Science.gov

Sample records for ranking malaria risk

  1. Ranking Malaria Risk Factors to Guide Malaria Control Efforts in African Highlands

    PubMed Central

    Protopopoff, Natacha; Van Bortel, Wim; Speybroeck, Niko; Van Geertruyden, Jean-Pierre; Baza, Dismas; D'Alessandro, Umberto; Coosemans, Marc

    2009-01-01

    Introduction Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. Methods and Findings A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through “classification and regression trees”, an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. Conclusions In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors. PMID:19946627

  2. Risk ranking by perception

    SciTech Connect

    Osei, E.K.; Amoh, G.E.A.; Schandorf, C.

    1997-02-01

    The study of people`s perception and acceptability of risk is important in understanding the public reaction to technology and its environmental and health impact. The perception of risk depends on several factors, including early experiences, education, controllability of the risk, the type of consequence, and the type of person(s) who makes the judgment. This paper reviews some of the main factors influencing people`s perception and acceptability of risk. Knowledge about which factors influence the perception of risk may enhance the understanding of different points of view brought into risk controversies, improve risk communication, and facilitate policy making. Results from a risk ranking by perception survey Conducted in Ghana are also presented. 18 refs., 8 figs., 1 tab.

  3. Malaria Risk in Travelers

    PubMed Central

    Askling, Helena Hervius; Nilsson, Jenny; Tegnell, Anders; Janzon, Ragnhild

    2005-01-01

    Imported malaria has been an increasing problem in several Western countries in the last 2 decades. To calculate the risk factors of age, sex, and travel destination in Swedish travelers, we used data from the routine reporting system for malaria (mixture of patients with and without adequate prophylaxis), a database on travel patterns, and in-flight or visa data on Swedish travelers of 1997 to 2003. The crude risk for travelers varied from 1 per 100,000 travelers to Central America and the Caribbean to 357 per 100,000 in central Africa. Travelers to East Africa had the highest adjusted odds ratio (OR = 341; 95% confidence intervals [CI] 134–886) for being reported with malaria, closely followed by travelers to central Africa and West Africa. Male travelers as well as children <1–6 years of age had a higher risk of being reported with malaria (OR = 1,7; 95% CI 1.3–2.3 and OR = 4,8; 95%CI 1.5–14.8) than women and other age groups. PMID:15757560

  4. Ranking of elimination feasibility between malaria-endemic countries

    PubMed Central

    Tatem, Andrew J; Smith, David L; Gething, Peter W; Kabaria, Caroline W; Snow, Robert W; Hay, Simon I

    2010-01-01

    Summary Experience gained from the Global Malaria Eradication Program (1955–72) identified a set of shared technical and operational factors that enabled some countries to successfully eliminate malaria. Spatial data for these factors were assembled for all malaria-endemic countries and combined to provide an objective, relative ranking of countries by technical, operational, and combined elimination feasibility. The analysis was done separately for Plasmodium falciparum and Plasmodium vivax, and the limitations of the approach were discussed. The relative rankings suggested that malaria elimination would be most feasible in countries in the Americas and Asia, and least feasible in countries in central and west Africa. The results differed when feasibility was measured by technical or operational factors, highlighting the different types of challenge faced by each country. The results are not intended to be prescriptive, predictive, or to provide absolute assessments of feasibility, but they do show that spatial information is available to facilitate evidence-based assessments of the relative feasibility of malaria elimination by country that can be rapidly updated. PMID:21035838

  5. Travel risk, malaria importation and malaria transmission in Zanzibar

    PubMed Central

    Le Menach, Arnaud; Tatem, Andrew J.; Cohen, Justin M.; Hay, Simon I.; Randell, Heather; Patil, Anand P.; Smith, David L.

    2011-01-01

    The prevalence of Plasmodium falciparum malaria in Zanzibar has reached historic lows. Improving control requires quantifying malaria importation rates, identifying high-risk travelers, and assessing onwards transmission. Estimates of Zanzibar's importation rate were calculated through two independent methodologies. First, mobile phone usage data and ferry traffic between Zanzibar and mainland Tanzania were re-analyzed using a model of heterogeneous travel risk. Second, a dynamic mathematical model of importation and transmission rates was used. Zanzibar residents traveling to malaria endemic regions were estimated to contribute 1–15 times more imported cases than infected visitors. The malaria importation rate was estimated to be 1.6 incoming infections per 1,000 inhabitants per year. Local transmission was estimated too low to sustain transmission in most places. Malaria infections in Zanzibar largely result from imported malaria and subsequent transmission. Plasmodium falciparum malaria elimination appears feasible by implementing control measures based on detecting imported malaria cases and controlling onward transmission. PMID:22355611

  6. Augmenting the Deliberative Method for Ranking Risks.

    PubMed

    Susel, Irving; Lasley, Trace; Montezemolo, Mark; Piper, Joel

    2016-01-01

    The Department of Homeland Security (DHS) characterized and prioritized the physical cross-border threats and hazards to the nation stemming from terrorism, market-driven illicit flows of people and goods (illegal immigration, narcotics, funds, counterfeits, and weaponry), and other nonmarket concerns (movement of diseases, pests, and invasive species). These threats and hazards pose a wide diversity of consequences with very different combinations of magnitudes and likelihoods, making it very challenging to prioritize them. This article presents the approach that was used at DHS to arrive at a consensus regarding the threats and hazards that stand out from the rest based on the overall risk they pose. Due to time constraints for the decision analysis, it was not feasible to apply multiattribute methodologies like multiattribute utility theory or the analytic hierarchy process. Using a holistic approach was considered, such as the deliberative method for ranking risks first published in this journal. However, an ordinal ranking alone does not indicate relative or absolute magnitude differences among the risks. Therefore, the use of the deliberative method for ranking risks is not sufficient for deciding whether there is a material difference between the top-ranked and bottom-ranked risks, let alone deciding what the stand-out risks are. To address this limitation of ordinal rankings, the deliberative method for ranking risks was augmented by adding an additional step to transform the ordinal ranking into a ratio scale ranking. This additional step enabled the selection of stand-out risks to help prioritize further analysis.

  7. Augmenting the Deliberative Method for Ranking Risks.

    PubMed

    Susel, Irving; Lasley, Trace; Montezemolo, Mark; Piper, Joel

    2016-01-01

    The Department of Homeland Security (DHS) characterized and prioritized the physical cross-border threats and hazards to the nation stemming from terrorism, market-driven illicit flows of people and goods (illegal immigration, narcotics, funds, counterfeits, and weaponry), and other nonmarket concerns (movement of diseases, pests, and invasive species). These threats and hazards pose a wide diversity of consequences with very different combinations of magnitudes and likelihoods, making it very challenging to prioritize them. This article presents the approach that was used at DHS to arrive at a consensus regarding the threats and hazards that stand out from the rest based on the overall risk they pose. Due to time constraints for the decision analysis, it was not feasible to apply multiattribute methodologies like multiattribute utility theory or the analytic hierarchy process. Using a holistic approach was considered, such as the deliberative method for ranking risks first published in this journal. However, an ordinal ranking alone does not indicate relative or absolute magnitude differences among the risks. Therefore, the use of the deliberative method for ranking risks is not sufficient for deciding whether there is a material difference between the top-ranked and bottom-ranked risks, let alone deciding what the stand-out risks are. To address this limitation of ordinal rankings, the deliberative method for ranking risks was augmented by adding an additional step to transform the ordinal ranking into a ratio scale ranking. This additional step enabled the selection of stand-out risks to help prioritize further analysis. PMID:26224206

  8. Malaria at Christmas: risks of prophylaxis versus risks of malaria.

    PubMed

    Reid, A J; Whitty, C J; Ayles, H M; Jennings, R M; Bovill, B A; Felton, J M; Behrens, R H; Bryceson, A D; Mabey, D C

    1998-11-28

    A large increase in the number of falciparum malaria cases imported into the UK was reported to the malaria reference laboratory in the first quarter of 1998. Contributory factors were unusually heavy rains in east Africa and a reduction in the use of the most effective antimalarial drug, mefloquine. There was also an increase in the number of cases of severe malaria in the UK. During December 1997 and January 1998, the Hospital for Tropical Diseases, London, treated 5 patients for severe malaria and gave advice on 20 more patients with malaria who had been admitted to intensive care units throughout England. 4 of the severe cases treated at the hospital are reported. In 3 of those 4 cases, incorrect, misleading, or inadequate advice was given by health care professionals. Media coverage of the adverse effects of antimalarial drugs has contributed to confusion about prophylactic regimens among both health care professionals and the public. The incidence of falciparum malaria among travellers who do not take prophylactic drugs is about 0.6% in east Africa and 3.5% in west Africa over a 2-week travel period. Travellers need to take measures to avoid being bitten by mosquitoes and should be taught to promptly seek medical help if they develop a fever while abroad or after they return. Moreover, using any one of the recommended prophylactic regimens is better than not using a potent regimen or no prophylaxis at all. Mefloquine is 90% protective against malaria in sub-Saharan Africa. While the efficacy of proguanil and chloroquine in 1987 was about 70% in west Africa and 50% in east Africa, those levels are now probably lower. The side effects of antimalarial drugs are discussed.

  9. A scale for ranking volcanoes by risk

    NASA Astrophysics Data System (ADS)

    Scandone, Roberto; Bartolini, Stefania; Martí, Joan

    2016-01-01

    We propose a simple volcanic risk coefficient (VRC) useful for comparing the degree of risk arising from different volcanoes, which may be used by civil protection agencies and volcano observatories to rapidly allocate limited resources even without a detailed knowledge of each volcano. Volcanic risk coefficient is given by the sum of the volcanic explosivity index (VEI) of the maximum expected eruption from the volcano, the logarithm of the eruption rate, and the logarithm of the population that may be affected by the maximum expected eruption. We show how to apply the method to rank the risk using as examples the volcanoes of Italy and in the Canary Islands. Moreover, we demonstrate that the maximum theoretical volcanic risk coefficient is 17 and pertains to the large caldera-forming volcanoes like Toba or Yellowstone that may affect the life of the entire planet. We develop also a simple plugin for a dedicated Quantum Geographic Information System (QGIS) software to graphically display the VRC of different volcanoes in a region.

  10. GIS and Remote Sensing for Malaria Risk Mapping, Ethiopia

    NASA Astrophysics Data System (ADS)

    Ahmed, A.

    2014-11-01

    Integrating malaria data into a decision support system (DSS) using Geographic Information System (GIS) and remote sensing tool can provide timely information and decision makers get prepared to make better and faster decisions which can reduce the damage and minimize the loss caused. This paper attempted to asses and produce maps of malaria prone areas including the most important natural factors. The input data were based on the geospatial factors including climatic, social and Topographic aspects from secondary data. The objective of study is to prepare malaria hazard, Vulnerability, and element at risk map which give the final output, malaria risk map. The malaria hazard analyses were computed using multi criteria evaluation (MCE) using environmental factors such as topographic factors (elevation, slope and flow distance to stream), land use/ land cover and Breeding site were developed and weighted, then weighted overlay technique were computed in ArcGIS software to generate malaria hazard map. The resulting malaria hazard map depicts that 19.2 %, 30.8 %, 25.1 %, 16.6 % and 8.3 % of the District were subjected to very high, high, moderate, low and very low malaria hazard areas respectively. For vulnerability analysis, health station location and speed constant in Spatial Analyst module were used to generate factor maps. For element at risk, land use land cover map were used to generate element at risk map. Finally malaria risk map of the District was generated. Land use land cover map which is the element at risk in the District, the vulnerability map and the hazard map were overlaid. The final output based on this approach is a malaria risk map, which is classified into 5 classes which is Very High-risk area, High-risk area, Moderate risk area, Low risk area and Very low risk area. The risk map produced from the overlay analysis showed that 20.5 %, 11.6 %, 23.8 %, 34.1 % and 26.4 % of the District were subjected to very high, high, moderate, low and very low

  11. Towards malaria risk prediction in Afghanistan using remote sensing

    PubMed Central

    2010-01-01

    Background Malaria is a significant public health concern in Afghanistan. Currently, approximately 60% of the population, or nearly 14 million people, live in a malaria-endemic area. Afghanistan's diverse landscape and terrain contributes to the heterogeneous malaria prevalence across the country. Understanding the role of environmental variables on malaria transmission can further the effort for malaria control programme. Methods Provincial malaria epidemiological data (2004-2007) collected by the health posts in 23 provinces were used in conjunction with space-borne observations from NASA satellites. Specifically, the environmental variables, including precipitation, temperature and vegetation index measured by the Tropical Rainfall Measuring Mission and the Moderate Resolution Imaging Spectoradiometer, were used. Regression techniques were employed to model malaria cases as a function of environmental predictors. The resulting model was used for predicting malaria risks in Afghanistan. The entire time series except the last 6 months is used for training, and the last 6-month data is used for prediction and validation. Results Vegetation index, in general, is the strongest predictor, reflecting the fact that irrigation is the main factor that promotes malaria transmission in Afghanistan. Surface temperature is the second strongest predictor. Precipitation is not shown as a significant predictor, as it may not directly lead to higher larval population. Autoregressiveness of the malaria epidemiological data is apparent from the analysis. The malaria time series are modelled well, with provincial average R2 of 0.845. Although the R2 for prediction has larger variation, the total 6-month cases prediction is only 8.9% higher than the actual cases. Conclusions The provincial monthly malaria cases can be modelled and predicted using satellite-measured environmental parameters with reasonable accuracy. The Third Strategic Approach of the WHO EMRO Malaria Control and

  12. Air pollution ranks as largest health risk

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-04-01

    The World Health Organization (WHO) reports that 7 million people died in 2012 from air-pollution-related sicknesses, marking air pollution as the single largest environmental health risk. This finding, a result of better knowledge and assessment of the diseases, is more than double previous estimates of the risk of death from air pollution.

  13. Understanding the link between malaria risk and climate.

    PubMed

    Paaijmans, Krijn P; Read, Andrew F; Thomas, Matthew B

    2009-08-18

    The incubation period for malaria parasites within the mosquito is exquisitely temperature-sensitive, so that temperature is a major determinant of malaria risk. Epidemiological models are increasingly used to guide allocation of disease control resources and to assess the likely impact of climate change on global malaria burdens. Temperature-based malaria transmission is generally incorporated into these models using mean monthly temperatures, yet temperatures fluctuate throughout the diurnal cycle. Here we use a thermodynamic malaria development model to demonstrate that temperature fluctuation can substantially alter the incubation period of the parasite, and hence malaria transmission rates. We find that, in general, temperature fluctuation reduces the impact of increases in mean temperature. Diurnal temperature fluctuation around means >21 degrees C slows parasite development compared with constant temperatures, whereas fluctuation around <21 degrees C speeds development. Consequently, models which ignore diurnal variation overestimate malaria risk in warmer environments and underestimate risk in cooler environments. To illustrate the implications further, we explore the influence of diurnal temperature fluctuation on malaria transmission at a site in the Kenyan Highlands. Based on local meteorological data, we find that the annual epidemics of malaria at this site cannot be explained without invoking the influence of diurnal temperature fluctuation. Moreover, while temperature fluctuation reduces the relative influence of a subtle warming trend apparent over the last 20 years, it nonetheless makes the effects biologically more significant. Such effects of short-term temperature fluctuations have not previously been considered but are central to understanding current malaria transmission and the consequences of climate change.

  14. Potential impact of global climate change on malaria risk

    SciTech Connect

    Martens, W.J.M.; Rotmans, J. |; Niessen, L.W.; Jetten, T.H.; McMichael, A.J.

    1995-05-01

    The biological activity and geographic distribution of the malarial parasite and its vector are sensitive to climatic influences, especially temperature and precipitation. We have incorporated General Circulation Model-based scenarios of anthropogenic global climate change in an integrated linked-system model for predicting changes in malaria epidemic potential in the next century. The concept of the disability-adjusted life years is included to arrive at a single measure of the effect of anthropogenic climate change on the health impact of malaria. Assessment of the potential impact of global climate change on the incidence of malaria suggests a widespread increase of risk due to expansion of the areas suitable for malaria transmission. This predicted increase is most pronounced at the borders of endemic malaria areas and at higher altitudes within malarial areas. The incidence of infection is sensitive to climate changes in areas of Southeast Asia, South America, and parts of Africa where the disease is less endemic; in these regions the numbers of years of healthy life lost may increase significantly. However, the simulated changes in malaria risk must be interpreted on the basis of local environmental conditions, the effects of socioeconomic developments, and malaria control programs or capabilities. 33 refs., 5 figs., 1 tab.

  15. DebtRank-transparency: Controlling systemic risk in financial networks

    PubMed Central

    Thurner, Stefan; Poledna, Sebastian

    2013-01-01

    Nodes in a financial network, such as banks, cannot assess the true risks associated with lending to other nodes in the network, unless they have full information on the riskiness of all other nodes. These risks can be estimated by using network metrics (as DebtRank) of the interbank liability network. With a simple agent based model we show that systemic risk in financial networks can be drastically reduced by increasing transparency, i.e. making the DebtRank of individual banks visible to others, and by imposing a rule, that reduces interbank borrowing from systemically risky nodes. This scheme does not reduce the efficiency of the financial network, but fosters a more homogeneous risk-distribution within the system in a self-organized critical way. The reduction of systemic risk is due to a massive reduction of cascading failures in the transparent system. A regulation-policy implementation of the proposed scheme is discussed. PMID:23712454

  16. DebtRank-transparency: controlling systemic risk in financial networks.

    PubMed

    Thurner, Stefan; Poledna, Sebastian

    2013-01-01

    Nodes in a financial network, such as banks, cannot assess the true risks associated with lending to other nodes in the network, unless they have full information on the riskiness of all other nodes. These risks can be estimated by using network metrics (as DebtRank) of the interbank liability network. With a simple agent based model we show that systemic risk in financial networks can be drastically reduced by increasing transparency, i.e. making the DebtRank of individual banks visible to others, and by imposing a rule, that reduces interbank borrowing from systemically risky nodes. This scheme does not reduce the efficiency of the financial network, but fosters a more homogeneous risk-distribution within the system in a self-organized critical way. The reduction of systemic risk is due to a massive reduction of cascading failures in the transparent system. A regulation-policy implementation of the proposed scheme is discussed.

  17. DebtRank-transparency: Controlling systemic risk in financial networks

    NASA Astrophysics Data System (ADS)

    Thurner, Stefan; Poledna, Sebastian

    2013-05-01

    Nodes in a financial network, such as banks, cannot assess the true risks associated with lending to other nodes in the network, unless they have full information on the riskiness of all other nodes. These risks can be estimated by using network metrics (as DebtRank) of the interbank liability network. With a simple agent based model we show that systemic risk in financial networks can be drastically reduced by increasing transparency, i.e. making the DebtRank of individual banks visible to others, and by imposing a rule, that reduces interbank borrowing from systemically risky nodes. This scheme does not reduce the efficiency of the financial network, but fosters a more homogeneous risk-distribution within the system in a self-organized critical way. The reduction of systemic risk is due to a massive reduction of cascading failures in the transparent system. A regulation-policy implementation of the proposed scheme is discussed.

  18. Predicting Disease Risk Using Bootstrap Ranking and Classification Algorithms

    PubMed Central

    Manor, Ohad; Segal, Eran

    2013-01-01

    Genome-wide association studies (GWAS) are widely used to search for genetic loci that underlie human disease. Another goal is to predict disease risk for different individuals given their genetic sequence. Such predictions could either be used as a “black box” in order to promote changes in life-style and screening for early diagnosis, or as a model that can be studied to better understand the mechanism of the disease. Current methods for risk prediction typically rank single nucleotide polymorphisms (SNPs) by the p-value of their association with the disease, and use the top-associated SNPs as input to a classification algorithm. However, the predictive power of such methods is relatively poor. To improve the predictive power, we devised BootRank, which uses bootstrapping in order to obtain a robust prioritization of SNPs for use in predictive models. We show that BootRank improves the ability to predict disease risk of unseen individuals in the Wellcome Trust Case Control Consortium (WTCCC) data and results in a more robust set of SNPs and a larger number of enriched pathways being associated with the different diseases. Finally, we show that combining BootRank with seven different classification algorithms improves performance compared to previous studies that used the WTCCC data. Notably, diseases for which BootRank results in the largest improvements were recently shown to have more heritability than previously thought, likely due to contributions from variants with low minimum allele frequency (MAF), suggesting that BootRank can be beneficial in cases where SNPs affecting the disease are poorly tagged or have low MAF. Overall, our results show that improving disease risk prediction from genotypic information may be a tangible goal, with potential implications for personalized disease screening and treatment. PMID:23990773

  19. Assessing introduction risk using species' rank-abundance distributions.

    PubMed

    Chan, Farrah T; Bradie, Johanna; Briski, Elizabeta; Bailey, Sarah A; Simard, Nathalie; MacIsaac, Hugh J

    2015-01-22

    Mixed-species assemblages are often unintentionally introduced into new ecosystems. Analysing how assemblage structure varies during transport may provide insights into how introduction risk changes before propagules are released. Characterization of introduction risk is typically based on assessments of colonization pressure (CP, the number of species transported) and total propagule pressure (total PP, the total abundance of propagules released) associated with an invasion vector. Generally, invasion potential following introduction increases with greater CP or total PP. Here, we extend these assessments using rank-abundance distributions to examine how CP : total PP relationships change temporally in ballast water of ocean-going ships. Rank-abundance distributions and CP : total PP patterns varied widely between trans-Atlantic and trans-Pacific voyages, with the latter appearing to pose a much lower risk than the former. Responses also differed by taxonomic group, with invertebrates experiencing losses mainly in total PP, while diatoms and dinoflagellates sustained losses mainly in CP. In certain cases, open-ocean ballast water exchange appeared to increase introduction risk by uptake of new species or supplementation of existing ones. Our study demonstrates that rank-abundance distributions provide new insights into the utility of CP and PP in characterizing introduction risk. PMID:25473007

  20. Assessing introduction risk using species’ rank-abundance distributions

    PubMed Central

    Chan, Farrah T.; Bradie, Johanna; Briski, Elizabeta; Bailey, Sarah A.; Simard, Nathalie; MacIsaac, Hugh J.

    2015-01-01

    Mixed-species assemblages are often unintentionally introduced into new ecosystems. Analysing how assemblage structure varies during transport may provide insights into how introduction risk changes before propagules are released. Characterization of introduction risk is typically based on assessments of colonization pressure (CP, the number of species transported) and total propagule pressure (total PP, the total abundance of propagules released) associated with an invasion vector. Generally, invasion potential following introduction increases with greater CP or total PP. Here, we extend these assessments using rank-abundance distributions to examine how CP : total PP relationships change temporally in ballast water of ocean-going ships. Rank-abundance distributions and CP : total PP patterns varied widely between trans-Atlantic and trans-Pacific voyages, with the latter appearing to pose a much lower risk than the former. Responses also differed by taxonomic group, with invertebrates experiencing losses mainly in total PP, while diatoms and dinoflagellates sustained losses mainly in CP. In certain cases, open-ocean ballast water exchange appeared to increase introduction risk by uptake of new species or supplementation of existing ones. Our study demonstrates that rank-abundance distributions provide new insights into the utility of CP and PP in characterizing introduction risk. PMID:25473007

  1. Malaria Risk Mapping for Control in the Republic of Sudan

    PubMed Central

    Noor, Abdisalan M.; ElMardi, Khalid A.; Abdelgader, Tarig M.; Patil, Anand P.; Amine, Ahmed A. A.; Bakhiet, Sahar; Mukhtar, Maowia M.; Snow, Robert W.

    2012-01-01

    Evidence shows that malaria risk maps are rarely tailored to address national control program ambitions. Here, we generate a malaria risk map adapted for malaria control in Sudan. Community Plasmodium falciparum parasite rate (PfPR) data from 2000 to 2010 were assembled and were standardized to 2–10 years of age (PfPR2–10). Space-time Bayesian geostatistical methods were used to generate a map of malaria risk for 2010. Surfaces of aridity, urbanization, irrigation schemes, and refugee camps were combined with the PfPR2–10 map to tailor the epidemiological stratification for appropriate intervention design. In 2010, a majority of the geographical area of the Sudan had risk of < 1% PfPR2–10. Areas of meso- and hyperendemic risk were located in the south. About 80% of Sudan's population in 2011 was in the areas in the desert, urban centers, or where risk was < 1% PfPR2–10. Aggregated data suggest reducing risks in some high transmission areas since the 1960s. PMID:23033400

  2. Malaria

    MedlinePlus

    MENU Return to Web version Malaria Overview What is malaria? Malaria is an infection of a part of the blood called the red blood cells. It is ... by mosquitoes that carry a parasite that causes malaria. If a mosquito carrying this parasite bites you, ...

  3. 59 FR- Human Health and Environmental Risk Ranking; Notice of Availability of Proceedings Document from...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1994-08-30

    ... AGENCY Human Health and Environmental Risk Ranking; Notice of Availability of Proceedings Document from Relative Risk Ranking Conference AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Availability. SUMMARY: EPA is announcing the availability of a document entitled ``Proceedings...

  4. Risk factors associated with malaria infection in an urban setting.

    PubMed

    Mendez, F; Carrasquilla, G; Muñoz, A

    2000-01-01

    Incidence of malaria in urban settings is a growing concern in many regions of the world and individual risk factors need to be identified to appropriately adjust control strategies. We carried out a cross-sectional study in 1993/94 in an urban area of the largest port of the Pacific Coast of Colombia, where transmission has had an upward trend over the past 5 years. Prevalence of malaria infection was estimated in areas of the city with the highest incidence of disease, and the association between some characteristics of the population and the risk of malaria infection was assessed. Prevalence of malaria infection was 4.4% among the 1380 studied people and we found that it decreased with older age, and with knowledge of disease and preventive measures directed to elimination of breeding sites. In addition, the infection was positively associated with exposure to the forest (P < 0.05), although most of the cases (57/61, 93%) were likely to have been acquired in the urban area. We also found that individuals receiving antimalarial treatment in the previous month had around twice the risk of being infected as compared with those without treatment. In addition, our results suggest that use of bednets could not be a very effective protective measure in settings such as that of our study, and that environmental interventions may be needed to decrease the risk of infection.

  5. Malaria.

    ERIC Educational Resources Information Center

    Dupasquier, Isabelle

    1989-01-01

    Malaria, the greatest pandemia in the world, claims an estimated one million lives each year in Africa alone. While it may still be said that for the most part malaria is found in what is known as the world's poverty belt, cases are now frequently diagnosed in western countries. Due to resistant strains of malaria which have developed because of…

  6. Malaria.

    PubMed

    Garcia, Lynne S

    2010-03-01

    Malaria has had a greater impact on world history than any other infectious disease. More than 300 to 500 million individuals worldwide are infected with Plasmodium spp, and 1.5 to 2.7 million people a year, most of whom are children, die from the infection. Malaria is endemic in over 90 countries in which 2400 million people live; this represents 40% of the world's population. Approximately 90% of malaria deaths occur in Africa. Despite continuing efforts in vaccine development, malaria prevention is difficult, and no drug is universally effective. This article examines malaria caused by the 4 most common Plasmodium spp that infect humans, P vivax, P ovale, P malariae, and P falciparum, as well as mixed infections and the simian parasite P knowlesi. A comprehensive review of the microbiology, clinical presentation, pathogenesis, diagnosis, and treatment of these forms of malaria is given.

  7. [Malaria].

    PubMed

    Burchard, G D

    2014-02-01

    Malaria is the most important infectious disease imported by travelers and migrants from tropical and subtropical areas. It is imported quite frequently. It is a life-threatening disease. Symptoms are nonspecific and cannot easily be distinguished from a wide range of other febrile conditions. Therefore, travel history must be taken in all patients with fever of unknown origin and malaria diagnostics must be performed immediately on suspicion of malaria. Uncomplicated falciparum malaria should be treated in the hospital with either atovaquone-proguanil or with an artemisinin-based combination preparation. If there is evidence of severe malaria, the patient must be moved to an intensive care unit. The antiparasitic agent of choice is then artesunate.

  8. Risk Factors for Border Malaria in a Malaria Elimination Setting: A Retrospective Case-Control Study in Yunnan, China

    PubMed Central

    Xu, Jian-Wei; Liu, Hui; Zhang, Yu; Guo, Xiang-Rui; Wang, Jia-Zhi

    2015-01-01

    A retrospective case-control study was conducted to identify risk factors for border malaria in a malaria elimination setting of Yunnan Province, China. The study comprised 214 cases and 428 controls. The controls were individually matched to the cases on the basis of residence, age, and gender. In addition, statistical associations are based on matched analyses. The frequencies of imported, male, adult, and vivax malaria cases were respectively 201 (93.9%), 194 (90.7%), 210 (98.1%), and 176 (82.2%). Overnight stay in Myanmar within the prior month was independently associated with malaria infection (odds ratio [OR] 159.5, 95% confidence interval [CI] 75.1–338.9). In particular, stays in lowland and foothill (OR 5.5, 95% CI 2.5–11.8) or mid-hill (OR 42.8, 95% CI 5.1–319.8) areas, or near streamlets (OR 15.3, 95% CI 4.3–55.2) or paddy field or pools (OR10.1, 95% CI 4.4–55.8) were found to be independently associated with malaria. Neither forest exposure nor use of vector control measures was associated with malaria. In conclusion, travel to lowland and foothill or mid-hill hyperendemic areas, especially along the waterside in Myanmar, was found to be the highest risk factor for malaria. In considering the limitations of the study, further investigations are needed to identify the major determinants of malaria risk and develop new strategies for malaria elimination on China-Myanmar border. PMID:25601994

  9. Action plan to regain unnecessary deferred blood donors due to malaria risk in Turkey.

    PubMed

    Değirmenci, Aysu; Döşkaya, Mert; Caner, Ayşe; Nergis, Sebnem; Gül, Kadri; Aydınok, Yeşim; Ertop, Tufan; Aksoy, Nurten; Korkmaz, Metin; Alkan, Mehmet Ziya; Üner, Ahmet; Gürüz, Yüksel

    2012-06-01

    Malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The present study aimed for the first time, to investigate malaria in "donors deferred for malaria risk" and to determine the regional rates of malaria deferral in Turkey. Blood samples were collected from several Blood Banks of southeastern provinces where local malaria cases still exist and from Blood Bank of Ege University Medical School (EUMS) located in western Turkey where malaria is eradicated decades ago. Plasmodium spp. and specific antibodies were investigated by stained smears, antigen detection, PCR and ELISA. Among the donors deferred for malaria risk, Plasmodium spp. were not detected by microscopy, PCR or antigen detection. Seroprevalances were 2% and 3.92% in western and southeastern regions, respectively. Rate of donor deferral for malaria risk was 0.9% in EUMS and deferrals were exclusively because of travel to southeastern Turkey. In southeastern provinces, deferrals were mainly due to malaria like fever history. The present study first time assessed regional rates of donor deferral due to malaria risk in Turkey. Previously, malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The results of the study showed that 97% of the deferrals were unnecessary. In conclusion, to reduce unnecessary donor deferrals in Turkey, in addition to comprehensive questioning for malaria history, the usage of a malaria antibody screening method should be initiated prior to deferral decision.

  10. Quantified Risk Ranking Model for Condition-Based Risk and Reliability Centered Maintenance

    NASA Astrophysics Data System (ADS)

    Chattopadhyaya, Pradip Kumar; Basu, Sushil Kumar; Majumdar, Manik Chandra

    2016-03-01

    In the recent past, risk and reliability centered maintenance (RRCM) framework is introduced with a shift in the methodological focus from reliability and probabilities (expected values) to reliability, uncertainty and risk. In this paper authors explain a novel methodology for risk quantification and ranking the critical items for prioritizing the maintenance actions on the basis of condition-based risk and reliability centered maintenance (CBRRCM). The critical items are identified through criticality analysis of RPN values of items of a system and the maintenance significant precipitating factors (MSPF) of items are evaluated. The criticality of risk is assessed using three risk coefficients. The likelihood risk coefficient treats the probability as a fuzzy number. The abstract risk coefficient deduces risk influenced by uncertainty, sensitivity besides other factors. The third risk coefficient is called hazardous risk coefficient, which is due to anticipated hazards which may occur in the future and the risk is deduced from criteria of consequences on safety, environment, maintenance and economic risks with corresponding cost for consequences. The characteristic values of all the three risk coefficients are obtained with a particular test. With few more tests on the system, the values may change significantly within controlling range of each coefficient, hence `random number simulation' is resorted to obtain one distinctive value for each coefficient. The risk coefficients are statistically added to obtain final risk coefficient of each critical item and then the final rankings of critical items are estimated. The prioritization in ranking of critical items using the developed mathematical model for risk assessment shall be useful in optimization of financial losses and timing of maintenance actions.

  11. The incidence of malaria in travellers to South-East Asia: is local malaria transmission a useful risk indicator?

    PubMed Central

    2010-01-01

    Background The presence of ongoing local malaria transmission, identified though local surveillance and reported to regional WHO offices, by S-E Asian countries, forms the basis of national and international chemoprophylaxis recommendations in western countries. The study was designed to examine whether the strategy of using malaria transmission in a local population was an accurate estimate of the malaria threat faced by travellers and a correlate of malaria in returning travellers. Methods Malaria endemicity was described from distribution and intensity in the local populations of ten S-E Asian destination countries over the period 2003-2008 from regionally reported cases to WHO offices. Travel acquired malaria was collated from malaria surveillance reports from the USA and 12 European countries over the same period. The numbers of travellers visiting the destination countries was based on immigration and tourism statistics collected on entry of tourists to the destination countries. Results In the destination countries, mean malaria rates in endemic countries ranged between 0.01 in Korea to 4:1000 population per year in Lao PDR, with higher regional rates in a number of countries. Malaria cases imported into the 13 countries declined by 47% from 140 cases in 2003 to 66 in 2008. A total of 608 cases (27.3% Plasmodium falciparum (Pf)) were reported over the six years, the largest number acquired in Indonesia, Thailand and Korea. Four countries had an incidence > 1 case per 100,000 traveller visits; Burma (Myanmar), Indonesia, Cambodia and Laos (range 1 to 11.8-case per 100,000 visits). The remaining six countries rates were < 1 case per 100,000 visits. The number of visitors arriving from source countries increased by 60% from 8.5 Million to 13.6 million over the 6 years. Conclusion The intensity of malaria transmission particularly sub-national activity did not correlate with the risk of travellers acquiring malaria in the large numbers of arriving visitors. It

  12. Ranking ecological risks of multiple chemical stressors on amphibians.

    PubMed

    Fedorenkova, Anastasia; Vonk, J Arie; Lenders, H J Rob; Creemers, Raymond C M; Breure, Anton M; Hendriks, A Jan

    2012-06-01

    Populations of amphibians have been declining worldwide since the late 1960s. Despite global concern, no studies have quantitatively assessed the major causes of this decline. In the present study, species sensitivity distributions (SSDs) were developed to analyze the sensitivity of anurans for ammonium, nitrate, heavy metals (cadmium, copper), pesticides (18 compounds), and acidification (pH) based on laboratory toxicity data. Ecological risk (ER) was calculated as the probability that a measured environmental concentration of a particular stressor in habitats where anurans were observed would exceed the toxic effect concentrations derived from the species sensitivity distributions. The assessment of ER was used to rank the stressors according to their potential risk to anurans based on a case study of Dutch freshwater bodies. The derived ERs revealed that threats to populations of anurans decreased in the sequence of pH, copper, diazinon, ammonium, and endosulfan. Other stressors studied were of minor importance. The method of deriving ER by combining field observation data and laboratory data provides insight into potential threats to species in their habitats and can be used to prioritize stressors, which is necessary to achieve effective management in amphibian conservation.

  13. Risk-ranking IST components into two categories

    SciTech Connect

    Rowley, C.W.

    1996-12-01

    The ASME has utilized several schemes for identifying the appropriate scope of components for inservice testing (IST). The initial scope was ASME Code Class 1/2/3, with all components treated equally. Later the ASME Operations and Maintenance (O&M) Committee decided to use safe shutdown and accident mitigation as the scoping criteria, but continued to treat all components equal inside that scope. Recently the ASME O&M Committee decided to recognize service condition of the component, hence the comprehensive pump test. Although probabilistic risk assessments (PRAs) are incredibly complex plant models and computer hardware and software intensive, they are a tool that can be utilized by many plant engineering organizations to analyze plant system and component applications. In 1992 the ASME O&M Committee got interested in using the PRA as a tool to categorize its pumps and valves. In 1994 the ASME O&M Committee commissioned the ASME Center for Research and Technology Development (CRTD) to develop a process that adapted the PRA technology to IST. In late 1995 that process was presented to the ASME O&M Committee. The process had three distinct portions: (1) risk-rank the IST components; (2) develop a more effective testing strategy for More Safety Significant Components; and (3) develop a more economic testing strategy for Less Safety Significant Components.

  14. Malaria

    MedlinePlus

    ... Malaria can be carried by mosquitoes in temperate climates, but the parasite disappears over the winter. The ... a major disease hazard for travelers to warm climates. In some areas of the world, mosquitoes that ...

  15. Malaria

    MedlinePlus

    ... a parasite. You get it when an infected mosquito bites you. Malaria is a major cause of ... insect repellent with DEET Cover up Sleep under mosquito netting Centers for Disease Control and Prevention

  16. Measuring Socioeconomic Inequalities in Relation to Malaria Risk: A Comparison of Metrics in Rural Uganda.

    PubMed

    Tusting, Lucy S; Rek, John C; Arinaitwe, Emmanuel; Staedke, Sarah G; Kamya, Moses R; Bottomley, Christian; Johnston, Deborah; Lines, Jo; Dorsey, Grant; Lindsay, Steve W

    2016-03-01

    Socioeconomic position (SEP) is an important risk factor for malaria, but there is no consensus on how to measure SEP in malaria studies. We evaluated the relative strength of four indicators of SEP in predicting malaria risk in Nagongera, Uganda. A total of 318 children resident in 100 households were followed for 36 months to measure parasite prevalence routinely every 3 months and malaria incidence by passive case detection. Household SEP was determined using: 1) two wealth indices, 2) income, 3) occupation, and 4) education. Wealth Index I (reference) included only asset ownership variables. Wealth Index II additionally included food security and house construction variables, which may directly affect malaria. In multivariate analysis, only Wealth Index II and income were associated with the human biting rate, only Wealth Indices I and II were associated with parasite prevalence, and only caregiver's education was associated with malaria incidence. This is the first evaluation of metrics beyond wealth and consumption indices for measuring the association between SEP and malaria. The wealth index still predicted malaria risk after excluding variables directly associated with malaria, but the strength of association was lower. In this setting, wealth indices, income, and education were stronger predictors of socioeconomic differences in malaria risk than occupation. PMID:26811432

  17. Measuring Socioeconomic Inequalities in Relation to Malaria Risk: A Comparison of Metrics in Rural Uganda.

    PubMed

    Tusting, Lucy S; Rek, John C; Arinaitwe, Emmanuel; Staedke, Sarah G; Kamya, Moses R; Bottomley, Christian; Johnston, Deborah; Lines, Jo; Dorsey, Grant; Lindsay, Steve W

    2016-03-01

    Socioeconomic position (SEP) is an important risk factor for malaria, but there is no consensus on how to measure SEP in malaria studies. We evaluated the relative strength of four indicators of SEP in predicting malaria risk in Nagongera, Uganda. A total of 318 children resident in 100 households were followed for 36 months to measure parasite prevalence routinely every 3 months and malaria incidence by passive case detection. Household SEP was determined using: 1) two wealth indices, 2) income, 3) occupation, and 4) education. Wealth Index I (reference) included only asset ownership variables. Wealth Index II additionally included food security and house construction variables, which may directly affect malaria. In multivariate analysis, only Wealth Index II and income were associated with the human biting rate, only Wealth Indices I and II were associated with parasite prevalence, and only caregiver's education was associated with malaria incidence. This is the first evaluation of metrics beyond wealth and consumption indices for measuring the association between SEP and malaria. The wealth index still predicted malaria risk after excluding variables directly associated with malaria, but the strength of association was lower. In this setting, wealth indices, income, and education were stronger predictors of socioeconomic differences in malaria risk than occupation.

  18. Investigation of Host Candidate Malaria-Associated Risk/Protective SNPs in a Brazilian Amazonian Population

    PubMed Central

    da Silva Santos, Simone; Clark, Taane G.; Campino, Susana; Suarez-Mutis, Martha Cecília; Rockett, Kirk A.; Kwiatkowski, Dominic P.; Fernandes, Octavio

    2012-01-01

    The Brazilian Amazon is a hypo-endemic malaria region with nearly 300,000 cases each year. A variety of genetic polymorphisms, particularly in erythrocyte receptors and immune response related genes, have been described to be associated with susceptibility and resistance to malaria. In order to identify polymorphisms that might be associated with malaria clinical outcomes in a Brazilian Amazonian population, sixty-four human single nucleotide polymorphisms in 37 genes were analyzed using a Sequenom massARRAY iPLEX platform. A total of 648 individuals from two malaria endemic areas were studied, including 535 malaria cases (113 individuals with clinical mild malaria, 122 individuals with asymptomatic infection and 300 individuals with history of previous mild malaria) and 113 health controls with no history of malaria. The data revealed significant associations (p<0.003) between one SNP in the IL10 gene (rs1800896) and one SNP in the TLR4 gene (rs4986790) with reduced risk for clinical malaria, one SNP in the IRF1 gene (rs2706384) with increased risk for clinical malaria, one SNP in the LTA gene (rs909253) with protection from clinical malaria and one SNP in the TNF gene (RS1800750) associated with susceptibility to clinical malaria. Also, a new association was found between a SNP in the CTL4 gene (rs2242665), located at the major histocompatibility complex III region, and reduced risk for clinical malaria. This study represents the first association study from an Amazonian population involving a large number of host genetic polymorphisms with susceptibility or resistance to Plasmodium infection and malaria outcomes. Further studies should include a larger number of individuals, refined parameters and a fine-scale map obtained through DNA sequencing to increase the knowledge of the Amazonian population genetic diversity. PMID:22615793

  19. Estimating Geographical Variation in the Risk of Zoonotic Plasmodium knowlesi Infection in Countries Eliminating Malaria

    PubMed Central

    Shearer, Freya M.; Huang, Zhi; Weiss, Daniel J.; Wiebe, Antoinette; Gibson, Harry S.; Battle, Katherine E.; Pigott, David M.; Brady, Oliver J.; Putaporntip, Chaturong; Jongwutiwes, Somchai; Lau, Yee Ling; Manske, Magnus; Amato, Roberto; Elyazar, Iqbal R. F.; Vythilingam, Indra; Bhatt, Samir; Gething, Peter W.; Singh, Balbir; Golding, Nick; Hay, Simon I.

    2016-01-01

    Background Infection by the simian malaria parasite, Plasmodium knowlesi, can lead to severe and fatal disease in humans, and is the most common cause of malaria in parts of Malaysia. Despite being a serious public health concern, the geographical distribution of P. knowlesi malaria risk is poorly understood because the parasite is often misidentified as one of the human malarias. Human cases have been confirmed in at least nine Southeast Asian countries, many of which are making progress towards eliminating the human malarias. Understanding the geographical distribution of P. knowlesi is important for identifying areas where malaria transmission will continue after the human malarias have been eliminated. Methodology/Principal Findings A total of 439 records of P. knowlesi infections in humans, macaque reservoir and vector species were collated. To predict spatial variation in disease risk, a model was fitted using records from countries where the infection data coverage is high. Predictions were then made throughout Southeast Asia, including regions where infection data are sparse. The resulting map predicts areas of high risk for P. knowlesi infection in a number of countries that are forecast to be malaria-free by 2025 (Malaysia, Cambodia, Thailand and Vietnam) as well as countries projected to be eliminating malaria (Myanmar, Laos, Indonesia and the Philippines). Conclusions/Significance We have produced the first map of P. knowlesi malaria risk, at a fine-scale resolution, to identify priority areas for surveillance based on regions with sparse data and high estimated risk. Our map provides an initial evidence base to better understand the spatial distribution of this disease and its potential wider contribution to malaria incidence. Considering malaria elimination goals, areas for prioritised surveillance are identified. PMID:27494405

  20. Highly Effective Therapy for Maternal Malaria Associated With a Lower Risk of Vertical Transmission

    PubMed Central

    Poespoprodjo, J. R.; Fobia, W.; Kenangalem, E.; Hasanuddin, A.; Sugiarto, P.; Tjitra, E.; Anstey, N. M.

