. Zero hunger, Schools, business.industry, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, Confidence interval, 3. Good health, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Data quality, [SDV.IMM]Life Sciences [q-bio]/Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health Facilities, business, Malaria
Abstract

Background In low-malaria–transmission areas of Madagascar, annual parasite incidence (API) from routine data has been used to target indoor residual spraying at subdistrict commune level. To assess validity of this approach, we conducted school-based serological surveys and health facility (HF) data quality assessments in 7 districts to compare API to gold-standard commune-level serological measures. Methods At 2 primary schools in each of 93 communes, 60 students were randomly selected with parents and teachers. Capillary blood was drawn for rapid diagnostic tests (RDTs) and serology. Multiplex bead-based immunoassays to detect antibodies to 5 Plasmodium falciparum antigens were conducted, and finite mixture models used to characterize seronegative and seropositive populations. Reversible catalytic models generated commune-level annual seroconversion rates (SCRs). HF register data were abstracted to assess completeness and accuracy. Results RDT positivity from 12 770 samples was 0.5%. Seroprevalence to tested antigens ranged from 17.9% (MSP-1) to 59.7% (PF13). Median commune-level SCR was 0.0108 (range, 0.001–0.075). Compared to SCRs, API identified 71% (95% confidence interval, 51%–87%) of the 30% highest-transmission communes; sensitivity declined at lower levels. Routine data accuracy did not substantially affect API performance. Conclusions API performs reasonably well at identifying higher-transmission communes but sensitivity declined at lower transmission levels.

Published
2020

4. Remote sensing and multi-criteria evaluation for malaria risk mapping to support indoor residual spraying prioritization in the Central highlands of Madagascar

Author

Hobiniaina Anthonio Rakotoarison, Mampionona Rasamimalala, Jean Marius Rakotondramanga, Brune Ramiranirina, Thierry Franchard, Laurent Kapesa, Jocelyn Razafindrakoto, Hélène Guis, Luciano Michaël Tantely, Romain Girod, Solofoarisoa Rakotoniaina, Laurence Baril, Patrice Piola, Fanjasoa Rakotomanana, Unité d’Épidémiologie et de Recherche clinique [Antananarivo, Madagascar], Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Territoires, Environnement, Télédétection et Information Spatiale (UMR TETIS), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-AgroParisTech-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université d'Antananarivo, Ministère de la Santé Publique [Antananarivo, Madagascar], U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Animal, Santé, Territoires, Risques et Ecosystèmes (UMR ASTRE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre National de Recherche Appliquée au Développement Rural (FOFIFA), Unité d'Entomologie Médicale [Antananarivo, Madagascar] (IPM), Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Unité d'Épidémiologie et de Santé Publique [Phnom Penh], United States Agency for International Development (USAID) - CGIAR - AID-687-G-13-00003, and ANISETTE - French Space Agency, CNES - DAR 4800001029

Subjects
multi-criteria evaluation, Télédétection, Évaluation du risque, Distribution spatiale, L73 - Maladies des animaux, Malaria, remote sensing, spatial modeling, parasitic diseases, [SDE]Environmental Sciences, Madagascar, lcsh:Q, U30 - Méthodes de recherche, lcsh:Science
Abstract

The National Malaria Control Program (NMCP) in Madagascar classifies Malagasy districts into two malaria situations: districts in the pre-elimination phase and districts in the control phase. Indoor residual spraying (IRS) is identified as the main intervention means to control malaria in the Central Highlands. However, it involves an important logistical mobilization and thus necessitates prioritization of interventions according to the magnitude of malaria risks. Our objectives were to map the malaria transmission risk and to develop a tool to support the Malagasy Ministry of Public Health (MoH) for selective IRS implementation. For the 2014&ndash, 2016 period, different sources of remotely sensed data were used to update land cover information and substitute in situ climatic data. Spatial modeling was performed based on multi-criteria evaluation (MCE) to assess malaria risk. Models were mainly based on environment and climate. Three annual malaria risk maps were obtained for 2014, 2015, and 2016. Annual parasite incidence data were used to validate the results. In 2016, the validation of the model using a receiver operating characteristic (ROC) curve showed an accuracy of 0.736, 95% CI [0.669&ndash, 0.803]. A free plugin for QGIS software was made available for NMCP decision makers to prioritize areas for IRS. An annual update of the model provides the basic information for decision making before each IRS campaign. In Madagascar and beyond, the availability of the free plugin for open-source software facilitates the transfer to the MoH and allows further application to other problems and contexts.

