Assessment of strategic management practice of malaria control in the dangme west district, GhanaArticle submitted to the west african college of nursing for the award of a fellow

Strategic management (SM) practice was as-sessed in all HCFs both in the public and private and some chemical shops within the Dangme West district using semi-structured question-naires. In-depth interviews were carried out with healthcare managers in their clinical setting. The study utilized both qualitative and quantitative methods in describing the SM practice. Healthcare managers were using all the elements of SM in the management of malaria but these were not holistically coordinated. Present were short ranged informal planning based on the objectives of NMCP and day-to-day operation of the HCFs especially with Ghana Health Service facilities. Due to homogenous nature of Dangme West district, management of culture wasn’t given much attention by healthcare managers though healthcare providers were acutely aware of its importance to quality service delivery. Competition was woefully absent in the healthcare environment. No formal structure has been created for the management of malaria control activities with the exception of the involvement of Community Based agents. The district was widely implementing all the strategies of the NMCP with favourable outcomes.

Human Habitats and Malaria Vector Control in Benin: Current Situation and Implications for Effective Control

Long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) are the main indoor malaria vector tools control tools. The study examined housing characteristics and investigated the relationship between the total volume of household possessions, the volume of the sleeping room, and the hanging of LLINs. A total of 831 bedrooms were randomly selected in Benin in 2015. The findings showed that mud walls were predominant in rural areas (more than 75%), while metal roofs were common (77.3% - 97.9%). Battery-powered lighting was prevalent in rural areas in Northern (97%), while open-flame oil lamps were commonly used in rural areas in Southern (86%). The availability of correct bedding was low, ranging from 1% to 10% in all households. 20% of the bedrooms had at least 50% of their volume occupied by household possessions in urban areas. In rural areas, bedrooms without LLINs had a lower mean rate ratio of the volume occupied by possessions per the total volume of the room compared to bedrooms with at least one LLIN installed (p < 0.0001). The characteristics of human habitats are not favourable to the correct use of vector control intervention indoors. It is therefore important to improve people’s living conditions as the next step for malaria elimination.

Mosquito Control, Killing off the Females

In addition to causing discomfort, female mosquitoes introduce disease-carrying viruses and bacteria into the bloodstream of their victims. There are numerous publications describing the uses of sugary mosquito baits with promising results. Without temperature control measures however, these methods are mainly useful for only nectar-feeding insects, including male mosquitoes, because the warmth of the blood is a condition for the females to locate their meals. The efforts required to keep the baits fresh against the natural spoiling process make them less attractive or impractical to implement. These experiments address these issues by using warm baits of water, sugar, boric acid, and antibiotics. Overnight, the general areas became clear of blood-sucking female mosquitoes while in numbers, the harmless males concentrated into the immediate vicinities. Control vs. experiment protocol established no other logical explanation for this phenomenon other than that females were attracted and killed by the bait. As expected, there was no female mosquito’s activity in these areas. There weren’t many left to do the work.

Evaluation of Malaria Transmission and Vector Control Strategies in the Dry Season in the Cotonou V Health Zone, Benin, West Africa

The anarchic urbanization of certain African cities favors the multiplication of the malaria parasite. Thus, the urgent mobilization of African cities is essential to combat this health risk. It is, therefore, with the objective of contributing to the investigation of problem areas that the present study evaluates malaria transmission and vector control strategies in the Cotonou V health zone in particular. This is a cross-sectional study taking into account four neighborhoods, including Wologuèdè, Sainte Rita, Gbèdjromèdé and the area around Etoile Rouge. Two nocturnal captures on voluntary humans and the method of spray were carried out in the dry season from December 2021 to February 2022. On the captured Anopheles, the ELISA Circum-Sporozoite Protein test was performed to determine the infectivity and calculate some transmission parameters. Finally, we conducted a survey using the second stage sampling method with one step to ask selected households about their knowledge of vector control methods, their use and the physical integrity of LLINs. We collected 2386 culicidae of which the majority was Culex quinquefasciatus. After the ELISA test, the 29 Anopheles tested, showed no infectivity, i.e. an EIR of 0 pi/h/n. In addition, 99% of the populations in the Cotonou V area use LLINs to protect themselves. However, coils, door and window screens, aerosol sprays, skin and household repellents, and periodic indoor spraying were used. Finally, the majority of nets observed had T1 tears, but there were also T2, T3 and T4 nets (P-value = 0.0). This study confirms that malaria transmission during the dry season in the Cotonou V health zone is almost negligible but not non-existent. Also, populations are exposed to the nuisance of Culex quinquefasciatus mosquitoes continuously throughout the year.