    2011-01-01

    Background. The epidemiology of congenital malaria was investigated in a hospital-based malaria surveillance study in Papua, Indonesia. Methods. From April 2005 to January 2010, 4878 delivering women and their newborns underwent prospective clinical review and malaria screening by peripheral blood microscopy. Findings. Congenital malaria occurred in 8 per 1000 (38/4884) live births, with Plasmodium falciparum accounting for 76.3% (29) and P. vivax for 15.8% (6) of infections. Maternal malaria at delivery (adjusted odds ratio [AOR], 9.5; 95% confidence interval [CI], 4.2–21.5; P < .001), age ≤ 16 years (AOR, 4; 95% CI, 1.4–12.1; P = .011), and prior malaria during pregnancy (AOR, 2.2; 95% CI, 1.1–4.4, P = .022) were independent risk factors for vertical transmission. Of 29 mothers and neonates with contemporaneous peripheral parasitemia, 17% (5) had discordant parasite species, suggesting possible antenatal malaria transmission. Newborns with malaria were at significantly greater risk of low birth weight (AOR, 2.8; 95% CI, 1.2–6.6; P = .002). Following introduction of dihydroartemisinin-piperaquine for uncomplicated malaria in the second and third trimesters of pregnancy, congenital malaria incidence fell from 3.2% to 0.2% (odds ratio, 0.07; 95% CI, .03–.15; P < .001). Conclusions. Congenital malaria is an important cause of neonatal morbidity in this region co-endemic for P. falciparum and P. vivax malaria. The introduction of artemisinin-combination therapy was associated with a significant risk reduction in the vertical transmission of malaria. PMID:21908728

  1. Asymptomatic Malaria and Associated Risk Factors among School Children in Sanja Town, Northwest Ethiopia

    PubMed Central

    Worku, Ligabaw; Damtie, Demekech; Endris, Mengistu; Getie, Sisay

    2014-01-01

    Introduction. Asymptomatic malaria is prevalent in highly endemic areas of Africa and is new challenge for malaria prevention and control strategies. Objective. To determine the prevalence of asymptomatic malaria and associated risk factors among school children in Sanja Town, northwest Ethiopia. Methods. A cross-sectional study was conducted from February to March 2013, on 385 school children selected using stratified proportionate systematic sampling technique. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. Giemsa-stained thin and thick blood films were examined for detection, identification, and quantification of malaria parasites. Data were entered and analyzed using SPSS 20.0 statistical software. Multivariate logistic regression was done for assessing associated risk factors and proportions for categorical variables were compared using chi-square test. P values less than 0.05 were taken as statistically significant. Results. The prevalence of asymptomatic malaria was 6.8% (n = 26). The majority of parasitemic study participants had low parasite density 65.5% (17/26). Level of grade, age, bed net usage, and frequent exposure to malaria infection were associated with risk of asymptomatic malaria. Conclusion. Asymptomatic malaria was low in this study area and is associated with level of grade, age, bed net usage, and frequent exposure to malaria infection. PMID:27355032

  2. Assessing Malaria Risks in Greater Mekong Subregion based on Environmental Parameters

    NASA Technical Reports Server (NTRS)

    Kiang, Richard; Soika, Valerii; Adimi, Farida; Nigro, Joseph

    2005-01-01

    At 4,200 km, the Mekong River is the tenth longest river in the world. It directly and indirectly influences the lives of hundreds of millions of inhabitants in its basin. The riparian countries - Thailand, Myanmar, Cambodia, Laos, Vietnam, and a small part of China - form the Greater Mekong Subregion (GMS). This geographical region has the misfortune of being the world's epicenter of falciparum malaria, which is the most severe form of malaria caused by Plasmodium falciparum. Depending on the country, approximately 50 to 90% of all malaria cases are due to this species. In the Malaria Modeling and Surveillance Project, we have been developing techniques to enhance public health s decision capability for malaria risk assessments and controls. The main objectives are: 1) identifying the potential breeding sites for major vector species; 2) implementing a malaria transmission model to identify the key factors that sustain or intensify malaria transmission; and 3) implementing a risk algorithm to predict the occurrence of malaria and its transmission intensity. The potential benefits are: 1) increased warning time for public health organizations to respond to malaria outbreaks; 2) optimized utilization of pesticide and chemoprophylaxis; 3) reduced likelihood of pesticide and drug resistance; and 4) reduced damage to environment. Environmental parameters important to malaria transmission include temperature, relative humidity, precipitation, and vegetation conditions. The NASA Earth science data sets that have been used for malaria surveillance and risk assessment include AVHRR Pathfinder, TRMM, MODIS, NSIPP, and SIESIP. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records. Socioeconomic factors that may influence malaria transmissions will also be incorporated into the predictive models.

  3. The global distribution and population at risk of malaria: past, present, and future

    PubMed Central

    Hay, Simon I; Guerra, Carlos A; Tatem, Andrew J; Noor, Abdisalan M; Snow, Robert W

    2011-01-01

    The aim of this review was to use geographic information systems in combination with historical maps to quantify the anthropogenic impact on the distribution of malaria in the 20th century. The nature of the cartographic record enabled global and regional patterns in the spatial limits of malaria to be investigated at six intervals between 1900 and 2002. Contemporaneous population surfaces also allowed changes in the numbers of people living in areas of malaria risk to be quantified. These data showed that during the past century, despite human activities reducing by half the land area supporting malaria, demographic changes resulted in a 2 billion increase in the total population exposed to malaria risk. Furthermore, stratifying the present day malaria extent by endemicity class and examining regional differences highlighted that nearly 1 billion people are exposed to hypoendemic and mesoendemic malaria in southeast Asia. We further concluded that some distortion in estimates of the regional distribution of malaria burden could have resulted from different methods used to calculate burden in Africa. Crude estimates of the national prevalence of Plasmodium falciparum infection based on endemicity maps corroborate these assertions. Finally, population projections for 2010 were used to investigate the potential effect of future demographic changes. These indicated that although population growth will not substantially change the regional distribution of people at malaria risk, around 400 million births will occur within the boundary of current distribution of malaria by 2010: the date by which the Roll Back Malaria initiative is challenged to halve the world’s malaria burden. PMID:15172341

  4. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions.

    PubMed

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J; Curriero, Frank C

    2015-12-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting.

  5. Transmission Risk from Imported Plasmodium vivax Malaria in the China–Myanmar Border Region

    PubMed Central

    Wang, Duoquan; Li, Shengguo; Cheng, Zhibin; Cotter, Chris; Hwang, Jimee; Li, Xishang; Yin, Shouqin; Wang, Jiazhi; Bai, Liang; Zheng, Zhi; Wang, Sibao

    2015-01-01

    Malaria importation and local vector susceptibility to imported Plasmodium vivax infection are a continuing risk along the China–Myanmar border. Malaria transmission has been prevented in 3 border villages in Tengchong County, Yunnan Province, China, by use of active fever surveillance, integrated vector control measures, and intensified surveillance and response. PMID:26401843

  6. Malaria Hyperendemicity and Risk for Artemisinin Resistance among Illegal Gold Miners, French Guiana.

    PubMed

    Pommier de Santi, Vincent; Djossou, Félix; Barthes, Nicolas; Bogreau, Hervé; Hyvert, Georges; Nguyen, Christophe; Pelleau, Stéphane; Legrand, Eric; Musset, Lise; Nacher, Mathieu; Briolant, Sébastien

    2016-05-01

    To assess the prevalence of malaria among illegal gold miners in the French Guiana rainforest, we screened 205 miners during May-June 2014. Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. Patients reported self-medication with artemisinin-based combination therapy. Risk for emergence and spread of artemisinin resistance among gold miners in the rainforest is high.

  7. Visualizing the uncertainty in the relationship between seasonal average climate and malaria risk.

    PubMed

    MacLeod, D A; Morse, A P

    2014-12-02

    Around $1.6 billion per year is spent financing anti-malaria initiatives, and though malaria morbidity is falling, the impact of annual epidemics remains significant. Whilst malaria risk may increase with climate change, projections are highly uncertain and to sidestep this intractable uncertainty, adaptation efforts should improve societal ability to anticipate and mitigate individual events. Anticipation of climate-related events is made possible by seasonal climate forecasting, from which warnings of anomalous seasonal average temperature and rainfall, months in advance are possible. Seasonal climate hindcasts have been used to drive climate-based models for malaria, showing significant skill for observed malaria incidence. However, the relationship between seasonal average climate and malaria risk remains unquantified. Here we explore this relationship, using a dynamic weather-driven malaria model. We also quantify key uncertainty in the malaria model, by introducing variability in one of the first order uncertainties in model formulation. Results are visualized as location-specific impact surfaces: easily integrated with ensemble seasonal climate forecasts, and intuitively communicating quantified uncertainty. Methods are demonstrated for two epidemic regions, and are not limited to malaria modeling; the visualization method could be applied to any climate impact.

  8. Visualizing the uncertainty in the relationship between seasonal average climate and malaria risk

    NASA Astrophysics Data System (ADS)

    MacLeod, D. A.; Morse, A. P.

    2014-12-01

    Around $1.6 billion per year is spent financing anti-malaria initiatives, and though malaria morbidity is falling, the impact of annual epidemics remains significant. Whilst malaria risk may increase with climate change, projections are highly uncertain and to sidestep this intractable uncertainty, adaptation efforts should improve societal ability to anticipate and mitigate individual events. Anticipation of climate-related events is made possible by seasonal climate forecasting, from which warnings of anomalous seasonal average temperature and rainfall, months in advance are possible. Seasonal climate hindcasts have been used to drive climate-based models for malaria, showing significant skill for observed malaria incidence. However, the relationship between seasonal average climate and malaria risk remains unquantified. Here we explore this relationship, using a dynamic weather-driven malaria model. We also quantify key uncertainty in the malaria model, by introducing variability in one of the first order uncertainties in model formulation. Results are visualized as location-specific impact surfaces: easily integrated with ensemble seasonal climate forecasts, and intuitively communicating quantified uncertainty. Methods are demonstrated for two epidemic regions, and are not limited to malaria modeling; the visualization method could be applied to any climate impact.

  9. Cost effective malaria risk control using remote sensing and environmental data

    NASA Astrophysics Data System (ADS)

    Rahman, Md. Z.; Roytman, Leonid; Kadik, Abdel Hamid

    2012-06-01

    Malaria transmission in many part of the world specifically in Bangladesh and southern African countries is unstable and epidemic. An estimate of over a million cases is reported annually. Malaria is heterogeneous, potentially due to variations in ecological settings, socio-economic status, land cover, and agricultural practices. Malaria control only relies on treatment and supply of bed networks. Drug resistance to these diseases is widespread. Vector control is minimal. Malaria control in those countries faces many formidable challenges such as inadequate accessibility to effective treatment, lack of trained manpower, inaccessibility of endemic areas, poverty, lack of education, poor health infrastructure and low health budgets. Health facilities for malaria management are limited, surveillance is inadequate, and vector control is insufficient. Control can only be successful if the right methods are used at the right time in the right place. This paper aims to improve malaria control by developing malaria risk maps and risk models using satellite remote sensing data by identifying, assessing, and mapping determinants of malaria associated with environmental, socio-economic, malaria control, and agricultural factors.

  10. Climate change and malaria risk in the European part of Russia in 21st century

    NASA Astrophysics Data System (ADS)

    Shartova, N.; Malkhazova, S.

    2009-04-01

    The purpose of this research is development of prognostic model of malaria risk for European part of Russia (EPR) in the 21st century according to climate scenario IPCC "A2". The following issues have been formulated to reach the goal of the research: define the basic epidemiological parameters describing malaria situation and methods of data processing; creating of maps of malaria risk; analysis of changes in malaria distribution for predictable future climate conditions in comparison with conditions of a modern climate. A lot of reasons (biological, social and economic) impact on malaria distribution. Nevertheless, incubation period of the parasite first of all depends on temperature. This is a primary factor that defines a potential area of infection, ability and specificity to transmit malaria. According to this, the model is based on the relationship between climate (average daily temperature) and the intensity of malaria transmission. The object of research is malaria parasite Plasmodium vivax, which has for Russia (particularly for EPR) the greatest importance because it has the lowest minimal temperature threshold for development. Climate data is presented by daily average temperatures of air for three analyzed periods. 1961 -1989 describes a modern climate and corresponds to the minimum 30-year period that is necessary for an assessment of climate and changes connected with biotic components. Prognostic malaria model is based on predicted daily average temperatures for 2046-2065 (the middle of century) and 2089-2100 (the end of century). All data sets for EPR are presented in the grid 2x2. The conclusion on possible changes in malaria distribution and transmission in the middle and the end of the 21st century: There is going to be the increase of duration of effective temperatures period (period when parasite development is possible), period of effective susceptibility to infection of mosquitoes (period when malaria transmission cycle is possible); shift

  11. Ranking the risk of wildlife species hazardous to military aircraft

    USGS Publications Warehouse

    Zakrajsek, E.J.; Bissonette, J.A.

    2005-01-01

    Collisions between birds and aircraft (birdstrikes) pose a major threat to aviation safety. Different species pose different levels of threat; thus, identification of the most hazardous species can help managers identify the level of hazard and prioritize mitigation efforts. Dolbeer et al. (2000) assessed the hazard posed by birds to civilian aircraft by analyzing data from the Federal Aviation Administration's (FAA) Wildlife Strike Database to rank the hazardous species and species groups. A similar analysis has not been done for the military but would be useful and necessary. Military flight characteristics differ from those of civilian flights. During the period 1985-1998, birdstrikes cost the United States Air Force (USAF) an average of $35 million/year in damage. Using the USAF Birdstrike Database, we selected and evaluated each species or species group by the number of strikes recorded in each of 3 damage categories. We weighted damage categories to reflect extent and cost of damage. The USAF Birdstrike Database contained 25,519 records of wildlife strikes in the United States. During the period 1985-1998, 22 (mean = 1.6/year) Class-A birdstrikes (>$1,000,000 damage, loss of aircraft, loss of life, or permanent total disability) were sustained, accounting for 80% of total monetary losses caused by birds. Vultures (Cathartes aura, Coragyps atratus, Caracara cheriway) were ranked the most hazardous species group (Hazard Index Rank [HIR] = 127) to USAF aircraft, followed by geese (Branta canadensis, Chen caerulescens, HIR = 76), pelicans (Pelecanus erythrorhynchos, P. occidentalis, HIR = 47), and buteos (Buteo sp., HIR = 30). Of the smaller flocking birds, blackbirds and starlings (mostly Agelaius phoeniceus, Euphagus cyanocephalus, Molothrus ater, Sturnus vulgaris, HIR = 46), horned larks (Eremophila alpestris, HIR = 24), and swallows (Families Hirundinidae, Apodidae, HIR = 23) were species groups ranked highest. Coupling these results with local bird census

  12. Challenges for modelling spatio-temporal variations of malaria risk in Malawi

    NASA Astrophysics Data System (ADS)

    Lowe, R.; Chirombo, J.; Tompkins, A. M.

    2012-04-01

    Malaria is the leading cause of morbidity and mortality in Malawi with more than 6 million episodes reported each year. Malaria poses a huge economic burden to Malawi in terms of the direct cost of treating malaria patients and also indirect costs resulting from workdays lost in agriculture and industry and absenteeism from school. Malawi implements malaria control activities within the Roll Back Malaria framework, with the objective to provide those most at risk (i.e. children under five years, pregnant woman and individuals with suppressed immune systems) access to personal and community protective measures. However, at present there is no mechanism by which to target the most 'at risk' populations ahead of an impending epidemic. Malaria transmission is influenced by variations in meteorological conditions, which impact the biology of the mosquito and the availability of breeding sites, but also socio-economic conditions such as levels of urbanisation, poverty and education, which influence human vulnerability and vector habitat. The many potential drivers of malaria, both extrinsic, such as climate, and intrinsic, such as population immunity are often difficult to disentangle. This presents a challenge for modelling of malaria risk in space and time. Using an age-stratified spatio-temporal dataset of malaria cases at the district level from July 2004 - June 2011, we use a spatio-temporal modelling framework to model variations in malaria risk in Malawi. Climatic and topographic variations are accounted for using an interpolation method to relate gridded products to administrative districts. District level data is tested in the model to account for confounding factors, including the proportion of the population living in urban areas; residing in traditional housing; with no toilet facilities; who do not attend school, etc, the number of health facilities per population and yearly estimates of insecticide-treated mosquito net distribution. In order to account for

  13. Gender roles and perceptions of malaria risk in agricultural communities of Mwea Division in Central Kenya.

    PubMed

    Woldu, Dawit Okubatsion; Haile, Zelalem Teka

    2015-01-01

    We examined gender differences in the perception of high malaria risk in women and factors associated with a high number of malaria episodes in the Mwea Division of Central Kenya. Ethnographic and successive free listing interviews (an open-ended data collection technique used to show the relation of items in a given domain) with 53 key informants and structured interviews conducted from June to October 2010 with 250 respondents who represented the socioeconomic and geographical diversity of the area were analyzed. Qualitative text analysis and inferential statistics were employed. While a greater proportion of men (51.6%) attributed women's high malaria risk to their "biological weakness," most women believed that their high malaria risk was related to their role in the agricultural fields (43.6%) and to their household responsibilities (23.1%). Compared to men, women were more likely to work in wet aspects of agricultural activities (χ(2) (2, N = 153) = 13.47, p < .01). Women were nearly twice as likely as men to report high episodes of malaria (adjusted odds ratio: 2.54; 95% confidence interval: 1.05-6.15). Culturally prescribed gender roles in agricultural communities in Mwea may play an important role in explaining disparity in reported malaria incidence. While identification of ecological and economic determinants of malaria is important, gender-based research can make a significant contribution to the development of effective and sustainable malaria reduction strategies.

  14. Migrants and malaria risk factors: a study of the Thai-Myanmar border.

    PubMed

    Tipmontree, Rungrawee; Fungladda, Wijitr; Kaewkungwal, Jaranit; Tempongko, M A Sandra B; Schelp, Frank-Peter

    2009-11-01

    The objective of this study was to investigate factors influencing self-reported malaria among migrants living along the Thai-Myanmar border. Songkaria Village, with 1600 inhabitants and 290 households in Sangkhla Buri District, Kanchanaburi Province, was selected for the study due to its intense malaria transmission. One hundred twenty-five households were randomly selected. Household members were interviewed about the history of malaria, socioeconomic status and knowledge and practices in regard to malaria using a structured questionnaire. Of the respondents, 10%, 42%, and 48% belonged to the Thai, Mon, and Karen ethnic groups, respectively. About 40 % of Thai and Karen migrants and almost 30% of Mon migrants reported having suffered from malaria at least once. Multivariate analysis focused on migrants. The results identified three independent factors for previous malaria: a high risk occupation, ie working primarily in the forest [odds ratio (OR), 3.55; 95% confidence interval 1.3-10.0], ability to read Thai [OR, 4.13 (1.5-11.7)], and correct knowledge about malaria symptoms [OR, 5.18 (1.1-23.5)]. Working conditions among migrants played a major role in acquiring malaria. They could not afford to apply additional preventive measures, such as using a mosquito net or repellent to be used while working. The concept of enhancing the environment for migrants to enable them to protect themselves against malaria needs to be examined. Ways and means of improving the economic conditions of migrants should be considered to minimize exposure to the vector.

  15. Climate change and malaria risk in Russia in 21st century

    NASA Astrophysics Data System (ADS)

    Malkhazova, S.; Shartova, N.

    2010-09-01

    The purpose of this research is development of prognostic model of malaria risk for Russia in the 21st century according to climate scenario IPCC "А2". The following issues have been formulated to reach the goal of the research: - define the basic epidemiological parameters describing malaria situation and methods of data processing; - creating of maps of malaria risk; - analysis of changes in malaria distribution for predictable future climate conditions in comparison with conditions of a modern climate. A lot of reasons (biological, social and economic) impact on malaria distribution. Nevertheless, incubation period of the parasite first of all depends on temperature. This is a primary factor that defines a potential area of infection, ability and specificity to transmit malaria. According to this, the model is based on the relationship between climate (average daily temperature) and the intensity of malaria transmission. The object of research is malaria parasite Plasmodium vivax, which has for Russia the greatest importance because it has the lowest minimal temperature threshold for development. Climate data is presented by daily average temperatures of air for three analyzed periods. 1961 -1989 describes a modern climate and corresponds to the minimum 30-year period that is necessary for an assessment of climate and changes connected with biotic components. Prognostic malaria model is based on predicted daily average temperatures for 2046-2065 (the middle of century) and 2089-2100 (the end of century). All data sets are presented in the grid 2х20. The conclusion on possible changes in malaria distribution and transmission in the middle and the end of the 21st century: There is going to be the increase of duration of effective temperatures period (period when parasite development is possible), period of effective susceptibility to infection of mosquitoes (period when malaria transmission cycle is possible); shift of the beginning of malaria transmission

  16. Epidemiology and Risk Analysis of Malaria among Pregnant Women

    PubMed Central

    Dhiman, S; Yadav, K; Goswami, D; Das, NG; Baruah, I; Singh, L

    2012-01-01

    Malaria remains a complex problem during the pregnancy, which threatens > 35 millions pregnant women every year. Malaria pathogenesis in pregnancy results in accumulation of infected RBCs in the intervillous spaces causing severe alterations leading to the reduced materno-foetal exchanges. In this article we have revisited the current evidences of clinical implications and overall burden of malaria in pregnancy. Many adverse aftermaths including, low birth weight, intrauterine growth retardation, preterm delivery, stillbirth and anemia were found associated with malaria in pregnant women. Despite of worldwide comprehensive control programmes for malaria in pregnancy, the disease control has been a daunting task everywhere. Socio cultural, economical, lack of awareness and various logistic problems compound the disease in developing countries. Thorough evidence based information and estimates, education and awareness and strengthening of prevention programmes are needed urgently to achieve success in malaria control in pregnancy. PMID:23113116

  17. Cumulative Benefit Analysis for Ranking Risk Reduction Actions

    SciTech Connect

    Leverenz, Fred L.; Aysa Jimenez, Julio

    2007-04-25

    The Hazard and Operability (HAZOP) study approach, and other similar methods, are very effective ways to qualitatively identify a comprehensive set of accident scenarios for a facility. If these analyses are modified to incorporate a simple system for evaluating relative risk, such as an order-of-magnitude scoring system, the resultant study can be a very powerful input to developing risk reduction strategies. By adding the concept of Risk Reduction Worth evaluations for all accident Causes, Safeguards, and proposal Action Items, an analyst can then formulate a strategy to select the minimal set of risk reduction actions that maximizes risk reduction. One strategy for doing this involves the iterative evaluation of RRW after postulation of risk reduction actions, until the residual risk reaches a tolerable value, termed Cumulative Risk Benefit Analysis. This concept was developed for the evaluation of a set of pipeline pumping stations, and provided valuable insight into how to reduce risk in a sensible, prioritized fashion.

  18. Applications of fuzzy ranking methods to risk-management decisions

    NASA Astrophysics Data System (ADS)

    Mitchell, Harold A.; Carter, James C., III

    1993-12-01

    The Department of Energy is making significant improvements to its nuclear facilities as a result of more stringent regulation, internal audits, and recommendations from external review groups. A large backlog of upgrades has resulted. Currently, a prioritization method is being utilized which relies on a matrix of potential consequence and probability of occurrence. The attributes of the potential consequences considered include likelihood, exposure, public health and safety, environmental impact, site personnel safety, public relations, legal liability, and business loss. This paper describes an improved method which utilizes fuzzy multiple attribute decision methods to rank proposed improvement projects.

  19. Risk-Based Ranking Experiences for Cold War Legacy Facilities in the United States

    SciTech Connect

    Droppo, James G.

    2003-05-01

    Over the past two decades, a number of government agencies in the United States have faced increasing public scrutiny for their efforts to address the wide range of potential environmental issues related to Cold War legacies. Risk-based ranking was selected as a means of defining the relative importance of issues. Ambitious facility-wide risk-based ranking applications were undertaken. However, although facility-wide risk-based ranking efforts can build invaluable understanding of the potential issues related to Cold War legacies, conducting such efforts is difficult because of the potentially enormous scope and the potentially strong institutional barriers. The U.S. experience is that such efforts are worth undertaking to start building a knowledge base and infrastructure that are based on a thorough understanding of risk. In both the East and the West, the legacy of the Cold War includes a wide range of potential environmental issues associated with large industrial complexes of weapon production facilities. The responsible agencies or ministries are required to make decisions that could benefit greatly from information on the relative importance of these potential issues. Facility-wide risk-based ranking of potential health and environmental issues is one means to help these decision makers. The initial U.S. risk-based ranking applications described in this chapter were “ground-breaking” in that they defined new methodologies and approaches to meet the challenges. Many of these approaches fit the designation of a population-centred risk assessment. These U.S. activities parallel efforts that are just beginning for similar facilities in the countries of the former Soviet Union. As described below, conducting a facility-wide risk-based ranking has special challenges and potential pitfalls. Little guidance exists to conduct major risk-based rankings. For those considering undertaking such efforts, the material contained in this chapter should be useful

  20. Low perception of malaria risk among the Ra-glai ethnic minority in south-central Vietnam: implications for forest malaria control

    PubMed Central

    2010-01-01

    Background Despite Vietnam's success in reducing malaria mortality and morbidity over the last decade, malaria persists in the forested and mountainous areas of the central and southern provinces, where more than 50% of the clinical cases and 90% of severe cases and malaria deaths occur. Methods Between July 2005 and September 2006, a multi-method study, triangulating a malariometric cross-sectional survey and qualitative data from focused ethnography, was carried out among the Ra-glai ethnic minority in the hilly forested areas of south-central Vietnam. Results Despite the relatively high malaria burden among the Ra-glai and their general awareness that mosquitoes can transmit an unspecific kind of fever (84.2%), the use of bed nets, distributed free of charge by the national malaria control programme, remains low at the farmers' forest fields where the malaria risk is the highest. However, to meet work requirements during the labour intensive malaria transmission and rainy season, Ra-glai farmers combine living in government supported villages along the road with a second home or shelter at their slash and burn fields located in the forest. Bed net use was 84.6% in the villages but only 52.9% at the forest fields; 20.6% of the respondents slept unprotected in both places. Such low use may be explained by the low perception of the risk for malaria, decreasing the perceived need to sleep protected. Several reasons may account for this: (1) only 15.6% acknowledged the higher risk of contracting malaria in the forest than in the village; (2) perceived mosquito biting times only partially coincided with Anopheles dirus ss and Anopheles minimus A true biting times; (3) the disease locally identified as 'malaria' was hardly perceived as having an impact on forest farmers' daily lives as they were unaware of the specific kind of fevers from which they had suffered even after being diagnosed with malaria at the health centre (20.9%). Conclusions The progressive

  1. Participatory Risk Mapping of Malaria Vector Exposure in Northern South America using Environmental and Population Data

    PubMed Central

    Fuller, D.O.; Troyo, A.; Alimi, T.O.; Beier, J.C.

    2014-01-01

    Malaria elimination remains a major public health challenge in many tropical regions, including large areas of northern South America. In this study, we present a new high spatial resolution (90 × 90 m) risk map for Colombia and surrounding areas based on environmental and human population data. The map was created through a participatory multi-criteria decision analysis in which expert opinion was solicited to determine key environmental and population risk factors, different fuzzy functions to standardize risk factor inputs, and variable factor weights to combine risk factors in a geographic information system. The new risk map was compared to a map of malaria cases in which cases were aggregated to the municipio (municipality) level. The relationship between mean municipio risk scores and total cases by muncípio showed a weak correlation. However, the relationship between pixel-level risk scores and vector occurrence points for two dominant vector species, Anopheles albimanus and An. darlingi, was significantly different (p < 0.05) from a random point distribution, as was a pooled point distribution for these two vector species and An. nuneztovari. Thus, we conclude that the new risk map derived based on expert opinion provides an accurate spatial representation of risk of potential vector exposure rather than malaria transmission as shown by the pattern of malaria cases, and therefore it may be used to inform public health authorities as to where vector control measures should be prioritized to limit human-vector contact in future malaria outbreaks. PMID:24976656

  2. Precipitation Based Malaria Patterns in the Amazon -- Will Deforestation Alter Risk?

    NASA Astrophysics Data System (ADS)

    Olson, S. H.; Durieux, L.; Elguero, E.; Foley, J.; Gagnon, R.; Guegan, J.; Patz, J.

    2007-12-01

    The World Health Organization, estimates that forty-two percent of malaria cases are "associated with policies and practices regarding land use, deforestation, water resource management, settlement siting and modified house design". This estimate was drawn from expert opinion and studies performed at local scales, but little research has investigated the cumulative impacts of land use and land cover changes occurring in the Amazon Basin on malaria. Much less is understood about the impact of changing land use and subsequent precipitation regimes on malaria risk. To understand how land use practices may alter malaria patterns in the Basin we present an analysis of municipio (n=755) malaria case data and monthly precipitation patterns between 1996 and 1999. Climate data originated from the CRU TS 2.1 half-degree grid resolution climate data set. We present a hierarchical (random coefficients) log-linear Poisson model relating malaria incidence to precipitation for both municipos and states. At the Basin scale precipitation and cases show strong relationships. Precipitation and cases are asynchronous across the period of observation, but detailed inspection of states and individual municipios reveal geographic dependencies of precipitation and malaria incidence. Future research will link the patterns of precipitation and malaria to anticipated changes in climate from deforestation in the Basin.

  3. Fine-Scale Mapping by Spatial Risk Distribution Modeling for Regional Malaria Endemicity and Its Implications under the Low-to-Moderate Transmission Setting in Western Cambodia

    PubMed Central

    Okami, Suguru; Kohtake, Naohiko

    2016-01-01

    The disease burden of malaria has decreased as malaria elimination efforts progress. The mapping approach that uses spatial risk distribution modeling needs some adjustment and reinvestigation in accordance with situational changes. Here we applied a mathematical modeling approach for standardized morbidity ratio (SMR) calculated by annual parasite incidence using routinely aggregated surveillance reports, environmental data such as remote sensing data, and non-environmental anthropogenic data to create fine-scale spatial risk distribution maps of western Cambodia. Furthermore, we incorporated a combination of containment status indicators into the model to demonstrate spatial heterogeneities of the relationship between containment status and risks. The explanatory model was fitted to estimate the SMR of each area (adjusted Pearson correlation coefficient R2 = 0.774; Akaike information criterion AIC = 149.423). A Bayesian modeling framework was applied to estimate the uncertainty of the model and cross-scale predictions. Fine-scale maps were created by the spatial interpolation of estimated SMRs at each village. Compared with geocoded case data, corresponding predicted values showed conformity [Spearman’s rank correlation r = 0.662 in the inverse distance weighed interpolation and 0.645 in ordinal kriging (95% confidence intervals of 0.414–0.827 and 0.368–0.813, respectively), Welch’s t-test; Not significant]. The proposed approach successfully explained regional malaria risks and fine-scale risk maps were created under low-to-moderate malaria transmission settings where reinvestigations of existing risk modeling approaches were needed. Moreover, different representations of simulated outcomes of containment status indicators for respective areas provided useful insights for tailored interventional planning, considering regional malaria endemicity. PMID:27415623

  4. Fine-Scale Mapping by Spatial Risk Distribution Modeling for Regional Malaria Endemicity and Its Implications under the Low-to-Moderate Transmission Setting in Western Cambodia.

    PubMed

    Okami, Suguru; Kohtake, Naohiko

    2016-01-01

    The disease burden of malaria has decreased as malaria elimination efforts progress. The mapping approach that uses spatial risk distribution modeling needs some adjustment and reinvestigation in accordance with situational changes. Here we applied a mathematical modeling approach for standardized morbidity ratio (SMR) calculated by annual parasite incidence using routinely aggregated surveillance reports, environmental data such as remote sensing data, and non-environmental anthropogenic data to create fine-scale spatial risk distribution maps of western Cambodia. Furthermore, we incorporated a combination of containment status indicators into the model to demonstrate spatial heterogeneities of the relationship between containment status and risks. The explanatory model was fitted to estimate the SMR of each area (adjusted Pearson correlation coefficient R2 = 0.774; Akaike information criterion AIC = 149.423). A Bayesian modeling framework was applied to estimate the uncertainty of the model and cross-scale predictions. Fine-scale maps were created by the spatial interpolation of estimated SMRs at each village. Compared with geocoded case data, corresponding predicted values showed conformity [Spearman's rank correlation r = 0.662 in the inverse distance weighed interpolation and 0.645 in ordinal kriging (95% confidence intervals of 0.414-0.827 and 0.368-0.813, respectively), Welch's t-test; Not significant]. The proposed approach successfully explained regional malaria risks and fine-scale risk maps were created under low-to-moderate malaria transmission settings where reinvestigations of existing risk modeling approaches were needed. Moreover, different representations of simulated outcomes of containment status indicators for respective areas provided useful insights for tailored interventional planning, considering regional malaria endemicity. PMID:27415623

  5. Deconstructing the Risk for Malaria in United States Donors Deferred for Travel to Mexico

    PubMed Central

    Spencer, Bryan; Kleinman, Steven; Custer, Brian; Cable, Ritchard; Wilkinson, Susan L; Steele, Whitney; High, Patrick M; Wright, David

    2013-01-01

    Background More than 66,000 blood donors are deferred annually in the U.S. due to travel to malaria-endemic areas of Mexico. Mexico accounts for the largest share of malaria travel deferrals, yet it has extremely low risk for malaria transmission throughout most of its national territory, suggesting a suboptimal balance between blood safety and availability. This study sought to determine whether donor deferral requirements might be relaxed for parts of Mexico without compromising blood safety. Study Design and Methods Travel destination was recorded from a representative sample of presenting blood donors deferred for malaria travel from six blood centers during 2006. We imputed to these donors reporting Mexican travel a risk for acquiring malaria equivalent to Mexican residents in the destination location, adjusted for length of stay. We extrapolated these results to the overall U.S. blood donor population. Results Risk for malaria in Mexico varies significantly across endemic areas and is greatest in areas infrequently visited by study donors. Over 70% of blood donor deferrals were triggered by travel to the state of Quintana Roo on the Yucatán Peninsula, an area of very low malaria transmission. Eliminating the travel deferral requirement for all areas except the state of Oaxaca might result in the recovery of almost 65,000 blood donors annually at risk of approximately one contaminated unit collected every 20 years. Conclusion Deferral requirements should be relaxed for presenting donors who travelled to areas within Mexico that confer exceptionally small risks for malaria, such as Quintana Roo. PMID:21564102

  6. Environmental factors as determinants of malaria risk. A descriptive study on the northern coast of Peru.

    PubMed

    Guthmann, J P; Llanos-Cuentas, A; Palacios, A; Hall, A J

    2002-06-01

    We conducted a series of studies on the northern Pacific coast of Peru to determine environmental risk factors for malaria. We report in this paper the results of both a descriptive study of incidence and a prevalence survey of malaria. Both studies showed that the area was at low risk for malaria. The malaria incidence rate was 40/1000 p.a. during the study period, and the prevalence of infection was 0.9% (95% CI: 0.4-1.7) before and 1.4% (95% CI: 0.8-2.2) after the high incidence period. However, the risk of malaria varied according to season, village and even house within a single village. Incidence rates increased from February (2.6/1000 p.a.) to May (12.9/1000 p.a.) and decreased during the second part of the year. Most of the cases were clustered in four villages that constituted only 21% of the total population of the area. Houses where multiple cases were recorded were often located near a source of water. Our observations suggested that environmental factors, and particularly the presence of water for irrigation around villages and houses, played a major role in determining the risk of malaria. These observations were extended through an entomological study and a case-control study, to be published elsewhere.

  7. Malaria Hyperendemicity and Risk for Artemisinin Resistance among Illegal Gold Miners, French Guiana.

    PubMed

    Pommier de Santi, Vincent; Djossou, Félix; Barthes, Nicolas; Bogreau, Hervé; Hyvert, Georges; Nguyen, Christophe; Pelleau, Stéphane; Legrand, Eric; Musset, Lise; Nacher, Mathieu; Briolant, Sébastien

    2016-05-01

    To assess the prevalence of malaria among illegal gold miners in the French Guiana rainforest, we screened 205 miners during May-June 2014. Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. Patients reported self-medication with artemisinin-based combination therapy. Risk for emergence and spread of artemisinin resistance among gold miners in the rainforest is high. PMID:27089004

  8. Malaria Hyperendemicity and Risk for Artemisinin Resistance among Illegal Gold Miners, French Guiana

    PubMed Central

    Pommier de Santi, Vincent; Djossou, Félix; Barthes, Nicolas; Bogreau, Hervé; Hyvert, Georges; Nguyen, Christophe; Pelleau, Stéphane; Legrand, Eric; Musset, Lise; Nacher, Mathieu

    2016-01-01

    To assess the prevalence of malaria among illegal gold miners in the French Guiana rainforest, we screened 205 miners during May–June 2014. Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. Patients reported self-medication with artemisinin-based combination therapy. Risk for emergence and spread of artemisinin resistance among gold miners in the rainforest is high. PMID:27089004

  9. Socio-economic & household risk factors of malaria in tribal areas of Madhya Pradesh, central India

    PubMed Central

    Sharma, Ravendra K.; Singh, Mrigendra P.; Saha, Kalyan B.; Bharti, Praveen K.; Jain, Vidhan; Singh, P. P.; Silawat, Nipun; Patel, R.; Hussain, M.; Chand, S.K.; Pandey, Arvind; Singh, Neeru

    2015-01-01

    Background & objectives: Malaria is a major public health problem in many States of the country, particularly, in Madhya Pradesh where both Plasmodium vivax and P. falciparum are endemic. Although many studies have been conducted to investigate risk factors for malaria, but only a few have examined household and socio-economic risk factors. The present study was, therefore, undertaken to explore the relationship of different socio-demographic, socio-economic and behavioural risk factors with malaria prevalence in tribal areas of Madhya Pradesh, India. Methods: This study was undertaken in all 62 villages of Bargi Primary Health Centre from May 2005 to June 2008. These villages comprised 7117 households with an average family size of five members. Fortnightly fever surveys were conducted in all villages to assess prevalence of malaria infection in the community. The distinct univariate and multivariate logistic regression models were fitted on the data set. Results: The important socio-demographic risk factors like age of household head, social group, occupation and family size; socio-economic factors like type of walls of house, place of drinking water source, irrigated land, cash crop; and behavioural variables like place of sleeping, use of bed nets, etc. were found significantly associated with malaria in univariate analyses. In multivariate analyses only social groups, family size, type of walls of house, and place of sleeping had strong significant association with prevalence of malaria. Interpretation & conclusions: The study shows that in tribal areas where people are living in poor quality of houses with no proper use of preventive measures, malaria is firmly established. We conclude that community based interventions which bring improvement in standard of living, access to healthcare facilities and health awareness, will have a significant impact on malaria prevention in these areas. PMID:26139773

  10. What is a resistance gene? Ranking risk in resistomes.

    PubMed

    Martínez, José L; Coque, Teresa M; Baquero, Fernando

    2015-02-01

    Metagenomic studies have shown that antibiotic resistance genes are ubiquitous in the environment, which has led to the suggestion that there is a high risk that these genes will spread to bacteria that cause human infections. If this is true, estimating the real risk of dissemination of resistance genes from environmental reservoirs to human pathogens is therefore very difficult. In this Opinion article, we analyse the current definitions of antibiotic resistance and antibiotic resistance genes, and we describe the bottlenecks that affect the transfer of antibiotic resistance genes to human pathogens. We propose rules for estimating the risks associated with genes that are present in environmental resistomes by evaluating the likelihood of their introduction into human pathogens, and the consequences of such events for the treatment of infections.

  11. Malaria morbidity and temperature variation in a low risk Kenyan district: a case of overdiagnosis?

    NASA Astrophysics Data System (ADS)

    Njuguna, John; Muita, James; Mundia, George

    2009-05-01

    Diagnosis of malaria using only clinical means leads to overdiagnosis. This has implications due to safety concerns and the recent introduction of more expensive drugs. Temperature is a major climatic factor influencing the transmission dynamics of malaria. This study looked at trends in malaria morbidity in the low risk Kenyan district of Nyandarua, coupled with data on temperature and precipitation for the years 2003-2006. July had the highest number of cases (12.2% of all cases) followed by August (10.2% of all cases). July and August also had the lowest mean maximum temperatures, 20.1 and 20.2 °C respectively. April, July and August had the highest rainfall, with daily means of 4.0, 4.3 and 4.9 mm, respectively. Observation showed that the coldest months experienced the highest number of cases of malaria. Despite the high rainfall, transmission of malaria tends to be limited by low temperatures due to the long duration required for sporogony, with fewer vectors surviving. These cold months also tend to have the highest number of cases of respiratory infections. There is a possibility that some of these were misdiagnosed as malaria based on the fact that only a small proportion of malaria cases were diagnosed using microscopy or rapid diagnostic tests. We conclude that overdiagnosis may be prevalent in this district and there may be a need to design an intervention to minimise it.

  12. Conflict in Neighboring Countries, a Great Risk for Malaria Elimination in Southwestern Iran: Narrative Review Article.

    PubMed

    Molaee Zadeh, Maryam; Shahandeh, Khandan; Bigdeli, Shahla; Basseri, Hamid Reza

    2014-12-01

    The intensity of the conflict such as war is one of the determinants of the flow of migrants and refuges with consequence of introducing infectious disease to other countries. This paper investigates the relationship between malaria incidence and forced immigration due to war from neighboring countries in Dezful district, southwestern Iran. All available data and accessible archived documentary records on malaria cases in the period 1988-2011 in Dezful Health Centers were reviewed. Retrospective analysis of routine surveillance data from the Health authority of Dezful district was conducted to assess the trend of malaria incidence and prevalence in the last two decades. Malaria transmission dynamics was described using surveillance indicators viz, Annual Parasite Incidence (API), Slide Positivity Rate (SPR), Annual Blood Examination Rate (ABER) and based on personal information of patients. Two peaks of malaria incidence occurred during past two decades. The first one arisen by Iran-Iraq war due to residential instability in Dezful while the API reached to 8 per 1000. The second peak happened after to civil war of Afghanistan began which caused large immigrates moved into the study area. During the second peak, API reached 1.7 per 1000 at maximum and the majority of patients were immigrants. This study describes the linkage between incidence and prevalence of malaria and immigration due to civil conflict. Therefore, malaria screening of immigrants and early warning programme are effective to prevent outbreak of disease in a potential risk area such Dezful. PMID:26171354

  13. Mind the Gap: House Structure and the Risk of Malaria in Uganda

    PubMed Central

    Wanzirah, Humphrey; Tusting, Lucy S.; Arinaitwe, Emmanuel; Katureebe, Agaba; Maxwell, Kilama; Rek, John; Bottomley, Christian; Staedke, Sarah G.; Kamya, Moses; Dorsey, Grant; Lindsay, Steve W.

    2015-01-01

    Background Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. We assessed how house design may affect mosquito house entry and malaria risk in Uganda. Methods 100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878) were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves) or traditional (all other homes). Results A total of 113,618 female Anopheles were collected over 6,765 nights. 6,816 routine blood smears were taken of which 1,061 (15.6%) were malaria parasite positive. 2,582 episodes of uncomplicated malaria were diagnosed after 1,569 person years of follow-up, giving an overall incidence of 1.6 episodes per person year at risk. The human biting rate was lower in modern homes than in traditional homes (adjusted incidence rate ratio (IRR) 0.48, 95% confidence interval (CI) 0.37–0.64, p<0.001). The odds of malaria infection were lower in modern homes across all the sub-counties (adjusted odds ratio 0.44, 95%CI 0.30–0.65, p<0.001), while malaria incidence was lower in modern homes in Kihihi (adjusted IRR 0.61, 95%CI 0.40–0.91, p = 0.02) but not in Walukuba or Nagongera. Conclusions House design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas. PMID:25635688

  14. Mapping Malaria Transmission Risk in Northern Morocco Using Entomological and Environmental Data

    PubMed Central

    Adlaoui, E.; Faraj, C.; El Bouhmi, M.; El Aboudi, A.; Ouahabi, S.; Tran, A.; Fontenille, D.; El Aouad, R.

    2011-01-01

    Malaria resurgence risk in Morocco depends, among other factors, on environmental changes as well as the introduction of parasite carriers. The aim of this paper is to analyze the receptivity of the Loukkos area, large wetlands in Northern Morocco, to quantify and to map malaria transmission risk in this region using biological and environmental data. This risk was assessed on entomological risk basis and was mapped using environmental markers derived from satellite imagery. Maps showing spatial and temporal variations of entomological risk for Plasmodium vivax and P. falciparum were produced. Results showed this risk to be highly seasonal and much higher in rice fields than in swamps. This risk is lower for Afrotropical P. falciparum strains because of the low infectivity of Anopheles labranchiae, principal malaria vector in Morocco. However, it is very high for P. vivax mainly during summer corresponding to the rice cultivation period. Although the entomological risk is high in Loukkos region, malaria resurgence risk remains very low, because of the low vulnerability of the area. PMID:22312566

  15. Development of nutritionally at-risk young children is predicted by malaria, anemia, and stunting in Pemba, Zanzibar

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nutritionally at-risk children suffer delays in physical growth and motor and language development. Infectious diseases such as malaria pose an additional risk. We examined the cross-sectional relationships among malaria infection, hemoglobin (Hb) concentration, length-for-age Z-scores (LAZ), motor ...

