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Koji Wada - One of the best experts on this subject based on the ideXlab platform.
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malaria rapid diagnostic test hrp2 pldh positivity incidence care accessibility and impact of community wash action programme in dr congo mixed method study involving 625 households
Malaria Journal, 2021Co-Authors: Nlandu Roger Ngatu, Basilua Andre Muzembo, Sakiko Kanbara, Roger Wumba, Mitsunori Ikeda, Etongola Papy Mbelambela, Sifa Marie Joelle Muchanga, Nattadech Choomplang, Tomoko Suzuki, Koji WadaAbstract:BACKGROUND Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. METHODS Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. RESULTS Long-lasting Insecticide-Treated Net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05-3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11-7.08; p < 0.001) were predictors of household malaria. CONCLUSION This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.
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malaria rapid diagnostic test hrp2 pldh positivity incidence care accessibility and impact of community wash action programme in dr congo mixed method study involving 625 households
Malaria Journal, 2021Co-Authors: Nlandu Roger Ngatu, Basilua Andre Muzembo, Sakiko Kanbara, Roger Wumba, Mitsunori Ikeda, Etongola Papy Mbelambela, Sifa Marie Joelle Muchanga, Nattadech Choomplang, Tomoko Suzuki, Koji WadaAbstract:Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. Long-lasting Insecticide-Treated Net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2–29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were predictors of household malaria. This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.
Nlandu Roger Ngatu - One of the best experts on this subject based on the ideXlab platform.
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malaria rapid diagnostic test hrp2 pldh positivity incidence care accessibility and impact of community wash action programme in dr congo mixed method study involving 625 households
Malaria Journal, 2021Co-Authors: Nlandu Roger Ngatu, Basilua Andre Muzembo, Sakiko Kanbara, Roger Wumba, Mitsunori Ikeda, Etongola Papy Mbelambela, Sifa Marie Joelle Muchanga, Nattadech Choomplang, Tomoko Suzuki, Koji WadaAbstract:BACKGROUND Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. METHODS Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. RESULTS Long-lasting Insecticide-Treated Net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05-3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11-7.08; p < 0.001) were predictors of household malaria. CONCLUSION This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.
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malaria rapid diagnostic test hrp2 pldh positivity incidence care accessibility and impact of community wash action programme in dr congo mixed method study involving 625 households
Malaria Journal, 2021Co-Authors: Nlandu Roger Ngatu, Basilua Andre Muzembo, Sakiko Kanbara, Roger Wumba, Mitsunori Ikeda, Etongola Papy Mbelambela, Sifa Marie Joelle Muchanga, Nattadech Choomplang, Tomoko Suzuki, Koji WadaAbstract:Malaria is one of the most prevalent and deadliest illnesses in sub-Saharan Africa. Despite recent gains made towards its control, many African countries still have endemic malaria transmission. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory Water, Sanitation and Hygiene (WASH) Action programme. Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (a WASH action site) and Kasangulu (a WASH control site) in DRC between 1 January 2017 through March 2018, involving 625 households (3,712 household members). Baseline and post-intervention malaria surveys were conducted with the use of World Bank/WHO Malaria Indicator Questionnaire. An action research consisting of a six-month study was carried out which comprised two interventions: a community participatory WASH action programme aiming at eliminating mosquito breeding areas in the residential environment and a community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention malaria rapid diagnostic test (RDT) was performed among the respondents. Furthermore, a six-month hospital-based epidemiological study was conducted at selected referral hospitals at each site from 1 January through June 2017 to determine malaria trend. Long-lasting Insecticide-Treated Net (LLIN) was the most commonly used preventive measure (55%); 24% of households did not use any measures. Baseline malaria survey showed that 96% of respondents (heads of households) reported at least one episode occurring in the previous six months; of them only 66.5% received malaria care at a health setting. In the Action Research, mean incident household malaria cases decreased significantly at WASH action site (2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases, respectively; p < 0.05), whereas it remained unchanged at the Control site. Similar findings were observed with RDT results. Data collected from referral hospitals showed high malaria incidence rate, 67.4%. Low household income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), proximity to high risk area for malaria (ORa = 5.13; 95%CI: 2–29-8.07; p < 0.001), poor WASH (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were predictors of household malaria. This research showed high prevalence of positive malaria RDT among the responders and high household malaria incidence, which were reduced by a 6-month WASH intervention. DRC government should scale up malaria control strategy by integrating efficient indoor and outdoor preventive measures and improve malaria care accessibility.
Emmanuel Mbuba - One of the best experts on this subject based on the ideXlab platform.