Sustaining the gains made in malaria control and elimination

Significant progress has been made in the last 25 years to reduce the malaria burden,but considerable challenges remain.These gains have resulted from large investments in a range of control measures targeting malaria.Fana and co-authors find a strong relationship between education level and net usage with malaria parasitemia in pregnant women,suggesting the need for targeted control strategies.Mayala and co-workers find important links between agriculture and malaria with implications for inter-sectoral collaboration for malaria control.

Lessons on malaria control in the ethnic minority regions in Northern Myanmar along the China border, 2007–2014

Background:For many countries where malaria is endemic,the burden of malaria is high in border regions.In ethnic minority areas along the Myanmar-China border,residents have poor access to medical care for diagnosis and treatment,and there have been many malaria outbreaks in such areas.Since 2007,with the support of the Global Fund to Fight AIDS,Tuberculosis and Malaria(GFATM),a malaria control project was introduced to reduce the malaria burden in several ethnic minority regions.Methods:A malaria control network was established during the period from 2007 to 2014.Multiple malaria interventions,including diagnosis,treatment,distribution of LLINs and health education,were conducted to improve the accessibility and quality of malaria control services for local residents.Annual cross-sectional surveys were conducted to evaluate intervention coverage and indicators of malaria transmission.Results:In ethnic minority regions where a malaria control network was established,both the annual malaria incidence(19.1 per thousand per year,in 2009;8.7,in 2014)and malaria prevalence(13.6%in 2008;0.43%in 2014)decreased dramatically during the past 5–6 years.A total of 851393 febrile patients were detected,202598 malaria cases(including confirmed cases and suspected cases)were treated,and 759574 LLINs were delivered to populations at risk.Of households in 2012,73.9%had at least one ITNs/LLINs(vs.28.3%,in 2008),and 50.7%of children less than 5 years and 50.3%of pregnant women slept under LLINs the night prior to their visit.Additionally,malaria knowledge was improved in 68.4%of residents.Conclusion:There has been great success in improving malaria control in these regions from 2007 to 2014.Malaria burdens have decreased,especially in KOK and WA.The continued maintenance of sustainable malaria control networks in these regions may be a long-term process,due to regional conflicts and the lack of funds,technology,and health workers.Furthermore,information and scientific support from the international community should be offered to these ethnic minority regions to uphold recent achievements.

A Mathematical Modelling of the Effect of Treatment in the Control of Malaria in a Population with Infected Immigrants

In this work, we developed a compartmental bio-mathematical model to study the effect of treatment in the control of malaria in a population with infected immigrants. In particular, the vector-host population model consists of eleven variables, for which graphical profiles were provided to depict their individual variations with time. This was possible with the help of MathCAD software which implements the Runge-Kutta numerical algorithm to solve numerically the eleven differential equations representing the vector-host malaria population model. We computed the basic reproduction ratio R0 following the next generation matrix. This procedure converts a system of ordinary differential equations of a model of infectious disease dynamics to an operator that translates from one generation of infectious individuals to the next. We obtained R0 = , i.e., the square root of the product of the basic reproduction ratios for the mosquito and human populations respectively. R0m explains the number of humans that one mosquito can infect through contact during the life time it survives as infectious. R0h on the other hand describes the number of mosquitoes that are infected through contacts with the infectious human during infectious period. Sensitivity analysis was performed for the parameters of the model to help us know which parameters in particular have high impact on the disease transmission, in other words on the basic reproduction ratio R0.

From control to eradication of malaria:the end of being stuck in second gear?

More than 2 billion people are at risk of malaria,which primarily affects poor populations in tropical and subtropical areas,including Southern Asia.As malaria incidence has been reduced strongly in some parts of endemic regions by combinations of interventions,including artemisinin-based therapies and insecticide-treated bed nets,a new goal has been established recently by charity foundations which support research on malaria:the worldwide eradication of the pathology.Doing away with control approaches which have been applied for the last 50 years and more focus on elimination objectives will deeply change priorities in the area of malaria treatment,chemoprevention,vector control,vaccine research and health system assessment.In this review,actual knowledge on pathogenesis and pharmacology is discussed,and new drugs, vaccines and insecticides are described.