  16. A risk-ranking methodology for prioritizing historic, potentially contaminated mine sites in British Columbia.

    PubMed

    Power, Beth A; Tinholt, Mark J; Hill, Ryan A; Fikart, Alena; Wilson, Ross M; Stewart, Gregg G; Sinnett, Geoff D; Runnells, Joanna L

    2010-01-01

    The Crown Land Restoration Branch (CLRB) of the British Columbia Ministry of Agriculture and Lands is responsible for managing thousands of historic and abandoned mine sites on provincial lands (referred to as Crown Contaminated Sites). For most of these sites, there is limited information available regarding the extent of potential contamination or potential human health and ecological risks. Given the large number of sites, the CLRB sought a system for prioritizing investigation and management efforts among them. We developed a Risk-Ranking Methodology (RRM) to meet this objective, which was implemented in 2007/2008 with an emphasis on historic mine sites because of the significant number of sites and related potential risk. The RRM uses a risk-based Preliminary Site Investigation to gather key information about the sites. The information for each site is analyzed and summarized according to several attributes aimed at characterizing potential health and ecological risks. The summary information includes, but is not limited to, generic comparisons of exposure with effects levels (screening quotients) for human and ecological exposure pathways. The summary information (more than 25 attributes) is then used in a workshop setting to evaluate relative rankings among sites, and also to identify subsequent management actions for each site. Application of the RRM in 2007/2008 was considered successful, because there was confidence in the process, the content and the outputs. A key challenge was keeping the number of attributes to a manageable level. Ranking was based on discussion and consensus, which was a feasible approach given the relatively small number of sites that need to be ranked each year, and facilitated transparency in the ranking process. We do not rule out the future possibility of developing a quantitative function to capture trade-offs among attributes.

  17. Net Risk: A Risk Assessment of Long-Lasting Insecticide Bed Nets Used for Malaria Management

    PubMed Central

    Peterson, Robert K. D.; Barber, Loren M.; Schleier, Jerome J.

    2011-01-01

    Despite the demonstrated ability of bed nets that have been factory-impregnated with long-lasting insecticides (LLINs) to protect people from malaria and despite the ambitious plans for their widespread use, the health risks from the LLINs themselves have not been adequately investigated and reported in the peer-reviewed science literature. Here, we use a probabilistic risk assessment approach to estimate the risks to Africans from inhalation, dermal, and oral exposures to the newer LLINs with permethrin, α-cypermethrin, or deltamethrin as the insecticide active ingredient. We estimated exposures to LLINs using 17 age groups to incorporate different body weights and sleeping behaviors. Risk quotients (exposure divided by toxic threshold) at the 50th and 90th percentiles for non-cancer risks were < 1.0 for lifetime adjusted risk and all youth and adult age groups. Risk quotients for infants and toddlers (0–3 years) and child groups from 3 to 10 years were ≥ 1.0 for specific bed nets. PMID:21633033

  18. Geographical patterns and predictors of malaria risk in Zambia: Bayesian geostatistical modelling of the 2006 Zambia national malaria indicator survey (ZMIS)

    PubMed Central

    2010-01-01

    Background The Zambia Malaria Indicator Survey (ZMIS) of 2006 was the first nation-wide malaria survey, which combined parasitological data with other malaria indicators such as net use, indoor residual spraying and household related aspects. The survey was carried out by the Zambian Ministry of Health and partners with the objective of estimating the coverage of interventions and malaria related burden in children less than five years. In this study, the ZMIS data were analysed in order (i) to estimate an empirical high-resolution parasitological risk map in the country and (ii) to assess the relation between malaria interventions and parasitaemia risk after adjusting for environmental and socio-economic confounders. Methods The parasitological risk was predicted from Bayesian geostatistical and spatially independent models relating parasitaemia risk and environmental/climatic predictors of malaria. A number of models were fitted to capture the (potential) non-linearity in the malaria-environment relation and to identify the elapsing time between environmental effects and parasitaemia risk. These models included covariates (a) in categorical scales and (b) in penalized and basis splines terms. Different model validation methods were used to identify the best fitting model. Model-based risk predictions at unobserved locations were obtained via Bayesian predictive distributions for the best fitting model. Results Model validation indicated that linear environmental predictors were able to fit the data as well as or even better than more complex non-linear terms and that the data do not support spatial dependence. Overall the averaged population-adjusted parasitaemia risk was 20.0% in children less than five years with the highest risk predicted in the northern (38.3%) province. The odds of parasitaemia in children living in a household with at least one bed net decreases by 40% (CI: 12%, 61%) compared to those without bed nets. Conclusions The map of parasitaemia

  19. Malaria and schistosomiasis risks associated with surface and sprinkler irrigation systems in Zimbabwe.

    PubMed

    Chimbari, M J; Chirebvu, E; Ndlela, B

    2004-01-01

    A comparative assessment of the malaria and schistosomiasis risks associated with surface and sprinkler irrigation systems in Zimbabwe was carried out. The risk assessment of the two diseases was done in accordance with the three standard components of health impact assessment, namely (i) community vulnerability, (ii) environmental receptivity, and (iii) capability of health services to respond to malaria and schistosomiasis. Records of the two diseases were obtained from four health centres serving two surface irrigation schemes and two sprinkler irrigation schemes. For comparison records were also obtained from health centres serving nearby dryland areas. Incidence of schistosomiasis as estimated from recorded new cases of the disease was much higher in surface irrigation schemes than in sprinkler irrigation schemes. For malaria it was the other way around. These findings were confirmed by rapid risk assessments. Malaria risk factors were more prominent in sprinkler irrigation schemes, whereas more schistosomiasis risk factors were identified in surface irrigation schemes. These observations were attributed to poorly maintained infrastructure and inadequate landscape-levelling, which created mosquito breeding sites within the fields in the case of sprinkler schemes, and to poor drainage structures, which created snail-breeding sites in the case of surface-irrigation schemes. Importantly, poor maintenance of sprinkler scheme infrastructure accounted for more disease promoting features than the engineering designs per se. This study demonstrated the value of complementing routinely collected health data with rapid assessment procedures for appraisal of commonly reported diseases. PMID:14732242

  20. AN OVERVIEW OF THE USE OF QSARS FOR RANKING AND PRIORITIZING LARGE CHEMICAL INVENTORIES FOR ENVIRONMENTAL RISK ASSESSMENT

    EPA Science Inventory

    Ecological risk assessments for chemical stressors are used to establish linkages between likely exposure concentrations and adverse effects to ecological receptors. At times, it is useful to conduct screening risk assessments to assist in prioritizing or ranking chemicals on the...

  1. Prospects and recommendations for risk mapping to improve strategies for effective malaria vector control interventions in Latin America.

    PubMed

    Alimi, Temitope O; Fuller, Douglas O; Quinones, Martha L; Xue, Rui-De; Herrera, Socrates V; Arevalo-Herrera, Myriam; Ulrich, Jill N; Qualls, Whitney A; Beier, John C

    2015-12-23

    With malaria control in Latin America firmly established in most countries and a growing number of these countries in the pre-elimination phase, malaria elimination appears feasible. A review of the literature indicates that malaria elimination in this region will be difficult without locally tailored strategies for vector control, which depend on more research on vector ecology, genetics and behavioural responses to environmental changes, such as those caused by land cover alterations, and human population movements. An essential way to bridge the knowledge gap and improve vector control is through risk mapping. Malaria risk maps based on statistical and knowledge-based modelling can elucidate the links between environmental factors and malaria vectors, explain interactions between environmental changes and vector dynamics, and provide a heuristic to demonstrate how the environment shapes malaria transmission. To increase the utility of risk mapping in guiding vector control activities, definitions of malaria risk for mapping purposes must be standardized. The maps must also possess appropriate scale and resolution in order to become essential tools in integrated vector management (IVM), so that planners can target areas in greatest need of control measures. Fully integrating risk mapping into vector control programmes will make interventions more evidence-based, making malaria elimination more attainable.

  2. Evaluation of a Web-Based Malaria Risk Reduction Game for Study Abroad Students

    PubMed Central

    Hartjes, Laurie B.; Baumann, Linda C.

    2012-01-01

    Objective Compare feedback strategies in three versions of an educational game. Participants Study abroad students (N = 482) participated by playing the game and completing pre-game/post-game surveys January-March 2010. Methods This study employed an experimental design. Primary outcome measures were knowledge gain, player-satisfaction, and risk perception. Results One-third had previously traveled to a malaria-risk region and two-thirds planned to do so. Baseline malaria knowledge was low. Post-game knowledge and risk perception were significantly higher than pre-game, irrespective of past travel status. The group that automatically received explanatory feedback following game decisions scored higher for mean knowledge gain, without differences in player-satisfaction. Conclusions The challenges of designing a feedback strategy to support Web-based learning make these results highly relevant to health educators developing interactive multimedia interventions. The increasing number of students traveling to higher-risk destinations demands attention. Both malaria-naive and malaria-experienced students would benefit from this approach to travel health education. PMID:22686363

  3. Analytical Hierarchy Process modeling for malaria risk zones in Vadodara district, Gujarat

    NASA Astrophysics Data System (ADS)

    Bhatt, B.; Joshi, J. P.

    2014-11-01

    Malaria epidemic is one of the complex spatial problems around the world. According to WHO, an estimated 6, 27, 000 deaths occurred due to malaria in 2012. In many developing nations with diverse ecological regions, it is still a large cause of human mortality. Owing to the incompleteness of epidemiological data and their spatial origin, the quantification of disease incidence burdening basic public health planning is a major constrain especially in developing countries. The present study focuses on the integrated Geospatial and Multi-Criteria Evaluation (AHP) technique to determine malaria risk zones. The study is conducted in Vadodara district, including 12 Taluka among which 4 Taluka are predominantly tribal. The influence of climatic and physical environmental factors viz., rainfall, hydro geomorphology; drainage, elevation, and land cover are used to score their share in the evaluation of malariogenic condition. This was synthesized on the basis of preference over each factor and the total weights of each data and data layer were computed and visualized. The district was divided into three viz., high, moderate and low risk zones .It was observed that a geographical area of 1885.2sq.km comprising 30.3% fall in high risk zone. The risk zones identified on the basis of these parameters and assigned weights shows a close resemblance with ground condition. As the API distribution for 2011overlaid corresponds to the risk zones identified. The study demonstrates the significance and prospect of integrating Geospatial tools and Analytical Hierarchy Process for malaria risk zones and dynamics of malaria transmission.

  4. Malaria risk factors in North West Tanzania: the effect of spraying, nets and wealth.

    PubMed

    West, Philippa A; Protopopoff, Natacha; Rowland, Mark; Cumming, Emma; Rand, Alison; Drakeley, Chris; Wright, Alexandra; Kivaju, Zuhura; Kirby, Matthew J; Mosha, Franklin W; Kisinza, William; Kleinschmidt, Immo

    2013-01-01

    Malaria prevalence remains high in many African countries despite massive scaling-up of insecticide treated nets (ITN) and indoor residual spraying (IRS). This paper evaluates the protective effect of pyrethroid IRS and ITNs in relation to risk factors for malaria based on a study conducted in North-West Tanzania, where IRS has been conducted since 2007 and universal coverage of ITNs has been carried out recently. In 2011 community-based cross-sectional surveys were conducted in the two main malaria transmission periods that occur after the short and long rainy seasons. These included 5,152 and 4,325 children aged 0.5-14 years, respectively. Data on IRS and ITN coverage, household demographics and socio-economic status were collected using an adapted version of the Malaria Indicator Survey. Children were screened for malaria by rapid diagnostic test. In the second survey, haemoglobin density was measured and filter paper blood spots were collected to determine age-specific sero-prevalence in each community surveyed. Plasmodium falciparum infection prevalence in children 0.5-14 years old was 9.3% (95%CI:5.9-14.5) and 22.8% (95%CI:17.3-29.4) in the two surveys. Risk factors for infection after the short rains included households not being sprayed (OR = 0.39; 95%CI:0.20-0.75); low community net ownership (OR = 0.45; 95%CI:0.21-0.95); and low community SES (least poor vs. poorest tertile: OR = 0.13, 95%CI:0.05-0.34). Risk factors after the long rains included household poverty (per quintile increase: OR = 0.89; 95%CI:0.82-0.97) and community poverty (least poor vs. poorest tertile: OR = 0.26, 95%CI:0.15-0.44); household IRS or high community ITN ownership were not protective. Despite high IRS coverage and equitable LLIN distribution, poverty was an important risk factor for malaria suggesting it could be beneficial to target additional malaria control activities to poor households and communities. High malaria prevalence in some clusters and the

  5. A Comparative Approach for Ranking Contaminated Sites Based on the Risk Assessment Paradigm Using Fuzzy PROMETHEE

    NASA Astrophysics Data System (ADS)

    Zhang, Kejiang; Kluck, Cheryl; Achari, Gopal

    2009-11-01

    A ranking system for contaminated sites based on comparative risk methodology using fuzzy Preference Ranking Organization METHod for Enrichment Evaluation (PROMETHEE) was developed in this article. It combines the concepts of fuzzy sets to represent uncertain site information with the PROMETHEE, a subgroup of Multi-Criteria Decision Making (MCDM) methods. Criteria are identified based on a combination of the attributes (toxicity, exposure, and receptors) associated with the potential human health and ecological risks posed by contaminated sites, chemical properties, site geology and hydrogeology and contaminant transport phenomena. Original site data are directly used avoiding the subjective assignment of scores to site attributes. When the input data are numeric and crisp the PROMETHEE method can be used. The Fuzzy PROMETHEE method is preferred when substantial uncertainties and subjectivities exist in site information. The PROMETHEE and fuzzy PROMETHEE methods are both used in this research to compare the sites. The case study shows that this methodology provides reasonable results.

  6. Spatiotemporal Analysis of Malaria in Urban Ahmedabad (Gujarat), India: Identification of Hot Spots and Risk Factors for Targeted Intervention.

    PubMed

    Parizo, Justin; Sturrock, Hugh J W; Dhiman, Ramesh C; Greenhouse, Bryan

    2016-09-01

    The world population, especially in developing countries, has experienced a rapid progression of urbanization over the last half century. Urbanization has been accompanied by a rise in cases of urban infectious diseases, such as malaria. The complexity and heterogeneity of the urban environment has made study of specific urban centers vital for urban malaria control programs, whereas more generalizable risk factor identification also remains essential. Ahmedabad city, India, is a large urban center located in the state of Gujarat, which has experienced a significant Plasmodium vivax and Plasmodium falciparum disease burden. Therefore, a targeted analysis of malaria in Ahmedabad city was undertaken to identify spatiotemporal patterns of malaria, risk factors, and methods of predicting future malaria cases. Malaria incidence in Ahmedabad city was found to be spatially heterogeneous, but temporally stable, with high spatial correlation between species. Because of this stability, a prediction method utilizing historic cases from prior years and seasons was used successfully to predict which areas of Ahmedabad city would experience the highest malaria burden and could be used to prospectively target interventions. Finally, spatial analysis showed that normalized difference vegetation index, proximity to water sources, and location within Ahmedabad city relative to the dense urban core were the best predictors of malaria incidence. Because of the heterogeneity of urban environments and urban malaria itself, the study of specific large urban centers is vital to assist in allocating resources and informing future urban planning.

  7. Spatiotemporal Analysis of Malaria in Urban Ahmedabad (Gujarat), India: Identification of Hot Spots and Risk Factors for Targeted Intervention.

    PubMed

    Parizo, Justin; Sturrock, Hugh J W; Dhiman, Ramesh C; Greenhouse, Bryan

    2016-09-01

    The world population, especially in developing countries, has experienced a rapid progression of urbanization over the last half century. Urbanization has been accompanied by a rise in cases of urban infectious diseases, such as malaria. The complexity and heterogeneity of the urban environment has made study of specific urban centers vital for urban malaria control programs, whereas more generalizable risk factor identification also remains essential. Ahmedabad city, India, is a large urban center located in the state of Gujarat, which has experienced a significant Plasmodium vivax and Plasmodium falciparum disease burden. Therefore, a targeted analysis of malaria in Ahmedabad city was undertaken to identify spatiotemporal patterns of malaria, risk factors, and methods of predicting future malaria cases. Malaria incidence in Ahmedabad city was found to be spatially heterogeneous, but temporally stable, with high spatial correlation between species. Because of this stability, a prediction method utilizing historic cases from prior years and seasons was used successfully to predict which areas of Ahmedabad city would experience the highest malaria burden and could be used to prospectively target interventions. Finally, spatial analysis showed that normalized difference vegetation index, proximity to water sources, and location within Ahmedabad city relative to the dense urban core were the best predictors of malaria incidence. Because of the heterogeneity of urban environments and urban malaria itself, the study of specific large urban centers is vital to assist in allocating resources and informing future urban planning. PMID:27382081

  8. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR)

    PubMed Central

    Evans, Scott R.; Rubin, Daniel; Follmann, Dean; Pennello, Gene; Huskins, W. Charles; Powers, John H.; Schoenfeld, David; Chuang-Stein, Christy; Cosgrove, Sara E.; Fowler, Vance G.; Lautenbach, Ebbing; Chambers, Henry F.

    2015-01-01

    Clinical trials that compare strategies to optimize antibiotic use are of critical importance but are limited by competing risks that distort outcome interpretation, complexities of noninferiority trials, large sample sizes, and inadequate evaluation of benefits and harms at the patient level. The Antibacterial Resistance Leadership Group strives to overcome these challenges through innovative trial design. Response adjusted for duration of antibiotic risk (RADAR) is a novel methodology utilizing a superiority design and a 2-step process: (1) categorizing patients into an overall clinical outcome (based on benefits and harms), and (2) ranking patients with respect to a desirability of outcome ranking (DOOR). DOORs are constructed by assigning higher ranks to patients with (1) better overall clinical outcomes and (2) shorter durations of antibiotic use for similar overall clinical outcomes. DOOR distributions are compared between antibiotic use strategies. The probability that a randomly selected patient will have a better DOOR if assigned to the new strategy is estimated. DOOR/RADAR represents a new paradigm in assessing the risks and benefits of new strategies to optimize antibiotic use. PMID:26113652

  9. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR).

    PubMed

    Evans, Scott R; Rubin, Daniel; Follmann, Dean; Pennello, Gene; Huskins, W Charles; Powers, John H; Schoenfeld, David; Chuang-Stein, Christy; Cosgrove, Sara E; Fowler, Vance G; Lautenbach, Ebbing; Chambers, Henry F

    2015-09-01

    Clinical trials that compare strategies to optimize antibiotic use are of critical importance but are limited by competing risks that distort outcome interpretation, complexities of noninferiority trials, large sample sizes, and inadequate evaluation of benefits and harms at the patient level. The Antibacterial Resistance Leadership Group strives to overcome these challenges through innovative trial design. Response adjusted for duration of antibiotic risk (RADAR) is a novel methodology utilizing a superiority design and a 2-step process: (1) categorizing patients into an overall clinical outcome (based on benefits and harms), and (2) ranking patients with respect to a desirability of outcome ranking (DOOR). DOORs are constructed by assigning higher ranks to patients with (1) better overall clinical outcomes and (2) shorter durations of antibiotic use for similar overall clinical outcomes. DOOR distributions are compared between antibiotic use strategies. The probability that a randomly selected patient will have a better DOOR if assigned to the new strategy is estimated. DOOR/RADAR represents a new paradigm in assessing the risks and benefits of new strategies to optimize antibiotic use.

  10. Social and environmental malaria risk factors in urban areas of Ouagadougou, Burkina Faso

    PubMed Central

    Baragatti, Meili; Fournet, Florence; Henry, Marie-Claire; Assi, Serge; Ouedraogo, Herman; Rogier, Christophe; Salem, Gérard

    2009-01-01

    Background Despite low endemicity, malaria remains a major health problem in urban areas where a high proportion of fevers are presumptively treated using anti-malarial drugs. Low acquired malaria immunity, behaviour of city-dwellers, access to health care and preventive interventions, and heterogenic suitability of urban ecosystems for malaria transmission contribute to the complexity of the malaria epidemiology in urban areas. Methods The study was designed to identify the determinants of malaria transmission estimated by the prevalence of anti-circumsporozoite (CSP) antibodies, the prevalence and density of Plasmodium falciparum infection, and the prevalence of malarial disease in areas of Ouagadougou, Burkina-Faso. Thick blood smears, dried blood spots and clinical status have been collected from 3,354 randomly chosen children aged 6 months to 12 years using two cross-sectional surveys (during the dry and rainy seasons) in eight areas from four ecological strata defined according to building density and land tenure (regular versus irregular). Demographic characteristics, socio-economic information, and sanitary and environmental data concerning the children or their households were simultaneously collected. Dependent variables were analysed using mixed multivariable models with random effects, taking into account the clustering of participants within compounds and areas. Results Overall prevalences of CSP-antibodies and P. falciparum infections were 7.7% and 16.6% during the dry season, and 12.4% and 26.1% during the rainy season, respectively, with significant differences according to ecological strata. Malaria risk was significantly higher among children who i) lived in households with lower economic or education levels, iii) near the hydrographic network, iv) in sparsely built-up areas, v) in irregularly built areas, vi) who did not use a bed net, vii) were sampled during the rainy season or ii) had traveled outside of Ouagadougou. Conclusion Malaria control

  11. Spatial analysis and mapping of malaria risk in Malawi using point-referenced prevalence of infection data

    PubMed Central

    Kazembe, Lawrence N; Kleinschmidt, Immo; Holtz, Timothy H; Sharp, Brian L

    2006-01-01

    Background Current malaria control initiatives aim at reducing malaria burden by half by the year 2010. Effective control requires evidence-based utilisation of resources. Characterizing spatial patterns of risk, through maps, is an important tool to guide control programmes. To this end an analysis was carried out to predict and map malaria risk in Malawi using empirical data with the aim of identifying areas where greatest effort should be focussed. Methods Point-referenced prevalence of infection data for children aged 1–10 years were collected from published and grey literature and geo-referenced. The model-based geostatistical methods were applied to analyze and predict malaria risk in areas where data were not observed. Topographical and climatic covariates were added in the model for risk assessment and improved prediction. A Bayesian approach was used for model fitting and prediction. Results Bivariate models showed a significant association of malaria risk with elevation, annual maximum temperature, rainfall and potential evapotranspiration (PET). However in the prediction model, the spatial distribution of malaria risk was associated with elevation, and marginally with maximum temperature and PET. The resulting map broadly agreed with expert opinion about the variation of risk in the country, and further showed marked variation even at local level. High risk areas were in the low-lying lake shore regions, while low risk was along the highlands in the country. Conclusion The map provided an initial description of the geographic variation of malaria risk in Malawi, and might help in the choice and design of interventions, which is crucial for reducing the burden of malaria in Malawi. PMID:16987415

  12. Assessment of Risk Factors Associated with Malaria Transmission in Tubu Village, Northern Botswana

    PubMed Central

    Chirebvu, Elijah; Chimbari, Moses John; Ngwenya, Barbara Ntombi

    2014-01-01

    This study investigated potential risk factors associated with malaria transmission in Tubu village, Okavango subdistrict, a malaria endemic area in northern Botswana. Data was derived from a census questionnaire survey, participatory rural appraisal workshop, field observations, and mosquito surveys. History of malaria episodes was associated with several factors: household income (P < 0.05), late outdoor activities (OR = 7.016; CI = 1.786–27.559), time spent outdoors (P = 0.051), travel outside study area (OR = 2.70; CI = 1.004–7.260), nonpossession of insecticide treated nets (OR = 0.892; CI = 0.797–0.998), hut/house structure (OR = 11.781; CI = 3.868–35.885), and homestead location from water bodies (P < 0.05). No associations were established between history of malaria episodes and the following factors: being a farmer (P > 0.05) and number of nets possessed (P > 0.05). Eave size was not associated with mosquito bites (P > 0.05), frequency of mosquito bites (P > 0.05), and time of mosquito bites (P > 0.05). Possession of nets was very high (94.7%). Close proximity of a health facility and low vegetation cover were added advantages. Some of the identified risk factors are important for developing effective control and elimination strategies involving the community, with limited resources. PMID:24757573

  13. Occupational Stress and Cardiovascular Risk Factors in High-Ranking Government Officials and Office Workers

    PubMed Central

    Mirmohammadi, Seyyed Jalil; Taheri, Mahmoud; Mehrparvar, Amir Houshang; Heydari, Mohammad; Saadati Kanafi, Ali; Mostaghaci, Mehrdad

    2014-01-01

    Background: Cardiovascular diseases are among the most important sources of mortality and morbidity, and have a high disease burden. There are some major well-known risk factors, which contribute to the development of these diseases. Occupational stress is caused due to imbalance between job demands and individual’s ability, and it has been implicated as an etiology for cardiovascular diseases. Objectives: This study was conducted to evaluate the cardiovascular risk factors and different dimensions of occupational stress in high-ranking government officials, comparing an age and sex-matched group of office workers with them. Patients and Methods: We invited 90 high-ranking officials who managed the main governmental offices in a city, and 90 age and sex-matched office workers. The subjects were required to fill the occupational role questionnaire (Osipow) which evaluated their personal and medical history as well as occupational stress. Then, we performed physical examination and laboratory tests to check for cardiovascular risk factors. Finally, the frequency of cardiovascular risk factors and occupational stress of two groups were compared. Results: High-ranking officials in our study had less work experience in their current jobs and smoked fewer pack-years of cigarette, but they had higher waist and hip circumference, higher triglyceride level, more stress from role overload and responsibility, and higher total stress score. Our group of office workers had more occupational stress because of role ambiguity and insufficiency, but their overall job stress was less than officials. Conclusions: The officials have higher scores in some dimensions of occupational stress and higher overall stress score. Some cardiovascular risk factors were also more frequent in managers. PMID:25389469

  14. Ranking Cancer Risks of Organic Hazardous Air Pollutants in the United States

    PubMed Central

    Loh, Miranda M.; Levy, Jonathan I.; Spengler, John D.; Houseman, E. Andres; Bennett, Deborah H.

    2007-01-01

    Background In this study we compared cancer risks from organic hazardous air pollutants (HAPs) based on total personal exposure summed across different microenvironments and exposure pathways. Methods We developed distributions of personal exposure concentrations using field monitoring and modeling data for inhalation and, where relevant, ingestion pathways. We calculated risks for a nonoccupationally exposed and nonsmoking population using U.S. Environmental Protection Agency (EPA) and California Office of Environmental Health and Hazard Assessment (OEHHA) unit risks. We determined the contribution to risk from indoor versus outdoor sources using indoor/outdoor ratios for gaseous compounds and the infiltration factor for particle-bound compounds. Results With OEHHA’s unit risks, the highest ranking compounds based on the population median are 1,3-butadiene, formaldehyde, benzene, and dioxin, with risks on the order of 10−4–10−5. The highest risk compounds with the U.S. EPA unit risks were dioxin, benzene, formaldehyde, and chloroform, with risks on a similar order of magnitude. Although indoor exposures are responsible for nearly 70% of risk using OEHHA’s unit risks, when infiltration is accounted for, inhalation of outdoor sources contributed 50% to total risk, on average. Additionally, 15% of risk resulted from exposures through food, mainly due to dioxin. Conclusions Most of the polycyclic aromatic hydrocarbon, benzene, acetaldehyde, and 1,3-butadiene risk came from outdoor sources, whereas indoor sources were primarily responsible for chloroform, formaldehyde, and naphthalene risks. The infiltration of outdoor pollution into buildings, emissions from indoor sources, and uptake through food are all important to consider in reducing overall personal risk to HAPs. PMID:17687442

  15. Choice of scale for integrating land use in malaria risk monitoring

    NASA Astrophysics Data System (ADS)

    Spangler, K. R.; Zaitchik, B. F.; Pan, W.; Vittor, A.; Patz, J.

    2011-12-01

    There were nearly 37,000 reported cases of malaria in Peru in 2009 alone. With over 30% of the population identified as being at "high risk" for exposure, detailed risk mapping, along with early detection and warning systems, are in critical need. While there is evidence that the increased formation of puddles arising from deforestation increases the breeding of the rainforest's primary malaria vector, Anopheles darlingi, neither the spatial structure of land uses/land cover changes (LUCC) nor the area of influence of LUCC on mosquito density has been systematically addressed. The radius of influence that LUCC - particularly areas of deforested land and other regions likely to see increases in stagnant water formation - has on mosquito presence is of particular importance, both for the design of warning systems and to inform future malaria transmission studies. Here, we present the results of satellite-based analysis of land use patterns and mosquito density along the Iquitos-Nauta road in the Peruvian Amazon. Comparing supervised classifications of Landsat images of the Iquitos region from 1996 and 2001 , land cover features around each of 832 mosquito sites were tabulated by percent at six different radii: 250m, 500m, 1000m, 2000m, 3000m, and 5000m. These results were then used as inputs in a mosquito prediction model that determined the most pertinent spatial scale necessary to predict both adult and larvae Anopheles mosquitoes (darlingi, benerocchi, oswaldoi, mattogrossenis, and rangeli). The application of this study is to provide a systematic means of determining which areas are at the highest risk of malaria infection in order to inform design of warning systems and future studies of land use and malaria in the Amazonian frontier.

  16. Ranking freshwater fish farms for the risk of pathogen introduction and spread.

    PubMed

    Oidtmann, B C; Crane, C N; Thrush, M A; Hill, B J; Peeler, E J

    2011-12-15

    A semi-quantitative model is presented to rank freshwater rainbow trout farms within a country or region with regards to the risk of becoming infected and spreading a specified pathogen. The model was developed to support a risk-based surveillance scheme for notifiable salmonid pathogens. Routes of pathogen introduction and spread were identified through a process of expert consultation in a series of workshops. The routes were combined into themes (e.g. exposure via water, mechanical transmission). Themes were weighted based on expert opinion. Risk factors for each route were scored and combined into a theme score which was adjusted by the weight. The number of sources and consignments were used to assess introduction via live fish movements onto the farm. Biosecurity measures were scored to assess introduction on fomites. Upstream farms, wild fish and processing plants were included in assessing the likelihood of introduction by water. The scores for each theme were combined to give separate risk scores for introduction and spread. A matrix was used to combine these to give an overall risk score. A case study for viral haemorrhagic septicaemia is presented. Nine farms that represent a range of farming practices of rainbow trout farms in England and Wales are used as worked examples of the model. The model is suited to risk rank freshwater salmonid farms which are declared free of the pathogen(s) under consideration. The score allocated to a farm does not equate to a quantitative probability estimate of the farm to become infected or spread infection. Nevertheless, the method provides a transparent approach to ranking farms with regards to pathogen transmission risks. The output of the model at a regional or national level allows the allocation of surveillance effort to be risk based. It also provides fish farms with information on how they can reduce their risk score by improving biosecurity. The framework of the model can be applied to different production

  17. The participatory vulnerability scoping diagram - deliberative risk ranking for community water systems

    USGS Publications Warehouse

    Howe, Peter D.; Yarnal, Brent; Coletti, Alex; Wood, Nathan J.

    2013-01-01

    Natural hazards and climate change present growing challenges to community water system (CWS) managers, who are increasingly turning to vulnerability assessments to identify, prioritize, and adapt to risks. Effectively assessing CWS vulnerability requires information and participation from various sources, one of which is stakeholders. In this article, we present a deliberative risk-ranking methodology, the participatory vulnerability scoping diagram (P-VSD), which allows rapid assessment and integration of multiple stakeholder perspectives of vulnerability. This technique is based on methods of deliberative risk evaluation and the vulnerability scoping diagram. The goal of the methodology is to engage CWS managers and stakeholders collectively to provide qualitative contextual risk rankings as a first step in a vulnerability assessment. We conduct an initial assessment using a case study of CWS in two U.S. counties, sites with broadly similar exposures but differences in population, land use, and other social sensitivity factors. Results demonstrate that CWS managers and stakeholders in the two case study communities all share the belief that their CWS are vulnerable to hazards but differ in how this vulnerability manifests itself in terms of the exposure, sensitivity, and adaptive capacity of the system.

  18. Socio-economic determinants for malaria transmission risk in an endemic primary health centre in Assam, India

    PubMed Central

    2014-01-01

    Background Malaria is a major cause of morbidity and mortality in Northeast India. As there is limited information available on the potential influence of socio-economic variables on malaria risk, the present study was conducted to assess the influence of demographic factors, the socio-economic status, and knowledge, awareness and education on malaria occurrence. Methods Demographics, malaria knowledge and socio-economic variables were collected in four randomly selected health sub-centres of the Orang primary health centre in the Udalguri district, Assam and the association of malaria occurrence with different variables were analysed. The trend of malaria occurrence for different income groups, proximity to health centres and number of mosquito bites per day was also determined using the chi-square test. Relative risk (RR) for gender, house type, knowledge and use of bed nets was determined using Katz approximation. Results Out of the 71 household heads interviewed, 70.4% (50/71) were males. About half (54.9%, 39/71) of the participants had a history of malaria in the last two years, of which 64.1% (25/39) were males, while 35.9% (14/39) were females (χ2 = 5.13; p = 0.02; RR = 1.79). Of the total population surveyed, 49.3% lived in bamboo houses and 35.2% lived at a distance of >3 km from the nearest health centre. The number of participants who had a history of malaria decreased with an increasing monthly income (p < 0.0001). Malaria occurrence was higher among the households living in bamboo houses (69.2%), as compared to Kucha houses (20.5%) and Pucca houses (10.3%). No significant association was observed between education level and malaria occurrence (p = 0.93). The participants who did not use bed nets regularly reported a high occurrence of malaria infection as compared to those who used bed nets everyday (p < 0.0001). Conclusions Lower income, house type, distance to health sub-centre, knowledge and awareness about malaria, number of mosquito bites per

  19. Elimination of malaria risk through integrated combination strategies in a tropical military training island.

    PubMed

    Lee, Vernon J; Ow, Samuel; Heah, Harold; Tan, Meng Yaw; Lam, Patrick; Ng, Lee-Ching; Lam-Phua, Sai Gek; Imran, Abdul Qadir; Seet, Benjamin

    2010-06-01

    On the military training facility of Tekong Island, Singapore, a comprehensive vector-borne disease control program was started in end-2006 to reduce mosquito populations and negate the need for anti-malaria chemoprophylaxis. The program was based on 1) preventing importation of malaria through screening of visitors, 2) preventing human-to-mosquito transmission through early case detection and mosquito control, 3) preventing mosquito-to-human transmission through personal protection, and 4) contingency plans. Systematic environmental works were performed to reduce breeding sites, and insecticide use targeted both adult mosquitoes and larvae. Mosquito populations declined from 103 mosquitoes per sampling site in January 2007 to 6 per site by March 2007 (P < 0.001). The proportion of positive ovitraps declined from 93% in January 2007-2% in March 2007 (P < 0.001). There were no malaria cases on the island despite chemoprophylaxis termination, showing that comprehensive combination vector-control strategies were effective in reducing the risk of malaria.

  20. Elimination of Malaria Risk through Integrated Combination Strategies in a Tropical Military Training Island

    PubMed Central

    Lee, Vernon J.; Ow, Samuel; Heah, Harold; Tan, Meng Yaw; Lam, Patrick; Ng, Lee-Ching; Lam-Phua, Sai Gek; Imran, Abdul Qadir; Seet, Benjamin

    2010-01-01

    On the military training facility of Tekong Island, Singapore, a comprehensive vector-borne disease control program was started in end-2006 to reduce mosquito populations and negate the need for anti-malaria chemoprophylaxis. The program was based on 1) preventing importation of malaria through screening of visitors, 2) preventing human-to-mosquito transmission through early case detection and mosquito control, 3) preventing mosquito-to-human transmission through personal protection, and 4) contingency plans. Systematic environmental works were performed to reduce breeding sites, and insecticide use targeted both adult mosquitoes and larvae. Mosquito populations declined from 103 mosquitoes per sampling site in January 2007 to 6 per site by March 2007 (P < 0.001). The proportion of positive ovitraps declined from 93% in January 2007–2% in March 2007 (P < 0.001). There were no malaria cases on the island despite chemoprophylaxis termination, showing that comprehensive combination vector-control strategies were effective in reducing the risk of malaria. PMID:20519595

  1. Ranking the risks of 12 major environmental pollutants that occur in Japan.

    PubMed

    Gamo, Masashi; Oka, Tosihiro; Nakanishi, Junko

    2003-10-01

    The risks posed by 12 major environmental pollutants in Japan were evaluated and ranked on the same scale. These were arsenic, benzene, cadmium, chlordane, chlorpyrifos, DDTs, dioxins, formaldehyde, methylmercury, radon, toluene, and xylenes. Approximately half of these substances are carcinogenic while the other half are non-carcinogenic. We applied a risk estimation framework that can evaluate both cancer and non-cancer risks on the same scale. The framework consists of two parts: the calculation of the probability of adverse health effects, and the evaluation of the severity of the effects. In order to calculate the probability of adverse health effects, individual variabilities in exposure level, metabolizing rate, and sensitivity were taken into account. Loss of life expectancy (LLE; days) was used as a measure of severity of the adverse health effects and of the resulting risk level. The risk level of the substances in terms of LLE ranged from approximately 0.01 to 10 days. The risks from radon and formaldehyde were found to be the highest, while those from DDT and chlordane were the lowest. Our findings also suggested that the risk levels posed by non-carcinogenic substances were comparable to those posed by carcinogenic substances.

  2. Environmental risk factors for clinical malaria: a case-control study in the Grau region of Peru.

    PubMed

    Guthmann, J P; Hall, A J; Jaffar, S; Palacios, A; Lines, J; Llanos-Cuentas, A

    2001-01-01

    The role of environmental risk factors in clinical malaria has been studied mainly in Africa and Asia, few investigations have been carried out in Latin America. Field observations in northern coastal Peru, where the prevalence of malaria is high during the agricultural season, suggested that the risk of disease varied according to the characteristics of the house and the house environment. Environmental determinants of the risk of clinical malaria were therefore investigated through a case-control study: 323 clinical cases of malaria, recruited through community-based active case-finding, and 969 age-, sex- and village-matched controls were recruited into the study over a period of 12 months ending June 1997. Residual spraying of houses in the previous 6 months, living more than 100 m from a canal, a level of education equal to primary school or above and working in agriculture conferred significant protection from the risk of developing clinical malaria. The presence of spaces between the wall and roof in the subject's bedroom (eaves) and a house aged > 4 years statistically significantly increased the risk of disease. Based on these results we discuss possible control measures for malaria in this area of the country.

  3. Duration of residency in a non-endemic area and risk of severe malaria in African immigrants.

    PubMed

    Färnert, A; Wyss, K; Dashti, S; Naucler, P

    2015-05-01

    In malaria-endemic areas, adults very rarely succumb to severe malaria, suggesting that immunity to severe disease is life-long under conditions of repeated exposure. To what extent this protection persists in the absence of exposure remains to be established. The aim of this study was to assess whether duration of residency in a malaria-free country affects the risk for severe malaria in immigrants originating from sub-Saharan Africa. We conducted a retrospective chart review of 948 cases of malaria diagnosed in Stockholm, Sweden in 1995-2013. Among 501 adult patients with Plasmodium falciparum (315 of endemic origin and 186 of non-endemic origin, mainly Sweden), 41 (8.2%) had severe malaria according to WHO criteria (including 5% with parasitaemia), 22 (4.4%) had factors prognostic of poor outcome, and 35 (7.0%) were admitted to intensive care. Overall, patient origin did not affect the odds of severe malaria, according to any of these definitions. However, when the immigrants were stratified with regard to their duration of residency in Sweden, the risk of factors prognostic for poor outcome was associated with duration of prior residency in a malaria-free country among patients of endemic origin (p 0.02), and immigrants who had lived for ≥ 15 years in Sweden had a similar risk as non-immune travellers. The results of this explorative study suggest that, although immunity to severe malaria is maintained for several years in African adults, this protection might be lost with time without repeated re-exposure. A larger study, preferably including multiple centres, will be needed to confirm our findings. PMID:25656623

  4. Duration of residency in a non-endemic area and risk of severe malaria in African immigrants.

    PubMed

    Färnert, A; Wyss, K; Dashti, S; Naucler, P

    2015-05-01

    In malaria-endemic areas, adults very rarely succumb to severe malaria, suggesting that immunity to severe disease is life-long under conditions of repeated exposure. To what extent this protection persists in the absence of exposure remains to be established. The aim of this study was to assess whether duration of residency in a malaria-free country affects the risk for severe malaria in immigrants originating from sub-Saharan Africa. We conducted a retrospective chart review of 948 cases of malaria diagnosed in Stockholm, Sweden in 1995-2013. Among 501 adult patients with Plasmodium falciparum (315 of endemic origin and 186 of non-endemic origin, mainly Sweden), 41 (8.2%) had severe malaria according to WHO criteria (including 5% with parasitaemia), 22 (4.4%) had factors prognostic of poor outcome, and 35 (7.0%) were admitted to intensive care. Overall, patient origin did not affect the odds of severe malaria, according to any of these definitions. However, when the immigrants were stratified with regard to their duration of residency in Sweden, the risk of factors prognostic for poor outcome was associated with duration of prior residency in a malaria-free country among patients of endemic origin (p 0.02), and immigrants who had lived for ≥ 15 years in Sweden had a similar risk as non-immune travellers. The results of this explorative study suggest that, although immunity to severe malaria is maintained for several years in African adults, this protection might be lost with time without repeated re-exposure. A larger study, preferably including multiple centres, will be needed to confirm our findings.

  5. DebtRank: Too Central to Fail? Financial Networks, the FED and Systemic Risk

    NASA Astrophysics Data System (ADS)

    Battiston, Stefano; Puliga, Michelangelo; Kaushik, Rahul; Tasca, Paolo; Caldarelli, Guido

    2012-08-01

    Systemic risk, here meant as the risk of default of a large portion of the financial system, depends on the network of financial exposures among institutions. However, there is no widely accepted methodology to determine the systemically important nodes in a network. To fill this gap, we introduce, DebtRank, a novel measure of systemic impact inspired by feedback-centrality. As an application, we analyse a new and unique dataset on the USD 1.2 trillion FED emergency loans program to global financial institutions during 2008-2010. We find that a group of 22 institutions, which received most of the funds, form a strongly connected graph where each of the nodes becomes systemically important at the peak of the crisis. Moreover, a systemic default could have been triggered even by small dispersed shocks. The results suggest that the debate on too-big-to-fail institutions should include the even more serious issue of too-central-to-fail.

  6. DebtRank: too central to fail? Financial networks, the FED and systemic risk.

    PubMed

    Battiston, Stefano; Puliga, Michelangelo; Kaushik, Rahul; Tasca, Paolo; Caldarelli, Guido

    2012-01-01

    Systemic risk, here meant as the risk of default of a large portion of the financial system, depends on the network of financial exposures among institutions. However, there is no widely accepted methodology to determine the systemically important nodes in a network. To fill this gap, we introduce, DebtRank, a novel measure of systemic impact inspired by feedback-centrality. As an application, we analyse a new and unique dataset on the USD 1.2 trillion FED emergency loans program to global financial institutions during 2008-2010. We find that a group of 22 institutions, which received most of the funds, form a strongly connected graph where each of the nodes becomes systemically important at the peak of the crisis. Moreover, a systemic default could have been triggered even by small dispersed shocks. The results suggest that the debate on too-big-to-fail institutions should include the even more serious issue of too-central-to-fail.

  7. Integrating rapid risk mapping and mobile phone call record data for strategic malaria elimination planning

    PubMed Central

    2014-01-01

    Background As successful malaria control programmes re-orientate towards elimination, the identification of transmission foci, targeting of attack measures to high-risk areas and management of importation risk become high priorities. When resources are limited and transmission is varying seasonally, approaches that can rapidly prioritize areas for surveillance and control can be valuable, and the most appropriate attack measure for a particular location is likely to differ depending on whether it exports or imports malaria infections. Methods/Results Here, using the example of Namibia, a method for targeting of interventions using surveillance data, satellite imagery, and mobile phone call records to support elimination planning is described. One year of aggregated movement patterns for over a million people across Namibia are analyzed, and linked with case-based risk maps built on satellite imagery. By combining case-data and movement, the way human population movements connect transmission risk areas is demonstrated. Communities that were strongly connected by relatively higher levels of movement were then identified, and net export and import of travellers and infection risks by region were quantified. These maps can aid the design of targeted interventions to maximally reduce the number of cases exported to other regions while employing appropriate interventions to manage risk in places that import them. Conclusions The approaches presented can be rapidly updated and used to identify where active surveillance for both local and imported cases should be increased, which regions would benefit from coordinating efforts, and how spatially progressive elimination plans can be designed. With improvements in surveillance systems linked to improved diagnosis of malaria, detailed satellite imagery being readily available and mobile phone usage data continually being collected by network providers, the potential exists to make operational use of such valuable

  8. Using a new high resolution regional model for malaria that accounts for population density and surface hydrology to determine sensitivity of malaria risk to climate drivers

    NASA Astrophysics Data System (ADS)

    Tompkins, Adrian; Ermert, Volker; Di Giuseppe, Francesca

    2013-04-01

    In order to better address the role of population dynamics and surface hydrology in the assessment of malaria risk, a new dynamical disease model been developed at ICTP, known as VECTRI: VECtor borne disease community model of ICTP, TRIeste (VECTRI). The model accounts for the temperature impact on the larvae, parasite and adult vector populations. Local host population density affects the transmission intensity, and the model thus reproduces the differences between peri-urban and rural transmission noted in Africa. A new simple pond model framework represents surface hydrology. The model can be used on with spatial resolutions finer than 10km to resolve individual health districts and thus can be used as a planning tool. Results of the models representation of interannual variability and longer term projections of malaria transmission will be shown for Africa. These will show that the model represents the seasonality and spatial variations of malaria transmission well matching a wide range of survey data of parasite rate and entomological inoculation rate (EIR) from across West and East Africa taken in the period prior to large-scale interventions. The model is used to determine the sensitivity of malaria risk to climate variations, both in rainfall and temperature, and then its use in a prototype forecasting system coupled with ECMWF forecasts will be demonstrated.