Published
2020

5. Evaluating Effectiveness of Mass and Continuous Long-lasting Insecticidal Net Distributions Over Time in Madagascar: A Sentinel Surveillance Based Epidemiological Study

Author

Laurence Randrianasolo, Thomas Kesteman, Maherisoa Ratsitorahina, Yoann Madec, Patrice Piola, Vincent Herbreteau, Florian Girond, Milijaona Randrianarivelojosia, Christophe Rogier, Rindra Randremanana, Lea Randriamampionona, Judith Hedje, UMR 228 Espace-Dev, Espace pour le développement, Université de Guyane (UG)-Université des Antilles (UA)-Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM), Unité d'Epidémiologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Elimination 8 (E8), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Fondation Mérieux, Unité de Recherche sur le Paludisme [Antananarivo, Madagascar], Direction de la Veille Sanitaire et de la Surveillance Epidémiologique [Madagascar] (DVSSE), Ministère de la Santé Publique [Antananarivo, Madagascar], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Réseau International des Instituts Pasteur (RIIP), Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), 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)-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), Institut de Recherche Biomédicale des Armées (IRBA), Unité d'Épidémiologie et de Santé Publique [Phnom Penh], Institut Pasteur du Cambodge, This research was supported by ASPR within the US DHHS (Assistant Secretary for Preparedness and Response with the US Department of Health and Human Services, grant No. 5 IDSEP140020-03-00) and by the USAID (grant No. AID-687-G-13-00003)., RANDRIAMANANTSOA, Volatiana Manohisoa, Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), 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, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Ministère de la Santé Publique - Ministry of Public Health [Antananarivo, Madagascar], and Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)

Subjects
Long lasting, EPIDEMIOLOGIE, medicine.medical_specialty, 030231 tropical medicine, Sentinel surveillance, 03 medical and health sciences, 0302 clinical medicine, High transmission, Statistical analyses, SURVEILLANCE, Epidemiology, parasitic diseases, Madagascar, Medicine, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, ANALYSE STATISTIQUE, lcsh:R5-920, ANALYSE DIACHRONIQUE, business.industry, 1. No poverty, General Medicine, Percentile value, PALUDISME, PREVENTION SANITAIRE, medicine.disease, LLINs effectiveness, 3. Good health, Malaria, Malaria incidence, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, INSECTICIDE CHIMIQUE, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Medicine (General), business, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Demography, Research Paper
Abstract

Background: The reduction of global malaria burden over the past 15 years is much attributed to the expansion of mass distribution campaigns (MDCs) of long-lasting insecticidal nets (LLIN). In Madagascar, two LLIN MDCs were implemented and one district also benefited from a community-based continuous distribution (CB-CD). Malaria incidence dropped but eventually rebounded after a decade. Methods: Data from a sentinel surveillance network over the 2009–2015 period was analyzed. Alerts were defined as weekly number of malaria cases exceeding the 90th percentile value for three consecutive weeks. Statistical analyses assessed the temporal relationship between LLIN MDCs and (i) number of malaria cases and (ii) malaria alerts detected, and (iii) the effect of a combination of MDCs and a CB-CD in Toamasina District. Findings: Analyses showed an increase of 13.6 points and 21.4 points in the percentile value of weekly malaria cases during the second and the third year following the MDC of LLINs respectively. The percentage of alert-free sentinel sites was 98.2% during the first year after LLIN MDC, 56.7% during the second year and 31.5% during the third year. The number of weekly malaria cases decreased by 14% during the CB-CD in Toamasina District. In contrast, sites without continuous distribution had a 12% increase of malaria cases. Interpretation: These findings support the malaria-preventive effectiveness of MDCs in Madagascar but highlight their limited duration when not followed by continuous distribution. The resulting policy implications are crucial to sustain reductions in malaria burden in high transmission settings. Keywords: Malaria, Madagascar, LLINs effectiveness, Sentinel surveillance

Published
2018

6. Measuring the impact of seasonal malaria chemoprevention as part of routine malaria control in Kita, Mali

Author

Fatou Diawara, Abdoulaye Djimde, Mouctar Diallo, Beh Kamate, Laura C. Steinhardt, Issaka Sagara, Diakalia Koné, Alassane Dicko, Halimatou Diawara, Daouda T. Kone, Almahamoudou Mahamar, Jules Mihigo, Tiangoua Traore, Erin Eckert, Aboubacar Sadou, Université des sciences, des techniques et des technologies de Bamako, Université des sciences, des techniques et des technologies de Bamako (USTTB), Malaria Research and Training Center - MRTC [Bamako, Mali], Département d'Epidémiologie des Affections parasitaires, Malaria Research and training center Université de Bamako, Mali, Université de Bamako, Save the Children, Bamako, Mali, National Malaria Control Programme, Ministry of Health and Social Welfare, Department of Epidemiology of Parasitic Diseases, Malaria Research and Training Centre-Université de Bamako, U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Département d'épidémiologie des affections parasitaires (DEAP), Université de Bamako-Malaria Research and Training Center (MRTC)-Facultés de Médecine, de Pharmacie et d'Odonto-Stomatologie-Centre National de la Recherche Scientifique (CNRS), University of Texas at Arlington [Arlington], Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Université de Bamako-Malaria Research and Training Centre, and Lissalde, Claire