Evaluation of the Anti-Salivary IgG Response Specific to Anopheles Vectors of Malaria in Children under Five Seen in Health Care Settings in Areas of Low and High Insecticide Resistance in Southern Benin

The widespread use of long-lasting insecticidal nets (LLINs) is a major intervention method for malaria control. While coverage of LLINs has increased, there is a need for information on the operational effectiveness of nets deployed in the field in the context of malaria vector resistance to insecticides used for impregnation. The development of specific anti-malarial biomarkers to assess exposure to mosquito bites is an important development in evaluations. The aim of this study was to characterize the human IgG antibody response to Anopheles gSG6-P1 saliva, a salivary peptide antigen previously shown to be a relevant biomarker of human exposure to Anopheles bites, in order to assess the LLINs under field conditions in areas of low and high vector resistance to insecticides. We analyzed data from 240 randomly selected children ( 0.05). Furthermore, the same finding was observed for antibody expression in children whether or not they used LLINs on the day before the survey (p = 0.7724). Similarly, gender and especially age, major factors of variation in the adaptive immune response, did not have a significant effect on IgG expression.

美国对非双边抗疟卫生发展援助策略研究及启示

目的:分析美国对非双边抗疟卫生发展援助的主要特点,为中国抗疟援助策略制定提供建议。方法:使用政策文献分析与描述性统计分析,总结美国抗疟援助机制总统疟疾防控计划(President s Malaria Initiative,PMI)的资金投入、方案设计、监督评估三方面特点。结果:到2022财年,PMI为24个非洲国家提供资金86.21亿美元。其援助行动遵循“预防—病例管理—监测—行为干预—卫生系统能力建设”框架,80%以上资金用于预防和病例管理,近年来监测和卫生系统能力建设也得到更多支持。项目监督评估包括绩效管理和实施性研究。结论与建议:PMI援助特点包括:政治承诺强,资源投入力度大;方案顺应国际指南并融合自身优势;重视结果导向评估与研究。未来中国应加大资源投入,落实既有承诺,结合国际指南与本土经验制定援助规划,并落实项目监督评估。

西南地区疟疾联防机制与边疆健康共同体塑造研究——以1950年后云南疟疾防治为例

中国疟疾防治的政策和制度建设,以及所取得的良好成效,与云南的联防机制及严密的边疆疟疾监管体系有密切关系。1950—1979年间建立起了初步的疟疾防治政策,1980—2000年间疟防制度化建设取得了重大进展,21世纪后国内专项疟疾防治研究项目及其制度推广取得明显成效。在疾病防治体系塑造中,云南疟疾防控的内外能力得到增强,疟疾防治研究机构的建立是疾病防治体系塑造的基础,在疾病防治体系的塑造中彰显其内控能力增强的内显性效应,疟疾控制的国际化实践暨境内向境外防治的格局彰显了其严防疟疾源头的外显性效应。但在新的国际局势及环境危机背景下,疾控能力的提升也遇到了新危机,因势优化的新型防治策略,成为新疾控防治体系建设及人类卫生健康共同体目标实现的当务之急。

Eradication of malaria through genetic engineering:the current situation

Malaria is an intra-cellular parasitic protozoon responsible for millions of deaths annually.Host and parasite genetic factors are crucial in affecting susceptibility to malaria and progression of the disease.Recent increased deployment of vector controls and new artemisinin combination therapies have dramatically reduced the mortality and morbidity of malaria worldwide.However, the gradual emergence of parasite and mosquito resistance has raised alarm regarding the effectiveness of current artemisinin-based therapies.In this review,mechanisms of anti-malarial drug resistance in the Plasmodium parasite and new genetically engineered tools of research priorities are discussed.The complexity of the parasite lifecycle demands novel interventions to achieve global eradication.However,turning laboratory discovered transgenic interventions into functional products entails multiple experimental phases in addition to ethical and safety hurdles.Uncertainty over the regulatory status and public acceptance further discourage the implementation of genetically modified organisms.