  9. [Imported malaria in Tunisia: consequences on the risk of resurgence of the disease].

    PubMed

    Aoun, K; Siala, E; Tchibkere, D; Ben Abdallah, R; Zallagua, N; Chahed, M K; Bouratbine, A

    2010-02-01

    Although malaria has been eradicated in Tunisia since 1979, the disease is still a health issue due to the persistence of mosquitoes and coexistence with a potential parasite reservoir in the form of imported cases. From 1999 to 2006, 98 cases of imported malaria were diagnosed at the Pasteur Institute in Tunis where nearly 30% of national cases are recorded. Tunisians accounted for 24.5% of these cases versus 75.5% involving foreigners. The occurrence rate has steadily increased in volunteer workers, businessmen, diplomats and athletes who together accounted for 41.7% of cases in 1995 as compared to only 17.4% in 1980 (p<0.01). Most cases (96.5%) were imported from sub-Saharan Africa. The most frequent countries involved in importation were Cote d'Ivoire (23 cases) and Mali (8 cases) that are now linked to Tunisia by regular flights. About one third of patients were asymptomatic at the time of diagnosis. This finding underlines the importance of recommending systematic screening in high-risk groups. Fever (70.6%) and gastro-intestinal manifestations (27.9%) were the most frequent clinical findings in the 69 symptomatic cases. Plasmodium falciparum (71.4%) was the most common species followed by Plasmodium ovale (19.4%). Gametocytes were detected in 9.2% of subjects, thus creating a theoretical source of infection for mosquitoes especially since 60.2% of all cases were recorded between June and October when mosquitoes are active in Tunisia. Due to increasing exchange with endemic malaria areas in Africa that has resulted in a higher incidence of imported cases and a futher risk of introduction of tropical mosquito species as well as to global warming that promotes plasmodium transmission, greater vigilance is necessary to ensure eradication of malaria in Tunisia.

  10. Using risk-ranking of metals to identify which poses the greatest threat to freshwater organisms in the UK.

    PubMed

    Donnachie, Rachel L; Johnson, Andrew C; Moeckel, Claudia; Pereira, M Glória; Sumpter, John P

    2014-11-01

    Freshwater aquatic organisms face the challenge of being exposed to a multitude of chemicals discharged by the human population. The objective of this study was to rank metals according to the threat they pose to aquatic organisms. This will contribute to a wider Chemical Strategy for freshwater which will risk-rank all chemicals based on their potential risk to wildlife in a UK setting. The method involved comparing information on ecotoxicological thresholds with measured concentrations in rivers. The bioconcentration factor was also considered as a ranking method. The metals; Ag, Al, As, Cd, Cr, Cu, Fe, Hg, Mn, Ni, Pb and Zn, were analysed using this approach. Triclosan and lindane were used as comparative organic pollutants. Using a range of ranking techniques, Cu, Al and Zn came top of the list of concern, with Cu coming first.

  11. Malaria and blood transfusion: major issues of blood safety in malaria-endemic countries and strategies for mitigating the risk of Plasmodium parasites.

    PubMed

    Abdullah, Saleh; Karunamoorthi, Kaliyaperumal

    2016-01-01

    Malaria inflicts humankind over centuries, and it remains as a major threat to both clinical medicine and public health worldwide. Though hemotherapy is a life-sustaining modality, it continues to be a possible source of disease transmission. Hence, hemovigilance is a matter of grave concern in the malaria-prone third-world countries. In order to pursue an effective research on hemovigilance, a comprehensive search has been conducted by using the premier academic-scientific databases, WHO documents, and English-language search engines. One hundred two appropriate articles were chosen for data extraction, with a particular reference to emerging pathogens transmitted through blood transfusion, specifically malaria. Blood donation screening is done through microscopic examination and immunological assays to improve the safety of blood products by detection major blood-borne pathogens, viz., HIV, HBV, HCV, syphilis, and malarial parasites. Transfusion therapy significantly dwindles the preventable morbidity and mortality attributed to various illnesses and diseases, particularly AIDS, tuberculosis, and malaria. Examination of thick and thin blood smears are performed to detect positivity and to identify the Plasmodium species, respectively. However, all of these existing diagnostic tools have their own limitations in terms of sensitivity, specificity, cost-effectiveness, and lack of resources and skilled personnel. Globally, despite the mandate need of screening blood and its components according to the blood-establishment protocols, it is seldom practiced in the low-income/poverty-stricken settings. In addition, each and every single phase of transfusion chain carries sizable inherent risks from donors to recipients. Interestingly, opportunities also lie ahead to enhance the safety of blood-supply chain and patients. It can be achieved through sustainable blood-management strategies like (1) appropriate usage of precise diagnostic tools/techniques, (2) promoting

  12. Malaria and blood transfusion: major issues of blood safety in malaria-endemic countries and strategies for mitigating the risk of Plasmodium parasites.

    PubMed

    Abdullah, Saleh; Karunamoorthi, Kaliyaperumal

    2016-01-01

    Malaria inflicts humankind over centuries, and it remains as a major threat to both clinical medicine and public health worldwide. Though hemotherapy is a life-sustaining modality, it continues to be a possible source of disease transmission. Hence, hemovigilance is a matter of grave concern in the malaria-prone third-world countries. In order to pursue an effective research on hemovigilance, a comprehensive search has been conducted by using the premier academic-scientific databases, WHO documents, and English-language search engines. One hundred two appropriate articles were chosen for data extraction, with a particular reference to emerging pathogens transmitted through blood transfusion, specifically malaria. Blood donation screening is done through microscopic examination and immunological assays to improve the safety of blood products by detection major blood-borne pathogens, viz., HIV, HBV, HCV, syphilis, and malarial parasites. Transfusion therapy significantly dwindles the preventable morbidity and mortality attributed to various illnesses and diseases, particularly AIDS, tuberculosis, and malaria. Examination of thick and thin blood smears are performed to detect positivity and to identify the Plasmodium species, respectively. However, all of these existing diagnostic tools have their own limitations in terms of sensitivity, specificity, cost-effectiveness, and lack of resources and skilled personnel. Globally, despite the mandate need of screening blood and its components according to the blood-establishment protocols, it is seldom practiced in the low-income/poverty-stricken settings. In addition, each and every single phase of transfusion chain carries sizable inherent risks from donors to recipients. Interestingly, opportunities also lie ahead to enhance the safety of blood-supply chain and patients. It can be achieved through sustainable blood-management strategies like (1) appropriate usage of precise diagnostic tools/techniques, (2) promoting

  13. Communications: Mosquito Habitats, Land Use, and Malaria Risk in Belize from Satellite Imagery

    NASA Technical Reports Server (NTRS)

    Pope, Kevin; Masuoka, Penny; Rejmankova, Eliska; Grieco, John; Johnson, Sarah; Roberts, Donald

    2004-01-01

    Satellite imagery of northern Belize is used to examine the distribution of land use and breeding habitats of the malaria vector the Anopheles mosquito. A land cover classification based on multispectral SPOT and multitemporal Radarsat images identified eleven land cover classes, including agricultural, forest, and marsh types. Two of the land cover types, Typha domingensis marsh and flooded forest, are Anopheles vestitipennis larval habitats, and one, Eleocharis spp. marsh, is the larval habitat for Anopheles albimanus. Geographic Information Systems (GIS) analyses of land cover demonstrate that the amount of Typha domingensis in a marsh is positively correlated with the amount of agricultural land in the adjacent upland, and negatively correlated with the amount of adjacent forest. This finding is consistent with the hypothesis that nutrient (phosphorus) runoff from agricultural lands is causing an expansion of Typha domingensis in northern Belize. Thus, land use induced expansion of Anopheles vestitipennis larval habitat is potentially increasing malaria risk in Belize, and in other regions where Anopheles vestitipennis is a major malaria vector.

  14. Community exposures to airborne agricultural pesticides in California: ranking of inhalation risks.

    PubMed

    Lee, Sharon; McLaughlin, Robert; Harnly, Martha; Gunier, Robert; Kreutzer, Richard

    2002-12-01

    We assessed inhalation risks to California communities from airborne agricultural pesticides by probability distribution analysis using ambient air data provided by the California Air Resources Board and the California Department of Pesticide Regulation. The pesticides evaluated include chloropicrin, chlorothalonil, chlorpyrifos, S,S,S-tributyl phosphorotrithioate, diazinon, 1,3-dichloropropene, dichlorvos (naled breakdown product), endosulfan, eptam, methidathion, methyl bromide, methyl isothiocyanate (MITC; metam sodium breakdown product), molinate, propargite, and simazine. Risks were estimated for the median and 75th and 95th percentiles of probability (50, 25, and 5% of the exposed populations). Exposure estimates greater than or equal to noncancer reference values occurred for 50% of the exposed populations (adults and children) for MITC subchronic and chronic exposures, methyl bromide subchronic exposures (year 2000 monitoring), and 1,3-dichloropropene subchronic exposures (1990 monitoring). Short-term chlorpyrifos exposure estimates exceeded the acute reference value for 50% of children (not adults) in the exposed population. Noncancer risks were uniformly higher for children due to a proportionately greater inhalation rate-to-body weight ratio compared to adults and other factors. Target health effects of potential concern for these exposures include neurologic effects (methyl bromide and chlorpyrifos) and respiratory effects (1,3-dichloropropene and MITC). The lowest noncancer risks occurred for simazine and chlorothalonil. Lifetime cancer risks of one-in-a-million or greater were estimated for 50% of the exposed population for 1,3-dichloropropene (1990 monitoring) and 25% of the exposed populations for methidathion and molinate. Pesticide vapor pressure was found to be a better predictor of inhalation risk compared to other methods of ranking pesticides as potential toxic air contaminants. PMID:12460795

  15. Community exposures to airborne agricultural pesticides in California: ranking of inhalation risks.

    PubMed Central

    Lee, Sharon; McLaughlin, Robert; Harnly, Martha; Gunier, Robert; Kreutzer, Richard

    2002-01-01

    We assessed inhalation risks to California communities from airborne agricultural pesticides by probability distribution analysis using ambient air data provided by the California Air Resources Board and the California Department of Pesticide Regulation. The pesticides evaluated include chloropicrin, chlorothalonil, chlorpyrifos, S,S,S-tributyl phosphorotrithioate, diazinon, 1,3-dichloropropene, dichlorvos (naled breakdown product), endosulfan, eptam, methidathion, methyl bromide, methyl isothiocyanate (MITC; metam sodium breakdown product), molinate, propargite, and simazine. Risks were estimated for the median and 75th and 95th percentiles of probability (50, 25, and 5% of the exposed populations). Exposure estimates greater than or equal to noncancer reference values occurred for 50% of the exposed populations (adults and children) for MITC subchronic and chronic exposures, methyl bromide subchronic exposures (year 2000 monitoring), and 1,3-dichloropropene subchronic exposures (1990 monitoring). Short-term chlorpyrifos exposure estimates exceeded the acute reference value for 50% of children (not adults) in the exposed population. Noncancer risks were uniformly higher for children due to a proportionately greater inhalation rate-to-body weight ratio compared to adults and other factors. Target health effects of potential concern for these exposures include neurologic effects (methyl bromide and chlorpyrifos) and respiratory effects (1,3-dichloropropene and MITC). The lowest noncancer risks occurred for simazine and chlorothalonil. Lifetime cancer risks of one-in-a-million or greater were estimated for 50% of the exposed population for 1,3-dichloropropene (1990 monitoring) and 25% of the exposed populations for methidathion and molinate. Pesticide vapor pressure was found to be a better predictor of inhalation risk compared to other methods of ranking pesticides as potential toxic air contaminants. PMID:12460795

  16. Altered environment and risk of malaria outbreak in South Andaman, Andaman & Nicobar Islands, India affected by tsunami disaster

    PubMed Central

    Krishnamoorthy, Kaliannagoun; Jambulingam, Purushothaman; Natarajan, R; Shriram, AN; Das, Pradeep K; Sehgal, SC

    2005-01-01

    Background Pools of salt water and puddles created by giant waves from the sea due to the tsunami that occurred on 26th December 2004 would facilitate increased breeding of brackish water malaria vector, Anopheles sundaicus. Land uplifts in North Andaman and subsidence in South Andaman have been reported and subsidence may lead to environmental disturbances and vector proliferation. This warrants a situation analysis and vector surveillance in the tsunami hit areas endemic for malaria transmitted by brackish water mosquito, An. sundaicus to predict the risk of outbreak. Methods An extensive survey was carried out in the tsunami-affected areas in Andaman district of the Andaman and Nicobar Islands, India to assess the extent of breeding of malaria vectors in the habitats created by seawater flooding. Types of habitats in relation to source of seawater inundation and frequency were identified. The salinity of the water samples and the mosquito species present in the larval samples collected from these habitats were recorded. The malaria situation in the area was also analysed. Results South Andaman, covering Port Blair and Ferrargunj sub districts, is still under the recurring phenomenon of seawater intrusion either directly from the sea or through a network of creeks. Both daily cycles of high tides and periodical spring tides continue to cause flooding. Low-lying paddy fields and fallow land, with a salinity ranging from 3,000 to 42,505 ppm, were found to support profuse breeding of An. sundaicus, the local malaria vector, and Anopheles subpictus, a vector implicated elsewhere. This area is endemic for both vivax and falciparum malaria. Malaria slide positivity rate has started increasing during post-tsunami period, which can be considered as an indication of risk of malaria outbreak. Conclusion Paddy fields and fallow land with freshwater, hitherto not considered as potential sites for An. sundaicus, are now major breeding sites due to saline water. Consequently

  17. Hazard Ranking System and toxicological risk assessment models yield different results

    SciTech Connect

    Dehghani, T.; Sells, G. . CER-CLA Site Assessment Div.)

    1993-09-01

    A major goal of the Superfund Site Assessment program is identifying hazardous waste sites that pose unacceptable risks to human health and the environment. To accomplish this, EPA developed the Hazard Ranking System (HRS), a mathematical model used to assess the relative risks associated with actual or potential releases of hazardous wastes from a site. HRS is a scoring system based on factors grouped into three categories--likelihood of release, waste characteristics and targets. Values for the factor categories are multiplied, then normalized to 100 points to obtain a pathway score. Four pathways--groundwater, surface water, air migration and soil exposure--are evaluated and scored. The final HRS score is obtained by combining pathway scores using a root-mean-square method. HRS is intended to be a screening tool for measuring relative, rather than absolute, risk. The Superfund site assessment program usually requires at least two studies of a potential hazardous waste site before it is proposed for listing on the NPL. The initial study, or preliminary assessment (PA), is a limited-scope evaluation based on available historical information and data that can be gathered readily during a site reconnaissance.

  18. Elevated Blood Lead Levels Are Associated with Reduced Risk of Malaria in Beninese Infants

    PubMed Central

    Moya-Alvarez, Violeta; Mireku, Michael Osei; Ayotte, Pierre; Cot, Michel; Bodeau-Livinec, Florence

    2016-01-01

    Introduction Elevated blood lead levels (BLL) and malaria carry an important burden of disease in West Africa. Both diseases might cause anemia and they might entail long-term consequences for the development and the health status of the child. Albeit the significant impact of malaria on lead levels described in Nigeria, no evaluation of the effect of elevated BLL on malaria risk has been investigated so far. Materials and Methods Between 2010 and 2012, blood lead levels of 203 Beninese infants from Allada, a semi-rural area 50km North from Cotonou, were assessed at 12 months of age. To assess lead levels, blood samples were analyzed by mass spectrometry. In parallel, clinical, microbiological and hematological data were collected. More precisely, hemoglobin, serum ferritin, CRP, vitamin B12, folate levels, and Plasmodium falciparum parasitemia were assessed and stool samples were also analyzed. Results At 12 months, the mean BLL of infants was 7.41 μg/dL (CI: 65.2; 83), and 128 infants (63%) had elevated blood lead levels, defined by the CDC as BLL>5 μg/dL. Lead poisoning, defined as BLL>10 μg/dL, was found in 39 infants (19%). Twenty-five infants (12.5%) had a positive blood smear at 12 months and 144 infants were anemic (71%, hemoglobin<110 g/L). Elevated blood lead levels were significantly associated with reduced risk of a positive blood smear (AOR = 0.38, P-value = 0.048) and P. falciparum parasite density (beta-estimate = -1.42, P-value = 0.03) in logistic and negative binomial regression multivariate models, respectively, adjusted on clinical and environmental indicators. Conclusion Our study shows for the first time that BLL are negatively associated with malarial risk considering other risk factors. Malaria is one of the main causes of morbidity and mortality in infants under 5 years worldwide, and lead poisoning is the 6th most important contributor to the global burden of diseases measured in disability adjusted life years (DALYs) according to the

  19. Remote Sensing as a Landscape Epidemiologic Tool to Identify Villages at High Risk for Malaria Transmission

    NASA Technical Reports Server (NTRS)

    Beck, Louisa R.; Rodriquez, Mario H.; Dister, Sheri W.; Rodriquez, Americo D.; Rejmankova, Eliska; Ulloa, Armando; Meza, Rosa A.; Roberts, Donald R.; Paris, Jack F.; Spanner, Michael A.; Washino, Robert K.; Hacker, Carl; Legters, Llewellyn F.

    1994-01-01

    A landscape approach using remote sensing and Geographic Information System (GIS) technologies was developed to discriminate between villages at high and low risk for malaria transmission, as defined by adult Anopheles albimanus abundance. Satellite data for an area in southern Chiapas, Mexico were digitally processed to generate a map of landscape elements. The GIS processes were used to determine the proportion of mapped landscape elements surrounding 40 villages where An. albimanus data had been collected. The relationships between vector abundance and landscape element proportions were investigated using stepwise discriminant analysis and stepwise linear regression. Both analyses indicated that the most important landscape elements in terms of explaining vector abundance were transitional swamp and unmanaged pasture. Discriminant functions generated for these two elements were able to correctly distinguish between villages with high ind low vector abundance, with an overall accuracy of 90%. Regression results found both transitional swamp and unmanaged pasture proportions to be predictive of vector abundance during the mid-to-late wet season. This approach, which integrates remotely sensed data and GIS capabilities to identify villages with high vector-human contact risk, provides a promising tool for malaria surveillance programs that depend on labor-intensive field techniques. This is particularly relevant in areas where the lack of accurate surveillance capabilities may result in no malaria control action when, in fact, directed action is necessary. In general, this landscape approach could be applied to other vector-borne diseases in areas where: 1. the landscape elements critical to vector survival are known and 2. these elements can be detected at remote sensing scales.

  20. Lack of patient risk counselling and a broader provider training affect malaria control in remote Somalia Kenya border: Qualitative assessment.

    PubMed

    Asgary, Ramin; Grigoryan, Zoya; Naderi, Ramesh; Allan, Richard

    2012-01-01

    Effectiveness of providing health education solely via mass media and the providers' targeted training in malaria control needs further exploration. During pre-epidemic season, we conducted a qualitative study of 40 providers and community leaders using focus groups, comprehensive semi-structured interviews and consultation observations. Interviews were transcribed, coded and analysed for major themes. Community leaders believe that they can acquire malaria from contaminated water, animal products, air or garbage. Consequently, they under-utilise bed nets and other protective measures due to perceived continued exposure to other potential malaria sources. Practitioners do not provide individualised health counselling and risk assessment to patients during sick visits, leading to a range of misconceptions about malaria based on limited knowledge from rumours and mass media, and a strong belief in the curative power of traditional medicine. Providers overdiagnose malaria clinically and underutilise available tests due to time constraints, and the lack of training and resources to correctly diagnose other illnesses. Subsequently, misdiagnoses lead them to question the efficacy of recommended treatments. Promoting counselling during clinical encounters to address patient misconception and change risky behaviour is warranted. Wider-ranging ongoing training could enable providers to properly diagnose and manage differential diagnoses to manage malaria better.

  1. Ranking prescribed pharmaceuticals in terms of environmental risk: Inclusion of hospital data and the importance of regular review.

    PubMed

    Helwig, Karin; Hunter, Colin; McNaughtan, Moyra; Roberts, Joanne; Pahl, Ole

    2016-04-01

    A newly available dataset on pharmaceuticals used in Scottish hospitals enabled an environmental risk assessment that includes hospital consumption of pharmaceuticals, as previous United Kingdom rankings have been based on community prescriptions only. Although health and the environment are devolved issues for the Scottish government, it is merited to consider a Scottish ranking separately; regional differentiation is particularly relevant in the spatial context of the European Commission's Water Framework Directive. Nine pharmaceuticals are identified as having a risk quotient greater than 1. Four of these, the antibacterials piperacillin, tazobactam, flucloxacillin, and ciprofloxacin, had high hospital contributions and had not been highlighted previously in rankings based on community prescriptions. Some drugs with a risk quotient < 0.1 are used almost exclusively in hospitals and could be more concentrated near effluents carrying hospital wastewater, where they may be of local concern. Although treating hospital effluents separately is a policy option, specifically including hospital consumption is important. Continually increasing the availability of ecotoxicological data and trends in consumption further contributes to a substantially different prioritization than in previous rankings. This leads the authors to conclude that regular review of risk is necessary.

  2. Risk Assessment of Malaria Prevalence in Ludian, Yongshan, and Jinggu Counties, Yunnan Province, after 2014 Earthquake Disaster

    PubMed Central

    Feng, Jun; Xia, Zhigui; Zhang, Li; Cheng, Siyuan; Wang, Rubo

    2016-01-01

    The objective of this study was to investigate malaria prevalence after the 2014 earthquakes in Ludian, Yongshan, and Jinggu counties, Yunnan Province, China. We collected and analyzed epidemiological data and made a risk assessment of transmission probability. From January 2005 to July 2015, 87 malaria cases were reported in the three counties, most of which (81.6%) occurred between 2005 and 2009, with five cases reported in Jinggu County between January 2014 and July 2015, of which one case was reported after the earthquake. In addition, no local transmission occurred in the three counties from 2010, and 95.5% of imported malaria occurred in patients who had returned from Myanmar. The townships of Lehong, Qingsheng, and Weiyuan were the main endemic areas in the three counties. The probability of malaria transmission in the three counties was low, but Jinggu County had a higher risk due to the existence of infected patients and an appropriate vector. With sporadic cases reported annually, close monitoring should continue to enhance early detection of a possible malaria outbreak. PMID:26711514

  3. Risk Assessment of Malaria Prevalence in Ludian, Yongshan, and Jinggu Counties, Yunnan Province, After 2014 Earthquake Disaster.

    PubMed

    Feng, Jun; Xia, Zhigui; Zhang, Li; Cheng, Siyuan; Wang, Rubo

    2016-03-01

    The objective of this study was to investigate malaria prevalence after the 2014 earthquakes in Ludian, Yongshan, and Jinggu counties, Yunnan Province, China. We collected and analyzed epidemiological data and made a risk assessment of transmission probability. From January 2005 to July 2015, 87 malaria cases were reported in the three counties, most of which (81.6%) occurred between 2005 and 2009, with five cases reported in Jinggu County between January 2014 and July 2015, of which one case was reported after the earthquake. In addition, no local transmission occurred in the three counties from 2010, and 95.5% of imported malaria occurred in patients who had returned from Myanmar. The townships of Lehong, Qingsheng, and Weiyuan were the main endemic areas in the three counties. The probability of malaria transmission in the three counties was low, but Jinggu County had a higher risk due to the existence of infected patients and an appropriate vector. With sporadic cases reported annually, close monitoring should continue to enhance early detection of a possible malaria outbreak.

  4. Risk Assessment of Malaria Prevalence in Ludian, Yongshan, and Jinggu Counties, Yunnan Province, After 2014 Earthquake Disaster.

    PubMed

    Feng, Jun; Xia, Zhigui; Zhang, Li; Cheng, Siyuan; Wang, Rubo

    2016-03-01

    The objective of this study was to investigate malaria prevalence after the 2014 earthquakes in Ludian, Yongshan, and Jinggu counties, Yunnan Province, China. We collected and analyzed epidemiological data and made a risk assessment of transmission probability. From January 2005 to July 2015, 87 malaria cases were reported in the three counties, most of which (81.6%) occurred between 2005 and 2009, with five cases reported in Jinggu County between January 2014 and July 2015, of which one case was reported after the earthquake. In addition, no local transmission occurred in the three counties from 2010, and 95.5% of imported malaria occurred in patients who had returned from Myanmar. The townships of Lehong, Qingsheng, and Weiyuan were the main endemic areas in the three counties. The probability of malaria transmission in the three counties was low, but Jinggu County had a higher risk due to the existence of infected patients and an appropriate vector. With sporadic cases reported annually, close monitoring should continue to enhance early detection of a possible malaria outbreak. PMID:26711514

  5. A quantitative risk assessment approach for mosquito-borne diseases: malaria re-emergence in southern France

    PubMed Central

    Ponçon, Nicolas; Tran, Annelise; Toty, Céline; Luty, Adrian JF; Fontenille, Didier

    2008-01-01

    Background The Camargue region is a former malaria endemic area, where potential Anopheles vectors are still abundant. Considering the importation of Plasmodium due to the high number of imported malaria cases in France, the aim of this article was to make some predictions regarding the risk of malaria re-emergence in the Camargue. Methods Receptivity (vectorial capacity) and infectivity (vector susceptibility) were inferred using an innovative probabilistic approach and considering both Plasmodium falciparum and Plasmodium vivax. Each parameter of receptivity (human biting rate, anthropophily, length of trophogonic cycle, survival rate, length of sporogonic cycle) and infectivity were estimated based on field survey, bibliographic data and expert knowledge and fitted with probability distributions taking into account the variability and the uncertainty of the estimation. Spatial and temporal variations of the parameters were determined using environmental factors derived from satellite imagery, meteorological data and entomological field data. The entomological risk (receptivity/infectivity) was calculated using 10,000 different randomly selected sets of values extracted from the probability distributions. The result was mapped in the Camargue area. Finally, vulnerability (number of malaria imported cases) was inferred using data collected in regional hospitals. Results The entomological risk presented large spatial, temporal and Plasmodium species-dependent variations. The sensitivity analysis showed that susceptibility, survival rate and human biting rate were the three most influential parameters for entomological risk. Assessment of vulnerability showed that among the imported cases in the region, only very few were imported in at-risk areas. Conclusion The current risk of malaria re-emergence seems negligible due to the very low number of imported Plasmodium. This model demonstrated its efficiency for mosquito-borne diseases risk assessment. PMID:18673551

  6. Nutritional and socio-demographic risk indicators of malaria in children under five: a cross-sectional study in a Sudanese rural community.

    PubMed

    el Samani, F Z; Willett, W C; Ware, J H

    1987-04-01

    This paper reports the results of a cross-sectional study of the association between nutritional, environmental and socio-demographic factors, and malaria occurrence among 445 children under 5 years of age in a Sudanese rural community. The overall frequency of malaria as defined by a history of clinical illness during the previous 2 months was 27%. Malaria occurrence was positively associated with the degree of malnutrition as assessed by weight-for-age. The age-adjusted odds ratio for mild malnutrition and history of malaria was 1.2 (95% confidence interval (CI): 0.7-2.0) and for moderate malnutrition and malaria was 2.1 (95% CI: 1.1-4.0). Malaria was less frequent among children 0-11 months of age relative to older children (OR = 0.4; 95% CI:0.2-0.7), and was inversely associated with ownership of a refrigerator (OR = 0.5; 95% CI:0.36-0.94), an indicator of socio-economic status. Indicators of crowding were the best predictors of the risk of malaria. Less malaria was observed in households with three or more rooms (OR = 0.6; 95% CI:0.37-0.98) and more malaria was observed in households with more than five people (OR = 2.5; 95% CI:1.4-4.5). Malaria was slightly, but not significantly, more frequent among boys and was associated with anaemia, which was probably an outcome of malaria in the past. These data suggest that undernutrition may increase the risk of malaria, and draw attention to the importance of socio-economic and environmental factors in relation to this disease. These relationships deserve further examination in prospective follow-up studies that are better able to evaluate the temporal relations of malnutrition and malaria.

  7. Potential Influences of Residencies' Health Risk Policies on Their Rankings by Ohio Applicants.

    ERIC Educational Resources Information Center

    Painter, Albert F.; And Others

    1992-01-01

    A survey of 341 fourth-year Ohio medical students investigated attitudes regarding residencies' policies on drug screening, human immunodeficiency virus (HIV) testing, and smoke-free workplaces. Substantial subsets indicated they would rank lower, or not at all, programs requiring preresidency drug screening or HIV testing but would rank schools…

  8. Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force.

    PubMed

    McCarthy, Stuart

    2015-01-01

    The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.

  9. Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force.

    PubMed

    McCarthy, Stuart

    2015-01-01

    The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies. PMID:26793391

  10. Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

    PubMed Central

    McCarthy, Stuart

    2015-01-01

    The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies. PMID:26793391

  11. Model for ranking freshwater fish farms according to their risk of infection and illustration for viral haemorrhagic septicaemia.

    PubMed

    Oidtmann, Birgit C; Pearce, Fiona M; Thrush, Mark A; Peeler, Edmund J; Ceolin, Chiara; Stärk, Katharina D C; Dalla Pozza, Manuela; Afonso, Ana; Diserens, Nicolas; Reese, R Allan; Cameron, Angus

    2014-08-01

    We developed a model to calculate a quantitative risk score for individual aquaculture sites. The score indicates the risk of the site being infected with a specific fish pathogen (viral haemorrhagic septicaemia virus (VHSV); infectious haematopoietic necrosis virus, Koi herpes virus), and is intended to be used for risk ranking sites to support surveillance for demonstration of zone or member state freedom from these pathogens. The inputs to the model include a range of quantitative and qualitative estimates of risk factors organised into five risk themes (1) Live fish and egg movements; (2) Exposure via water; (3) On-site processing; (4) Short-distance mechanical transmission; (5) Distance-independent mechanical transmission. The calculated risk score for an individual aquaculture site is a value between zero and one and is intended to indicate the risk of a site relative to the risk of other sites (thereby allowing ranking). The model was applied to evaluate 76 rainbow trout farms in 3 countries (42 from England, 32 from Italy and 2 from Switzerland) with the aim to establish their risk of being infected with VHSV. Risk scores for farms in England and Italy showed great variation, clearly enabling ranking. Scores ranged from 0.002 to 0.254 (mean score 0.080) in England and 0.011 to 0.778 (mean of 0.130) for Italy, reflecting the diversity of infection status of farms in these countries. Requirements for broader application of the model are discussed. Cost efficient farm data collection is important to realise the benefits from a risk-based approach.

  12. Urban and architectural risk factors for malaria in indigenous Amazonian settlements in Brazil: a typological analysis.

    PubMed

    Leandro-Reguillo, Patricia; Thomson-Luque, Richard; Monteiro, Wuelton M; de Lacerda, Marcus V G

    2015-01-01

    In the Amazon, m alaria is highly endemic in indigenous populations, which are often considered one of the last barriers to malaria elimination due to geographic isolation. Although the improvement of housing conditions is a good strategy towards the control and prevention of vector-borne diseases, such as malaria, this preventive practice has been barely undertaken in Latin America. An analysis of the architectural and urban features of indigenous Amazonian populations is essential to define and adapt these vector control measures. A total of 32 villages of 29 different ethnicities were studied and mapped by reviewing literature and visual information, and using a geographic information system. The most important architectural and urban characteristics influencing malaria were analysed according to the following categories: number of households and dimensions, supporting area, openings, materials, lifespan and location. Housing typologies found were classified within each of these variables. The results of this typological analysis included an easy-to-handle working template and revealing of features that benefit or hamper the presence of malaria vectors in Amerindians communities. Among risk factors, presence of open eaves, permeable walls, open-side constructions, large number of sleepers indoors, temporary-ephemeral houses, linear villages along stream banks, houseboats villages, poor urban drainage and villages surrounded by anthropogenic environments were highlighted. Indigenous settlements very permissive for anophelines were identified in ethnic groups, such as the Yanomami, Palikur, Paumari, Waimiri-Atroari and Wajãpi. Positive features were also recognized, including opaque and closed houses, large radial villages on bare soil, highly elevated stilted houses and the fire indoors, found among the Yawalapiti, Ashaninka, and Gavião-Parkatejê tribes. However, as Amazonian indigenous settlement typologies vary greatly even among villages of the same ethnic

  13. Application of Risk Analysis Based On Remote Sensing and Geographic Information System Technologies To Control of Malaria In Nigeria

    NASA Astrophysics Data System (ADS)

    Njemanze, Philip; Njemanze, Philip; Peters, Constance; Uwaeziozi, Amarachukwu

    More than 1 million Africans die from malaria each year. Remote sensing (RS) and geographic information system (GIS) technologies could be applied to study the risk of malaria epidemic. The patient population included 45,140 of persons aged 0-85 years seen at primary health centers in 18 different local government areas (LGAs) of Imo State. Maps of old Imo State were converted to digital form using ARC/INFO GIS software, and the resulting coverages included hydrology, towns, and villages. Remote sensing images from Advanced Very High Resolution Radiometer (AVHRR) data set were used to obtain color-coded monthly normalized-difference vegetation index or NDVI. Three groups were distinguished as: group A LGAs using water from natural hydrology and bore-holes, group B - using rain water harvesting from roof tops into surface water reservoirs, and group C - using ground surface catchment of rain water with ground ponds. These stagnant ponds were Anopheles mosquito breeding sites. The NDVI values were used to determine water availability, and were least in January/February each year, and highest in April/May. Probabilistic layer analysis (PLA) was used to determine the Odds Ratio (OR), Relative Risk (RR) and Attributable Risk (AR) for malaria in groups A, B, C. Significant risk for malaria was associated with local water conservation methods in group C, compared to A, (OR = 4.55; RR = 4.46, AR = 77.6

  14. Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict

    PubMed Central

    Fürst, Thomas; Raso, Giovanna; Acka, Cinthia A.; Tschannen, Andres B.; N'Goran, Eliézer K.; Utzinger, Jürg

    2009-01-01

    Background Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Côte d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. Methodology The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Côte d'Ivoire, shortly before and after the 2002/2003 armed conflict. Principal Findings There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict. Conclusion New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects. PMID:19907632

  15. Prevalence, Features and Risk Factors for Malaria Co-Infections amongst Visceral Leishmaniasis Patients from Amudat Hospital, Uganda

    PubMed Central

    Adams, Emily R.; Mens, Pètra F.; Sentongo, Elizabeth; Mbulamberi, Dawson B.; Straetemans, Masja; Schallig, Henk D. F. H.; Chappuis, Francois

    2012-01-01

    Background and methodology Due to geographic overlap of malaria and visceral leishmaniasis (VL), co-infections may exist but have been poorly investigated. To describe prevalence, features and risk factors for VL-malaria co-infections, a case-control analysis was conducted on data collected at Amudat Hospital, Uganda (2000–2006) by Médecins sans Frontières. Cases were identified as patients with laboratory-confirmed VL and malaria at hospital admission or during hospitalization; controls were VL patients with negative malaria smears. A logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection. Results Of 2414 patients with confirmed VL, 450 (19%) were positively diagnosed with concomitant malaria. Most co-infected patients were males, residing in Kenya (69%). While young age was identified by multivariate analysis as a risk factor for concurrent VL and malaria, particularly the age groups 0–4 (odds ratio (OR): 2.44; 95% confidence interval (CI): 1.52–3.92) and 5–9 years (OR: 2.23, 95% CI: 1.45-3-45), mild (OR: 0.53; 95% CI: 0.32–0.88) and moderate (OR: 0.45; 95% CI: 0.27–0.77) anemia negatively correlated with the co-morbidity. VL patients harboring skin infections were nearly three times less likely to have the co-infection (OR: 0.35; 95% CI: 0.17–0.72), as highlighted by the multivariate model. Anorexia was slightly more frequent among co-infected patients (OR: 1.71; 95% CI: 0.96–3.03). The in-hospital case-fatality rate did not significantly differ between cases and controls, being 2.7% and 3.1% respectively (OR: 0.87; 95% CI: 0.46–1.63). Conclusions Concurrent malaria represents a common condition among young VL patients living in the Pokot region of Kenya and Uganda. Although these co-morbidities did not result in a poorer prognosis, possibly due to early detection of malaria, a positive trend towards more severe symptoms was identified, indicating that

  16. Hazard potential ranking of hazardous waste landfill sites and risk of congenital anomalies

    PubMed Central

    Vrijheid, M; Dolk, H; Armstrong, B; Boschi, G; Busby, A; Jorgensen, T; Pointer, P

    2002-01-01

    Background: A 33% increase in the risk of congenital anomalies has been found among residents near hazardous waste landfill sites in a European collaborative study (EUROHAZCON). Aims: To develop and evaluate an expert panel scoring method of the hazard potential of EUROHAZCON landfill sites, and to investigate whether sites classified as posing a greater potential hazard are those with a greater risk of congenital anomaly among nearby residents relative to more distant residents. Methods: A total of 1270 cases of congenital anomaly and 2308 non-malformed control births were selected in 14 study areas around 20 landfill sites. An expert panel of four landfill specialists scored each site in three categories—overall, water, and air hazard—based on readily available, documented data on site characteristics. Tertiles of the average ranking scores defined low, medium, and high hazard sites. Calculation of odds ratios was based on distance of residence from the sites, comparing a 0–3 km "proximate" with a 3–7 km "distant" zone. Results: Agreement between experts measured by intraclass correlation coefficients was 0.50, 0.44, and 0.20 for overall, water, and air hazard before a consensus meeting and 0.60, 0.56, and 0.53 respectively after this meeting. There was no evidence for a trend of increasing odds ratios with increasing overall hazard or air hazard. For non-chromosomal anomalies, odds ratios by water hazard category showed an increasing trend of borderline statistical significance (p = 0.06) from 0.79 in the low hazard category, 1.43 in the medium, to 1.60 in the high water hazard category. Conclusions: There is little evidence for a relation between risk of congenital anomaly in proximate relative to distant zones and hazard potential of landfill sites as classified by the expert panel, but without external validation of the hazard potential scoring method interpretation is difficult. Potential misclassification of sites may have reduced our ability to

  17. High spatial resolution mapping of malaria transmission risk in the Gambia, west Africa, using LANDSAT TM satellite imagery.

    PubMed

    Bøgh, Claus; Lindsay, Steven W; Clarke, Siân E; Dean, Andy; Jawara, Musa; Pinder, Margaret; Thomas, Christopher J

    2007-05-01

    Understanding local variability in malaria transmission risk is critically important when designing intervention or vaccine trials. Using a combination of field data, satellite image analysis, and GIS modeling, we developed a high-resolution map of malaria entomological inoculation rates (EIR) in The Gambia, West Africa. The analyses are based on the variation in exposure to malaria parasites experienced in 48 villages in 1996 and 21 villages in 1997. The entomological inoculation rate (EIR) varied from 0 to 166 infective bites per person per rainy season. Detailed field surveys identified the major Anopheles gambiae s.l. breeding habitats. These habitats were mapped by classification of a LANDSAT TM satellite image with an overall accuracy of 85%. Village EIRs decreased as a power function based on the breeding areas size and proximity. We use this relationship and the breeding habitats to map the variation in EIR over the entire 2500-km(2) study area.

  18. Mosquito Larval Habitats, Land Use, and Potential Malaria Risk in Northern Belize from Satellite Image Analyses

    NASA Technical Reports Server (NTRS)

    Pope, Kevin; Masuoka, Penny; Rejmankova, Eliska; Grieco, John; Johnson, Sarah; Roberts, Donald

    2004-01-01

    The distribution of Anopheles mosquito habitats and land use in northern Belize is examined with satellite data. -A land cover classification based on multispectral SPOT and multitemporal Radarsat images identified eleven land cover classes, including agricultural, forest, and marsh types. Two of the land cover types, Typha domingensis marsh and flooded forest, are Anopheles vestitipennis larval habitats. Eleocharis spp. marsh is the larval habitat for Anopheles albimanus. Geographic Information Systems (GIS) analyses of land cover demonstrate that the amount of T-ha domingensis in a marsh is positively correlated with the amount of agricultural land in the adjacent upland, and negatively correlated with the amount of adjacent forest. This finding is consistent with the hypothesis that nutrient (phosphorus) runoff from agricultural lands is causing an expansion of Typha domingensis in northern Belize. This expansion of Anopheles vestitipennis larval habitat may in turn cause an increase in malaria risk in the region.

  19. Development of a risk-ranking framework to evaluate potential high-threat microorganisms, toxins, and chemicals in food.

    PubMed

    Newsome, R; Tran, N; Paoli, G M; Jaykus, L A; Tompkin, B; Miliotis, M; Ruthman, T; Hartnett, E; Busta, F F; Petersen, B; Shank, F; McEntire, J; Hotchkiss, J; Wagner, M; Schaffner, D W

    2009-03-01

    Through a cooperative agreement with the U.S. Food and Drug Administration, the Institute of Food Technologists developed a risk-ranking framework prototype to enable comparison of microbiological and chemical hazards in foods and to assist policy makers, risk managers, risk analysts, and others in determining the relative public health impact of specific hazard-food combinations. The prototype is a bottom-up system based on assumptions that incorporate expert opinion/insight with a number of exposure and hazard-related risk criteria variables, which are propagated forward with food intake data to produce risk-ranking determinations. The prototype produces a semi-quantitative comparative assessment of food safety hazards and the impacts of hazard control measures. For a specific hazard-food combination the prototype can produce a single metric: a final risk value expressed as annual pseudo-disability adjusted life years (pDALY). The pDALY is a harmonization of the very different dose-response relationships observed for chemicals and microbes. The prototype was developed on 2 platforms, a web-based user interface and an Analytica(R) model (Lumina Decision Systems, Los Gatos, Calif., U.S.A.). Comprising visual basic language, the web-based platform facilitates data input and allows use concurrently from multiple locations. The Analytica model facilitates visualization of the logic flow, interrelationship of input and output variables, and calculations/algorithms comprising the prototype. A variety of sortable risk-ranking reports and summary information can be generated for hazard-food pairs, showing hazard and dose-response assumptions and data, per capita consumption by population group, and annual p-DALY. PMID:19323766

  20. Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa.

    PubMed

    Pistone, T; Guibert, P; Gay, F; Malvy, D; Ezzedine, K; Receveur, M C; Siriwardana, M; Larouzé, B; Bouchaud, O

    2007-10-01

    An observational prospective cohort study assessed malaria risk perception, knowledge and prophylaxis practices among individuals of African ethnicity living in Paris and travelling to their country of origin to visit friends or relatives (VFR). The study compared two groups of VFR who had visited a travel clinic (TC; n=122) or a travel agency (TA; n=69) before departure. Of the 47% of VFR citing malaria as a health concern, 75% knew that malaria is mosquito-borne and that bed nets are an effective preventive measure. Perception of high malaria risk was greater in the TA group (33%) than in the TC group (7%). The availability of a malaria vaccine was mentioned by 35% of VFR, with frequent confusion between yellow fever vaccine and malaria prevention. Twenty-nine percent took adequate chemoprophylaxis with complete adherence, which was higher among the TC group (41%) than the TA group (12%). Effective antivector protection measures used were bed nets (16%), wearing long clothes at night (14%) and air conditioning (8%), with no differences between the study groups except in the use of impregnated bed nets (11% of the TC group and none of the TA group). Media coverage, malaria chemoprophylaxis repayment and cultural adaptation of preventive messages should be improved to reduce the high rate of inadequate malaria prophylaxis in VFR.