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comparing the new ifakara ambient chamber test with who cone and tunnel tests for bioefficacy and non inferiority testing of Insecticide Treated Nets
Malaria Journal, 2019Co-Authors: Dennis J Massue, William Kisinza, Lena M Lorenz, Jason Moore, Watson S Ntabaliba, Samuel Ackerman, Zawadi M Mboma, Emmanuel MbubaAbstract:Insecticide-Treated Net (ITN) durability, measured through physical integrity and bioefficacy, must be accurately assessed in order to plan the timely replacement of worn out Nets and guide procurement of longer-lasting, cost-effective Nets. World Health Organization (WHO) guidance advises that new intervention class ITNs be assessed 3 years after distribution, in experimental huts. In order to obtain information on whole-Net efficacy cost-effectively and with adequate replication, a new bioassay, the Ifakara Ambient Chamber Test (I-ACT), a semi-field whole Net assay baited with human host, was compared to established WHO durability testing methods. Two experiments were conducted using pyrethroid-susceptible female adult Anopheles gambiae sensu stricto comparing bioefficacy of Olyset®, PermaNet® 2.0 and NetProtect® evaluated by I-ACT and WHO cone and tunnel tests. In total, 432 Nets (144/brand) were evaluated using I-ACT and cone test. Olyset® Nets (132/144) that did not meet the WHO cone test threshold criteria (≥ 80% mortality or ≥ 95% knockdown) were evaluated using tunnel tests with threshold criteria of ≥ 80% mortality or ≥ 90% feeding inhibition for WHO tunnel and I-ACT. Pass rate of Nets tested by WHO combined standard WHO bioassays (cone/tunnel tests) was compared to pass in I-ACT only by Net brand and time after distribution. Overall, more Nets passed WHO threshold criteria when tested with I-ACT than with standard WHO bioassays 92% vs 69%, (OR: 4.1, 95% CI 3.5–4.7, p < 0.0001). The proportion of Olyset® Nets that passed differed if WHO 2005 or WHO 2013 LN testing guidelines were followed: 77% vs 71%, respectively. Based on I-ACT results, PermaNet® 2.0 and NetProtect® demonstrated superior mortality and non-inferior feeding inhibition to Olyset® over 3 years of field use in Tanzania. Ifakara Ambient Chamber Test may have use for durability studies and non-inferiority testing of new ITN products. It measures composite bioefficacy and physical integrity with both mortality and feeding inhibition endpoints, using fewer mosquitoes than standard WHO bioassays (cone and tunnel tests). The I-ACT is a high-throughput assay to evaluate ITN products that work through either contact toxicity or feeding inhibition. I-ACT allows mosquitoes to interact with a host sleeping underneath a Net as encountered in the field, without risk to human participants.
Jeremy T Kerr - One of the best experts on this subject based on the ideXlab platform.
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Nets versus spraying a spatial modelling approach reveals indoor residual spraying targets anopheles mosquito habitats better than mosquito Nets in tanzania
PLOS ONE, 2018Co-Authors: Emily Sohanna Acheson, Jeremy T KerrAbstract:The global implementation of malaria interventions has averted hundreds of millions of clinical malaria cases in the last decade. This study assesses predicted Anopheles mosquito distributions across the United Republic of Tanzania before large-scale Insecticide-Treated Net (ITN) rollouts and indoor residual spraying (IRS) initiatives to determine whether mosquito Net usage by children under the age of five and IRS are targeted to areas where historical evidence indicates mosquitoes thrive. Demographic and Health Surveys data from 2011-2012 and 2015-2016 include detailed measurements of mosquito Net and IRS use across Tanzania. Anopheline data are far less intensively collected, but we constructed a Maxent-built baseline mosquito habitat suitability (MHS) map (AUC = 0.872) with Tanzanian Anopheles occurrence records from 1999-2003. This MHS model was tested against independently-observed georeferenced Plasmodium falciparum cases from the Malaria Atlas Project, with ~87% of cases from 1999-2003 (n = 107) and ~84% of cases from 1985-2012 (n = 919) occurring in areas of high predicted suitability for mosquitoes. We compared the validated MHS with subsequent malaria interventions using mixed effects logistic regression. Specifically, we assessed whether Anopheles habitat suitability related to the frequency that ≥1 child in a household reportedly slept under a mosquito Net when that intervention later became widely available, and whether IRS was reportedly applied to dwellings over a one-year period. There was no evidence that mosquito Net use the night before the survey related to MHS from 2011-2012 and marginally significant evidence (p<0.05) from 2015-2016 (β = 1.466, 95% C.I. = 0.848-2.103, marginal R2 = 0.020, respectively). However, the likelihood of IRS treatments rose relatively strongly in the 12 months prior to both surveys (β = 13.466, 95% C.I. = 10.488-16.456, marginal R2 = 0.144, and β = 6.817, 95% C.I. = 5.439-8.303, marginal R2 = 0.136, respectively). IRS treatments have therefore been targeted more effectively than mosquito Nets toward areas where anopheline habitat suitability was previously found to be high.