Larvicidal and repellent potential of Moringa oleifera against malarial vector,Anopheles stephensi Liston(Insecta:Diptera:Culicidae)

Objective:To evaluate the larvicidal and pupicidal potential of the methanolic extracts from Moringa oleifera(M.oleifera) plant seeds against malarial vector Anopheles stephensi(A.stephensi) mosquitoes at different concentrations(20,40,60,80 and 100 ppm).Methods:M.oleifera was collected from the area of around Bharathiar University,Coimbatore.The dried plant materials were powdered by an electrical blender.From each sample,100 g of the plant material were extracted with 300 mL of methanol for 8 h in a Soxhlet apparatus.The extracts were evaporated to dryness in rotary vacuum evaporator to yield 122 mg and 110 mg of dark greenish material(residue) from Arcang amara and Ocimum basilicum,respectively.One gram of the each plant residue was dissolved separately in 100 mL of acetone(stock solution) from which different concentrations, i.e.,20,40,60,80 and 100 ppm were prepared.Results:Larvicidal activity of M.oleifera exhibited in the first to fourth instar larvae of the A.stephensi,and the LC_(50) and LC_(90) values were 57.79 ppm and 125.93 ppm for the first instar,63.90 ppm and 133.07 ppm for the second inslar,72.45 ppm and 139.82 ppm for the third instar,78.93 ppm and 143.20 ppm for the fourth instar,respectively. During the pupal stage the methanolic extract of M.oleifera showed that the LC_(50),and LC_(90) values were 67.77 ppm and 141.00 ppm,respectively.Conclusions:The present study indicates that the phytochemicals derived from M.oleifera seeds extracts are effective mosquito vector control agents and the plant extracts may be used for further integrated pest management programs.

Malaria prevalence in north-eastern Nigeria:A cross-sectional study Houben CH^(1*),Fleischmann H^2,Gǜckel M^3

Objective:To assess the prevalence of malaria parasitemia in north-east Nigeria and to evaluate the measures for the prevention of malaria.Methods:A village in north-eastern Nigeria was selected for the cross sectional study at the height of the rainy season in October 2011.A total of 550 inhabitants of a hamlet were recruited for this study.After obtaining the consent individuals received a structured interview and were tested for malaria parasites in their blood films.Recruits testing positive for malaria were given a course of artemesinin-based combination therapy(ACT).Results:A total of 497 inhabitants representing approximately 90 percent of the population participated:a quarter of the study group carried malaria parasitesexclusively Plasmodium falciparum(P.falciparum)-representing a P.falciparum parasite rate(PfPR) of 24.5%.Besides,53/138 in the age group of 2 to < 10 years old children tested positive for P.falciparum representing a PfPR_(2-10) value of 38.4%.Malaria control measures were used in just under a third(157/497) of this cohort.Despite these measures 28/157(17.8%) still tested positive for P.falciparum.Conclusions:The malaria burden is overestimated for this region in north-east Nigeria.The findings support an intermediate pattern of malaria endemicity.The 30%bed nets coverage for malaria control is well below the WHO estimates for 2011.

Mathematical Modelling of Sterile Insect Technology for Mosquito Control

Reduction of mosquito populations will, at least, reduce substantially the transmission of malaria disease. One potential method of achieving this reduction is the environmentally-friendly population control method known as the Sterile Insect Control (SIT) method. The SIT method has so far not been widely used against insect disease vectors, such as mosquitoes, because of various practical difficulties in rearing, sterilization and distribution of the parasite population. For mosquitoes, male-only release is considered essential since sterile females will bite and so may transmit disease, whereas male mosquitoes do not bite. This work concerns the mathematical modelling of the effectiveness of Sterile Insect Technique for Aedes aegypti mosquitoes, when the female sexual preference is incorporated. We found that for a released value of the sterile male mosquito below 40,000, the wild mosquito population decreases over time while the sterile male mosquito population increases. Therefore, the transmission of malaria and dengue infection declines because the sterile male mosquitoes dominated the environment. We also found that for a released value of the sterile male mosquito above 40,000, the wild mosquito population decreases and the sterile male mosquito population decreases as well. Therefore, if the injection of sterile male mosquitoes is large enough, the environment will be rid of mosquitoes over time. The result also shows that if sexual selection is incorporated into a reaction diffusion system, modelling the spread of Aedes aegypti mosquitoes, the Sterile Insect Technique (SIT) will still be a successful control measure.