  1. Effect of meteorological factors on clinical malaria risk among children: an assessment using village-based meteorological stations and community-based parasitological survey

    PubMed Central

    Yé, Yazoumé; Louis, Valérie R; Simboro, Séraphin; Sauerborn, Rainer

    2007-01-01

    Background Temperature, rainfall and humidity have been widely associated with the dynamics of malaria vector population and, therefore, with spread of the disease. However, at the local scale, there is a lack of a systematic quantification of the effect of these factors on malaria transmission. Further, most attempts to quantify this effect are based on proxy meteorological data acquired from satellites or interpolated from a different scale. This has led to controversies about the contribution of climate change to malaria transmission risk among others. Our study addresses the original question of relating meteorological factors measured at the local scale with malaria infection, using data collected at the same time and scale. Methods 676 children (6–59 months) were selected randomly from three ecologically different sites (urban and rural). During weekly home visits between December 1, 2003, and November 30, 2004, fieldworkers tested children with fever for clinical malaria. They also collected data on possible confounders monthly. Digital meteorological stations measured ambient temperature, humidity, and rainfall in each site. Logistic regression was used to estimate the risk of clinical malaria given the previous month's meteorological conditions. Results The overall incidence of clinical malaria over the study period was 1.07 episodes per child. Meteorological factors were associated with clinical malaria with mean temperature having the largest effect. Conclusion Temperature was the best predictor for clinical malaria among children under five. A systematic measurement of local temperature through ground stations and integration of such data in the routine health information system could support assessment of malaria transmission risk at the district level for well-targeted control efforts. PMID:17559638

  2. Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study

    PubMed Central

    Bôtto-Menezes, Camila; Silva dos Santos, Mônica Caroline; Lopes Simplício, Janicéia; Menezes de Medeiros, Jandira; Barroso Gomes, Kelly Cristina; de Carvalho Costa, Isabel Cristina; Batista-Silva, Eva; Teixeira do Nascimento, Cristiana; da Silva Chagas, Eda Cristina; Jardim Sardinha, José Felipe; Simões de Santana Filho, Franklin; Brock, Marianna

    2015-01-01

    Introduction Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW). Methods/Principal Findings Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54%) were between 20–29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503) reported more than one malaria episode and most malaria episodes (84.5%, 846/1001) were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16–0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10–0.58]; p = 0.001, respectively). The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19–0.95]; p = 0.037) and among those women who reported higher antenatal care (ANC) attendance (OR, 0.32 [95% CI, 0.15–0.70]; p = 0.005). Conclusion This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance. PMID:26675007

  3. Malaria Research

    MedlinePlus

    ... Malaria > Research Malaria Understanding Research NIAID Role Basic Biology Prevention and Control Strategies Strategic Partnerships and Research ... the malaria parasite. Related Links Global Research​ Vector Biology International Centers of Excellence for Malaria Research (ICEMR) ...

  4. Quality of life and the risk of contracting malaria by multivariate analysis in the Brazilian Amazon region

    PubMed Central

    2014-01-01

    Background The incidence of malaria in the Amazon basin is closely related to social inequalities, given that precarious economic and socio-environmental conditions represent favourable factors for the transmission of the disease in tropical regions, such as the Brazilian state of Pará. In the present study, an association was found between the variation in a quality of life index (QLI), based on the socioeconomic differences between the municipalities of this state, and the risk of contracting malaria, based on the Annual Parasitic Index (API), with the primary objective of providing guidelines for the development of effective strategies for the control of the disease. Methods The API scores for the years between 2003 and 2011 were collected from the Brazilian Ministry of Health’s DATASUS database, and socioeconomic data for the 143 municipalities of Pará were obtained from the 2010 census. The data were analysed using multivariate factorial and correspondence techniques. Results The QLI was calculated for each municipality, of which, 69.23% were classified as having a poor or regular quality of life. The municipalities with poor QLI scores also presented moderate to high rates of malaria, with probabilities of 80.97% and 95.13%, respectively, while those with good QLI scores had low rates of malaria, with a probability of 79.24%. The results indicated a concentration of malaria in the south-west of the state of Pará, with an increase of 8.82% in the incidence of the disease over the study period, and the northeastern and Marajó mesoregions, where there was an increase of over 90%. In south-eastern Pará, by contrast, there was a marked reduction (78%) in the incidence of the disease, reflecting the heterogeneous distribution of malaria among the different municipalities and mesoregions of the state, especially those with moderate to high risk of transmission. Conclusions These findings confirm that malaria is endemic to Pará and is typical of the state

  5. Modelling the risk of being bitten by malaria vectors in a vector control area in southern Benin, west Africa

    PubMed Central

    2013-01-01

    Background The diversity of malaria vector populations, expressing various resistance and/or behavioural patterns could explain the reduced effectiveness of vector control interventions reported in some African countries. A better understanding of the ecology and distribution of malaria vectors is essential to design more effective and sustainable strategies for malaria control and elimination. Here, we analyzed the spatio-temporal risk of the contact between humans and the sympatric An. funestus and both M and S molecular forms of An. gambiae s.s. in an area of Benin with high coverage of vector control measures with an unprecedented level of resolution. Methods Presence-absence data for the three vectors from 1-year human-landing collections in 19 villages were assessed using binomial mixed-effects models according to vector control measures and environmental covariates derived from field and remote sensing data. After 8-fold cross-validations of the models, predictive maps of the risk of the contact between humans and the sympatric An. funestus and both molecular M and S forms of An. gambiae s.s. were computed. Results Model validations showed that the An. funestus, An. gambiae M form, and S form models provided an excellent (Area Under Curve>0.9), a good (AUC>0.8), and an acceptable (AUC>0.7) level of prediction, respectively. The distribution area of the probability of contact between human and An. funestus largely overlaps that of An. gambiae M form but this latter showed important seasonal variation. An. gambiae S form also showed seasonal variation but with different ecological preferences. Landscape data were useful to discriminate between the species’ distributions. Conclusions These results showed that available remote sensing data could help in predicting the human-vector contact for several species of malaria vectors at a village level scale. The predictive maps showed seasonal and spatial variations in the risk of human-vector contact for all three

  6. Geostatistical modelling of the malaria risk in Mozambique: effect of the spatial resolution when using remotely-sensed imagery.

    PubMed

    Giardina, Federica; Franke, Jonas; Vounatsou, Penelope

    2015-11-26

    The study of malaria spatial epidemiology has benefited from recent advances in geographic information system and geostatistical modelling. Significant progress in earth observation technologies has led to the development of moderate, high and very high resolution imagery. Extensive literature exists on the relationship between malaria and environmental/climatic factors in different geographical areas, but few studies have linked human malaria parasitemia survey data with remote sensing-derived land cover/land use variables and very few have used Earth Observation products. Comparison among the different resolution products to model parasitemia has not yet been investigated. In this study, we probe a proximity measure to incorporate different land cover classes and assess the effect of the spatial resolution of remotely sensed land cover and elevation on malaria risk estimation in Mozambique after adjusting for other environmental factors at a fixed spatial resolution. We used data from the Demographic and Health survey carried out in 2011, which collected malaria parasitemia data on children from 0 to 5 years old, analysing them with a Bayesian geostatistical model. We compared the risk predicted using land cover and elevation at moderate resolution with the risk obtained employing the same variables at high resolution. We used elevation data at moderate and high resolution and the land cover layer from the Moderate Resolution Imaging Spectroradiometer as well as the one produced by MALAREO, a project covering part of Mozambique during 2010-2012 that was funded by the European Union's 7th Framework Program. Moreover, the number of infected children was predicted at different spatial resolutions using AFRIPOP population data and the enhanced population data generated by the MALAREO project for comparison of estimates. The Bayesian geostatistical model showed that the main determinants of malaria presence are precipitation and day temperature. However, the presence

  7. Predictive study on the risk of malaria spreading due to global warming

    SciTech Connect

    Ono, Masaji

    1996-12-31

    Global warming will bring about a temperature elevation, and the habitat of vectors of infectious diseases, such as malaria and dengue fever, will spread into subtropical or temperate zone. The purpose of this study is to simulate the spreading of these diseases through reexamination of existing data and collection of some additional information by field survey. From these data, the author will establish the relationship between meteorological conditions, vector density and malaria occurrence. And then he will simulate and predict the malaria epidemics in case of temperature elevation in southeast Asia and Japan.

  8. Investigating malaria risk in the northern region of Nigeria using satellite imagery

    NASA Astrophysics Data System (ADS)

    Emetere, M. E.; Nikouravan, Bijan; Olawole, O. F.

    2015-08-01

    The dynamics of infectious diseases are dependent on salient environment and climate factors which are directly proportional to its transmission. Malaria is a common disease of typical tropics of the West African sub-region. The influences of malaria transmission via meteorological and environmental parameters were examined. Remotely sensed parameters i.e. skin temperature, sensible heat flux, latent heat flux and total precipitation were obtained from the NASA-MERRA. The results show that the meteorological and environmental parameters of northern Nigeria favour the long malaria dominance.

  9. Sri Lanka Malaria Maps

    PubMed Central

    Briët, Olivier JT; Gunawardena, Dissanayake M; van der Hoek, Wim; Amerasinghe, Felix P

    2003-01-01

    Background Despite a relatively good national case reporting system in Sri Lanka, detailed maps of malaria distribution have not been publicly available. Methods In this study, monthly records over the period 1995 – 2000 of microscopically confirmed malaria parasite positive blood film readings, at sub-district spatial resolution, were used to produce maps of malaria distribution across the island. Also, annual malaria trends at district resolution were displayed for the period 1995 – 2002. Results The maps show that Plasmodium vivax malaria incidence has a marked variation in distribution over the island. The incidence of Plasmodium falciparum malaria follows a similar spatial pattern but is generally much lower than that of P. vivax. In the north, malaria shows one seasonal peak in the beginning of the year, whereas towards the south a second peak around June is more pronounced. Conclusion This paper provides the first publicly available maps of both P. vivax and P. falciparum malaria incidence distribution on the island of Sri Lanka at sub-district resolution, which may be useful to health professionals, travellers and travel medicine professionals in their assessment of malaria risk in Sri Lanka. As incidence of malaria changes over time, regular updates of these maps are necessary. PMID:12914667

  10. Special infectious disease risks of expatriates and long-term travelers in tropical countries. Part I: malaria.

    PubMed

    Toovey, Stephen; Moerman, Filip; van Gompel, Alfons

    2007-01-01

    Malaria risk is dependent upon the entomological inoculation rate actually faced by the long-term traveler. Risk is cumulative, increases with duration of exposure, is greatest in rural and periurban areas, and least in urban centers. Risk may be zero in some urban centers, especially during dry seasons. Chemoprophylaxis compliance is hindered by the high adverse event rate often reported by users, is often suboptimal in expatriates, and decreases with duration of stay. Compliance with personal protection measures may also be suboptimal, and use of insecticide-treated nets and effective repellents should be encouraged. Alternative strategies to mitigate risk include seasonal chemoprophylaxis, nonuse of chemoprophylaxis with rapid treatment, self-testing, self-treatment where competent care and quality drugs are unavailable, and vector control. Choice of strategies will depend upon assessment of actual risk and likely compliance, with a combination of measures usually appropriate.

  11. Screening and ranking framework (SRF) for geologic CO2 storagesite selection on the basis of HSE risk

    SciTech Connect

    Oldenburg, Curtis M.

    2006-11-27

    A screening and ranking framework (SRF) has been developedto evaluate potential geologic carbon dioxide (CO2) storage sites on thebasis of health, safety, and environmental (HSE) risk arising from CO2leakage. The approach is based on the assumption that CO2 leakage risk isdependent on three basic characteristics of a geologic CO2 storage site:(1) the potential for primary containment by the target formation; (2)the potential for secondary containment if the primary formation leaks;and (3) the potential for attenuation and dispersion of leaking CO2 ifthe primary formation leaks and secondary containment fails. Theframework is implemented in a spreadsheet in which users enter numericalscores representing expert opinions or published information along withestimates of uncertainty. Applications to three sites in Californiademonstrate the approach. Refinements and extensions are possible throughthe use of more detailed data or model results in place of propertyproxies.

  12. Malaria ecotypes and stratification.

    PubMed

    Schapira, Allan; Boutsika, Konstantina

    2012-01-01

    To deal with the variability of malaria, control programmes need to stratify their malaria problem into a number of smaller units. Such stratification may be based on the epidemiology of malaria or on its determinants such as ecology. An ecotype classification was developed by the World Health Organization (WHO) around 1990, and it is time to assess its usefulness for current malaria control as well as for malaria modelling on the basis of published research. Journal and grey literature was searched for articles on malaria or Anopheles combined with ecology or stratification. It was found that all malaria in the world today could be assigned to one or more of the following ecotypes: savanna, plains and valleys; forest and forest fringe; foothill; mountain fringe and northern and southern fringes; desert fringe; coastal and urban. However, some areas are in transitional or mixed zones; furthermore, the implications of any ecotype depend on the biogeographical region, sometimes subregion, and finally, the knowledge on physiography needs to be supplemented by local information on natural, anthropic and health system processes including malaria control. Ecotyping can therefore not be seen as a shortcut to determine control interventions, but rather as a framework to supplement available epidemiological and entomological data so as to assess malaria situations at the local level, think through the particular risks and opportunities and reinforce intersectoral action. With these caveats, it does however emerge that several ecotypic distinctions are well defined and have relatively constant implications for control within certain biogeographic regions. Forest environments in the Indo-malay and the Neotropics are, with a few exceptions, associated with much higher malaria risk than in adjacent areas; the vectors are difficult to control, and the anthropic factors also often converge to impose constraints. Urban malaria in Africa is associated with lower risk than savanna

  13. On the use of RADARSAT-1 for monitoring malaria risk in Kenya

    NASA Astrophysics Data System (ADS)

    Ross, S. G.; Thomson, M. C.; Pultz, T.; Mbogo, C. M.; Regens, J. L.; Swalm, C.; Githure, J.; Yan, G.; Gu, W.; Beier, J. C.

    2002-01-01

    The incidence and spread of vector-borne infectious diseases are increasing concerns in many parts of the world. Earth obervation techniques provide a recognised means for monitoring and mapping disease risk as well as correlating environmental indicators with various disease vectors. Because the areas most impacted by vector-borne disease are remote and not easily monitored using traditional, labor intensive survey techniques, high spatial and temporal coverage provided by spaceborne sensors allows for the investigation of large areas in a timely manner. However, since the majority of infectious diseases occur in tropical areas, one of the main barriers to earth observation techniques is persistent cloud-cover. Synthetic Aperture Radar (SAR) technology offers a solution to this problem by providing all-weather, day and night imaging capability. Based on SAR's sensitivity to target moisture conditions, sensors such as RADARSAT-1 can be readily used to map wetland and swampy areas that are conducive to functioning as aquatic larval habitats. Irrigation patterns, deforestation practises and the effects of local flooding can be monitored using SAR imagery, and related to potential disease vector abundance and proximity to populated areas. This paper discusses the contribution of C-band radar remote sensing technology to monitoring and mapping malaria. Preliminary results using RADARSAT-1 for identifying areas of high mosquito (Anopheles gambiae s.l.) abundance along the Kenya coast will be discussed. The authors consider the potential of RADARSAT-1 data based on SAR sensor characteristics and the preliminary results obtained. Further potential of spaceborne SAR data for monitoring vector-borne disease is discussed with respect to future advanced SAR sensors such as RADARSAT-2.

  14. Malaria prevention in travelers.

    PubMed

    Genton, Blaise; D'Acremont, Valérie

    2012-09-01

    A common approach to malaria prevention is to follow the "A, B, C, D" rule: Awareness of risk, Bite avoidance, Compliance with chemoprophylaxis, and prompt Diagnosis in case of fever. The risk of acquiring malaria depends on the length and intensity of exposure; the risk of developing severe disease is primarily determined by the health status of the traveler. These parameters need to be assessed before recommending chemoprophylaxis and/or stand-by emergency treatment. This review discusses the different strategies and drug options available for the prevention of malaria during and post travel.

  15. Extreme Polymorphism in a Vaccine Antigen and Risk of Clinical Malaria: Implications for Vaccine Development

    PubMed Central

    Takala, Shannon L.; Coulibaly, Drissa; Thera, Mahamadou A.; Batchelor, Adrian H.; Cummings, Michael P.; Escalante, Ananias A.; Ouattara, Amed; Traoré, Karim; Niangaly, Amadou; Djimdé, Abdoulaye A.; Doumbo, Ogobara K.; Plowe, Christopher V.

    2010-01-01

    Vaccines directed against the blood stages of Plasmodium falciparum malaria are intended to prevent the parasite from invading and replicating within host cells. No blood-stage malaria vaccine has shown clinical efficacy in humans. Most malaria vaccine antigens are parasite surface proteins that have evolved extensive genetic diversity, and this diversity could allow malaria parasites to escape vaccine-induced immunity. We examined the extent and within-host dynamics of genetic diversity in the blood-stage malaria vaccine antigen apical membrane antigen–1 in a longitudinal study in Mali. Two hundred and fourteen unique apical membrane antigen–1 haplotypes were identified among 506 human infections, and amino acid changes near a putative invasion machinery binding site were strongly associated with the development of clinical symptoms, suggesting that these residues may be important to consider in designing polyvalent apical membrane antigen–1 vaccines and in assessing vaccine efficacy in field trials. This extreme diversity may pose a serious obstacle to an effective polyvalent recombinant subunit apical membrane antigen–1 vaccine. PMID:20165550

  16. Imported malaria in Albania and the risk factors that could allow its reappearance.

    PubMed

    Shkurti, Klodiana; Vyshka, Gentian; Velo, Enkelejda; Boçari, Arben; Kokici, Majlinda; Kraja, Dhimitër

    2013-06-12

    Malaria is an infectious disease gradually becoming a serious concern for public health institutions, even in European countries where the eradication of the disease was previously taken for granted. Albania was listed as an endemic area from the beginning of the 20th Century, but the disease was gradually under control and some decades after the World War II it was merely considered a historical curiosity. Nevertheless, for many reasons, since 1994 and in increasing trend, Albanian health facilities have registered several cases of malaria. Tracing the remnants of the autochthonous disease and finding links with the actual situation seems difficult, due to the relatively long period separating the proclaimed eradication of malaria with the re-appearance of the infection. Among major factors leading to such re-appearance might be massive migratory movements, and environmental changes such as the flooding of areas close to river deltas that flow into the Adriatic and Ionian Seas. These factors, combined with the constant presence of several Anopheles species, have led to newly-diagnosed imported malaria cases in Albania. Although all reported cases are considered imported, measures have to be put in place, in order to prevent reappearance of autochthonous malaria cases, and to control disease spread.

  17. Development of a comparative risk ranking system for agents posing a bioterrorism threat to human or animal populations.

    PubMed

    Tomuzia, Katharina; Menrath, Andrea; Frentzel, Hendrik; Filter, Matthias; Weiser, Armin A; Bräunig, Juliane; Buschulte, Anja; Appel, Bernd

    2013-09-01

    Various systems for prioritizing biological agents with respect to their applicability as biological weapons are available, ranging from qualitative to (semi)quantitative approaches. This research aimed at generating a generic risk ranking system applicable to human and animal pathogenic agents based on scientific information. Criteria were evaluated and clustered to create a criteria list. Considering availability of data, a number of 28 criteria separated by content were identified that can be classified in 11 thematic areas or categories. Relevant categories contributing to probability were historical aspects, accessibility, production efforts, and possible paths for dispersion. Categories associated with impact are dealing with containment measures, availability of diagnostics, preventive and treatment measures in human and animal populations, impact on society, human and veterinary public health, and economic and ecological consequences. To allow data-based scoring, each criterion was described by at least 1 measure that allows the assignment of values. These values constitute quantities, ranges, or facts that are as explicit and precise as possible. The consideration of minimum and maximum values that can occur due to natural variations and that are often described in the literature led to the development of minimum and maximum criteria and consequently category scores. Missing or incomplete data, and uncertainty resulting therefrom, were integrated into the scheme via a cautious (but not overcautious) approach. The visualization technique that was used allows the description and illustration of uncertainty on the level of probability and impact. The developed risk ranking system was evaluated by assessing the risk originating from the bioterrorism threat of the animal pathogen bluetongue virus, the human pathogen Enterohemorrhagic Escherichia coli O157:H7, the zoonotic Bacillus anthracis, and Botulinum neurotoxin.

  18. Development of a comparative risk ranking system for agents posing a bioterrorism threat to human or animal populations.

    PubMed

    Tomuzia, Katharina; Menrath, Andrea; Frentzel, Hendrik; Filter, Matthias; Weiser, Armin A; Bräunig, Juliane; Buschulte, Anja; Appel, Bernd

    2013-09-01

    Various systems for prioritizing biological agents with respect to their applicability as biological weapons are available, ranging from qualitative to (semi)quantitative approaches. This research aimed at generating a generic risk ranking system applicable to human and animal pathogenic agents based on scientific information. Criteria were evaluated and clustered to create a criteria list. Considering availability of data, a number of 28 criteria separated by content were identified that can be classified in 11 thematic areas or categories. Relevant categories contributing to probability were historical aspects, accessibility, production efforts, and possible paths for dispersion. Categories associated with impact are dealing with containment measures, availability of diagnostics, preventive and treatment measures in human and animal populations, impact on society, human and veterinary public health, and economic and ecological consequences. To allow data-based scoring, each criterion was described by at least 1 measure that allows the assignment of values. These values constitute quantities, ranges, or facts that are as explicit and precise as possible. The consideration of minimum and maximum values that can occur due to natural variations and that are often described in the literature led to the development of minimum and maximum criteria and consequently category scores. Missing or incomplete data, and uncertainty resulting therefrom, were integrated into the scheme via a cautious (but not overcautious) approach. The visualization technique that was used allows the description and illustration of uncertainty on the level of probability and impact. The developed risk ranking system was evaluated by assessing the risk originating from the bioterrorism threat of the animal pathogen bluetongue virus, the human pathogen Enterohemorrhagic Escherichia coli O157:H7, the zoonotic Bacillus anthracis, and Botulinum neurotoxin. PMID:23971819

  19. Risk factors for house-entry by malaria vectors in a rural town and satellite villages in The Gambia

    PubMed Central

    Kirby, Matthew J; Green, Clare; Milligan, Paul M; Sismanidis, Charalambos; Jasseh, Momadou; Conway, David J; Lindsay, Steven W

    2008-01-01

    Background In the pre-intervention year of a randomized controlled trial investigating the protective effects of house screening against malaria-transmitting vectors, a multi-factorial risk factor analysis study was used to identify factors that influence mosquito house entry. Methods Mosquitoes were sampled using CDC light traps in 976 houses, each on one night, in Farafenni town and surrounding villages during the malaria-transmission season in The Gambia. Catches from individual houses were both (a) left unadjusted and (b) adjusted relative to the number of mosquitoes caught in four sentinel houses that were operated nightly throughout the period, to allow for night-to-night variation. Houses were characterized by location, architecture, human occupancy and their mosquito control activities, and the number and type of domestic animals within the compound. Results 106,536 mosquitoes were caught, of which 55% were Anopheles gambiae sensu lato, the major malaria vectors in the region. There were seven fold higher numbers of An. gambiae s.l. in the villages (geometric mean per trap night = 43.7, 95% confidence intervals, CIs = 39.5–48.4) than in Farafenni town (6.3, 5.7–7.2) and significant variation between residential blocks (p < 0.001). A negative binomial multivariate model performed equally well using unadjusted or adjusted trap data. Using the unadjusted data the presence of nuisance mosquitoes was reduced if the house was located in the town (odds ratio, OR = 0.11, 95% CIs = 0.09–0.13), the eaves were closed (OR = 0.71, 0.60–0.85), a horse was tethered near the house (OR = 0.77, 0.73–0.82), and churai, a local incense, was burned in the room at night (OR = 0.56, 0.47–0.66). Mosquito numbers increased per additional person in the house (OR = 1.04, 1.02–1.06) or trapping room (OR = 1.19, 1.13–1.25) and when the walls were made of mud blocks compared with concrete (OR = 1.44, 1.10–1.87). Conclusion This study demonstrates that the risk of

  20. Ranking the contributions of commercial fish and shellfish varieties to mercury exposure in the United States: implications for risk communication.

    PubMed

    Groth, Edward

    2010-04-01

    Fish and shellfish have important nutritional benefits, and US per capita seafood consumption has increased substantially since 2002. Recent research has reinforced concerns about adverse effects of methylmercury exposure, suggesting that methylmercury doses associated with typical US rates of fish consumption may pose measurable risks, with no threshold. These converging trends create a need to improve risk communication about fish consumption and mercury. The analysis performed here identifies the relative importance of different fish and shellfish as sources of mercury in the US seafood supply and proposes improved consumer advice, so that the public can benefit from fish consumption while minimizing mercury exposure. I have quantified contributions to total mercury in the US seafood supply by 51 different varieties of fish and shellfish, then ranked and sorted the 51 varieties in terms of relative impact. Except for swordfish, most fish with the highest mercury levels are relatively minor contributors to total inputs. Tuna (canned light, canned albacore and fresh/frozen varieties) accounts for 37.4 percent of total mercury inputs, while two-thirds of the seafood supply and nine of the 11 most heavily consumed fish and shellfish are low or very low in mercury. Substantial improvement in risk communication about mercury in fish and seafood is needed; in particular, several population subsets need better guidance to base their seafood choices more explicitly on mercury content. I have sorted the 51 seafood varieties into six categories based on mercury levels, as a framework for improving risk communication in this regard. PMID:20116785

  1. Mapping the Risks of Malaria, Dengue and Influenza Using Satellite Data

    NASA Astrophysics Data System (ADS)

    Kiang, R. K.; Soebiyanto, R. P.

    2012-07-01

    It has long been recognized that environment and climate may affect the transmission of infectious diseases. The effects are most obvious for vector-borne infectious diseases, such as malaria and dengue, but less so for airborne and contact diseases, such as seasonal influenza. In this paper, we examined the meteorological and environmental parameters that influence the transmission of malaria, dengue and seasonal influenza. Remotely sensed parameters that provide such parameters were discussed. Both statistical and biologically inspired, processed based models can be used to model the transmission of these diseases utilizing the remotely sensed parameters as input. Examples were given for modelling malaria in Thailand, dengue in Indonesia, and seasonal influenza in Hong Kong.

  2. Rank Dynamics

    NASA Astrophysics Data System (ADS)

    Gershenson, Carlos

    Studies of rank distributions have been popular for decades, especially since the work of Zipf. For example, if we rank words of a given language by use frequency (most used word in English is 'the', rank 1; second most common word is 'of', rank 2), the distribution can be approximated roughly with a power law. The same applies for cities (most populated city in a country ranks first), earthquakes, metabolism, the Internet, and dozens of other phenomena. We recently proposed ``rank diversity'' to measure how ranks change in time, using the Google Books Ngram dataset. Studying six languages between 1800 and 2009, we found that the rank diversity curves of languages are universal, adjusted with a sigmoid on log-normal scale. We are studying several other datasets (sports, economies, social systems, urban systems, earthquakes, artificial life). Rank diversity seems to be universal, independently of the shape of the rank distribution. I will present our work in progress towards a general description of the features of rank change in time, along with simple models which reproduce it

  3. Risk ranking of LANL nuclear material storage containers for repackaging prioritization.

    PubMed

    Smith, Paul H; Jordan, Hans; Hoffman, Jenifer A; Eller, P Gary; Balkey, Simon

    2007-05-01

    Safe handling and storage of nuclear material at U.S. Department of Energy facilities relies on the use of robust containers to prevent container breaches and subsequent worker contamination and uptake. The U.S. Department of Energy has no uniform requirements for packaging and storage of nuclear materials other than those declared excess and packaged to DOE-STD-3013-2000. This report describes a methodology for prioritizing a large inventory of nuclear material containers so that the highest risk containers are repackaged first. The methodology utilizes expert judgment to assign respirable fractions and reactivity factors to accountable levels of nuclear material at Los Alamos National Laboratory. A relative risk factor is assigned to each nuclear material container based on a calculated dose to a worker due to a failed container barrier and a calculated probability of container failure based on material reactivity and container age. This risk-based methodology is being applied at LANL to repackage the highest risk materials first and, thus, accelerate the reduction of risk to nuclear material handlers. PMID:17440328

  4. Risk ranking priority of carcinogenic and/or genotoxic environmental contaminants in food in Belgium.

    PubMed

    Vromman, V; Maghuin-Rogister, G; Vleminckx, C; Saegerman, C; Pussemier, L; Huyghebaert, A

    2014-01-01

    This paper focuses on the risks of environmental carcinogenic and/or genotoxic contaminants in food. It describes, for each contaminant studied, the carcinogenicity and genotoxicity, the toxicological reference values, the exposure and the risk characterisation. The compounds studied were classified into 3 categories based on a risk assessment. Effects others than carcinogenicity and/or genotoxicity (e.g. endocrine disruption activity) were also taken into account for the classification. Given the low margin of exposure values for arsenic and lead, these two compounds are classified as priority 1 (high concern) for food safety and as a first priority to take actions to reduce exposure. Cadmium, methylmercury, dioxins and dioxin-like polychlorinated biphenyls (PCB), non-dioxin-like PCB and toxaphene are classified as priority 2 (medium concern). Polybrominated biphenyls, chlordane, heptachlor, dichlorodiphenyltrichloroethane (DDT) and metabolites, hexachlorobenzene, hexachlorocyclohexane (lindane included), polychlorophenols and their salts are classified as priority 3 (low concern). PMID:24471940

  5. Risk ranking priority of carcinogenic and/or genotoxic environmental contaminants in food in Belgium.

    PubMed

    Vromman, V; Maghuin-Rogister, G; Vleminckx, C; Saegerman, C; Pussemier, L; Huyghebaert, A

    2014-01-01

    This paper focuses on the risks of environmental carcinogenic and/or genotoxic contaminants in food. It describes, for each contaminant studied, the carcinogenicity and genotoxicity, the toxicological reference values, the exposure and the risk characterisation. The compounds studied were classified into 3 categories based on a risk assessment. Effects others than carcinogenicity and/or genotoxicity (e.g. endocrine disruption activity) were also taken into account for the classification. Given the low margin of exposure values for arsenic and lead, these two compounds are classified as priority 1 (high concern) for food safety and as a first priority to take actions to reduce exposure. Cadmium, methylmercury, dioxins and dioxin-like polychlorinated biphenyls (PCB), non-dioxin-like PCB and toxaphene are classified as priority 2 (medium concern). Polybrominated biphenyls, chlordane, heptachlor, dichlorodiphenyltrichloroethane (DDT) and metabolites, hexachlorobenzene, hexachlorocyclohexane (lindane included), polychlorophenols and their salts are classified as priority 3 (low concern).

  6. Disentangling the effects of forage, social rank, and risk on movement autocorrelation of elephants using Fourier and wavelet analyses.

    PubMed

    Wittemyer, George; Polansky, Leo; Douglas-Hamilton, Iain; Getz, Wayne M

    2008-12-01

    The internal state of an individual-as it relates to thirst, hunger, fear, or reproductive drive-can be inferred by referencing points on its movement path to external environmental and sociological variables. Using time-series approaches to characterize autocorrelative properties of step-length movements collated every 3 h for seven free-ranging African elephants, we examined the influence of social rank, predation risk, and seasonal variation in resource abundance on periodic properties of movement. The frequency domain methods of Fourier and wavelet analyses provide compact summaries of temporal autocorrelation and show both strong diurnal and seasonal based periodicities in the step-length time series. This autocorrelation is weaker during the wet season, indicating random movements are more common when ecological conditions are good. Periodograms of socially dominant individuals are consistent across seasons, whereas subordinate individuals show distinct differences diverging from that of dominants during the dry season. We link temporally localized statistical properties of movement to landscape features and find that diurnal movement correlation is more common within protected wildlife areas, and multiday movement correlations found among lower ranked individuals are typically outside of protected areas where predation risks are greatest. A frequency-related spatial analysis of movement-step lengths reveal that rest cycles related to the spatial distribution of critical resources (i.e., forage and water) are responsible for creating the observed patterns. Our approach generates unique information regarding the spatial-temporal interplay between environmental and individual characteristics, providing an original approach for understanding the movement ecology of individual animals and the spatial organization of animal populations.

  7. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India.

    PubMed

    Sohail, Mohammad; Shakeel, Shayan; Kumari, Shweta; Bharti, Aakanksha; Zahid, Faisal; Anwar, Shadab; Singh, Krishn Pratap; Islam, Mazahirul; Sharma, Ajay Kumar; Lata, Sneh; Ali, Vahab; Adak, Tridibes; Das, Pradeep; Raziuddin, Mohammad

    2015-01-01

    The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome.

  8. Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India

    PubMed Central

    Sohail, Mohammad; Shakeel, Shayan; Kumari, Shweta; Bharti, Aakanksha; Zahid, Faisal; Anwar, Shadab; Singh, Krishn Pratap; Islam, Mazahirul; Sharma, Ajay Kumar; Lata, Sneh; Ali, Vahab; Adak, Tridibes; Das, Pradeep; Raziuddin, Mohammad

    2015-01-01

    The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome. PMID:26783526

  9. Ranking Profiles

    ERIC Educational Resources Information Center

    Van Der Werf, Martin

    2007-01-01

    This article presents the "U.S. News" ranking profiles of four colleges, namely: (1) Smith College; (2) Washington University in St. Louis; (3) Colorado State University at Fort Collins; and (4) Whitman College. Smith College was in the top 10 of the nation's liberal-arts colleges, or just outside it, almost since the "U.S. News" rankings began.…

  10. Feasibility of developing risk-based rankings of pressure boundary systems for inservice inspection

    SciTech Connect

    Vo, T.V.; Smith, B.W.; Simonen, F.A.; Gore, B.F.

    1994-08-01

    The goals of the Evaluation and Improvement of Non-destructive Examination Reliability for the In-service Inspection of Light Water Reactors Program sponsored by the Nuclear Regulatory Commission at Pacific Northwest Laboratory (PNL) are to (1) assess current ISI techniques and requirements for all pressure boundary systems and components, (2) determine if improvements to the requirements are needed, and (3) if necessary, develop recommendations for revising the applicable ASME Codes and regulatory requirements. In evaluating approaches that could be used to provide a technical basis for improved inservice inspection plans, PNL has developed and applied a method that uses results of probabilistic risk assessment (PRA) to establish piping system ISI requirements. In the PNL program, the feasibility of generic ISI requirements is being addressed in two phases. Phase I involves identifying and prioritizing the systems most relevant to plant safety. The results of these evaluations will be later consolidated into requirements for comprehensive inservice inspection of nuclear power plant components that will be developed in Phase II. This report presents Phase I evaluations for eight selected plants and attempts to compare these PRA-based inspection priorities with current ASME Section XI requirements for Class 1, 2 and 3 systems. These results show that there are generic insights that can be extrapolated from the selected plants to specific classes of light water reactors.

  11. Malaria: prevention in travellers

    PubMed Central

    Croft, Ashley

    2000-01-01

    Definition Malaria is caused by a protozoan infection of red blood cells with one of four species of the genus plasmodium: P falciparum, P vivax, P ovale, or P malariae.1 Clinically, malaria may present in different ways, but it is usually characterised by fever (which may be swinging), tachycardia, rigors, and sweating. Anaemia, hepatosplenomegaly, cerebral involvement, renal failure, and shock may occur. Incidence/prevalence Each year there are 300-500 million clinical cases of malaria. About 40% of the world's population is at risk of acquiring the disease.23 Each year 25-30 million people from non-tropical countries visit areas in which malaria is endemic,4 of whom between 10 000 and 30 000 contract malaria.5 Aetiology/risk factors Malaria is mainly a rural disease, requiring standing water nearby. It is transmitted by bites6 from infected female anopheline mosquitoes,7 mainly at dusk and during the night.18 In cities, mosquito bites are usually from female culicene mosquitoes, which are not vectors of malaria.9 Malaria is resurgent in most tropical countries and the risk to travellers is increasing.10 Prognosis Ninety per cent of travellers who contract malaria do not become ill until after they return home.5 “Imported malaria” is easily treated if diagnosed promptly, and it follows a serious course in only about 12% of people.1112 The most severe form of the disease is cerebral malaria, with a case fatality rate in adult travellers of 2-6%,3 mainly because of delays in diagnosis.5 Aims To reduce the risk of infection; to prevent illness and death. Outcomes Rates of malarial illness and death, and adverse effects of treatment. Proxy measures include number of mosquito bites and number of mosquitoes in indoor areas. We found limited evidence linking number of mosquito bites and risk of malaria.13 Methods Clinical Evidence search and appraisal in November 1999. We reviewed all identified systematic reviews and randomised controlled trials (RCTs

  12. Environmental Risk Evaluation System – An Approach to Ranking Risk of Ocean Energy Development on Coastal and Estuarine Environments

    SciTech Connect

    Copping, Andrea E.; Hanna, Luke A.; Van Cleve, Frances B.; Blake, Kara M.; Anderson, Richard M.

    2015-01-01

    Deployment and operation of ocean energy devices does not represent the first foray into industrialization of the oceans; shipping, nearshore development, waste disposal, subsea mining, oil and gas extraction, and large-scale commercial fishing all coexist in various states of equilibrium with the marine environment. In most cases these industries were developed without a clear understanding of the likely outcomes of large-scale development. In virtually every country where the harvest of ocean energy is emerging, regulators and stakeholders require that the industry examine potential effects of devices, minimize the footprint of effects, and provide management measures that either avoid the impacts or mitigate to further reduce the residual impacts. The ERES analysis is based on scenarios that are consistent with sequences of events that lead to adverse impacts, distinguishing between episodic, intermittent, and chronic risks. In the context of ocean energy development, an episodic scenario might involve the exceedingly rare but potentially devastating event of an oil spill from vessels caused by the presence of the device, while vulnerable receptors are present; understanding the risk of such a scenario involves determining the probability of the occurrence by examining factors such as the petroleum content of ocean energy devices, the vessel traffic volume and the proximity of shipping lanes to the ocean energy devices, the reliability of the control measures to avoid an episodic event, and the likely presence of seabirds, marine mammals, or fish that may be affected by oil. In contrast, chronic risk scenarios involve events or circumstances that are continuous, so that risk characterization involves assessing only the severity of the consequences. An example of a chronic risk scenario might be the toxicity to marine organisms due to low-level chemical releases from anti-biofouling paints and coatings that may be used on devices, and the effect that the level of

  13. Factors that are associated with the risk of acquiring Plasmodium knowlesi malaria in Sabah, Malaysia: a case-control study protocol

    PubMed Central

    Grigg, M J; William, T; Drakeley, C J; Jelip, J; von Seidlein, L; Barber, B E; Fornace, K M; Anstey, N M; Yeo, T W; Cox, J

    2014-01-01

    Introduction Plasmodium knowlesi has long been present in Malaysia, and is now an emerging cause of zoonotic human malaria. Cases have been confirmed throughout South-East Asia where the ranges of its natural macaque hosts and Anopheles leucosphyrus group vectors overlap. The majority of cases are from Eastern Malaysia, with increasing total public health notifications despite a concurrent reduction in Plasmodium falciparum and P. vivax malaria. The public health implications are concerning given P. knowlesi has the highest risk of severe and fatal disease of all Plasmodium spp in Malaysia. Current patterns of risk and disease vary based on vector type and competence, with individual exposure risks related to forest and forest-edge activities still poorly defined. Clustering of cases has not yet been systematically evaluated despite reports of peri-domestic transmission and known vector competence for human-to-human transmission. Methods and analysis A population-based case–control study will be conducted over a 2-year period at two adjacent districts in north-west Sabah, Malaysia. Confirmed malaria cases presenting to the district hospital sites meeting relevant inclusion criteria will be requested to enrol. Three community controls matched to the same village as the case will be selected randomly. Study procedures will include blood sampling and administration of household and individual questionnaires to evaluate potential exposure risks associated with acquisition of P. knowlesi malaria. Secondary outcomes will include differences in exposure variables between P. knowlesi and other Plasmodium spp, risk of severe P. knowlesi malaria, and evaluation of P. knowlesi case clustering. Primary analysis will be per protocol, with adjusted ORs for exposure risks between cases and controls calculated using conditional multiple logistic regression models. Ethics This study has been approved by the human research ethics committees of Malaysia, the Menzies School of

  14. Polymorphisms in host genes encoding NOSII, C-reactive protein, and adhesion molecules thrombospondin and E-selectin are risk factors for Plasmodium falciparum malaria in India.

    PubMed

    Kanchan, K; Pati, S S; Mohanty, S; Mishra, S K; Sharma, S K; Awasthi, S; Venkatesh, V; Habib, S

    2015-10-01

    Cytoadherence of Plasmodium falciparum-infected red blood cells (RBCs) in host microvasculature and complex regulation of the immune response are important contributors to the clinical outcome of disease. We tested the association of 23 single nucleotide polymorphisms (SNPs) and a microsatellite repeat in adhesion molecule genes THBS1 and ESEL, and immune regulatory molecule genes NOSII, CRP, and MBL2 with falciparum malaria in populations residing in a malaria-endemic and a non-endemic region of India. The THBS1 haplotype CCCCA (rs1478604, rs7170682, rs2664141, rs12912082, rs3743125) was a risk factor in the endemic region (relative risk = 3.78) and an ESEL SNP (rs5368, His468Tyr) associated with cerebral malaria (CM) [CM vs. non-cerebral malaria (NCM), odds ratio (OR) = 2.23, p = 0.03]. In the non-endemic region, an ESEL 3'UTR SNP (rs5359) associated with enhanced risk of disease (OR = 3.62, p = 1 × 10(-4)) and the CT genotype of the CRP promoter SNP (C/T/A) strongly associated with protection (severe vs. control, OR = 0.29, p = 6 × 10(-5)). Long repeat alleles of the NOSII promoter microsatellite (CCTTT)n exhibited strong association with protection and the NOSII ATG haplotype (rs3729508, rs2297520, rs9282801) was strongly protective against severe malaria in both regions (endemic, severe vs. control, OR = 0.05, p = 0.0001; non-endemic, severe vs. control, OR = 0.3, p = 1 × 10(-5)). Our results suggest differential contribution of variants of the investigated genes in determining the outcome of malaria in Indian populations.

  15. Migration and malaria.

    PubMed

    Jitthai, Nigoon

    2013-01-01

    Migration is an important global issue as poorly managed migration can result in a diversity of problems, including an increase in the transmission of diseases such as malaria. There is evidence to suggest that malaria is no longer a forest-dependent disease and may largely be affected by population movements, mostly to agricultural areas. While internal and transnational migration has different legal implications in most countries, both types of migration occur for the same reasons; economic and/ or safety. Although migration in itself is not a definitive risk for malaria, several factors can put, migrants and local communities alike, in vulnerable situations. In particular, infrastructure and rural development, deforestation for logging and economic farming, political movements, and natural disasters are some of the major factors that push and pull people in and out of malaria-endemic areas. Therefore, understanding the changing socio-environmental situation as well as population movements and their associated risks for malaria infection, is critical for malaria control, containment, and elimination. Efforts to address these issues should include advocacy, mapping exercises and expanded/ strengthened surveillance to also include migrant health information systems. Malaria related information, prevention measures, and early diagnosis and appropriate treatment should be made easily accessible for migrants regardless of their migration status; not only to ensure that they are equipped with appropriate knowledge and devices to protect themselves, but also to ensure that they are properly diagnosed and treated, to prevent further transmission, and to ensure that they are captured by the surveillance system. PMID:24159832

  16. Randomized, Double-Blind, Placebo-Controlled Trial of Monthly versus Bimonthly Dihydroartemisinin-Piperaquine Chemoprevention in Adults at High Risk of Malaria

    PubMed Central

    Lwin, Khin Maung; Phyo, Aung Pyae; Tarning, Joel; Hanpithakpong, Warunee; Ashley, Elizabeth A.; Lee, Sue J.; Cheah, Phaikyeong; Singhasivanon, Pratap; White, Nicholas J.; Lindegårdh, Niklas

    2012-01-01

    Intermittent preventive treatment (IPT) is increasingly used to reduce malaria morbidity and mortality in children and pregnant women. The efficacy of IPT depends on the pharmacokinetic and pharmacodynamic properties of the antimalarial drugs used. Healthy adult male volunteers whose occupation put them at high risk of malaria on the Northwest border of Thailand were randomized to receive a 3-day-treatment dose of dihydroartemisinin-piperaquine monthly (DPm) or every 2 months (DPalt) or an identical placebo with or without fat (6.4g/dose) over a 9-month period. All volunteers were monitored weekly. One thousand adults were recruited. Dihydroartemisinin-piperaquine was well tolerated. There were 114 episodes of malaria (49 Plasmodium falciparum, 63 P. vivax, and 2 P. ovale). The protective efficacy against all malaria at 36 weeks was 98% (95% confidence interval [CI], 96% to 99%) in the DPm group and 86% (95% CI, 81% to 90%) in the DPalt group (for both, P < 0.0001 compared to the placebo group). As a result, the placebo group also had lower hematocrits during the study (P < 0.0001). Trough plasma piperaquine concentrations were the main determinant of efficacy; no malaria occurred in participants with a trough concentration above 31 ng/ml. Neither plasma piperaquine concentration nor efficacy was influenced by the coadministration of fat. DPm is safe to use and is effective in the prevention of malaria in adult males living in an area where P. vivax and multidrug-resistant P. falciparum malaria are endemic. PMID:22252804

  17. An analysis of timing and frequency of malaria infection during pregnancy in relation to the risk of low birth weight, anaemia and perinatal mortality in Burkina Faso

    PubMed Central

    2012-01-01

    Background A prospective study aiming at assessing the effect of adding a third dose sulphadoxine-pyrimethamine (SP) to the standard two-dose intermittent preventive treatment for pregnant women was carried out in Hounde, Burkina Faso, between March 2006 and July 2008. Pregnant women were identified as earlier as possible during pregnancy through a network of home visitors, referred to the health facilities for inclusion and followed up until delivery. Methods Study participants were enrolled at antenatal care (ANC) visits and randomized to receive either two or three doses of SP at the appropriate time. Women were visited daily and a blood slide was collected when there was fever (body temperature > 37.5°C) or history of fever. Women were encouraged to attend ANC and deliver in the health centre, where the new-born was examined and weighed. The timing and frequency of malaria infection was analysed in relation to the risk of low birth weight, maternal anaemia and perinatal mortality. Results Data on birth weight and haemoglobin were available for 1,034 women. The incidence of malaria infections was significantly lower in women having received three instead of two doses of SP. Occurrence of first malaria infection during the first or second trimester was associated with a higher risk of low birth weight: incidence rate ratios of 3.56 (p < 0.001) and 1.72 (p = 0.034), respectively. After adjusting for possible confounding factors, the risk remained significantly higher for the infection in the first trimester of pregnancy (adjusted incidence rate ratio = 2.07, p = 0.002). The risk of maternal anaemia and perinatal mortality was not associated with the timing of first malaria infection. Conclusion Malaria infection during first trimester of pregnancy is associated to a higher risk of low birth weight. Women should be encouraged to use long-lasting insecticidal nets before and throughout their pregnancy. PMID:22433778

  18. Risk ranking of multiple-POPs in detritivorous fish from the Río de la Plata.

    PubMed

    Colombo, J C; Cappelletti, N; Williamson, M; Migoya, M C; Speranza, E; Sericano, J; Muir, D C G

    2011-04-01

    To evaluate the bioaccumulation and the risk associated to consumption of lipid-rich detritivorous fish, a comprehensive set of organic pollutants (n=213) including polychlorinated biphenyls (PCBs), dioxin like PCBs (dlPCBs), chlorinated pesticides (CHLPs), chlorobenzenes (CBzs), polybrominated diphenyl ethers (PBDEs), polychlorinated dibenzo dioxins and furans (PCDD/F), resolved (ALI) and unresolved aliphatic hydrocarbons (UCM) and linear alkyl benzenes (LABs) were analyzed in Sábalo fish (Prochilodus lineatus) collected in the polluted Metropolitan Buenos Aires coast and in migrating specimens. Fatty fish muscles (lipids: 74±9.3% dry weight) contained homogeneous (24-51% variability) and very high-concentrations of organic pollutants ranging from 60 to 1,300 μg g(-1) fresh weight (fw) ALI+UCM; 10-40 μg g(-1) fw LABs and PCBs; 0.1-1 μg g(-1) fw dlPCBs, DDTs, chlordanes, CBzs and PBDEs; 0.01-0.1 μg g(-1) fw mirex, endosulfans, aldrin, dieldrin, endrin and 0.07-0.2 ng g(-1) PCDD/F. Total toxicity equivalents (TEQs) ranged from 60 to 395 pg g(-1) fw (34±17 and 213±124 pg g(-1) TEQs for PCDD/F and dlPCBs respectively). These are among the highest concentrations reported for fish and point out the remarkable ability of Sábalo to feed on anthropogenic organic-enriched particles and tolerate a high pollutant load. Contaminant signatures show partial alteration with still abundant lower molecular weight components indicating that fish feeds directly in the outfalls. Consumption limits based on reference doses ranged from 0.1 (PCBs) to >1,2000 g d(-1) (endosulfan) allowing a comprehensive risk-based ranking of contaminants in this long-range migrating, detritivorous fish.