Subjects
Male, Veterinary medicine, Cross-sectional study, medicine.medical_treatment, Mali, law.invention, 0302 clinical medicine, Randomized controlled trial, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prevalence, Medicine, 030212 general & internal medicine, Child, Anemia, 3. Good health, Drug Combinations, Infectious Diseases, Tolerability, Child, Preschool, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, cardiovascular system, Female, Seasons, medicine.drug, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Sulfadoxine, lcsh:RC955-962, 030231 tropical medicine, Amodiaquine, Chemoprevention, lcsh:Infectious and parasitic diseases, Antimalarials, 03 medical and health sciences, Internal medicine, parasitic diseases, Humans, lcsh:RC109-216, business.industry, Research, Infant, medicine.disease, Malaria, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Tropical medicine, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Background Seasonal malaria chemoprevention (SMC) is a new strategy recommended by WHO in areas of highly seasonal transmission in March 2012. Although randomized controlled trials (RCTs) have shown SMC to be highly effective, evidence and experience from routine implementation of SMC are limited. Methods A non-randomized pragmatic trial with pre-post design was used, with one intervention district (Kita), where four rounds of SMC with sulfadoxine + amodiaquine (SP + AQ) took place in August–November 2014, and one comparison district (Bafoulabe). The primary aims were to evaluate SMC coverage and reductions in prevalence of malaria and anaemia when SMC is delivered through routine programmes using existing community health workers. Children aged 3–59 months from 15 selected localities per district, sampled with probability proportional to size, were surveyed and blood samples collected for malaria blood smears, haemoglobin (Hb) measurement, and molecular markers of drug resistance in two cross-sectional surveys, one before SMC (July 2014) and one after SMC (December 2014). Difference-in-differences regression models were used to assess and compare changes in malaria and anaemia in the intervention and comparison districts. Adherence and tolerability of SMC were assessed by cross-sectional surveys 4–7 days after each SMC round. Coverage of SMC was assessed in the post-SMC survey. Results During round 1, 84% of targeted children received at least the first SMC dose, but coverage declined to 67% by round 4. Across the four treatment rounds, 54% of children received four complete SMC courses. Prevalence of parasitaemia was similar in intervention and comparison districts prior to SMC (23.4 vs 29.5%, p = 0.34) as was the prevalence of malaria illness (2.4 vs 1.9%, p = 0.75). After SMC, parasitaemia prevalence fell to 18% in the intervention district and increased to 46% in the comparison district [difference-in-differences (DD) OR = 0.35; 95% CI 0.20–0.60]. Prevalence of malaria illness fell to a greater degree in the intervention district versus the comparison district (DD OR = 0.20; 95% CI 0.04–0.94) and the same for moderate anaemia (Hb

Published
2017

7. Analysing trends and forecasting malaria epidemics in Madagascar using a sentinel surveillance network: a web‑based application

Author

Florian Girond, Vincent Herbreteau, Sixte Zigiumugabe, Fanjasoa Rakotomanana, Judith Hedje, Lea Randriamampionona, Patrice Piola, Laurence Randrianasolo, Télesphore Yao Brou, Morgan Mangeas, Christophe Rogier, Maherisoa Ratsitorahina, Milijaona Randrianarivelojosia, Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), UMR 228 Espace-Dev, Espace pour le développement, Université de Guyane (UG)-Université des Antilles (UA)-Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM), Polytechnic of Namibia [Windhoek], Ministère de la Santé Publique [Antananarivo, Madagascar], U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), 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)-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), Institute for Biomedical Research of the French Armed Forces (IRBA), This research was supported by the USAID (Grant No. AID-687-G-13-00003). We thank administration authorities and health authorities from the Ministry of Health, the National Malaria Control Program and the President’s Malaria Initiative. We especially thank all the sentinel surveillance team of the Institut Pasteur de Madagascar., Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Ministère de la Santé Publique - Ministry of Public Health [Antananarivo, Madagascar], 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, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Solofoharivelo, Marie Chrystine, and Institut de Recherche Biomédicale des Armées (IRBA)