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where have all the mosquito Nets gone spatial modelling reveals mosquito Net distributions across tanzania do not target optimal anopheles mosquito habitats
Malaria Journal, 2015Co-Authors: Emily Sohanna Acheson, Andrew A Plowright, Jeremy T KerrAbstract:Malaria remains the deadliest vector-borne disease despite long-term, costly control efforts. The United Republic of Tanzania has implemented countrywide anti-malarial interventions over more than a decade, including national Insecticide-Treated Net (ITN) rollouts and subsequent monitoring. While previous analyses have compared spatial variation in malaria endemicity with ITN distributions, no study has yet compared Anopheles habitat suitability to determine proper allocation of ITNs. This study assesses where mosquitoes were most likely to thrive before implementation of large-scale ITN interventions in Tanzania and determine if ITN distributions successfully targeted those areas. Using Maxent, a species distribution model was constructed relating anopheline mosquito occurrences for 1999–2003 to high resolution environmental observations. A 2011–2012 layer of mosquito Net ownership was created using georeferenced data across Tanzania from the Demographic and Health Surveys. The baseline mosquito habitat suitability was compared to subsequent ITN ownership using (1) the average ITN numbers per house and (2) the proportion of households with ≥1 Net to test whether national ITN ownership targets have been met and have tracked malaria risk. Elevation, land cover, and human population distribution outperformed variants of temperature and Normalized Difference Vegetation Index (NDVI) in anopheline distribution models. The spatial distribution of ITN ownership across Tanzania was near-random spatially (Moran’s I = 0.07). Householders reported owning 2.488 ITNs on average and 93.41 % of households had ≥1 ITN. Mosquito habitat suitability was statistically unrelated to reported ITN ownership and very weakly to the proportion of households with ≥1 ITN (R2 = 0.051). Proportional ITN ownership/household varied relative to mosquito habitat suitability (Levene’s test F = 3.0037). Quantile regression was used to assess trends in ITN ownership among households with the highest and lowest 10 % of ITN ownership. ITN ownership declined significantly toward areas with the highest vector habitat suitability among households with lowest ITN ownership (t = −3.38). In areas with lowest habitat suitability, ITN ownership was consistently higher. Insecticide-Treated Net ownership is critical for malaria control. While Tanzania-wide efforts to distribute ITNs has reduced malaria impacts, gaps and variance in ITN ownership are unexpectedly large in areas where malaria risk is highest. Supplemental ITN distributions targeting prime Anopheles habitats are likely to have disproportionate human health benefits.
Jason Moore - One of the best experts on this subject based on the ideXlab platform.
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comparing the new ifakara ambient chamber test with who cone and tunnel tests for bioefficacy and non inferiority testing of Insecticide Treated Nets
Malaria Journal, 2019Co-Authors: Dennis J Massue, William Kisinza, Lena M Lorenz, Jason Moore, Watson S Ntabaliba, Samuel Ackerman, Zawadi M Mboma, Emmanuel MbubaAbstract:Insecticide-Treated Net (ITN) durability, measured through physical integrity and bioefficacy, must be accurately assessed in order to plan the timely replacement of worn out Nets and guide procurement of longer-lasting, cost-effective Nets. World Health Organization (WHO) guidance advises that new intervention class ITNs be assessed 3 years after distribution, in experimental huts. In order to obtain information on whole-Net efficacy cost-effectively and with adequate replication, a new bioassay, the Ifakara Ambient Chamber Test (I-ACT), a semi-field whole Net assay baited with human host, was compared to established WHO durability testing methods. Two experiments were conducted using pyrethroid-susceptible female adult Anopheles gambiae sensu stricto comparing bioefficacy of Olyset®, PermaNet® 2.0 and NetProtect® evaluated by I-ACT and WHO cone and tunnel tests. In total, 432 Nets (144/brand) were evaluated using I-ACT and cone test. Olyset® Nets (132/144) that did not meet the WHO cone test threshold criteria (≥ 80% mortality or ≥ 95% knockdown) were evaluated using tunnel tests with threshold criteria of ≥ 80% mortality or ≥ 90% feeding inhibition for WHO tunnel and I-ACT. Pass rate of Nets tested by WHO combined standard WHO bioassays (cone/tunnel tests) was compared to pass in I-ACT only by Net brand and time after distribution. Overall, more Nets passed WHO threshold criteria when tested with I-ACT than with standard WHO bioassays 92% vs 69%, (OR: 4.1, 95% CI 3.5–4.7, p < 0.0001). The proportion of Olyset® Nets that passed differed if WHO 2005 or WHO 2013 LN testing guidelines were followed: 77% vs 71%, respectively. Based on I-ACT results, PermaNet® 2.0 and NetProtect® demonstrated superior mortality and non-inferior feeding inhibition to Olyset® over 3 years of field use in Tanzania. Ifakara Ambient Chamber Test may have use for durability studies and non-inferiority testing of new ITN products. It measures composite bioefficacy and physical integrity with both mortality and feeding inhibition endpoints, using fewer mosquitoes than standard WHO bioassays (cone and tunnel tests). The I-ACT is a high-throughput assay to evaluate ITN products that work through either contact toxicity or feeding inhibition. I-ACT allows mosquitoes to interact with a host sleeping underneath a Net as encountered in the field, without risk to human participants.