  19. Changing landscape of malaria in China: progress and feasibility of malaria elimination.

    PubMed

    Diouf, Gorgui; Kpanyen, Patrick N; Tokpa, Augustine F; Nie, Shaofa

    2014-01-01

    Large-scale malaria control activities in China have been conducted with significant success, since the launch of the nationwide malaria control program. This study investigated the malaria distribution in China, particularly in provinces with high risks. Spatial and temporal data were assembled for all endemic or historically endemic areas and combined to identify common patterns and to investigate the actual changes in the burden of malaria in the country. Data were analyzed and the progress in malaria elimination feasibility was discussed. The results indicated that the current distribution of malaria and vectors associated could provide evidence on the assessment of the feasibility of the malaria elimination in China.

  20. Investigating the Contribution of Peri-domestic Transmission to Risk of Zoonotic Malaria Infection in Humans

    PubMed Central

    Manin, Benny O.; Ferguson, Heather M.; Vythilingam, Indra; Fornace, Kim; William, Timothy; Torr, Steve J.; Drakeley, Chris; Chua, Tock H.

    2016-01-01

    Background In recent years, the primate malaria Plasmodium knowlesi has emerged in human populations throughout South East Asia, with the largest hotspot being in Sabah, Malaysian Borneo. Control efforts are hindered by limited knowledge of where and when people get exposed to mosquito vectors. It is assumed that exposure occurs primarily when people are working in forest areas, but the role of other potential exposure routes (including domestic or peri-domestic transmission) has not been thoroughly investigated. Methodology/Principal Findings We integrated entomological surveillance within a comprehensive case-control study occurring within a large hotspot of transmission in Sabah, Malaysia. Mosquitoes were collected at 28 pairs households composed of one where an occupant had a confirmed P. knowlesi infection within the preceding 3 weeks (“case”) and an associated “control” where no infection was reported. Human landing catches were conducted to measure the number and diversity of mosquitoes host seeking inside houses and in the surrounding peri-domestic (outdoors but around the household) areas. The predominant malaria vector species was Anopheles balabacensis, most of which were caught outdoors in the early evening (6pm - 9pm). It was significantly more abundant in the peri-domestic area than inside houses (5.5-fold), and also higher at case than control households (0.28±0.194 vs 0.17±0.127, p<0.001). Ten out of 641 An. balabacensis tested were positive for simian malaria parasites, but none for P. knowlesi. Conclusions/Significance This study shows there is a possibility that humans can be exposed to P. knowlesi infection around their homes. The vector is highly exophagic and few were caught indoors indicating interventions using bednets inside households may have relatively little impact. PMID:27741235

  1. Diagnosis of placental malaria.

    PubMed

    Mockenhaupt, Frank P; Ulmen, Ulrike; von Gaertner, Christiane; Bedu-Addo, George; Bienzle, Ulrich

    2002-01-01

    In a group of 596 delivering Ghanaian women, the sensitivities of peripheral blood thick film microscopy, ICT Malaria P.f/P.v test, and PCR in detecting microscopically confirmed placental Plasmodium falciparum infection were 42, 80, and 97%, respectively. In addition to the gross underestimation of placental malaria by peripheral blood film microscopy, submicroscopic infections were found to be a risk factor for maternal anemia.

  2. Malaria Facts

    MedlinePlus

    ... a CDC Malaria Branch clinician. malaria@cdc.gov File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel ...

  3. Dehydration and malaria augment the risk of developing chronic kidney disease in Sri Lanka

    PubMed Central

    Siriwardhana, E. A. R. I. E.; Perera, P. A. J.; Sivakanesan, R.; Abeysekara, T.; Nugegoda, D. B.; Jayaweera, J. A. A. S.

    2015-01-01

    Chronic kidney disease (CKD) of unknown etiology (CKDu) is a serious health issue in Sri Lanka. One-to-one age and sex-matched two sample comparative study was carried out in the Medawachchiya divisional secretariat area of the North Central Province (NCP) of Sri Lanka, by randomly selecting 100 CKDu patients and 100 age and sex-matched subjects from non-CKDu affected families from the same area. An interviewer-administered questionnaire was used for the collection of data pertaining to occupation, medical history and lifestyle. Data were analyzed using a conditional linear logistic model. Working for >6 h in the field per day, exposure to sun, drinking water only from well, consumption of <3 L of water per day, and having a history of malaria were found to be having significant (P < 0.05) likelihood toward the development of CKDu. Treatment of water prior to consumption had a significant protective effect against CKDu. Dehydration, history of malaria and drinking untreated well water from are likely contribute to the development of CKD of unknown etiology among the inhabitants of NCP, Sri Lanka. PMID:26060363

  4. International Air Travel to Ohio, USA, and the Impact on Malaria, Influenza, and Hepatitis A

    PubMed Central

    Brannen, Donald E.; Alhammad, Ali; Branum, Melissa; Schmitt, Amy

    2016-01-01

    The State of Ohio led the United States in measles in 2014, ostensibly related to international air travel (IAT), and ranked lower than 43 other states in infectious disease outbreak preparedness. We conducted a retrospective cohort study using surveillance data of the total Ohio population of 11 million from 2010 through 2014 with a nested case control of air travelers to determine the risk of malaria, seasonal influenza hospitalizations (IH), and hepatitis A (HA) disease related to international travel and to estimate the association with domestic enplanement. IAT appeared protective for HA and IH with a risk of 0.031 (.02–.04) but for malaria was 2.7 (2.07–3.62). Enplanement increased the risk for nonendemic M 3.5 (2.5–4.9) and for HA and IH 1.39 (1.34–1.44). IAT's ratio of relative risk (RRR) of malaria to HA and IH was 87.1 (55.8–136) greater than 219 times versus domestic enplanement which was protective for malaria at 0.397 (0.282–0.559). Malaria is correlated with IAT with cases increasing by 6.9 for every 10,000 passports issued. PMID:27123365

  5. Malaria in Children

    PubMed Central

    Schumacher, Richard-Fabian; Spinelli, Elena

    2012-01-01

    This review is focused on childhood specific aspects of malaria, especially in resource-poor settings. We summarise the actual knowledge in the field of epidemiology, clinical presentation, diagnosis, management and prevention. These aspects are important as malaria is responsible for almost a quarter of all child death in sub-Saharan Africa. Malaria control is thus one key intervention to reduce childhood mortality, especially as malaria is also an important risk factor for other severe infections, namely bacteraemia. In children symptoms are more varied and often mimic other common childhood illness, particularly gastroenteritis, meningitis/encephalitis, or pneumonia. Fever is the key symptom, but the characteristic regular tertian and quartan patterns are rarely observed. There are no pathognomonic features for severe malaria in this age group. The well known clinical (fever, impaired consciousness, seizures, vomiting, respiratory distress) and laboratory (severe anaemia, thrombocytopenia, hypoglycaemia, metabolic acidosis, and hyperlactataemia) features of severe falciparum malaria in children, are equally typical for severe sepsis. Appropriate therapy (considering species, resistance patterns and individual patient factors) – possibly a drug combination of an artemisinin derivative with a long-acting antimalarial drug - reduces treatment duration to only three days and should be urgently started. While waiting for the results of ongoing vaccine trials, all effort should be made to better implement other malaria-control measures like the use of treated bed-nets, repellents and new chemoprophylaxis regimens. PMID:23205261

  6. Measuring malaria endemicity from intense to interrupted transmission

    PubMed Central

    Hay, Simon I; Smith, David L; Snow, Robert W

    2008-01-01

    Summary The quantification of malaria transmission for the classification of malaria risk has long been a concern for epidemiologists. During the era of the Global Malaria Eradication Programme, measurements of malaria endemicity were institutionalised by their incorporation into rules outlining defined action points for malaria control programmes. We review the historical development of these indices and their contemporary relevance. This is at a time when many malaria-endemic countries are scaling-up their malaria control activities and reconsidering their prospects for elimination. These considerations are also important to an international community that has recently been challenged to revaluate the prospects for malaria eradication. PMID:18387849

  7. Clinical, geographical, and temporal risk factors associated with presentation and outcome of vivax malaria imported into the United Kingdom over 27 years: observational study

    PubMed Central

    Broderick, Claire; Nadjm, Behzad; Smith, Valerie; Blaze, Marie; Checkley, Anna; Chiodini, Peter L

    2015-01-01

    Objective To examine temporal and geographical trends, risk factors, and seasonality of imported vivax malaria in the United Kingdom to inform clinical advice and policy. Design Observational study. Setting National surveillance data from the UK Public Health England Malaria Reference Laboratory, data from the International Passenger Survey, and international climactic data. Participants All confirmed and notified cases of malaria in the UK (n=50 187) from 1987 to 2013, focusing on 12 769 cases of vivax malaria. Main outcome measures Mortality, sociodemographic details (age, UK region, country of birth and residence, and purpose of travel), destination, and latency (time between arrival in the UK and onset of symptoms). Results Of the malaria cases notified, 25.4% (n=12 769) were due to Plasmodium vivax, of which 78.6% were imported from India and Pakistan. Most affected patients (53.5%) had travelled to visit friends and relatives, and 11.1% occurred in tourists. Imported P vivax is concentrated in areas with large communities of south Asian heritage. Overall mortality was 7/12 725 (0.05%), but with no deaths in 9927 patients aged under 50 years. Restricting the analysis to those aged more than 50 years, mortality was 7/2798 (0.25%), increasing to 4/526 (0.76%) (adjusted odds ratio 32.0, 95% confidence interval 7.1 to 144.0, P<0.001) in those aged 70 years or older. Annual notifications decreased sharply over the period, while traveller numbers between the UK and South Asia increased. The risk of acquiring P vivax from South Asia was year round but was twice as high from June to September (40 per 100 000 trips) compared with the rest of the year. There was strong seasonality in the latency from arrival in the UK to presentation, significantly longer in those arriving in the UK from South Asia from October to March (median 143 days) versus those arriving from April to September (37 days, P<0.001). Conclusions Travellers visiting friends and family in

  8. Mapping residual transmission for malaria elimination.

    PubMed

    Reiner, Robert C; Le Menach, Arnaud; Kunene, Simon; Ntshalintshali, Nyasatu; Hsiang, Michelle S; Perkins, T Alex; Greenhouse, Bryan; Tatem, Andrew J; Cohen, Justin M; Smith, David L

    2015-12-29

    Eliminating malaria from a defined region involves draining the endemic parasite reservoir and minimizing local malaria transmission around imported malaria infections . In the last phases of malaria elimination, as universal interventions reap diminishing marginal returns, national resources must become increasingly devoted to identifying where residual transmission is occurring. The needs for accurate measures of progress and practical advice about how to allocate scarce resources require new analytical methods to quantify fine-grained heterogeneity in malaria risk. Using routine national surveillance data from Swaziland (a sub-Saharan country on the verge of elimination), we estimated individual reproductive numbers. Fine-grained maps of reproductive numbers and local malaria importation rates were combined to show 'malariogenic potential', a first for malaria elimination. As countries approach elimination, these individual-based measures of transmission risk provide meaningful metrics for planning programmatic responses and prioritizing areas where interventions will contribute most to malaria elimination.

  9. Geographic information systems and logistic regression for high-resolution malaria risk mapping in a rural settlement of the southern Brazilian Amazon

    PubMed Central

    2013-01-01

    Background In Brazil, 99% of the cases of malaria are concentrated in the Amazon region, with high level of transmission. The objectives of the study were to use geographic information systems (GIS) analysis and logistic regression as a tool to identify and analyse the relative likelihood and its socio-environmental determinants of malaria infection in the Vale do Amanhecer rural settlement, Brazil. Methods A GIS database of georeferenced malaria cases, recorded in 2005, and multiple explanatory data layers was built, based on a multispectral Landsat 5 TM image, digital map of the settlement blocks and a SRTM digital elevation model. Satellite imagery was used to map the spatial patterns of land use and cover (LUC) and to derive spectral indices of vegetation density (NDVI) and soil/vegetation humidity (VSHI). An Euclidian distance operator was applied to measure proximity of domiciles to potential mosquito breeding habitats and gold mining areas. The malaria risk model was generated by multiple logistic regression, in which environmental factors were considered as independent variables and the number of cases, binarized by a threshold value was the dependent variable. Results Out of a total of 336 cases of malaria, 133 positive slides were from inhabitants at Road 08, which corresponds to 37.60% of the notifications. The southern region of the settlement presented 276 cases and a greater number of domiciles in which more than ten cases/home were notified. From these, 102 (30.36%) cases were caused by Plasmodium falciparum and 174 (51.79%) cases by Plasmodium vivax. Malaria risk is the highest in the south of the settlement, associated with proximity to gold mining sites, intense land use, high levels of soil/vegetation humidity and low vegetation density. Conclusions Mid-resolution, remote sensing data and GIS-derived distance measures can be successfully combined with digital maps of the housing location of (non-) infected inhabitants to predict relative

  10. Assessment of a remote sensing-based model for predicting malaria transmission risk in villages of Chiapas, Mexico

    NASA Technical Reports Server (NTRS)

    Beck, L. R.; Rodriguez, M. H.; Dister, S. W.; Rodriguez, A. D.; Washino, R. K.; Roberts, D. R.; Spanner, M. A.

    1997-01-01

    A blind test of two remote sensing-based models for predicting adult populations of Anopheles albimanus in villages, an indicator of malaria transmission risk, was conducted in southern Chiapas, Mexico. One model was developed using a discriminant analysis approach, while the other was based on regression analysis. The models were developed in 1992 for an area around Tapachula, Chiapas, using Landsat Thematic Mapper (TM) satellite data and geographic information system functions. Using two remotely sensed landscape elements, the discriminant model was able to successfully distinguish between villages with high and low An. albimanus abundance with an overall accuracy of 90%. To test the predictive capability of the models, multitemporal TM data were used to generate a landscape map of the Huixtla area, northwest of Tapachula, where the models were used to predict risk for 40 villages. The resulting predictions were not disclosed until the end of the test. Independently, An. albimanus abundance data were collected in the 40 randomly selected villages for which the predictions had been made. These data were subsequently used to assess the models' accuracies. The discriminant model accurately predicted 79% of the high-abundance villages and 50% of the low-abundance villages, for an overall accuracy of 70%. The regression model correctly identified seven of the 10 villages with the highest mosquito abundance. This test demonstrated that remote sensing-based models generated for one area can be used successfully in another, comparable area.

  11. Malaria (For Parents)

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Malaria KidsHealth > For Parents > Malaria Print A A A ... Prevention Diagnosis and Treatment en español Malaria About Malaria Malaria is a common infection in hot, tropical ...

  12. Malaria vaccine.

    PubMed

    Khurana, S K; Talib, V H

    1996-12-01

    Recently it has become evident that he same candidate antigen can be shared by several of the parasite stages, and thus the concept of a multistage vaccine is becoming more and more attractive. A TDR Task Force evaluated the promise and stage of development of some 20 existing asexual blood stage candidate antigens and prepared a strategy for their development leading to clinical testing and field trials, Amongst these are merozoite surface protein 1 (MSP-1), Serine Rich Antigen (SERA), Apical Membrane Antigen (AMA-1), and Erythrocyte Binding Antigen (EBA). A field study conducted in Tanzanian children showed that the SPf66 Colombian vaccine was safe, induced antibodies, and reduced the risk of developing clinical malaria by around 30%. This study, confirmed the potential of the vaccine to confer partial protection in areas of high as well as low intensity of transmission. Pfs25 is a leading candidate antigen for a transmission blocking vaccine. It is found in the ookinete stage of the parasite in the mosquito midgut. Gramme amounts of GMP-grade material have been produced and a vaccine based on the Pfs25 antigen formulated with alum should have gone into phase I and II clinical trials in the USA and Africa during 1995. Because the first malaria prototype vaccine to be tried out in people on a large scale has been the polymerized synthetic peptide developed by patarroye on the basis of the SPf66 antigen of P. faliciparum, the results are with much interest. It is still premature to predict the effectiveness of this vaccine globally, but its development will encourage further progress in a fields that has repeatedly been characterized by raised and then dashed drops. These various vaccines are based on the classical approach to vaccination, which is to raise host immunity against the parasite so as to reduce parasite densities or to sterilize an infection. A newer approach is development of antidisease vaccines which aim to alleviate morbidity by suppressing

  13. Use of Integrated Malaria Management Reduces Malaria in Kenya

    PubMed Central

    Okech, Bernard A.; Mwobobia, Isaac K.; Kamau, Anthony; Muiruri, Samuel; Mutiso, Noah; Nyambura, Joyce; Mwatele, Cassian; Amano, Teruaki; Mwandawiro, Charles S.

    2008-01-01

    Background During an entomological survey in preparation for malaria control interventions in Mwea division, the number of malaria cases at the Kimbimbi sub-district hospital was in a steady decline. The underlying factors for this reduction were unknown and needed to be identified before any malaria intervention tools were deployed in the area. We therefore set out to investigate the potential factors that could have contributed to the decline of malaria cases in the hospital by analyzing the malaria control knowledge, attitudes and practices (KAP) that the residents in Mwea applied in an integrated fashion, also known as integrated malaria management (IMM). Methods Integrated Malaria Management was assessed among community members of Mwea division, central Kenya using KAP survey. The KAP study evaluated community members' malaria disease management practices at the home and hospitals, personal protection measures used at the household level and malaria transmission prevention methods relating to vector control. Concurrently, we also passively examined the prevalence of malaria parasite infection via outpatient admission records at the major referral hospital in the area. In addition we studied the mosquito vector population dynamics, the malaria sporozoite infection status and entomological inoculation rates (EIR) over an 8 month period in 6 villages to determine the risk of malaria transmission in the entire division. Results A total of 389 households in Mwea division were interviewed in the KAP study while 90 houses were surveyed in the entomological study. Ninety eight percent of the households knew about malaria disease while approximately 70% of households knew its symptoms and methods to manage it. Ninety seven percent of the interviewed households went to a health center for malaria diagnosis and treatment. Similarly a higher proportion (81%) used anti-malarial medicines bought from local pharmacies. Almost 90% of households reported owning and using an

  14. Malaria resurgence risk in southern Europe: climate assessment in an historically endemic area of rice fields at the Mediterranean shore of Spain

    PubMed Central

    2010-01-01

    Background International travel and immigration have been related with an increase of imported malaria cases. This fact and climate change, prolonging the period favouring vector development, require an analysis of the malaria transmission resurgence risk in areas of southern Europe. Such a study is made for the first time in Spain. The Ebro Delta historically endemic area was selected due to its rice field landscape, the presence of only one vector, Anopheles atroparvus, with densities similar to those it presented when malaria was present, in a situation which pronouncedly differs from already assessed potential resurgence areas in other Mediterranean countries, such as France and Italy, where many different Anopheles species coexist and a different vector species dominates. Methods The transmission risk was assessed analysing: 1) climate diagrams including the minimum temperature for Plasmodium falciparum and Plasmodium vivax development; 2) monthly evolution of the Gradient Model Risk (GMR) index, specifying transmission risk period and number of potential Plasmodium generations; 3) ecological characteristics using remote sensing images with the Eurasia Land Cover characteristics database and the monthly evolution of the Normalized Difference Vegetation Index (NDVI); 4) evaluation of A. atroparvus population dynamics. Results Climatological analyses and GMR index show that a transmission risk presently exists, lasting from May until September for P. falciparum, and from May until October for P. vivax. The GMR index shows that the temperature increase does not actually mean a transmission risk increase if accompanied by a precipitation decrease reducing the number of parasite generations and transmission period. Nevertheless, this limitation is offset by the artificial flooding of the rice fields. Maximum NDVI values and A. atroparvus maximum abundance correspond to months with maximum growth of the rice fields. Conclusions The Ebro Delta presents the ecological

  15. Malaria entomological risk factors in relation to land cover in the Lower Caura River Basin, Venezuela

    PubMed Central

    Rubio-Palis, Yasmin; Bevilacqua, Mariapia; Medina, Domingo Alberto; Moreno, Jorge Ernesto; Cárdenas, Lya; Sánchez, Víctor; Estrada, Yarys; Anaya, William; Martínez, Ángela

    2013-01-01

    To explore the effects of deforestation and resulting differences in vegetation and land cover on entomological parameters, such as anopheline species composition, abundance, biting rate, parity and entomological inoculation rate (EIR), three villages were selected in the Lower Caura River Basin, state of Bolívar, Venezuela. All-night mosquito collections were conducted between March 2008-January 2009 using CDC light traps and Mosquito Magnet(r) Liberty Plus. Human landing catches were performed between 06:00 pm-10:00 pm, when anophelines were most active. Four types of vegetation were identified. The Annual Parasite Index was not correlated with the type of vegetation. The least abundantly forested village had the highest anopheline abundance, biting rate and species diversity. Anopheles darlingi and Anopheles nuneztovari were the most abundant species and were collected in all three villages. Both species showed unique biting cycles. The more abundantly forested village of El Palmar reported the highest EIR. The results confirmed previous observations that the impacts of deforestation and resulting changes in vegetation cover on malaria transmission are complex and vary locally. PMID:23579803

  16. Malaria Molecular Epidemiology: Lessons from the International Centers of Excellence for Malaria Research Network.

    PubMed

    Escalante, Ananias A; Ferreira, Marcelo U; Vinetz, Joseph M; Volkman, Sarah K; Cui, Liwang; Gamboa, Dionicia; Krogstad, Donald J; Barry, Alyssa E; Carlton, Jane M; van Eijk, Anna Maria; Pradhan, Khageswar; Mueller, Ivo; Greenhouse, Bryan; Pacheco, M Andreina; Vallejo, Andres F; Herrera, Socrates; Felger, Ingrid

    2015-09-01

    Molecular epidemiology leverages genetic information to study the risk factors that affect the frequency and distribution of malaria cases. This article describes molecular epidemiologic investigations currently being carried out by the International Centers of Excellence for Malaria Research (ICEMR) network in a variety of malaria-endemic settings. First, we discuss various novel approaches to understand malaria incidence and gametocytemia, focusing on Plasmodium falciparum and Plasmodium vivax. Second, we describe and compare different parasite genotyping methods commonly used in malaria epidemiology and population genetics. Finally, we discuss potential applications of molecular epidemiological tools and methods toward malaria control and elimination efforts.

  17. Malaria Molecular Epidemiology: Lessons from the International Centers of Excellence for Malaria Research Network

    PubMed Central

    Escalante, Ananias A.; Ferreira, Marcelo U.; Vinetz, Joseph M.; Volkman, Sarah K.; Cui, Liwang; Gamboa, Dionicia; Krogstad, Donald J.; Barry, Alyssa E.; Carlton, Jane M.; van Eijk, Anna Maria; Pradhan, Khageswar; Mueller, Ivo; Greenhouse, Bryan; Andreina Pacheco, M.; Vallejo, Andres F.; Herrera, Socrates; Felger, Ingrid

    2015-01-01

    Molecular epidemiology leverages genetic information to study the risk factors that affect the frequency and distribution of malaria cases. This article describes molecular epidemiologic investigations currently being carried out by the International Centers of Excellence for Malaria Research (ICEMR) network in a variety of malaria-endemic settings. First, we discuss various novel approaches to understand malaria incidence and gametocytemia, focusing on Plasmodium falciparum and Plasmodium vivax. Second, we describe and compare different parasite genotyping methods commonly used in malaria epidemiology and population genetics. Finally, we discuss potential applications of molecular epidemiological tools and methods toward malaria control and elimination efforts. PMID:26259945

  18. IL-4 Haplotype -590T, -34T and Intron-3 VNTR R2 Is Associated with Reduced Malaria Risk among Ancestral Indian Tribal Populations

    PubMed Central

    Jha, Aditya Nath; Singh, Vipin Kumar; Kumari, Namrata; Singh, Ashish; Antony, Justin; van Tong, Hoang; Singh, Sakshi; Pati, Sudhanshu S.; Patra, Pradeep K.; Singh, Rajender; Toan, Nguyen L.; Song, Le H.; Assaf, Amal; Messias–Reason, Iara J. T.; Velavan, Thirumalaisamy P.; Singh, Lalji; Thangaraj, Kumarasamy

    2012-01-01

    Background Interleukin 4 (IL-4) is an anti-inflammatory cytokine, which regulates balance between TH1 and TH2 immune response, immunoglobulin class switching and humoral immunity. Polymorphisms in this gene have been reported to affect the risk of infectious and autoimmune diseases. Methods We have analyzed three regulatory IL-4 polymorphisms; -590C>T, -34C>T and 70 bp intron-3 VNTR, in 4216 individuals; including: (1) 430 ethnically matched case-control groups (173 severe malaria, 101 mild malaria and 156 asymptomatic); (2) 3452 individuals from 76 linguistically and geographically distinct endogamous populations of India, and (3) 334 individuals with different ancestry from outside India (84 Brazilian, 104 Syrian, and 146 Vietnamese). Results The -590T, -34T and intron-3 VNTR R2 alleles were found to be associated with reduced malaria risk (P<0.001 for -590C>T and -34C>T, and P = 0.003 for VNTR). These three alleles were in strong LD (r2>0.75) and the TTR2 (-590T, -34T and intron-3 VNTR R2) haplotype appeared to be a susceptibility factor for malaria (P = 0.009, OR = 0.552, 95% CI = 0.356 –0.854). Allele and genotype frequencies differ significantly between caste, nomadic, tribe and ancestral tribal populations (ATP). The distribution of protective haplotype TTR2 was found to be significant (χ23 = 182.95, p-value <0.001), which is highest in ATP (40.5%); intermediate in tribes (33%); and lowest in caste (17.8%) and nomadic (21.6%). Conclusions Our study suggests that the IL-4 polymorphisms regulate host susceptibility to malaria and disease progression. TTR2 haplotype, which gives protection against malaria, is high among ATPs. Since they inhabited in isolation and mainly practice hunter-gatherer lifestyles and exposed to various parasites, IL-4 TTR2 haplotype might be under positive selection. PMID:23110190

  19. [The ABCD of malaria prevention in pediatric travelers].

    PubMed

    Berberian, Griselda; Rosanova, M Teresa; Torroija, Cecilia; Praino, M Laura

    2014-10-01

    The development and spread of drug resistant malaria parasites, population and travelers movements to malaria zones have led to the resurgence of malaria as a global health problem. Estimates suggest that 660,000 deaths occur annually, mainly in infants, children and pregnant woman. Disease knowledge and protection against mosquito bites are the first line of defense against malaria. Malaria chemoprophylaxis adds to these measures, it must be evaluated based on the individual risk.

  20. Estimating the Global Clinical Burden of Plasmodium falciparum Malaria in 2007

    PubMed Central

    Hay, Simon I.; Okiro, Emelda A.; Gething, Peter W.; Patil, Anand P.; Tatem, Andrew J.; Guerra, Carlos A.; Snow, Robert W.

    2010-01-01

    Background The epidemiology of malaria makes surveillance-based methods of estimating its disease burden problematic. Cartographic approaches have provided alternative malaria burden estimates, but there remains widespread misunderstanding about their derivation and fidelity. The aims of this study are to present a new cartographic technique and its application for deriving global clinical burden estimates of Plasmodium falciparum malaria for 2007, and to compare these estimates and their likely precision with those derived under existing surveillance-based approaches. Methods and Findings In seven of the 87 countries endemic for P. falciparum malaria, the health reporting infrastructure was deemed sufficiently rigorous for case reports to be used verbatim. In the remaining countries, the mapped extent of unstable and stable P. falciparum malaria transmission was first determined. Estimates of the plausible incidence range of clinical cases were then calculated within the spatial limits of unstable transmission. A modelled relationship between clinical incidence and prevalence was used, together with new maps of P. falciparum malaria endemicity, to estimate incidence in areas of stable transmission, and geostatistical joint simulation was used to quantify uncertainty in these estimates at national, regional, and global scales. Combining these estimates for all areas of transmission risk resulted in 451 million (95% credible interval 349–552 million) clinical cases of P. falciparum malaria in 2007. Almost all of this burden of morbidity occurred in areas of stable transmission. More than half of all estimated P. falciparum clinical cases and associated uncertainty occurred in India, Nigeria, the Democratic Republic of the Congo (DRC), and Myanmar (Burma), where 1.405 billion people are at risk. Recent surveillance-based methods of burden estimation were then reviewed and discrepancies in national estimates explored. When these cartographically derived national

  1. Characterization of imported malaria, the largest threat to sustained malaria elimination from Sri Lanka.

    PubMed

    Dharmawardena, Priyani; Premaratne, Risintha G; Gunasekera, W M Kumudunayana T de A W; Hewawitarane, Mihirini; Mendis, Kamini; Fernando, Deepika

    2015-01-01

    Sri Lanka has reached zero indigenous malaria cases in November 2012, two years before its targeted deadline for elimination. Currently, the biggest threat to the elimination efforts are the risk of resurgence of malaria due to imported cases. This paper describes two clusters of imported malaria infections reported in 2013 and 2014, one among a group of Pakistani asylum-seekers resident in Sri Lanka, and the other amongst local fishermen who returned from Sierra Leone. The two clusters studied reveal the potential impact of imported malaria on the risk of reintroducing the disease, as importation is the only source of malaria in the country at present. In the event of a case occurring, detection is a major challenge both amongst individuals returning from malaria endemic countries and the local population, as malaria is fast becoming a "forgotten" disease amongst health care providers. In spite of a very good coverage of diagnostic services (microscopy and rapid diagnostic tests) throughout the country, malaria is being repeatedly overlooked by health care providers even when individuals present with fever and a recent history of travel to a malaria endemic country. Given the high receptivity to malaria in previously endemic areas of the country due to the prevalence of the vector mosquito, such cases pose a significant threat for the reintroduction of malaria to Sri Lanka. The challenges faced by the Anti Malaria Campaign and measures taken to prevent the resurgence of malaria are discussed here. PMID:25902716

  2. Ranking and Sequencing Model

    2009-08-13

    This database application (commonly called the Supermodel) provides a repository for managing critical facility/project information, allows the user to subjectively an objectively assess key criteria , quantify project risks, develop ROM cost estimates, determine facility/project end states, ultimately performing risk-based modeling to rank facilities/project based on risk, sequencing project schedules and provides an optimized recommended sequencing/scheduling of these projects which maximize the S&M cost savings to perform closure projects which benefit all stakeholders.

  3. The treatment of malaria.

    PubMed

    White, N J

    1996-09-12

    Increasing drug resistance in Plasmodium falciparum and a resurgence of malaria in tropical areas have effected a change in treatment of malaria in the last two decades. Symptoms of malaria are fever, chills, headache, and malaise. The prognosis worsens as the parasite counts, counts of mature parasites, and counts of neutrophils containing pigment increase. Treatment depends on severity, age of patient, degree of background immunity, likely pattern of susceptibility to antimalarial drugs, and the cost and availability of drugs. Chloroquine should be used for P. vivax, P. malariae, and P. ovale. P. vivax has shown high resistance to chloroquine in Oceania, however. Primaquine may be needed to treat P. vivax and P. ovale to rid the body of hypnozoites that survive in the liver. Chloroquine can treat P. falciparum infections acquired in North Africa, Central America north of the Panama Canal, Haiti, or the Middle East but not in most of Africa and some parts of Asia and South America. In areas of low grade resistance to chloroquine, amodiaquine can be used to effectively treat falciparum malaria. A combination of sulfadoxine-pyrimethamine is responsive to falciparum infections with high grade resistance to chloroquine. Mefloquine, halofantrine, or quinine with tetracycline can be used to treat multidrug-resistant P. falciparum. Derivatives of artemisinin obtained from qinghao or sweet wormwood developed as pharmaceuticals in China are the most rapidly acting of all antimalarial drugs. Children tend to tolerate antimalarial drugs well. Children who weigh less than 15 kg should not be given mefloquine. Health workers should not prescribe primaquine to pregnant women or newborns due to the risk of hemolysis. Chloroquine, sulfadoxine-pyrimethamine, quinine, and quinidine can be safely given in therapeutic doses throughout pregnancy. Clinical manifestations of severe malaria are hypoglycemia, convulsions, severe anemia, acute renal failure, jaundice, pulmonary edema

  4. Individual and Household Level Risk Factors Associated with Malaria in Nchelenge District, a Region with Perennial Transmission: A Serial Cross-Sectional Study from 2012 to 2015

    PubMed Central

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy M.; Sichivula, James; Muleba, Mbanga; Mulenga, Modest; Kobayashi, Tamaki; Curriero, Frank C.; Moss, William J.

    2016-01-01

    Background The scale-up of malaria control interventions has resulted in substantial declines in transmission in some but not all regions of sub-Saharan Africa. Understanding factors associated with persistent malaria transmission despite control efforts may guide targeted interventions to high-risk areas and populations. Methods Household malaria surveys were conducted in Nchelenge District, Luapula Province, in northern Zambia. Structures that appeared to be households were enumerated from a high-resolution satellite image and randomly sampled for enrollment. Households were enrolled into cross-sectional (single visit) or longitudinal (visits every other month) cohorts but analyses were restricted to cross-sectional visits and the first visit to longitudinal households. During study visits, a questionnaire was administered to adults and caretakers of children and a blood sample was collected for a malaria rapid diagnostic test (RDT) from all household residents. Characteristics associated with RDT positivity were analyzed using multi-level models. Results A total of 2,486 individuals residing within 742 households were enrolled between April 2012 and July 2015. Over this period, 51% of participants were RDT positive. Forty-three percent of all RDT positive individuals were between the ages of 5 and 17 years although this age group comprised only 30% of study participants. In a multivariable model, the odds being RDT positive were highest in 5–17 year olds and did not vary by season. Children 5–17 years of age had 8.83 higher odds of being RDT positive compared with those >18 years of age (95% CI: 6.13, 12.71); there was an interaction between age and report of symptoms, with an almost 50% increased odds of report of symptoms with decreasing age category (OR = 1.49; 95% CI 1.11, 2.00). Conclusions Children and adolescents between the ages of 5 and 17 were at the highest risk of malaria infection throughout the year. School-based programs may be effective at

  5. Network-based gene prediction for Plasmodium falciparum malaria towards genetics-based drug discovery

    PubMed Central

    2015-01-01

    Background Malaria is the most deadly parasitic infectious disease. Existing drug treatments have limited efficacy in malaria elimination, and the complex pathogenesis of the disease is not fully understood. Detecting novel malaria-associated genes not only contributes in revealing the disease pathogenesis, but also facilitates discovering new targets for anti-malaria drugs. Methods In this study, we developed a network-based approach to predict malaria-associated genes. We constructed a cross-species network to integrate human-human, parasite-parasite and human-parasite protein interactions. Then we extended the random walk algorithm on this network, and used known malaria genes as the seeds to find novel candidate genes for malaria. Results We validated our algorithms using 77 known malaria genes: 14 human genes and 63 parasite genes were ranked averagely within top 2% and top 4%, respectively among human and parasite genomes. We also evaluated our method for predicting novel malaria genes using a set of 27 genes with literature supporting evidence. Our approach ranked 12 genes within top 1% and 24 genes within top 5%. In addition, we demonstrated that top-ranked candied genes were enriched for drug targets, and identified commonalities underlying top-ranked malaria genes through pathway analysis. In summary, the candidate malaria-associated genes predicted by our data-driven approach have the potential to guide genetics-based anti-malaria drug discovery. PMID:26099491

  6. Frequency-Rank Distributions

    ERIC Educational Resources Information Center

    Brookes, Bertram C.; Griffiths, Jose M.

    1978-01-01

    Frequency, rank, and frequency rank distributions are defined. Extensive discussion on several aspects of frequency rank distributions includes the Poisson process as a means of exploring the stability of ranks; the correlation of frequency rank distributions; and the transfer coefficient, a new measure in frequency rank distribution. (MBR)

  7. The Pattern of Variation between Diarrhea and Malaria Coexistence with Corresponding Risk Factors in, Chikhwawa, Malawi: A Bivariate Multilevel Analysis

    PubMed Central

    Masangwi, Salule; Ferguson, Neil; Grimason, Anthony; Morse, Tracy; Kazembe, Lawrence

    2015-01-01

    Developing countries face a huge burden of infectious diseases, a number of which co-exist. This paper estimates the pattern and variation of malaria and diarrhea coexistence in Chikhwawa, a district in Southern Malawi using bivariate multilevel modelling with Bayesian estimation. A probit link was employed to examine hierarchically built data from a survey of individuals (n = 6,727) nested within households (n = 1,380) nested within communities (n = 33). Results show significant malaria [σu12=0.901 (95% CI:0.746,1.056)] and diarrhea [σu22=1.009 (95% CI:0.860,1.158)] variations with a strong correlation between them [ru(1,2)=0.565] at household level. There are significant malaria [σv12=0.053(95% CI:0.018,0.088)] and diarrhea [σv22=0.099(95% CI:0.030,0.168)] variations at community level but with a small correlation [rv(1,2)=0.124] between them. There is also significant correlation between malaria and diarrhea at individual level [re(1,2)=0.241]. These results suggest a close association between reported malaria-like illness and diarrheal illness especially at household and individual levels in Southern Malawi. PMID:26197332

  8. The Pattern of Variation between Diarrhea and Malaria Coexistence with Corresponding Risk Factors in, Chikhwawa, Malawi: A Bivariate Multilevel Analysis.

    PubMed

    Masangwi, Salule; Ferguson, Neil; Grimason, Anthony; Morse, Tracy; Kazembe, Lawrence

    2015-07-01

    Developing countries face a huge burden of infectious diseases, a number of which co-exist. This paper estimates the pattern and variation of malaria and diarrhea coexistence in Chikhwawa, a district in Southern Malawi using bivariate multilevel modelling with Bayesian estimation. A probit link was employed to examine hierarchically built data from a survey of individuals (n = 6,727) nested within households (n = 1,380) nested within communities (n = 33). Results show significant malaria [σ²μ₁=0.901 (95% CI:0.746,1.056)] and diarrhea [σ²μ₂=1.009 (95% CI:0.860,1.158)] variations with a strong correlation between them [r(¹,²)μ=0.565] at household level. There are significant malaria [σ²ν₁=0.053 (95% CI: 0.018,0.088)] and diarrhea [σ²ν₂=0.099(95% CI : 0.030,0.168) ] variations at community level but with a small correlation [r(¹,²) ν=0.124] between them. There is also significant correlation between malaria and diarrhea at individual level [ r(¹,²) e=0.241]. These results suggest a close association between reported malaria-like illness and diarrheal illness especially at household and individual levels in Southern Malawi.

  9. Malaria in the WHO Southeast Asia region.

    PubMed

    Kondrashin, A V

    1992-09-01

    Malaria endemic countries in the southeast Asia region include Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, and Thailand. Population movement and rapid urbanization, both largely caused by unemployment, and environmental deterioration change the malaria pattern. They also increase the incidence of drug-resistant malaria, especially resistance to 4-aminoquinolines. In India, Plasmodium falciparum is linked to the density and distribution of tribals, and, in southern Thailand, rubber tappers have the highest malaria incidence rate (46.29%). Since the population is young and the young are highly sensitive to malaria infection, the region has low community immunity. High malaria priority areas are forests, forested hills, forest fringe areas, developmental project sites, and border areas. High risk groups include infants, young children, pregnant women, and mobile population groups. Malaria incidence is between 2.5-2.8 million cases, and the slide positivity rate is about 3%. P. falciparum constitutes 40% for all malaria cases. In 1988 in India, there were 222 malaria deaths. Malaria is the 7th most common cause of death in Thailand. 3 of the 19 Anopheline species are resistant to at least 1 insecticide, particularly DDT. Posteradication epidemics surfaced in the mid-1970s. Malaria control programs tend to use the primary health care and integration approach to malaria control. Antiparasite measures range from a single-dose of an antimalarial to mass drug administration. Residual spraying continues to be the main strategy of vector control. Some other vector control measures are fish feeding on mosquito larvae, insecticide impregnated mosquito nets, and repellents. Control programs also have health education activities. India allocates the highest percentage of its total health budget to malaria control (21.54%). Few malariology training programs exist in the region. Slowly processed surveillance data limit the countries' ability to

  10. How Well Are Malaria Maps Used to Design and Finance Malaria Control in Africa?

    PubMed Central

    Omumbo, Judy A.; Noor, Abdisalan M.; Fall, Ibrahima S.; Snow, Robert W.