Subjects
Male, Veterinary medicine, MESH: Text Messaging, Indoor residual spraying, MESH: Madagascar, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Child, Medicine, Prospective Studies, 030212 general & internal medicine, Child, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, MESH: Infant, Newborn, Middle Aged, MESH: Infant, 3. Good health, Infectious Diseases, MESH: Internet, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Young Adult, Child, Preschool, MESH: Sentinel Surveillance, Female, Adult, MESH: Forecasting, medicine.medical_specialty, Short Message Service, Adolescent, 030231 tropical medicine, MESH: Malaria, Young Adult, 03 medical and health sciences, MESH: Software, parasitic diseases, Madagascar, Humans, Web application, Epidemics, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Epidemics, Aged, Retrospective Studies, MESH: Adolescent, Internet, Text Messaging, MESH: Humans, business.industry, Research, Public health, MESH: Child, Preschool, Infant, Newborn, Infant, Outbreak, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Data science, MESH: Male, MESH: Prospective Studies, Malaria, Mews, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Early warning system, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Sentinel Surveillance, MESH: Female, Software, Forecasting
Abstract

Background : The use of a malaria early warning system (MEWS) to trigger prompt public health interventions is a key step in adding value to the epidemiological data routinely collected by sentinel surveillance systems. Methods : This study describes a system using various epidemic thresholds and a forecasting component with the support of new technologies to improve the performance of a sentinel MEWS. Malaria-related data from 21 sentinel sites collected by Short Message Service are automatically analysed to detect malaria trends and malaria outbreak alerts with automated feedback reports. Results : Roll Back Malaria partners can, through a user-friendly web-based tool, visualize potential outbreaks and generate a forecasting model. The system already demonstrated its ability to detect malaria outbreaks in Madagascar in 2014. Conclusion : This approach aims to maximize the usefulness of a sentinel surveillance system to predict and detect epidemics in limited-resource environments.

Published
2017

8. Averting a malaria disaster: will insecticide resistance derail malaria control?

Author

Maureen Coetzee, Jan H. Kolaczinski, Mark Hoppé, Peter W. Gething, Nicholas Hamon, Dabiré K Roch, John E. Gimnig, Hilary Ranson, Alan J. Magill, Clément Kerah Hinzoumbe, Janet Hemingway, Frédéric Simard, David Schellenberg, Christen Fornadel, John A. Pickett, Liverpool School of Tropical Medicine (LSTM), Bill & Melinda Gates Foundation [Seattle], The Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS [Genève, Suisse] (ONUSIDA), U.S. President’s Malaria Initiative [Antananarivo] (PMI), U.S. President's Malaria Initiative [Atlanta, GA,], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, University of the Witwatersrand [Johannesburg] (WITS), Diversity, ecology, evolution & Adaptation of arthropod vectors (MIVEGEC-DEEVA), Evolution des Systèmes Vectoriels (ESV), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Institut de Recherche en Sciences de la Santé (IRSS) / Centre Muraz, Rothamsted Research, University of Oxford [Oxford], and London School of Hygiene and Tropical Medicine (LSHTM)

Subjects
0301 basic medicine, medicine.medical_specialty, Mosquito Control, 030231 tropical medicine, Dose drugs, Article, Insecticide Resistance, 03 medical and health sciences, 0302 clinical medicine, Environmental health, parasitic diseases, Anopheles, Pyrethrins, medicine, Animals, Humans, Insecticide-Treated Bednets, Africa South of the Sahara, ComputingMilieux_MISCELLANEOUS, biology, business.industry, Public health, General Medicine, medicine.disease, biology.organism_classification, 3. Good health, Biotechnology, Insect Vectors, Malaria, Mosquito control, 030104 developmental biology, Insecticide resistance, Communicable Disease Control, Management methods, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Malaria control
Abstract

World Malaria Day 2015 highlighted the progress made in the development of new methods of prevention (vaccines and insecticides) and treatment (single dose drugs) of the disease. However, increasing drug and insecticide resistance threatens the successes made with existing methods. Insecticide resistance has decreased the efficacy of the most commonly used insecticide class of pyrethroids. This decreased efficacy has increased mosquito survival, which is a prelude to rising incidence of malaria and fatalities. Despite intensive research efforts, new insecticides will not reach the market for at least 5 years. Elimination of malaria is not possible without effective mosquito control. Therefore, to combat the threat of resistance, key stakeholders need to rapidly embrace a multifaceted approach including a reduction in the cost of bringing new resistance management methods to market and the streamlining of associated development, policy, and implementation pathways to counter this looming public health catastrophe.

Published
2016

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