Malaria Hyperendemicity: The Burden and Obstacles to Eradication in Nigeria

Malaria deaths and cases have been common among people living in tropical climatic countries like Nigeria, Ghana, Uganda, Tanzania, Mali, etc. Malaria is one of the leading causes of deaths in Nigeria and every person in Nigeria experiences at least three episodes of malaria sickness every year. Many efforts in the past to reduce malaria incidence and burden to patients have not proven successful as resistant strains of mosquitos emerge. Malaria incidence in Nigeria has risen to a hyper-endemic level over some decades whereas countries like Algeria, Morocco and Argentina etc. have controlled and eradicated malaria by following international intervention programs by the World Health Organization and similar agencies. Malaria is of public health concern in Nigeria. Through a review of literature and lived experiences, the author identified and discussed the political and biosocial contexts: ecological, economic, communication, and infrastructural conditions that pose challenge to eradication programs. Recommendations were made to set up surveillance and monitoring system, restructuring the funding and management system, improving community partnership, and promoting health education.

Astrodaucus persicus as a new source of bioinsectisides against malaria vector, Anopheles stephensi

Objective: To determine the larvicidal activities of petroleum ether, chloroform, ethyl acetate and methanol fractions of roots and fruits extracts of Astrodaucus persicus from Apiaceae family against malaria vector, Anopheles stephensi(An. stephensi).Methods: Twenty five third instar larvae of An. stephensi were exposed to various concentrations(10–160 g/L) of fractions and were assayed according to World Health Organization protocol. The larval mortality was calculated after 24 h treatment.Results: Among tested fractions, the highest larvicidal efficacy was observed from ethyl acetate fraction of fruits extract with 50% and 90% mortality values(LC_(50) and LC_(90)) of34.49 g/L and 108.61 g/L, respectively. Chloroform fraction of fruits extract was the second larvicidal sample with LC_(50) of 45.11 g/L and LC_(90) of 139.36 g/L. Petroleum ether fractions of fruits and roots and methanol fraction of fruits showed moderate toxicity against An. stephensi.Conclusions: Astrodaucus persicus is a potential source of valuable and natural larvicidal compounds against malaria vector, An. stephensi and can be used in mosquitoes control programs as an alternative to synthetic insecticides.

应用德尔菲法构建云南疟疾咨询服务站评价指标探索

目的应用德尔菲法构建云南省疟疾咨询服务站的评价指标,为云南消除疟疾后科学、可靠的评估服务站效能提供依据。方法于2016年6月—2018年8月设立研究组,经查阅文献,组内讨论,拟定服务站评价指标池,对22名从事疟疾防治的专家进行3轮问卷咨询,用统计学软件处理数据,得出评价指标。结果3轮问卷的有效回收率分别为100%(22/22)、90.9%(20/22)、81.8%(18/22);专家对指标的重要性赋值均数为5.20,权威程度均在0.70以上;专家意见的协调系数分别为0.619、0.600、0.763(P<0.001);最终共筛选出3个一级指标和4个二级指标。结论本研究筛选出的评价指标专家代表性强、权威程度高、专家意见集中、协调性好,如何科学、合理、有针对性地使用该评价指标,是保证服务站发挥其应有效能,为疟疾防控提供有效保障的关键。

2021年和2022年铜陵市传疟媒介监测分析

目的了解铜陵市传疟媒介种群分布、密度、季节消长及夜间活动等规律,为防治工作提供科学依据。方法2021年和2022年5—10月,采用诱蚊灯全通宵诱蚊法和室外全通宵双层叠帐人诱法开展传疟媒介按蚊监测。结果2021年和2022年铜陵市灯诱法捕获按蚊142只,人诱法捕获按蚊30只,经形态学鉴定均为中华按蚊。2021年、2022年按蚊密度分别为0.1597、0.1690只/(灯·h),鸡棚的按蚊密度两年均保持较高水平,中华按蚊密度高峰期出现在6—7月,中华按蚊夜间捕获高峰时段在4:00—5:00。结论铜陵市中华按蚊分布广泛,存在输入性疟疾传播的风险。