    2013-01-01

    Introduction Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. Materials and Methods An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. Results 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. Conclusion The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be

  11. Malaria vaccine.

    PubMed

    1994-05-01

    Some have argued that the vaccine against malaria developed by Manuel Pattaroyo, a Colombian scientist, is being tested prematurely in humans and that it is unlikely to be successful. While the Pattaroyo vaccine has been shown to confer protection against the relatively mild malaria found in Colombia, doubts exist over whether it will be effective in Africa. Encouraging first results, however, are emerging from field tests in Tanzania. The vaccine triggered a strong new immune response, even in individuals previously exposed to malaria. Additional steps must be taken to establish its impact upon mortality and morbidity. Five major trials are underway around the world. The creator estimates that the first ever effective malaria vaccine could be available for widespread use within five years and he has no intention of securing a patent for the discovery. In another development, malaria specialists from 35 African countries convened at an international workshop in Zimbabwe to compare notes. Participants disparaged financial outlays for the fight against malaria equivalent to 2% of total AIDS funding as insufficient; noted intercountry differences in prevention, diagnosis, and treatment; and found information exchange between anglophone and francophone doctors to be generally poor. PMID:12287671

  12. The changing risk of Plasmodium falciparum malaria infection in Africa: 2000–10: a spatial and temporal analysis of transmission intensity

    PubMed Central

    Noor, Abdisalan M; Kinyoki, Damaris K; Mundia, Clara W; Kabaria, Caroline W; Mutua, Jonesmus W; Alegana, Victor A; Fall, Ibrahima Socé; Snow, Robert W

    2014-01-01

    Summary Background Over a decade ago, the Roll Back Malaria Partnership was launched, and since then there has been unprecedented investment in malaria control. We examined the change in malaria transmission intensity during the period 2000–10 in Africa. Methods We assembled a geocoded and community Plasmodium falciparum parasite rate standardised to the age group 2–10 years (PfPR2–10) database from across 49 endemic countries and territories in Africa from surveys undertaken since 1980. The data were used within a Bayesian space–time geostatistical framework to predict PfPR2–10 in 2000 and 2010 at a 1 × 1 km spatial resolution. Population distribution maps at the same spatial resolution were used to compute populations at risk by endemicity class and estimate population-adjusted PfPR2–10 (PAPfPR2–10) for each of the 44 countries for which predictions were possible for each year. Findings Between 2000 and 2010, the population in hyperendemic (>50% to 75% PfPR2–10) or holoendemic (>75% PfPR2–10) areas decreased from 218·6 million (34·4%) of 635·7 million to 183·5 million (22·5%) of 815·7 million across 44 malaria-endemic countries. 280·1 million (34·3%) people lived in areas of mesoendemic transmission (>10% to 50% PfPR2–10) in 2010 compared with 178·6 million (28·1%) in 2000. Population in areas of unstable or very low transmission (<5% PfPR2–10) increased from 131·7 million people (20·7%) in 2000 to 219·0 million (26·8%) in 2010. An estimated 217·6 million people, or 26·7% of the 2010 population, lived in areas where transmission had reduced by at least one PfPR2–10 endemicity class. 40 countries showed a reduction in national mean PAPfPR2–10. Only ten countries contributed 87·1% of the population living in areas of hyperendemic or holoendemic transmission in 2010. Interpretation Substantial reductions in malaria transmission have been achieved in endemic countries in Africa over the period 2000–10. However, 57% of

  13. A Chemical Risk Ranking and Scoring Method for the Selection of Harmful Substances to be Specially Controlled in Occupational Environments

    PubMed Central

    Shin, Saemi; Moon, Hyung-Il; Lee, Kwon Seob; Hong, Mun Ki; Byeon, Sang-Hoon

    2014-01-01

    This study aimed to devise a method for prioritizing hazardous chemicals for further regulatory action. To accomplish this objective, we chose appropriate indicators and algorithms. Nine indicators from the Globally Harmonized System of Classification and Labeling of Chemicals were used to identify categories to which the authors assigned numerical scores. Exposure indicators included handling volume, distribution, and exposure level. To test the method devised by this study, sixty-two harmful substances controlled by the Occupational Safety and Health Act in Korea, including acrylamide, acrylonitrile, and styrene were ranked using this proposed method. The correlation coefficients between total score and each indicator ranged from 0.160 to 0.641, and those between total score and hazard indicators ranged from 0.603 to 0.641. The latter were higher than the correlation coefficients between total score and exposure indicators, which ranged from 0.160 to 0.421. Correlations between individual indicators were low (−0.240 to 0.376), except for those between handling volume and distribution (0.613), suggesting that each indicator was not strongly correlated. The low correlations between each indicator mean that the indicators and independent and were well chosen for prioritizing harmful chemicals. This method proposed by this study can improve the cost efficiency of chemical management as utilized in occupational regulatory systems. PMID:25419874

  14. Risk factors for Plasmodium falciparum and Plasmodium vivax gametocyte carriage in Papua New Guinean children with uncomplicated malaria.

    PubMed

    Karl, Stephan; Laman, Moses; Moore, Brioni R; Benjamin, John M; Salib, Mary; Lorry, Lina; Maripal, Samuel; Siba, Peter; Robinson, Leanne J; Mueller, Ivo; Davis, Timothy M E

    2016-08-01

    There are limited data on gametocytaemia risk factors before/after treatment with artemisinin combination therapy in children from areas with transmission of multiple Plasmodium species. We utilised data from a randomised trial comparing artemether-lumefantrine (AL) and artemisinin-naphthoquine (AN) in 230 Papua New Guinean children aged 0.5-5 years with uncomplicated malaria in whom determinants of gametocytaemia by light microscopy were assessed at baseline using logistic regression and during follow-up using multilevel mixed effects modelling. Seventy-four (32%) and 18 (8%) children presented with P. falciparum and P. vivax gametocytaemia, respectively. Baseline P. falciparum gametocytaemia was associated with Hackett spleen grade 1 (odds ratio (95% CI) 4.01 (1.60-10.05) vs grade 0; P<0.001) and haemoglobin (0.95 (0.92-0.97) per 1g/L increase; P<0.001), and P. falciparum asexual parasitaemia in slide-positive cases (0.36 (0.19-0.68) for a 10-fold increase; P=0.002). Baseline P. vivax gametocytaemia was associated with Hackett grade 2 (12.66 (1.31-122.56); P=0.028), mixed P. falciparum/vivax infection (0.16 (0.03-1.00); P=0.050), P. vivax asexual parasitaemia (5.68 (0.98-33.04); P=0.053) and haemoglobin (0.94 (0.88-1.00); P=0.056). For post-treatment P. falciparum gametocytaemia, independent predictors were AN vs AL treatment (4.09 (1.43-11.65)), haemoglobin (0.95 (0.93-0.97)), presence/absence of P. falciparum asexual forms (3.40 (1.66-0.68)) and day post-treatment (0.086 (0.82-0.90)) (P<0.001). Post-treatment P. vivax gametocytaemia was predicted by presence of P. vivax asexual forms (596 (12-28,433); P<0.001). Consistent with slow P. falciparum gametocyte maturation, low haemoglobin, low asexual parasite density and higher spleen grading, markers of increased prior infection exposure/immunity, were strong associates of pre-treatment gametocyte positivity. The persistent inverse association between P. falciparum gametocytaemia and haemoglobin during follow

  15. Risk factors for Plasmodium falciparum and Plasmodium vivax gametocyte carriage in Papua New Guinean children with uncomplicated malaria.

    PubMed

    Karl, Stephan; Laman, Moses; Moore, Brioni R; Benjamin, John M; Salib, Mary; Lorry, Lina; Maripal, Samuel; Siba, Peter; Robinson, Leanne J; Mueller, Ivo; Davis, Timothy M E

    2016-08-01

    There are limited data on gametocytaemia risk factors before/after treatment with artemisinin combination therapy in children from areas with transmission of multiple Plasmodium species. We utilised data from a randomised trial comparing artemether-lumefantrine (AL) and artemisinin-naphthoquine (AN) in 230 Papua New Guinean children aged 0.5-5 years with uncomplicated malaria in whom determinants of gametocytaemia by light microscopy were assessed at baseline using logistic regression and during follow-up using multilevel mixed effects modelling. Seventy-four (32%) and 18 (8%) children presented with P. falciparum and P. vivax gametocytaemia, respectively. Baseline P. falciparum gametocytaemia was associated with Hackett spleen grade 1 (odds ratio (95% CI) 4.01 (1.60-10.05) vs grade 0; P<0.001) and haemoglobin (0.95 (0.92-0.97) per 1g/L increase; P<0.001), and P. falciparum asexual parasitaemia in slide-positive cases (0.36 (0.19-0.68) for a 10-fold increase; P=0.002). Baseline P. vivax gametocytaemia was associated with Hackett grade 2 (12.66 (1.31-122.56); P=0.028), mixed P. falciparum/vivax infection (0.16 (0.03-1.00); P=0.050), P. vivax asexual parasitaemia (5.68 (0.98-33.04); P=0.053) and haemoglobin (0.94 (0.88-1.00); P=0.056). For post-treatment P. falciparum gametocytaemia, independent predictors were AN vs AL treatment (4.09 (1.43-11.65)), haemoglobin (0.95 (0.93-0.97)), presence/absence of P. falciparum asexual forms (3.40 (1.66-0.68)) and day post-treatment (0.086 (0.82-0.90)) (P<0.001). Post-treatment P. vivax gametocytaemia was predicted by presence of P. vivax asexual forms (596 (12-28,433); P<0.001). Consistent with slow P. falciparum gametocyte maturation, low haemoglobin, low asexual parasite density and higher spleen grading, markers of increased prior infection exposure/immunity, were strong associates of pre-treatment gametocyte positivity. The persistent inverse association between P. falciparum gametocytaemia and haemoglobin during follow

  16. [A histologic study of brain in fatal cerebral malaria].

    PubMed

    Burel-Vandenbos, Fanny; Effa'a, Christian; Alunni, Véronique; Cardot-Leccia, Nathalie; Haudebourg, Juliette; Michiels, Jean-François

    2008-12-01

    Plasmodium falciparum infection is an emergency because of the risk of cerebral malaria, that is the most severe complication. Malaria diagnosis is usually made on blood samples of feverish patients coming from endemic area. The pathologist is rarely confronted with malaria lesions. If the occasion arises, the diagnosis of malaria is often already known or suspected and the pathologist has to confirm it. Rarely, malaria is unknown before histological examination and the diagnosis is based on the identification of specific histological features. We report a case of sudden death due to cerebral malaria diagnosed on autopsy findings. PMID:19084718

  17. Reduced Risk of Plasmodium vivax Malaria in Papua New Guinean Children with Southeast Asian Ovalocytosis in Two Cohorts and a Case-Control Study

    PubMed Central

    Manning, Laurens; Rarau, Patricia; Laman, Moses; Senn, Nicolas; Grimberg, Brian T.; Tavul, Livingstone; Stanisic, Danielle I.; Robinson, Leanne J.; Aponte, John J.; Dabod, Elijah; Reeder, John C.; Siba, Peter; Zimmerman, Peter A.; Davis, Timothy M. E.; King, Christopher L.; Michon, Pascal; Mueller, Ivo

    2012-01-01

    Background The erythrocyte polymorphism, Southeast Asian ovalocytosis (SAO) (which results from a 27-base pair deletion in the erythrocyte band 3 gene, SLC4A1Δ27) protects against cerebral malaria caused by Plasmodium falciparum; however, it is unknown whether this polymorphism also protects against P. vivax infection and disease. Methods and Findings The association between SAO and P. vivax infection was examined through genotyping of 1,975 children enrolled in three independent epidemiological studies conducted in the Madang area of Papua New Guinea. SAO was associated with a statistically significant 46% reduction in the incidence of clinical P. vivax episodes (adjusted incidence rate ratio [IRR] = 0.54, 95% CI 0.40–0.72, p<0.0001) in a cohort of infants aged 3–21 months and a significant 52% reduction in P. vivax (blood-stage) reinfection diagnosed by PCR (95% CI 22–71, p = 0.003) and 55% by light microscopy (95% CI 13–77, p = 0.014), respectively, in a cohort of children aged 5–14 years. SAO was also associated with a reduction in risk of P. vivax parasitaemia in children 3–21 months (1,111/µl versus 636/µl, p = 0.011) and prevalence of P. vivax infections in children 15–21 months (odds ratio [OR] = 0.39, 95% CI 0.23–0.67, p = 0.001). In a case-control study of children aged 0.5–10 years, no child with SAO was found among 27 cases with severe P. vivax or mixed P. falciparum/P. vivax malaria (OR = 0, 95% CI 0–1.56, p = 0.11). SAO was associated with protection against severe P. falciparum malaria (OR = 0.38, 95% CI 0.15–0.87, p = 0.014) but no effect was seen on either the risk of acquiring blood-stage infections or uncomplicated episodes with P. falciparum. Although Duffy antigen receptor expression and function were not affected on SAO erythrocytes compared to non-SAO children, high level (>90% binding inhibition) P. vivax Duffy binding protein–specific binding inhibitory antibodies were

  18. Malaria Prophylaxis: A Comprehensive Review

    PubMed Central

    Castelli, Francesco; Odolini, Silvia; Autino, Beatrice; Foca, Emanuele; Russo, Rosario

    2010-01-01

    The flow of international travellers to and from malaria-endemic areas, especially Africa, has increased in recent years. Apart from the very high morbidity and mortality burden imposed on malaria-endemic areas, imported malaria is the main cause of fever possibly causing severe disease and death in travellers coming from tropical and subtropical areas, particularly Sub-Saharan Africa. The importance of behavioural preventive measures (bed nets, repellents, etc.), adequate chemoprophylaxis and, in selected circumstances, stand-by emergency treatment may not be overemphasized. However, no prophylactic regimen may offer complete protection. Expert advice is needed to tailor prophylactic advice according to traveller (age, baseline clinical conditions, etc.) and travel (destination, season, etc.) characteristics in order to reduce malaria risk.

  19. Climate change and malaria transmission.

    PubMed

    Lindsay, S W; Birley, M H

    1996-12-01

    There is a consensus among climatologists that our planet is experiencing a progressive rise in surface temperature due to the increased production of "greenhouse" gases. Some of the possible consequences of elevated temperature on malaria transmission are examined in the present review. A simple mathematical model is first used to examine the effect of temperature on the ability of Anopheles maculipennis to transmit vivax malaria. This indicates that small increases in temperature at low temperatures may increase the risk of transmission substantially. This is important, since vulnerable communities, poorly protected by health services, in areas of unstable or no malaria are likely to be at increased risk of future outbreaks. In contrast, areas of stable transmission may be little affected by rising temperature. It is thought that global warming will lead to coastal flooding, changes in precipitation and, indirectly, changes in land use. Just how these changes will effect transmission at a regional level requires an understanding of the ecology of local vectors, since environmental changes which favour malaria transmission in one vector species may reduce it in another. Methods for predicting future changes in malaria in different regions are discussed, highlighting the need for further research in this area. Most importantly, there is a need for researchers to validate the accuracy of the models used for predicting malaria and to confirm the assumptions on which the models are based.

  20. A Reduced Risk of Infection with Plasmodium vivax and Clinical Protection against Malaria Are Associated with Antibodies against the N Terminus but Not the C Terminus of Merozoite Surface Protein 1†

    PubMed Central

    Nogueira, Paulo Afonso; Piovesan Alves, Fabiana; Fernandez-Becerra, Carmen; Pein, Oliver; Rodrigues Santos, Neida; Pereira da Silva, Luiz Hildebrando; Plessman Camargo, Erney; del Portillo, Hernando A.

    2006-01-01

    Progress towards the development of a malaria vaccine against Plasmodium vivax, the most widely distributed human malaria parasite, will require a better understanding of the immune responses that confer clinical protection to patients in regions where malaria is endemic. The occurrence of clinical protection in P. vivax malaria in Brazil was first reported among residents of the riverine community of Portuchuelo, in Rondônia, western Amazon. We thus analyzed immune sera from this same human population to determine if naturally acquired humoral immune responses against the merozoite surface protein 1 of P. vivax, PvMSP1, could be associated with reduced risk of infection and/or clinical protection. Our results demonstrated that this association could be established with anti-PvMSP1 antibodies predominantly of the immunoglobulin G3 subclass directed against the N terminus but not against the C terminus, in spite of the latter being more immunogenic and capable of natural boosting. This is the first report of a prospective study of P. vivax malaria demonstrating an association of reduced risk of infection and clinical protection with antibodies against an antigen of this parasite. PMID:16622209

  1. Malaria and global change: Insights, uncertainties and possible surprises

    SciTech Connect

    Martin, P.H.; Steel, A.

    1996-12-31

    Malaria may change with global change. Indeed, global change may affect malaria risk and malaria epidemiology. Malaria risk may change in response to a greenhouse warming; malaria epidemiology, in response to the social, economic, and political developments which a greenhouse warming may trigger. To date, malaria receptivity and epidemiology futures have been explored within the context of equilibrium studies. Equilibrium studies of climate change postulate an equilibrium present climate (the starting point) and a doubled-carbon dioxide climate (the end point), simulate conditions in both instances, and compare the two. What happens while climate changes, i.e., between the starting point and the end point, is ignored. The present paper focuses on malaria receptivity and addresses what equilibrium studies miss, namely transient malaria dynamics.

  2. Ethical aspects of malaria control and research.

    PubMed

    Jamrozik, Euzebiusz; de la Fuente-Núñez, Vânia; Reis, Andreas; Ringwald, Pascal; Selgelid, Michael J

    2015-01-01

    Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria--and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy. PMID:26693920

  3. Ethical aspects of malaria control and research.

    PubMed

    Jamrozik, Euzebiusz; de la Fuente-Núñez, Vânia; Reis, Andreas; Ringwald, Pascal; Selgelid, Michael J

    2015-12-22

    Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria--and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy.

  4. Defining the global spatial limits of malaria transmission in 2005.

    PubMed

    Guerra, C A; Snow, R W; Hay, S I

    2006-01-01

    There is no accurate contemporary global map of the distribution of malaria. We show how guidelines formulated to advise travellers on appropriate chemoprophylaxis for areas of reported Plasmodium falciparum and Plasmodium vivax malaria risk can be used to generate crude spatial limits. We first review and amalgamate information on these guidelines to define malaria risk at national and sub-national administrative boundary levels globally. We then adopt an iterative approach to reduce these extents by applying a series of biological limits imposed by altitude, climate and population density to malaria transmission, specific to the local dominant vector species. Global areas of, and population at risk from, P. falciparum and often-neglected P. vivax malaria are presented for 2005 for all malaria endemic countries. These results reveal that more than 3 billion people were at risk of malaria in 2005.

  5. World Health Organization ranking of antimicrobials according to their importance in human medicine: A critical step for developing risk management strategies for the use of antimicrobials in food production animals.

    PubMed

    Collignon, Peter; Powers, John H; Chiller, Tom M; Aidara-Kane, Awa; Aarestrup, Frank M

    2009-07-01

    The use of antimicrobials in food animals creates an important source of antimicrobial-resistant bacteria that can spread to humans through the food supply. Improved management of the use of antimicrobials in food animals, particularly reducing the usage of those that are "critically important" for human medicine, is an important step toward preserving the benefits of antimicrobials for people. The World Health Organization has developed and applied criteria to rank antimicrobials according to their relative importance in human medicine. Clinicians, regulatory agencies, policy makers, and other stakeholders can use this ranking when developing risk management strategies for the use of antimicrobials in food production animals. The ranking allows stakeholders to focus risk management efforts on drugs used in food animals that are the most important to human medicine and, thus, need to be addressed most urgently, such as fluoroquinolones, macrolides, and third- and fourth-generation cephalosporins. PMID:19489713

  6. Chronic dietary risk characterization for pesticide residues: a ranking and scoring method integrating agricultural uses and food contamination data.

    PubMed

    Nougadère, Alexandre; Reninger, Jean-Cédric; Volatier, Jean-Luc; Leblanc, Jean-Charles

    2011-07-01

    A method has been developed to identify pesticide residues and foodstuffs for inclusion in national monitoring programs with different priority levels. It combines two chronic dietary intake indicators: ATMDI based on maximum residue levels and agricultural uses, and EDI on food contamination data. The mean and 95th percentile of exposure were calculated for 490 substances using individual and national consumption data. The results show that mean ATMDI exceeds the acceptable daily intake (ADI) for 10% of the pesticides, and the mean upper-bound EDI is above the ADI for 1.8% of substances. A seven-level risk scale is presented for substances already analyzed in food in France and substances not currently sought. Of 336 substances analyzed, 70 pesticides of concern (levels 2-5) should be particularly monitored, 22 of which are priority pesticides (levels 4 and 5). Of 154 substances not sought, 36 pesticides of concern (levels 2-4) should be included in monitoring programs, including 8 priority pesticides (level 4). In order to refine exposure assessment, analytical improvements and developments are needed to lower the analytical limits for priority pesticide/commodity combinations. Developed nationally, this method could be applied at different geographic scales.

  7. Geostatistical modelling of household malaria in Malawi

    NASA Astrophysics Data System (ADS)

    Chirombo, J.; Lowe, R.; Kazembe, L.

    2012-04-01

    Malaria is one of the most important diseases in the world today, common in tropical and subtropical areas with sub-Saharan Africa being the region most burdened, including Malawi. This region has the right combination of biotic and abiotic components, including socioeconomic, climatic and environmental factors that sustain transmission of the disease. Differences in these conditions across the country consequently lead to spatial variation in risk of the disease. Analysis of nationwide survey data that takes into account this spatial variation is crucial in a resource constrained country like Malawi for targeted allocation of scare resources in the fight against malaria. Previous efforts to map malaria risk in Malawi have been based on limited data collected from small surveys. The Malaria Indicator Survey conducted in 2010 is the most comprehensive malaria survey carried out in Malawi and provides point referenced data for the study. The data has been shown to be spatially correlated. We use Bayesian logistic regression models with spatial correlation to model the relationship between malaria presence in children and covariates such as socioeconomic status of households and meteorological conditions. This spatial model is then used to assess how malaria varies spatially and a malaria risk map for Malawi is produced. By taking intervention measures into account, the developed model is used to assess whether they have an effect on the spatial distribution of the disease and Bayesian kriging is used to predict areas where malaria risk is more likely to increase. It is hoped that this study can help reveal areas that require more attention from the authorities in the continuing fight against malaria, particularly in children under the age of five.

  8. Malaria in Brazil: an overview

    PubMed Central

    2010-01-01

    Brazilian populations have also been providing important information on whether immune responses specific to these antigens are generated in natural infections and their immunogenic potential as vaccine candidates. The present difficulties in reducing economic and social risk factors that determine the incidence of malaria in the Amazon Region render impracticable its elimination in the region. As a result, a malaria-integrated control effort - as a joint action on the part of the government and the population - directed towards the elimination or reduction of the risks of death or illness, is the direction adopted by the Brazilian government in the fight against the disease. PMID:20433744

  9. Hydrological and geomorphological controls of malaria transmission

    NASA Astrophysics Data System (ADS)

    Smith, M. W.; Macklin, M. G.; Thomas, C. J.

    2013-01-01

    Malaria risk is linked inextricably to the hydrological and geomorphological processes that form vector breeding sites. Yet environmental controls of malaria transmission are often represented by temperature and rainfall amounts, ignoring hydrological and geomorphological influences altogether. Continental-scale studies incorporate hydrology implicitly through simple minimum rainfall thresholds, while community-scale coupled hydrological and entomological models do not represent the actual diversity of the mosquito vector breeding sites. The greatest range of malaria transmission responses to environmental factors is observed at the catchment scale where seemingly contradictory associations between rainfall and malaria risk can be explained by hydrological and geomorphological processes that govern surface water body formation and persistence. This paper extends recent efforts to incorporate ecological factors into malaria-risk models, proposing that the same detailed representation be afforded to hydrological and, at longer timescales relevant for predictions of climate change impacts, geomorphological processes. We review existing representations of environmental controls of malaria and identify a range of hydrologically distinct vector breeding sites from existing literature. We illustrate the potential complexity of interactions among hydrology, geomorphology and vector breeding sites by classifying a range of water bodies observed in a catchment in East Africa. Crucially, the mechanisms driving surface water body formation and destruction must be considered explicitly if we are to produce dynamic spatial models of malaria risk at catchment scales.

  10. Ranking species in mutualistic networks

    NASA Astrophysics Data System (ADS)

    Domínguez-García, Virginia; Muñoz, Miguel A.

    2015-02-01

    Understanding the architectural subtleties of ecological networks, believed to confer them enhanced stability and robustness, is a subject of outmost relevance. Mutualistic interactions have been profusely studied and their corresponding bipartite networks, such as plant-pollinator networks, have been reported to exhibit a characteristic ``nested'' structure. Assessing the importance of any given species in mutualistic networks is a key task when evaluating extinction risks and possible cascade effects. Inspired in a recently introduced algorithm -similar in spirit to Google's PageRank but with a built-in non-linearity- here we propose a method which -by exploiting their nested architecture- allows us to derive a sound ranking of species importance in mutualistic networks. This method clearly outperforms other existing ranking schemes and can become very useful for ecosystem management and biodiversity preservation, where decisions on what aspects of ecosystems to explicitly protect need to be made.

  11. Ranking species in mutualistic networks.

    PubMed

    Domínguez-García, Virginia; Muñoz, Miguel A

    2015-02-02

    Understanding the architectural subtleties of ecological networks, believed to confer them enhanced stability and robustness, is a subject of outmost relevance. Mutualistic interactions have been profusely studied and their corresponding bipartite networks, such as plant-pollinator networks, have been reported to exhibit a characteristic "nested" structure. Assessing the importance of any given species in mutualistic networks is a key task when evaluating extinction risks and possible cascade effects. Inspired in a recently introduced algorithm--similar in spirit to Google's PageRank but with a built-in non-linearity--here we propose a method which--by exploiting their nested architecture--allows us to derive a sound ranking of species importance in mutualistic networks. This method clearly outperforms other existing ranking schemes and can become very useful for ecosystem management and biodiversity preservation, where decisions on what aspects of ecosystems to explicitly protect need to be made.

  12. Ranking species in mutualistic networks

    PubMed Central

    Domínguez-García, Virginia; Muñoz, Miguel A.

    2015-01-01

    Understanding the architectural subtleties of ecological networks, believed to confer them enhanced stability and robustness, is a subject of outmost relevance. Mutualistic interactions have been profusely studied and their corresponding bipartite networks, such as plant-pollinator networks, have been reported to exhibit a characteristic “nested” structure. Assessing the importance of any given species in mutualistic networks is a key task when evaluating extinction risks and possible cascade effects. Inspired in a recently introduced algorithm –similar in spirit to Google's PageRank but with a built-in non-linearity– here we propose a method which –by exploiting their nested architecture– allows us to derive a sound ranking of species importance in mutualistic networks. This method clearly outperforms other existing ranking schemes and can become very useful for ecosystem management and biodiversity preservation, where decisions on what aspects of ecosystems to explicitly protect need to be made. PMID:25640575

  13. Artemether for severe malaria

    PubMed Central

    Esu, Ekpereonne; Effa, Emmanuel E; Opie, Oko N; Uwaoma, Amirahobu; Meremikwu, Martin M

    2014-01-01

    Background In 2011 the World Health Organization (WHO) recommended parenteral artesunate in preference to quinine as first-line treatment for people with severe malaria. Prior to this recommendation, many countries, particularly in Africa, had begun to use artemether, an alternative artemisinin derivative. This review evaluates intramuscular artemether compared with both quinine and artesunate. Objectives To assess the efficacy and safety of intramuscular artemether versus any other parenteral medication in treating severe malaria in adults and children. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE and LILACS, ISI Web of Science, conference proceedings and reference lists of articles. We also searched the WHO clinical trial registry platform, ClinicalTrials.gov and the metaRegister of Controlled Trials (mRCT) for ongoing trials up to 9 April 2014. Selection criteria Randomized controlled trials (RCTs) comparing intramuscular artemether with intravenous or intramuscular antimalarial for treating severe malaria. Data collection and analysis The primary outcome was all-cause death.Two authors independently assessed trial eligibility, risk of bias and extracted data. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD), and presented both measures with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. Main results We included 18 RCTs, enrolling 2662 adults and children with severe malaria, carried out in Africa (11) and in Asia (7). Artemether versus quinine For children in Africa, there is probably little or no difference in the risk of death between intramuscular artemether and quinine (RR 0.96, 95% CI 0.76 to 1.20; 12 trials, 1447 participants, moderate quality evidence). Coma recovery may be about five hours shorter with

  14. Climate, environment and transmission of malaria.

    PubMed

    Rossati, Antonella; Bargiacchi, Olivia; Kroumova, Vesselina; Zaramella, Marco; Caputo, Annamaria; Garavelli, Pietro Luigi

    2016-06-01

    Malaria, the most common parasitic disease in the world, is transmitted to the human host by mosquitoes of the genus Anopheles. The transmission of malaria requires the interaction between the host, the vector and the parasite.The four species of parasites responsible for human malaria are Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae and Plasmodium vivax. Occasionally humans can be infected by several simian species, like Plasmodium knowlesi, recognised as a major cause of human malaria in South-East Asia since 2004. While P. falciparum is responsible for most malaria cases, about 8% of estimated cases globally are caused by P. vivax. The different Plasmodia are not uniformly distributed although there are areas of species overlap. The life cycle of all species of human malaria parasites is characterised by an exogenous sexual phase in which multiplication occurs in several species of Anopheles mosquitoes, and an endogenous asexual phase in the vertebrate host. The time span required for mature oocyst development in the salivary glands is quite variable (7-30 days), characteristic of each species and influenced by ambient temperature. The vector Anopheles includes 465 formally recognised species. Approximately 70 of these species have the capacity to transmit Plasmodium spp. to humans and 41 are considered as dominant vector capable of transmitting malaria. The intensity of transmission is dependent on the vectorial capacity and competence of local mosquitoes. An efficient system for malaria transmission needs strong interaction between humans, the ecosystem and infected vectors. Global warming induced by human activities has increased the risk of vector-borne diseases such as malaria. Recent decades have witnessed changes in the ecosystem and climate without precedent in human history although the emphasis in the role of temperature on the epidemiology of malaria has given way to predisposing conditions such as ecosystem changes, political

  15. Climate, environment and transmission of malaria.

    PubMed

    Rossati, Antonella; Bargiacchi, Olivia; Kroumova, Vesselina; Zaramella, Marco; Caputo, Annamaria; Garavelli, Pietro Luigi

    2016-06-01

    Malaria, the most common parasitic disease in the world, is transmitted to the human host by mosquitoes of the genus Anopheles. The transmission of malaria requires the interaction between the host, the vector and the parasite.The four species of parasites responsible for human malaria are Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae and Plasmodium vivax. Occasionally humans can be infected by several simian species, like Plasmodium knowlesi, recognised as a major cause of human malaria in South-East Asia since 2004. While P. falciparum is responsible for most malaria cases, about 8% of estimated cases globally are caused by P. vivax. The different Plasmodia are not uniformly distributed although there are areas of species overlap. The life cycle of all species of human malaria parasites is characterised by an exogenous sexual phase in which multiplication occurs in several species of Anopheles mosquitoes, and an endogenous asexual phase in the vertebrate host. The time span required for mature oocyst development in the salivary glands is quite variable (7-30 days), characteristic of each species and influenced by ambient temperature. The vector Anopheles includes 465 formally recognised species. Approximately 70 of these species have the capacity to transmit Plasmodium spp. to humans and 41 are considered as dominant vector capable of transmitting malaria. The intensity of transmission is dependent on the vectorial capacity and competence of local mosquitoes. An efficient system for malaria transmission needs strong interaction between humans, the ecosystem and infected vectors. Global warming induced by human activities has increased the risk of vector-borne diseases such as malaria. Recent decades have witnessed changes in the ecosystem and climate without precedent in human history although the emphasis in the role of temperature on the epidemiology of malaria has given way to predisposing conditions such as ecosystem changes, political

  16. [Fake malaria drugs].

    PubMed

    Bygbjerg, Ib Christian

    2009-03-01

    The literature on fake medicaments is sparse, even if approximately 15% of all medicaments are fake, a figure that for antimalarials in particular reaches 50% in parts of Africa and Asia. Sub-standard and fake medicines deplete the public's confidence in health systems, health professionals and in the pharmaceutical industry - and increase the risk that resistance develops. For a traveller coming from a rich Western country, choosing to buy e.g. preventive antimalarials over the internet or in poor malaria-endemic areas, the consequences may be fatal. International trade-, control- and police-collaboration is needed to manage the problem, as is the fight against poverty and poor governance.

  17. High Mortality Risk in Hypoglycemic and Dysglycemic Children Admitted at a Referral Hospital in a Non Malaria Tropical Setting of a Low Income Country

    PubMed Central

    Barennes, Hubert; Sayavong, Eng; Pussard, Eric

    2016-01-01

    Introduction Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. Methods Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI). Blood glucose was assessed once on admission through a finger prick using a bedside glucometer. Glycemia levels: hypoglycemia: < 2.2 mmol/L (< 40 mg⁄ dl), low glycemia: 2.2–4.4 mmol/L (40–79 mg⁄ dl), euglycemia: 4.4–8.3 mmol/L (80–149 mg⁄ dl), and hyperglycemia: > 8.3 mmol/L (≥150 mg⁄ dl), were related to the IMCI algorithm and case fatality using univariate and multivariate analysis. Results Of 350 children, 62.2% (n = 218) were severely ill and 49.1% (n = 172) had at least one IMCI danger sign. A total of 15 (4.2%, 95%CI: 2.4–6.9) had hypoglycemia, 99 (28.2%, 95%CI: 23.6–33.3) low glycemia, 201 (57.4%, 95% CI: 52.0–62.6) euglycemia and 35 (10.0%, 95% CI: 7.0–13.6) hyperglycemia. Hypoglycemia was associated with longer fasting (p = 0.001) and limited treatment before admission (p = 0.09). Hypoglycemia and hyperglycemia were associated with hypoxemia (SaO2) (p = 0.001). A total of 21 (6.0%) of the children died: 66.6% with hypoglycemic, 6.0% with low glycemic, 5.7% with hyperglycemic and 1.4% with euglycemic groups. A total of 9 (2.5%) deaths occurred during the first 24 hours of admission and 5 (1.7%) within 3 days of hospital discharge. Compared to euglycemic children, hypoglycemic and low glycemic children had a higher rate of early death (20%, p<0.001 and 5%, p = 0.008; respectively). They also had a

  18. Malaria situation in the Greater Mekong Subregion.

    PubMed

    Hewitt, Sean; Delacollette, Charles; Chavez, Irwin

    2013-01-01

    The epidemiology of malaria in the Greater Mekong Subregion is complex and rapidly evolving. Malaria control and elimination efforts face a daunting array of challenges including multidrug-resistant parasites. This review presents secondary data collected by the national malaria control programs in the six countries between 1998 and 2010 and examines trends over the last decade. This data has a number of limitations: it is derived exclusively from public sector health facilities; falciparum-specific and then pan-specific rapid diagnostic tests were introduced during the period under review; and, recently there has been a massive increase in case detection capability as a result of increased funding. It therefore requires cautious interpretation. A series of maps are presented showing trends in incidence, mortality and proportion of cases caused by Plasmodium falciparum over the last decade. A brief overview of institutional and implementation arrangements, historical background, demographics and key issues affecting malaria epidemiology is provided for each country. National malaria statistics for 2010 are presented and their robustness discussed in terms of the public sector's share of cases and other influencing factors such as inter-country variations in risk stratification, changes in diagnostic approach and immigration. Targets are presented for malaria control and where appropriate for elimination. Each country's artemisinin resistance status is described. The epidemiological trends presented reflect the improvement in the malaria situation, however the true malaria burden is as yet unknown. There is a need for continuing strengthening and updating of surveillance and response systems. PMID:24159830

  19. [Current malaria situation in Turkmenistan].

    PubMed

    Amangel'diev, K A

    2001-01-01

    from tertian malaria, which is the most dangerous from the epidemiological point of view since the main vectors in Turkmenistan, are highly susceptible to P. vivax infection. The particular dangerous phenomenon is the higher incidence of imported tertian malaria in rural areas where sick people and those who carry the parasite come into close contact with highly susceptible vectors. Thus, the risk that new malaria outbreaks will occur and the disease will become reestablished in the country is very high. It is also influenced by major changes in water use in the country, which have aggravated the mosquito situation. In the area around the Karakum canal and river basins, 17 large reservoirs have been constructed, with very extensive filtration ponds around them, which have become breeding ground's for malaria mosquitoes. There are 1219 water areas without any economic significance in the country, covering a total area of 1054 ha, which require regular treatment with insecticides. With assistance from the WHO European Regional Office, Dr. Guido Sabatinelli in particular, Turkmenistan has developed a plan for preventive malaria control measures for 1999-2001, which has been approved in a decree issued by the Ministry of Health and Medical Industry. The material support received has made it possible to provide large-scale prophylaxis for people who suffered from malaria in 1997-1999, seasonal treatment for people living near the active foci of the disease and interseasonal prophylaxis for people visiting these areas. Seasonal treatment with Dellaguil was made in 4,590 people living in the active foci of malaria infection, and 2,281 fixed-term military personnel belonging to the units stationed in the active foci of malaria infection. In all foci of infection, every person with malaria or carrying the parasite underwent epidemiological investigation and all cases were entered in health clinic records. In 1999, four seminars were held to train 75 specialists from all

  20. [Current malaria situation in Turkmenistan].

    PubMed

    Amangel'diev, K A

    2001-01-01

    from tertian malaria, which is the most dangerous from the epidemiological point of view since the main vectors in Turkmenistan, are highly susceptible to P. vivax infection. The particular dangerous phenomenon is the higher incidence of imported tertian malaria in rural areas where sick people and those who carry the parasite come into close contact with highly susceptible vectors. Thus, the risk that new malaria outbreaks will occur and the disease will become reestablished in the country is very high. It is also influenced by major changes in water use in the country, which have aggravated the mosquito situation. In the area around the Karakum canal and river basins, 17 large reservoirs have been constructed, with very extensive filtration ponds around them, which have become breeding ground's for malaria mosquitoes. There are 1219 water areas without any economic significance in the country, covering a total area of 1054 ha, which require regular treatment with insecticides. With assistance from the WHO European Regional Office, Dr. Guido Sabatinelli in particular, Turkmenistan has developed a plan for preventive malaria control measures for 1999-2001, which has been approved in a decree issued by the Ministry of Health and Medical Industry. The material support received has made it possible to provide large-scale prophylaxis for people who suffered from malaria in 1997-1999, seasonal treatment for people living near the active foci of the disease and interseasonal prophylaxis for people visiting these areas. Seasonal treatment with Dellaguil was made in 4,590 people living in the active foci of malaria infection, and 2,281 fixed-term military personnel belonging to the units stationed in the active foci of malaria infection. In all foci of infection, every person with malaria or carrying the parasite underwent epidemiological investigation and all cases were entered in health clinic records. In 1999, four seminars were held to train 75 specialists from all

  1. Cerebral malaria.

    PubMed

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

    Malaria, the most significant parasitic disease of man, kills approximately one million people per year. Half of these deaths occur in those with cerebral malaria (CM). The World Health Organization (WHO) defines CM as an otherwise unexplained coma in a patient with malarial parasitemia. Worldwide, CM occurs primarily in African children and Asian adults, with the vast majority (greater than 90%) of cases occurring in children 5 years old or younger in sub-Saharan Africa. The pathophysiology of the disease is complex and involves infected erythrocyte sequestration, cerebral inflammation, and breakdown of the blood-brain barrier. A recently characterized malarial retinopathy is visual evidence of Plasmodium falciparum's pathophysiological processes occurring in the affected patient. Treatment consists of supportive care and antimalarial administration. Thus far, adjuvant therapies have not been shown to improve mortality rates or neurological outcomes in children with CM. For those who survive CM, residual neurological abnormalities are common. Epilepsy, cognitive impairment, behavioral disorders, and gross neurological deficits which include motor, sensory, and language impairments are frequent sequelae. Primary prevention strategies, including bed nets, vaccine development, and chemoprophylaxis, are in varied states of development and implementation. Continuing efforts to find successful primary prevention options and strategies to decrease neurological sequelae are needed. PMID:23829902

  2. Prevalence of gestational, placental and congenital malaria in north-west Colombia

    PubMed Central

    2013-01-01

    Background The frequency of pregnancy-associated malaria is increasingly being documented in American countries. In Colombia, with higher frequency of Plasmodium vivax over Plasmodium falciparum infection, recent reports confirmed gestational malaria as a serious public health problem. Thick smear examination is the gold standard to diagnose malaria in endemic settings, but in recent years, molecular diagnostic methods have contributed to elucidate the dimension of the problem of gestational malaria. The study was aimed at exploring the prevalence of gestational, placental and congenital malaria in women who delivered at the local hospitals of north-west Colombia, between June 2008 and April 2011. Methods A group of 129 parturient women was selected to explore the prevalence of gestational, placental and congenital malaria in a descriptive, prospective and transversal (prevalence) design. Diagnosis was based on the simultaneous application of two independent diagnostic tests: microscopy of thick blood smears and a polymerase chain reaction assay (PCR). Results The prevalence of gestational malaria (thick smear /PCR) was 9.1%/14.0%; placental malaria was 3.3%/16.5% and congenital malaria was absent. A history of gestational malaria during the current pregnancy was significantly associated with gestational malaria at delivery. Plasmodium vivax caused 65% of cases of gestational malaria, whereas P. falciparum caused most cases of placental malaria. Conclusions Gestational and placental malaria are a serious problem in the region, but the risk of congenital malaria is low. A history of malaria during pregnancy may be a practical indicator of infection at delivery. PMID:24053184

  3. Climate Change and Malaria in Canada: A Systems Approach

    PubMed Central

    Berrang-Ford, L.; MacLean, J. D.; Gyorkos, Theresa W.; Ford, J. D.; Ogden, N. H.

    2009-01-01

    This article examines the potential for changes in imported and autochthonous malaria incidence in Canada as a consequence of climate change. Drawing on a systems framework, we qualitatively characterize and assess the potential direct and indirect impact of climate change on malaria in Canada within the context of other concurrent ecological and social trends. Competent malaria vectors currently exist in southern Canada, including within this range several major urban centres, and conditions here have historically supported endemic malaria transmission. Climate change will increase the occurrence of temperature conditions suitable for malaria transmission in Canada, which, combined with trends in international travel, immigration, drug resistance, and inexperience in both clinical and laboratory diagnosis, may increase malaria incidence in Canada and permit sporadic autochthonous cases. This conclusion challenges the general assumption of negligible malaria risk in Canada with climate change. PMID:19277107

  4. Malaria-associated rubber plantations in Thailand.

    PubMed

    Bhumiratana, Adisak; Sorosjinda-Nunthawarasilp, Prapa; Kaewwaen, Wuthichai; Maneekan, Pannamas; Pimnon, Suntorn

    2013-01-01

    Rubber forestry is intentionally used as a land management strategy. The propagation of rubber plantations in tropic and subtropic regions appears to influence the economical, sociological and ecological aspects of sustainable development as well as human well-being and health. Thailand and other Southeast Asian countries are the world's largest producers of natural rubber products; interestingly, agricultural workers on rubber plantations are at risk for malaria and other vector-borne diseases. The idea of malaria-associated rubber plantations (MRPs) encompasses the complex epidemiological settings that result from interactions among human movements and activities, land cover/land use changes, agri-environmental and climatic conditions and vector population dynamics. This paper discusses apparent issues pertaining to the connections between rubber plantations and the populations at high risk for malaria. The following questions are addressed: (i) What are the current and future consequences of rubber plantations in Thailand and Southeast Asia relative to malaria epidemics or outbreaks of other vector-borne diseases? (ii) To what extent is malaria transmission in Thailand related to the forest versus rubber plantations? and (iii) What are the vulnerabilities of rubber agricultural workers to malaria, and how contagious is malaria in these areas?

  5. Spatial targeting of interventions against malaria.

    PubMed Central

    Carter, R.; Mendis, K. N.; Roberts, D.

    2000-01-01

    Malaria transmission is strongly associated with location. This association has two main features. First, the disease is focused around specific mosquito breeding sites and can normally be transmitted only within certain distances from them: in Africa these are typically between a few hundred metres and a kilometre and rarely exceed 2-3 kilometres. Second, there is a marked clustering of persons with malaria parasites and clinical symptoms at particular sites, usually households. In localities of low endemicity the level of malaria risk or case incidence may vary widely between households because the specific characteristics of houses and their locations affect contact between humans and vectors. Where endemicity is high, differences in human/vector contact rates between different households may have less effect on malaria case incidences. This is because superinfection and exposure-acquired immunity blur the proportional relationship between inoculation rates and case incidences. Accurate information on the distribution of malaria on the ground permits interventions to be targeted towards the foci of transmission and the locations and households of high malaria risk within them. Such targeting greatly increases the effectiveness of control measures. On the other hand, the inadvertent exclusion of these locations causes potentially effective control measures to fail. The computerized mapping and management of location data in geographical information systems should greatly assist the targeting of interventions against malaria at the focal and household levels, leading to improved effectiveness and cost-effectiveness of control. PMID:11196487

  6. Radar Monitoring of Wetlands for Malaria Control

    NASA Technical Reports Server (NTRS)

    Pope, Kevin O.

    1997-01-01

    Malaria is the most important vector-borne tropical disease (Collins and Paskewitz, 1995) and there is no simple and universally applicable form of vector control. While new methods such as malaria vaccine or genetic manipulation of mosquitoes are being explored in the laboratories, the need for more field research on malaria transmission remains very strong. For the foreseeable future many malaria programs must focus on controlling the vector, the anopheline mosquito, often under the specter of shrinking budgets. Therefore information on which human populations are at the greatest risk is especially valuable when allocating scarce resources. The goal of the Radar Monitoring of Wetlands for Malaria Control Project is to demonstrate the feasibility of using Radarsat or other comparable satellite radar imaging systems to determine where and when human populations are at greatest risk for contracting malaria. The study area is northern Belize, a region with abundant wetlands and a potentially serious malaria problem. A key aspect of this study is the analysis of multi-temporal satellite imagery to track seasonal flooding of anopheline mosquito breeding sites. Radarsat images of the test site in Belize have been acquired one to three times a month over the last year, however,, to date only one processed image has been received from the Alaska SAR Facility for analysis. Therefore analysis at this stage is focussed on determining the radar backscatter characteristics of known anopheline breeding sites, with future work to be dedicated toward seasonal changes.

  7. Using a geographical information system to plan a malaria control programme in South Africa.

    PubMed Central

    Booman, M.; Durrheim, D. N.; La Grange, K.; Martin, C.; Mabuza, A. M.; Zitha, A.; Mbokazi, F. M.; Fraser, C.; Sharp, B. L.

    2000-01-01

    INTRODUCTION: Sustainable control of malaria in sub-Saharan Africa is jeopardized by dwindling public health resources resulting from competing health priorities that include an overwhelming acquired immunodeficiency syndrome (AIDS) epidemic. In Mpumalanga province, South Africa, rational planning has historically been hampered by a case surveillance system for malaria that only provided estimates of risk at the magisterial district level (a subdivision of a province). METHODS: To better map control programme activities to their geographical location, the malaria notification system was overhauled and a geographical information system implemented. The introduction of a simplified notification form used only for malaria and a carefully monitored notification system provided the good quality data necessary to support an effective geographical information system. RESULTS: The geographical information system displays data on malaria cases at a village or town level and has proved valuable in stratifying malaria risk within those magisterial districts at highest risk, Barberton and Nkomazi. The conspicuous west-to-east gradient, in which the risk rises sharply towards the Mozambican border (relative risk = 4.12, 95% confidence interval = 3.88-4.46 when the malaria risk within 5 km of the border was compared with the remaining areas in these two districts), allowed development of a targeted approach to control. DISCUSSION: The geographical information system for malaria was enormously valuable in enabling malaria risk at town and village level to be shown. Matching malaria control measures to specific strata of endemic malaria has provided the opportunity for more efficient malaria control in Mpumalanga province. PMID:11196490

  8. Malaria acquired in Haiti - 2010.

    PubMed

    2010-03-01

    On January 12, 2010, a 7.0 magnitude earthquake struck Haiti, which borders the Dominican Republic on the island of Hispaniola. The earthquake's epicenter was 10 miles west of the Haiti capital city of Port-au-Prince (estimated population: 2 million). According to the Haitian government, approximately 200,000 persons were killed, and 500,000 were left homeless. Malaria caused by Plasmodium falciparum infection is endemic in Haiti, and the principal mosquito vector is Anopheles albimanus, which frequently bites outdoors. Thus, displaced persons living outdoors or in temporary shelters and thousands of emergency responders in Haiti are at substantial risk for malaria. During January 12-February 25, CDC received reports of 11 laboratory-confirmed cases of P. falciparum malaria acquired in Haiti. Patients included seven U.S. residents who were emergency responders, three Haitian residents, and one U.S. traveler. This report summarizes the 11 cases and provides chemoprophylactic and additional preventive recommendations to minimize the risk for acquiring malaria for persons traveling to Haiti.

  9. Importance of active case detection in a malaria elimination programme

    PubMed Central

    2014-01-01

    Background With the aim of eliminating malaria from Sri Lanka by 2014, the Anti-Malaria Campaign of Sri Lanka (AMC) sought the support of Tropical and Environmental Disease and Health Associates Private Limited (TEDHA), a private sector organization. In 2009, TEDHA was assigned 43 government hospitals in the district of Mannar in the Northern Province and in districts of Trincomalee, Batticaloa and Ampara in the Eastern Province to carry out malaria surveillance to complement the surveillance activities of the AMC. Passive case detection (PCD), activated passive case detection (APCD) and active case detection (ACD) for malaria have been routinely carried out in Sri Lanka. Methods The active case detection programme of TEDHA involves screening of populations irrespective of the presence of fever or any other signs or symptoms of malaria to detect infections and residual parasite carriers. ACD is done by TEDHA in a) high risk populations through mobile malaria clinics including armed forces personnel and b) pregnant females who visit antenatal clinics for asymptomatic malaria infections during the first trimester of pregnancy. Populations are selected in consultation with the Regional Malaria Officer of the AMC thus avoiding any overlap with the population screened by the government. Results TEDHA screened 387,309 individuals in the four districts for malaria by ACD including high risk groups and pregnant women between January 2010 and December 2012. During this period seven individuals were diagnosed with Plasmodium vivax infections and one individual was detected with a mixed infection of P. vivax and Plasmodium falciparum. All eight cases were detected by ACD carried out by mobile malaria clinics among high risk groups in the Mannar district. Conclusion The progress made by Sri Lanka in the malaria elimination drive is largely due to increased surveillance and judicious use of control methods which has resulted in zero indigenous malaria cases being reported since

  10. UK malaria treatment guidelines 2016.

    PubMed

    Lalloo, David G; Shingadia, Delane; Bell, David J; Beeching, Nicholas J; Whitty, Christopher J M; Chiodini, Peter L

    2016-06-01

    1.Malaria is the tropical disease most commonly imported into the UK, with 1300-1800 cases reported each year, and 2-11 deaths. 2. Approximately three quarters of reported malaria cases in the UK are caused by Plasmodium falciparum, which is capable of invading a high proportion of red blood cells and rapidly leading to severe or life-threatening multi-organ disease. 3. Most non-falciparum malaria cases are caused by Plasmodium vivax; a few cases are caused by the other species of plasmodium: Plasmodium ovale, Plasmodium malariae or Plasmodium knowlesi. 4. Mixed infections with more than one species of parasite can occur; they commonly involve P. falciparum with the attendant risks of severe malaria. 5. There are no typical clinical features of malaria; even fever is not invariably present. Malaria in children (and sometimes in adults) may present with misleading symptoms such as gastrointestinal features, sore throat or lower respiratory complaints. 6. A diagnosis of malaria must always be sought in a feverish or sick child or adult who has visited malaria-endemic areas. Specific country information on malaria can be found at http://travelhealthpro.org.uk/. P. falciparum infection rarely presents more than six months after exposure but presentation of other species can occur more than a year after exposure. 7. Management of malaria depends on awareness of the diagnosis and on performing the correct diagnostic tests: the diagnosis cannot be excluded until more than one blood specimen has been examined. Other travel related infections, especially viral haemorrhagic fevers, should also be considered. 8. The optimum diagnostic procedure is examination of thick and thin blood films by an expert to detect and speciate the malarial parasites. P. falciparum and P. vivax (depending upon the product) malaria can be diagnosed almost as accurately using rapid diagnostic tests (RDTs) which detect plasmodial antigens. RDTs for other Plasmodium species are not as reliable. 9

  11. Immunochromatographic antigen testing alone is sufficient to identify asymptomatic refugees at risk of severe malaria presenting to a single health service in Victoria.

    PubMed

    Fedele, Pasquale L; Wheeler, Michael; Lemoh, Christopher; Chunilal, Sanjeev

    2014-10-01

    Current screening guidelines for malaria in new refugees include a combination of thick and thin film examination and immunochromatographic antigen test (ICT). However, as the prevalence of malaria in our population has decreased due to changing refugee demographics, we sought to determine if an ICT alone can reliably exclude malaria in our asymptomatic refugee population.A retrospective analysis was conducted of all investigations for malaria performed from 1 August 2011 to 31 July 2013, including thick and thin blood film examination, BinaxNOW ICT, and external morphological and polymerase chain reaction (PCR) validation where applicable.Malaria was diagnosed in 45 of 1248 (3.6%) patients investigated, all of whom were symptomatic and the majority (71.1%) returned travellers. All 599 asymptomatic refugees screened were negative. Overall, 42 of 45 malaria cases were detected by the ICT; sensitivity 93.3% (95% CI 80.7-98.3%) and negative predictive value (NPV) 99.8% (99.2-99.9%). All 21 cases of Plasmodium falciparum and 20 of 22 cases of Plasmodium vivax were detected, giving a sensitivity of 100% (80.8-100%) and 90.9% (69.4-98.4%) respectively. Too few cases of Plasmodium malariae and no cases of Plasmodium ovale or Plasmodium knowlesi were diagnosed for adequate assessment to be carried out.These data suggest that full malaria screening in all asymptomatic refugees with the combination of thick and thin blood films and rapid antigen test may not be warranted. Alternative screening approaches should be considered, including the use of ICT alone, or limiting screening of asymptomatic refugees to only those originating from countries with high incidence of malaria. PMID:25158813

  12. Risk ranking of pathogens in ready-to-eat unprocessed foods of non-animal origin (FoNAO) in the EU: initial evaluation using outbreak data (2007-2011).

    PubMed

    Da Silva Felício, M T; Hald, T; Liebana, E; Allende, A; Hugas, M; Nguyen-The, C; Johannessen, G Skoien; Niskanen, T; Uyttendaele, M; McLauchlin, J

    2015-02-16

    Foods of non-animal origin (FoNAO) are consumed in a variety of forms, being a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a semi-quantitative model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-2011), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grains. Despite the inherent assumptions and limitations, this risk model is considered a tool for risk managers, as it allows ranking of food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU. Efforts to collect additional data even in the absence of reported outbreaks as well as to enhance the quality of the EU-specific data, which was used as input for all the model criteria, will allow the improvement of the model outputs. Furthermore, it is recommended that harmonised terminology be applied to the categorisation of foods collected for different reasons, e.g. monitoring, surveillance, outbreak investigation and consumption. In addition, to assist future microbiological risk assessments, consideration should be given to the collection of additional information on how food has been processed, stored and prepared as part of the above data collection exercises. PMID:25500275

  13. Risk ranking of pathogens in ready-to-eat unprocessed foods of non-animal origin (FoNAO) in the EU: initial evaluation using outbreak data (2007-2011).

    PubMed

    Da Silva Felício, M T; Hald, T; Liebana, E; Allende, A; Hugas, M; Nguyen-The, C; Johannessen, G Skoien; Niskanen, T; Uyttendaele, M; McLauchlin, J

    2015-02-16

    Foods of non-animal origin (FoNAO) are consumed in a variety of forms, being a major component of almost all meals. These food types have the potential to be associated with large outbreaks as seen in 2011 associated with VTEC O104. In order to identify and rank specific food/pathogen combinations most often linked to human cases originating from FoNAO in the EU, a semi-quantitative model was developed using seven criteria: strength of associations between food and pathogen based on the foodborne outbreak data from EU Zoonoses Monitoring (2007-2011), incidence of illness, burden of disease, dose-response relationship, consumption, prevalence of contamination and pathogen growth potential during shelf life. The top ranking food/pathogen combination was Salmonella spp. and leafy greens eaten raw followed by (in equal rank) Salmonella spp. and bulb and stem vegetables, Salmonella spp. and tomatoes, Salmonella spp. and melons, and pathogenic Escherichia coli and fresh pods, legumes or grains. Despite the inherent assumptions and limitations, this risk model is considered a tool for risk managers, as it allows ranking of food/pathogen combinations most often linked to foodborne human cases originating from FoNAO in the EU. Efforts to collect additional data even in the absence of reported outbreaks as well as to enhance the quality of the EU-specific data, which was used as input for all the model criteria, will allow the improvement of the model outputs. Furthermore, it is recommended that harmonised terminology be applied to the categorisation of foods collected for different reasons, e.g. monitoring, surveillance, outbreak investigation and consumption. In addition, to assist future microbiological risk assessments, consideration should be given to the collection of additional information on how food has been processed, stored and prepared as part of the above data collection exercises.

  14. Imported malaria in children in industrialized countries, 1992-2002.

    PubMed

    Stäger, Katrin; Legros, Fabrice; Krause, Gérard; Low, Nicola; Bradley, David; Desai, Meghna; Graf, Simone; D'Amato, Stefania; Mizuno, Yasutaka; Janzon, Ragnhild; Petersen, Eskild; Kester, John; Steffen, Robert; Schlagenhauf, Patricia

    2009-02-01

    Children account for an appreciable proportion of total imported malaria cases, yet few studies have quantified these cases, identified trends, or suggested evidence-based prevention strategies for this group of travelers. We therefore sought to identify numbers of cases and deaths, Plasmodium species, place of malaria acquisition, preventive measures used, and national origin of malaria in children. We analyzed retrospective data from Australia, Denmark, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States and data provided by the United Nations World Tourism Organization. During 1992-2002, >17,000 cases of imported malaria in children were reported in 11 countries where malaria is not endemic; most (>70%) had been acquired in Africa. Returning to country of origin to visit friends and relatives was a risk factor. Malaria prevention for children should be a responsibility of healthcare providers and should be subsidized for low-income travelers to high-risk areas.

  15. Imported Malaria in Children in Industrialized Countries, 1992–2002

    PubMed Central

    Stäger, Katrin; Legros, Fabrice; Krause, Gérard; Low, Nicola; Bradley, David; Desai, Meghna; Graf, Simone; D’Amato, Stefania; Mizuno, Yasutaka; Janzon, Ragnhild; Petersen, Eskild; Kester, John; Steffen, Robert

    2009-01-01

    Children account for an appreciable proportion of total imported malaria cases, yet few studies have quantified these cases, identified trends, or suggested evidence-based prevention strategies for this group of travelers. We therefore sought to identify numbers of cases and deaths, Plasmodium species, place of malaria acquisition, preventive measures used, and national origin of malaria in children. We analyzed retrospective data from Australia, Denmark, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States and data provided by the United Nations World Tourism Organization. During 1992–2002, >17,000 cases of imported malaria in children were reported in 11 countries where malaria is not endemic; most (>70%) had been acquired in Africa. Returning to country of origin to visit friends and relatives was a risk factor. Malaria prevention for children should be a responsibility of healthcare providers and should be subsidized for low-income travelers to high-risk areas. PMID:19193261

  16. Impact of Malaria in Pregnancy as Latin America Approaches Elimination.

    PubMed

    Yanow, Stephanie K; Gavina, Kenneth; Gnidehou, Sedami; Maestre, Amanda

    2016-05-01

    In Latin America, four million pregnancies are at risk of malaria annually, but malaria in pregnancy is largely overlooked. As countries progress toward malaria elimination, targeting reservoirs of transmission is a priority. Pregnant women are an important risk group because they harbor asymptomatic infections and dormant liver stages of Plasmodium vivax that cause relapses. Of significant concern is the discovery that most infections in pregnant women fail to be detected by routine diagnostics. We review here recent findings on malaria in pregnancy within Latin America. We focus on the Amazon basin and Northwest Colombia, areas that harbor the greatest burden of malaria, and propose that more sensitive diagnostics and active surveillance at antenatal clinics will be necessary to eliminate malaria from these final frontiers.

  17. How to Rank Journals.

    PubMed

    Bradshaw, Corey J A; Brook, Barry W

    2016-01-01

    There are now many methods available to assess the relative citation performance of peer-reviewed journals. Regardless of their individual faults and advantages, citation-based metrics are used by researchers to maximize the citation potential of their articles, and by employers to rank academic track records. The absolute value of any particular index is arguably meaningless unless compared to other journals, and different metrics result in divergent rankings. To provide a simple yet more objective way to rank journals within and among disciplines, we developed a κ-resampled composite journal rank incorporating five popular citation indices: Impact Factor, Immediacy Index, Source-Normalized Impact Per Paper, SCImago Journal Rank and Google 5-year h-index; this approach provides an index of relative rank uncertainty. We applied the approach to six sample sets of scientific journals from Ecology (n = 100 journals), Medicine (n = 100), Multidisciplinary (n = 50); Ecology + Multidisciplinary (n = 25), Obstetrics & Gynaecology (n = 25) and Marine Biology & Fisheries (n = 25). We then cross-compared the κ-resampled ranking for the Ecology + Multidisciplinary journal set to the results of a survey of 188 publishing ecologists who were asked to rank the same journals, and found a 0.68-0.84 Spearman's ρ correlation between the two rankings datasets. Our composite index approach therefore approximates relative journal reputation, at least for that discipline. Agglomerative and divisive clustering and multi-dimensional scaling techniques applied to the Ecology + Multidisciplinary journal set identified specific clusters of similarly ranked journals, with only Nature & Science separating out from the others. When comparing a selection of journals within or among disciplines, we recommend collecting multiple citation-based metrics for a sample of relevant and realistic journals to calculate the composite rankings and their relative uncertainty windows.

  18. How to Rank Journals

    PubMed Central

    Bradshaw, Corey J. A.; Brook, Barry W.

    2016-01-01

    There are now many methods available to assess the relative citation performance of peer-reviewed journals. Regardless of their individual faults and advantages, citation-based metrics are used by researchers to maximize the citation potential of their articles, and by employers to rank academic track records. The absolute value of any particular index is arguably meaningless unless compared to other journals, and different metrics result in divergent rankings. To provide a simple yet more objective way to rank journals within and among disciplines, we developed a κ-resampled composite journal rank incorporating five popular citation indices: Impact Factor, Immediacy Index, Source-Normalized Impact Per Paper, SCImago Journal Rank and Google 5-year h-index; this approach provides an index of relative rank uncertainty. We applied the approach to six sample sets of scientific journals from Ecology (n = 100 journals), Medicine (n = 100), Multidisciplinary (n = 50); Ecology + Multidisciplinary (n = 25), Obstetrics & Gynaecology (n = 25) and Marine Biology & Fisheries (n = 25). We then cross-compared the κ-resampled ranking for the Ecology + Multidisciplinary journal set to the results of a survey of 188 publishing ecologists who were asked to rank the same journals, and found a 0.68–0.84 Spearman’s ρ correlation between the two rankings datasets. Our composite index approach therefore approximates relative journal reputation, at least for that discipline. Agglomerative and divisive clustering and multi-dimensional scaling techniques applied to the Ecology + Multidisciplinary journal set identified specific clusters of similarly ranked journals, with only Nature & Science separating out from the others. When comparing a selection of journals within or among disciplines, we recommend collecting multiple citation-based metrics for a sample of relevant and realistic journals to calculate the composite rankings and their relative uncertainty windows. PMID:26930052

  19. How to Rank Journals.

    PubMed

    Bradshaw, Corey J A; Brook, Barry W

    2016-01-01

    There are now many methods available to assess the relative citation performance of peer-reviewed journals. Regardless of their individual faults and advantages, citation-based metrics are used by researchers to maximize the citation potential of their articles, and by employers to rank academic track records. The absolute value of any particular index is arguably meaningless unless compared to other journals, and different metrics result in divergent rankings. To provide a simple yet more objective way to rank journals within and among disciplines, we developed a κ-resampled composite journal rank incorporating five popular citation indices: Impact Factor, Immediacy Index, Source-Normalized Impact Per Paper, SCImago Journal Rank and Google 5-year h-index; this approach provides an index of relative rank uncertainty. We applied the approach to six sample sets of scientific journals from Ecology (n = 100 journals), Medicine (n = 100), Multidisciplinary (n = 50); Ecology + Multidisciplinary (n = 25), Obstetrics & Gynaecology (n = 25) and Marine Biology & Fisheries (n = 25). We then cross-compared the κ-resampled ranking for the Ecology + Multidisciplinary journal set to the results of a survey of 188 publishing ecologists who were asked to rank the same journals, and found a 0.68-0.84 Spearman's ρ correlation between the two rankings datasets. Our composite index approach therefore approximates relative journal reputation, at least for that discipline. Agglomerative and divisive clustering and multi-dimensional scaling techniques applied to the Ecology + Multidisciplinary journal set identified specific clusters of similarly ranked journals, with only Nature & Science separating out from the others. When comparing a selection of journals within or among disciplines, we recommend collecting multiple citation-based metrics for a sample of relevant and realistic journals to calculate the composite rankings and their relative uncertainty windows. PMID:26930052

  20. Malaria Modeling and Surveillance for the Greater Mekong Subregion

    NASA Technical Reports Server (NTRS)

    Kiang, Richard; Adimi, Farida; Soika, Valerii; Nigro, Joseph

    2005-01-01

    At 4,200 km, the Mekong River is the tenth longest river in the world. It directly and indirectly influences the lives of hundreds of millions of inhabitants in its basin. The riparian countries - Thailand, Myanmar, Cambodia, Laos, Vietnam, and a small part of China - form the Greater Mekong Subregion (GMS). This geographical region has the misfortune of being the world's epicenter of falciparum malaria, which is the most severe form of malaria caused by Plasmodium falciparum. Depending on the country, approximately 50 to 90% of all malaria cases are due to this species. In the Malaria Modeling and Surveillance Project, we have been developing techniques to enhance public health's decision capability for malaria risk assessments and controls. The main objectives are: 1) Identifying the potential breeding sites for major vector species; 2) Implementing a malaria transmission model to identify the key factors that sustain or intensify malaria transmission; and 3) Implementing a risk algorithm to predict the occurrence of malaria and its transmission intensity. The potential benefits are: 1) Increased warning time for public health organizations to respond to malaria outbreaks; 2) Optimized utilization of pesticide and chemoprophylaxis; 3) Reduced likelihood of pesticide and drug resistance; and 4) Reduced damage to environment. Environmental parameters important to malaria transmission include temperature, relative humidity, precipitation, and vegetation conditions. These parameters are extracted from NASA Earth science data sets. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records.

  1. An affordable, quality-assured community-based system for high-resolution entomological surveillance of vector mosquitoes that reflects human malaria infection risk patterns

    PubMed Central

    2012-01-01

    Background More sensitive and scalable entomological surveillance tools are required to monitor low levels of transmission that are increasingly common across the tropics, particularly where vector control has been successful. A large-scale larviciding programme in urban Dar es Salaam, Tanzania is supported by a community-based (CB) system for trapping adult mosquito densities to monitor programme performance. Methodology An intensive and extensive CB system for routine, longitudinal, programmatic surveillance of malaria vectors and other mosquitoes using the Ifakara Tent Trap (ITT-C) was developed in Urban Dar es Salaam, Tanzania, and validated by comparison with quality assurance (QA) surveys using either ITT-C or human landing catches (HLC), as well as a cross-sectional survey of malaria parasite prevalence in the same housing compounds. Results Community-based ITT-C had much lower sensitivity per person-night of sampling than HLC (Relative Rate (RR) [95% Confidence Interval (CI)] = 0.079 [0.051, 0.121], P < 0.001 for Anopheles gambiae s.l. and 0.153 [0.137, 0.171], P < 0.001 for Culicines) but only moderately differed from QA surveys with the same trap (0.536 [0.406,0.617], P = 0.001 and 0.747 [0.677,0.824], P < 0.001, for An. gambiae or Culex respectively). Despite the poor sensitivity of the ITT per night of sampling, when CB-ITT was compared with QA-HLC, it proved at least comparably sensitive in absolute terms (171 versus 169 primary vectors caught) and cost-effective (153US$ versus 187US$ per An. gambiae caught) because it allowed more spatially extensive and temporally intensive sampling (4284 versus 335 trap nights distributed over 615 versus 240 locations with a mean number of samples per year of 143 versus 141). Despite the very low vectors densities (Annual estimate of about 170 An gambiae s.l bites per person per year), CB-ITT was the only entomological predictor of parasite infection risk (Odds Ratio [95% CI] = 4

  2. Malaria and Travelers

    MedlinePlus

    ... a CDC Malaria Branch clinician. malaria@cdc.gov File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel ...

  3. Malaria Treatment (United States)

    MedlinePlus

    ... a CDC Malaria Branch clinician. malaria@cdc.gov File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel ...

  4. Malaria Vaccine: A Future Hope to Curtail the Global Malaria Burden

    PubMed Central

    Karunamoorthi, Kaliyaperumal

    2014-01-01

    It has been estimated that nearly half of the world's population is at the risk of contracting malaria with sub Saharan Africa being the most risky area. The existing frontline malaria control interventions are not only expensive but also become ineffective owing to the emergence of insecticide and drug resistance. It calls for an innovative approach in terms of potential and reliable vaccine as an additional tool. Over centuries, the public health experts have been actively engaged to formulate a safe, affordable and potential malaria vaccine and accordingly a notable achievement has also been attained. However, many challenges are required to be flagged immediately and effectively to devise an ideal prophylactic malaria vaccine. Therefore, the global community has to remain waiting quite a few more years to build a wannabe malaria-free world in the near future. PMID:24932383

  5. On Rank and Nullity

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2012-01-01

    This note explains how Emil Artin's proof that row rank equals column rank for a matrix with entries in a field leads naturally to the formula for the nullity of a matrix and also to an algorithm for solving any system of linear equations in any number of variables. This material could be used in any course on matrix theory or linear algebra.

  6. The Malaria Transition on the Arabian Peninsula: Progress toward a Malaria-Free Region between 1960–2010

    PubMed Central

    Snow, Robert W.; Amratia, Punam; Zamani, Ghasem; Mundia, Clara W.; Noor, Abdisalan M.; Memish, Ziad A.; Al Zahrani, Mohammad H.; Al Jasari, Adel; Fikri, Mahmoud; Atta, Hoda

    2014-01-01

    The transmission of malaria across the Arabian Peninsula is governed by the diversity of dominant vectors and extreme aridity. It is likely that where malaria transmission was historically possible it was intense and led to a high disease burden. Here, we review the speed of elimination, approaches taken, define the shrinking map of risk since 1960 and discuss the threats posed to a malaria-free Arabian Peninsula using the archive material, case data and published works. From as early as the 1940s, attempts were made to eliminate malaria on the peninsula but were met with varying degrees of success through to the 1970s; however, these did result in a shrinking of the margins of malaria transmission across the peninsula. Epidemics in the 1990s galvanised national malaria control programmes to reinvigorate control efforts. Before the launch of the recent global ambition for malaria eradication, countries on the Arabian Peninsula launched a collaborative malaria-free initiative in 2005. This initiative led a further shrinking of the malaria risk map and today locally acquired clinical cases of malaria are reported only in Saudi Arabia and Yemen, with the latter contributing to over 98% of the clinical burden. PMID:23548086

  7. Radar Monitoring of Wetlands for Malaria Control

    NASA Technical Reports Server (NTRS)

    Pope, Kevin O.

    1997-01-01

    Malaria is perhaps the most serious human disease problem. It inflicts millions worldwide and is on the rise in many countries where it was once under control. This rise is in part due to the high costs, both economic and environmental, of current control programs. The search for more cost-effective means to combat malaria has focussed attention on new technologies, one of which is remote sensing. Remote sensing has become an important tool in the effort to control a variety of diseases worldwide and malaria is perhaps one of the most promising. This study is part of the malaria control effort in the Central American country of Belize, which has experienced a resurgence of malaria in the last two decades. The proposed project is a feasibility study of the use of Radarsat (and other similar radar systems) to monitor seasonal changes in the breeding sites of the anopheline mosquito, which is responsible for malaria transmission. We propose that spatial and temporal changes in anopheline mosquito production can be predicted by sensing where and when their breeding sites are flooded. Timely knowledge of anopheline mosquito production is a key factor in control efforts. Such knowledge can be used by local control agencies to direct their limited resources to selected areas and time periods when the human population is at greatest risk. Radar is a key sensor in this application because frequent cloud cover during the peak periods of malaria transmission precludes the use of optical sensors.

  8. The IL17F and IL17RA Genetic Variants Increase Risk of Cerebral Malaria in Two African Populations

    PubMed Central

    Conte, Ianina; Poudiougou, Belco; Argiro, Laurent; Cabantous, Sandrine; Dessein, Hélia; Burté, Florence; Oumar, Aboubacar A.; Brown, Biobele J.; Traore, Abdoualye; Afolabi, Nathaniel K.; Barry, Abdoulaye; Omokhodion, Samuel; Ndoumbe, Ursule Ewanda; Shokunbi, Wuraola A.; Sodeinde, Olugbemiro; Doumbo, Ogobara; Dessein, Alain J.

    2015-01-01

    Cerebral malaria (CM) is a neurological complication of infection with Plasmodium falciparum that is partly caused by cytokine-mediated inflammation. It is not known whether interleukin-17 (IL-17) cytokines, which regulate inflammation, control the development of CM. To evaluate the involvement of IL-17 cytokines in CM, we analyzed 46 common polymorphisms in IL17A, IL17F, and IL17RA (which encodes the common receptor chain of the members of the IL-17 family) in two independent African populations. A case-control study involving 115 Nigerian children with CM and 160 controls from the community (CC) showed that IL17F reference single nucleotide polymorphism (SNP) 6913472 (rs6913472) (P = 0.004; odds ratio [OR] = 3.12), IL17F rs4715291 (P = 0.004; OR = 2.82), IL17RA rs12159217 (P = 0.01; OR = 2.27), and IL17RA rs41396547 (P = 0.026; OR = 3.15) were independently associated with CM. A replication study was performed in 240 nuclear Malian family trios (two parents with one CM child). We replicated the association for 3 SNPs, IL17F rs6913472 (P = 0.03; OR = 1.39), IL17RA rs12159217 (P = 0.01; OR = 1.52), and IL17RA rs41396547 (P = 0.04; OR = 3.50). We also found that one additional SNP, IL17RA rs41433045, in linkage disequilibrium (LD) with rs41396547, was associated with CM in both Nigeria and Mali (P = 0.002; OR = 4.12 in the combined sample). We excluded the possibility that SNPs outside IL17F and IL17RA, in strong LD with the associated SNPs, could account for the observed associations. Furthermore, the results of a functional study indicated that the aggravating GA genotype of IL17F rs6913472 was associated with lower IL-17F concentrations. Our findings show for the first time that IL17F and IL17RA polymorphisms modulate susceptibility to CM and provide evidence that IL-17F protects against CM. PMID:26667835

  9. World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production.

    PubMed

    Collignon, Peter C; Conly, John M; Andremont, Antoine; McEwen, Scott A; Aidara-Kane, Awa

    2016-10-15

    Antimicrobial use in food animals selects for antimicrobial resistance in bacteria, which can spread to people. Reducing use of antimicrobials-particularly those deemed to be critically important for human medicine-in food production animals continues to be an important step for preserving the benefits of these antimicrobials for people. The World Health Organization ranking of antimicrobials according to their relative importance in human medicine was recently updated. Antimicrobials considered the highest priority among the critically important antimicrobials were quinolones, third- and fourth-generation cephalosporins, macrolides and ketolides, and glycopeptides. The updated ranking allows stakeholders in the agriculture sector and regulatory agencies to focus risk management efforts on drugs used in food animals that are the most important to human medicine. In particular, the current large-scale use of fluoroquinolones, macrolides, and third-generation cephalosporins and any potential use of glycopeptides and carbapenems need to be addressed urgently.

  10. Spatial synchrony of malaria outbreaks in a highland region of Ethiopia.

    PubMed

    Wimberly, Michael C; Midekisa, Alemayehu; Semuniguse, Paulos; Teka, Hiwot; Henebry, Geoffrey M; Chuang, Ting-Wu; Senay, Gabriel B

    2012-10-01

    To understand the drivers and consequences of malaria in epidemic-prone regions, it is important to know whether epidemics emerge independently in different areas as a consequence of local contingencies, or whether they are synchronised across larger regions as a result of climatic fluctuations and other broad-scale drivers. To address this question, we collected historical malaria surveillance data for the Amhara region of Ethiopia and analysed them to assess the consistency of various indicators of malaria risk and determine the dominant spatial and temporal patterns of malaria within the region. We collected data from a total of 49 districts from 1999-2010. Data availability was better for more recent years and more data were available for clinically diagnosed outpatient malaria cases than confirmed malaria cases. Temporal patterns of outpatient malaria case counts were correlated with the proportion of outpatients diagnosed with malaria and confirmed malaria case counts. The proportion of outpatients diagnosed with malaria was spatially clustered, and these cluster locations were generally consistent from year to year. Outpatient malaria cases exhibited spatial synchrony at distances up to 300 km, supporting the hypothesis that regional climatic variability is an important driver of epidemics. Our results suggest that decomposing malaria risk into separate spatial and temporal components may be an effective strategy for modelling and forecasting malaria risk across large areas. They also emphasise both the value and limitations of working with historical surveillance datasets and highlight the importance of enhancing existing surveillance efforts.

  11. Rationale for the coadministration of albendazole and ivermectin to humans for malaria parasite transmission control.

    PubMed

    Kobylinski, Kevin C; Alout, Haoues; Foy, Brian D; Clements, Archie; Adisakwattana, Poom; Swierczewski, Brett E; Richardson, Jason H

    2014-10-01

    Recently there have been calls for the eradication of malaria and the elimination of soil-transmitted helminths (STHs). Malaria and STHs overlap in distribution, and STH infections are associated with increased risk for malaria. Indeed, there is evidence that suggests that STH infection may facilitate malaria transmission. Malaria and STH coinfection may exacerbate anemia, especially in pregnant women, leading to worsened child development and more adverse pregnancy outcomes than these diseases would cause on their own. Ivermectin mass drug administration (MDA) to humans for malaria parasite transmission suppression is being investigated as a potential malaria elimination tool. Adding albendazole to ivermectin MDAs would maximize effects against STHs. A proactive, integrated control platform that targets malaria and STHs would be extremely cost-effective and simultaneously reduce human suffering caused by multiple diseases. This paper outlines the benefits of adding albendazole to ivermectin MDAs for malaria parasite transmission suppression.

  12. Ranking Adverse Drug Reactions With Crowdsourcing

    PubMed Central

    Gottlieb, Assaf; Hoehndorf, Robert; Dumontier, Michel

    2015-01-01

    Background There is no publicly available resource that provides the relative severity of adverse drug reactions (ADRs). Such a resource would be useful for several applications, including assessment of the risks and benefits of drugs and improvement of patient-centered care. It could also be used to triage predictions of drug adverse events. Objective The intent of the study was to rank ADRs according to severity. Methods We used Internet-based crowdsourcing to rank ADRs according to severity. We assigned 126,512 pairwise comparisons of ADRs to 2589 Amazon Mechanical Turk workers and used these comparisons to rank order 2929 ADRs. Results There is good correlation (rho=.53) between the mortality rates associated with ADRs and their rank. Our ranking highlights severe drug-ADR predictions, such as cardiovascular ADRs for raloxifene and celecoxib. It also triages genes associated with severe ADRs such as epidermal growth-factor receptor (EGFR), associated with glioblastoma multiforme, and SCN1A, associated with epilepsy. Conclusions ADR ranking lays a first stepping stone in personalized drug risk assessment. Ranking of ADRs using crowdsourcing may have useful clinical and financial implications, and should be further investigated in the context of health care decision making. PMID:25800813

  13. Special infectious disease risks of expatriates and long-term travelers in tropical countries. Part II: infections other than malaria.

    PubMed

    Toovey, Stephen; Moerman, Filip; van Gompel, Alfons

    2007-01-01

    A wide range of viral, bacterial, and protozoal diseases pose risk to long-term tropical travelers. Risk varies geographically and with lifestyle. For some infections, risk increases with duration of stay, coming to resemble that of the local population. Risk management strategies include vaccination, chemoprophylaxis, avoidance measures, and screening, where appropriate. Vaccination against hepatitis A and B, typhoid, and rabies is recommended for all long-term travelers to (sub-)tropical areas. Lowering of the vaccination threshold for Japanese encephalitis is suggested. Meningococcal disease is rare in travelers, but vaccination is safe and acceptable. The efficacy of Bacillus Calmette-Guérin (BCG) is uncertain; immunological testing avoids BCG's confounding of tuberculin testing. Diarrhea is common, and self-treatment may be recommended. Sexually transmitted infections including human immunodeficiency virus (HIV) are serious risks; education, screening, and HIV postexposure prophylaxis following involuntary exposure are recommended. Many infections are chronic or asymptomatic, and appropriate screening is recommended on return or after prolonged exposure.

  14. Global malaria connectivity through air travel

    PubMed Central

    2013-01-01

    Background Air travel has expanded at an unprecedented rate and continues to do so. Its effects have been seen on malaria in rates of imported cases, local outbreaks in non-endemic areas and the global spread of drug resistance. With elimination and global eradication back on the agenda, changing levels and compositions of imported malaria in malaria-free countries, and the threat of artemisinin resistance spreading from Southeast Asia, there is a need to better understand how the modern flow of air passengers connects each Plasmodium falciparum- and Plasmodium vivax-endemic region to the rest of the world. Methods Recently constructed global P. falciparum and P.vivax malaria risk maps, along with data on flight schedules and modelled passenger flows across the air network, were combined to describe and quantify global malaria connectivity through air travel. Network analysis approaches were then utilized to describe and quantify the patterns that exist in passenger flows weighted by malaria prevalence. Finally, the connectivity within and to the Southeast Asia region where the threat of imported artemisinin resistance arising is highest, was examined to highlight risk routes for its spread. Results The analyses demonstrate the substantial connectivity that now exists between and from malaria-endemic regions through air travel. While the air network provides connections to previously isolated malarious regions, it is clear that great variations exist, with significant regional communities of airports connected by higher rates of flow standing out. The structures of these communities are often not geographically coherent, with historical, economic and cultural ties evident, and variations between P. falciparum and P. vivax clear. Moreover, results highlight how well connected the malaria-endemic areas of Africa are now to Southeast Asia, illustrating the many possible routes that artemisinin-resistant strains could take. Discussion The continuing growth in air

  15. Recurrent fuzzy ranking methods

    NASA Astrophysics Data System (ADS)

    Hajjari, Tayebeh

    2012-11-01

    With the increasing development of fuzzy set theory in various scientific fields and the need to compare fuzzy numbers in different areas. Therefore, Ranking of fuzzy numbers plays a very important role in linguistic decision-making, engineering, business and some other fuzzy application systems. Several strategies have been proposed for ranking of fuzzy numbers. Each of these techniques has been shown to produce non-intuitive results in certain case. In this paper, we reviewed some recent ranking methods, which will be useful for the researchers who are interested in this area.

  16. Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia

    PubMed Central

    Ketema, Tsige

    2015-01-01

    Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years) seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20) software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%). Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P<0.05) among khat chewer malaria patients. However, relative risk to jaundice and renal failure were significantly higher (P<0.05) in khat chewers than in non-khat chewer malaria patients. Longer duration of khat use was positively associated with incidence of anemia. IgM and IgG antibody titers were significantly higher (P<0.05) among khat chewer malaria patients than among malaria positive non-chewers. Although levels of IgG subclasses in malaria patients did not show significant differences (P>0.05), IgG3 antibody was significantly higher (P<0.001) among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001) with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05) in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it

  17. Association of PECAM1/CD31 polymorphisms with cerebral malaria

    PubMed Central

    Ohashi, Jun; Naka, Izumi; Hananantachai, Hathairad; Patarapotikul, Jintana

    2016-01-01

    Platelet/endothelial cell adhesion molecule-1 (PECAM1/CD31), a receptor recognized by P. falciparum-infected red blood cells (iRBCs), on the vascular endothelium has been implicated in mediating cytoadherence in patients with P. falciparum malaria. To examine associations of PECAM1 polymorphisms with cerebral malaria, 11 tag single nucleotide polymorphisms (SNPs) of PECAM1 were analysed for 312 Thai patients with P. falciparum malaria (109 with cerebral malaria and 203 with mild malaria). The rs1122800-C allele was significantly associated with protection from cerebral malaria (P = 0.017), and the rs9912957-A significantly increased the risk for cerebral malaria (P = 0.0065) in malaria patients. Fine-scale mapping using genotyped and imputed SNPs and linkage disequilibrium (LD) analysis revealed that rs1122800 and rs9912957 were located in two distinct LD blocks and were independently associated with cerebral malaria. The rs1122800-C allele was significantly associated with lower expression level of PECAM1 in EBV-transformed lymphoblastoid cell lines (P = 0.045). The present results suggest that PECAM1-mediated cytoadherence of iRBCs to brain endothelium plays a crucial role in the pathogenesis of cerebral malaria. PMID:27335627

  18. Malaria-related anaemia: a Latin American perspective

    PubMed Central

    Quintero, Juan Pablo; Siqueira, André Machado; Tobón, Alberto; Blair, Silvia; Moreno, Alberto; Arévalo-Herrera, Myriam; Lacerda, Marcus Vinícius Guimarães; Valencia, Sócrates Herrera

    2016-01-01

    Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA), malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria. PMID:21881762

  19. Landscape ecology and epidemiology of malaria associated with rubber plantations in Thailand: integrated approaches to malaria ecotoping.

    PubMed

    Kaewwaen, Wuthichai; Bhumiratana, Adisak

    2015-01-01

    The agricultural land use changes that are human-induced changes in agroforestry ecosystems and in physical environmental conditions contribute substantially to the potential risks for malaria transmission in receptive areas. Due to the pattern and extent of land use change, the risks or negatively ecosystemic outcomes are the results of the dynamics of malaria transmission, the susceptibility of human populations, and the geographical distribution of malaria vectors. This review focused basically on what are the potential effects of agricultural land use change as a result of the expansion of rubber plantations in Thailand and how significant the ecotopes of malaria-associated rubber plantations (MRP) are. More profoundly, this review synthesized the novel concepts and perspectives on applied landscape ecology and epidemiology of malaria, as well as approaches to determine the degree to which an MRP ecotope as fundamental landscape scale can establish malaria infection pocket(s). Malaria ecotoping encompasses the integrated approaches and tools applied to or used in modeling malaria transmission. The scalability of MRP ecotope depends upon its unique landscape structure as it is geographically associated with the infestation or reinfestation of Anopheles vectors, along with the attributes that are epidemiologically linked with the infections. The MRP ecotope can be depicted as the hotspot such that malaria transmission is modeled upon the MRP factors underlying human settlements and movement activities, health behaviors, land use/land cover change, malaria vector population dynamics, and agrienvironmental and climatic conditions. The systemic and uniform approaches to malaria ecotoping underpin the stratification of the potential risks for malaria transmission by making use of remotely sensed satellite imagery or landscape aerial photography using unmanned aerial vehicle (UAV), global positioning systems (GPS), and geographical information systems (GIS). PMID

  20. Landscape Ecology and Epidemiology of Malaria Associated with Rubber Plantations in Thailand: Integrated Approaches to Malaria Ecotoping

    PubMed Central

    Kaewwaen, Wuthichai

    2015-01-01

    The agricultural land use changes that are human-induced changes in agroforestry ecosystems and in physical environmental conditions contribute substantially to the potential risks for malaria transmission in receptive areas. Due to the pattern and extent of land use change, the risks or negatively ecosystemic outcomes are the results of the dynamics of malaria transmission, the susceptibility of human populations, and the geographical distribution of malaria vectors. This review focused basically on what are the potential effects of agricultural land use change as a result of the expansion of rubber plantations in Thailand and how significant the ecotopes of malaria-associated rubber plantations (MRP) are. More profoundly, this review synthesized the novel concepts and perspectives on applied landscape ecology and epidemiology of malaria, as well as approaches to determine the degree to which an MRP ecotope as fundamental landscape scale can establish malaria infection pocket(s). Malaria ecotoping encompasses the integrated approaches and tools applied to or used in modeling malaria transmission. The scalability of MRP ecotope depends upon its unique landscape structure as it is geographically associated with the infestation or reinfestation of Anopheles vectors, along with the attributes that are epidemiologically linked with the infections. The MRP ecotope can be depicted as the hotspot such that malaria transmission is modeled upon the MRP factors underlying human settlements and movement activities, health behaviors, land use/land cover change, malaria vector population dynamics, and agrienvironmental and climatic conditions. The systemic and uniform approaches to malaria ecotoping underpin the stratification of the potential risks for malaria transmission by making use of remotely sensed satellite imagery or landscape aerial photography using unmanned aerial vehicle (UAV), global positioning systems (GPS), and geographical information systems (GIS). PMID

  1. [Malaria and intestinal protozoa].

    PubMed

    Rojo-Marcos, Gerardo; Cuadros-González, Juan

    2016-03-01

    Malaria is life threatening and requires urgent diagnosis and treatment. Incidence and mortality are being reduced in endemic areas. Clinical features are unspecific so in imported cases it is vital the history of staying in a malarious area. The first line treatments for Plasmodium falciparum are artemisinin combination therapies, chloroquine in most non-falciparum and intravenous artesunate if any severity criteria. Human infections with intestinal protozoa are distributed worldwide with a high global morbid-mortality. They cause diarrhea and sometimes invasive disease, although most are asymptomatic. In our environment populations at higher risk are children, including adopted abroad, immune-suppressed, travelers, immigrants, people in contact with animals or who engage in oral-anal sex. Diagnostic microscopic examination has low sensitivity improving with antigen detection or molecular methods. Antiparasitic resistances are emerging lately. PMID:26832999

  2. [Malaria and intestinal protozoa].

    PubMed

    Rojo-Marcos, Gerardo; Cuadros-González, Juan

    2016-03-01

    Malaria is life threatening and requires urgent diagnosis and treatment. Incidence and mortality are being reduced in endemic areas. Clinical features are unspecific so in imported cases it is vital the history of staying in a malarious area. The first line treatments for Plasmodium falciparum are artemisinin combination therapies, chloroquine in most non-falciparum and intravenous artesunate if any severity criteria. Human infections with intestinal protozoa are distributed worldwide with a high global morbid-mortality. They cause diarrhea and sometimes invasive disease, although most are asymptomatic. In our environment populations at higher risk are children, including adopted abroad, immune-suppressed, travelers, immigrants, people in contact with animals or who engage in oral-anal sex. Diagnostic microscopic examination has low sensitivity improving with antigen detection or molecular methods. Antiparasitic resistances are emerging lately.

  3. Malaria in selected non-Amazonian countries of Latin America

    PubMed Central

    Arevalo-Herrera, Myriam; Quiñones, Martha Lucia; Guerra, Carlos; Céspedes, Nora; Giron, Sandra; Ahumada, Martha; Piñeros, Juan Gabriel; Padilla, Norma; Terrientes, Zilka; Rosas, Ángel; Padilla, Julio Cesar; Escalante, Ananias A.; Beier, John C.; Herrera, Socrates

    2011-01-01

    Approximately 170 million inhabitants of the American continent live at risk of malaria transmission. Although the continent’s contribution to the global malaria burden is small, at least 1 to 1.2 million malaria cases are reported annually. Sixty per cent of the malaria cases occur in Brazil and the other 40% are distributed in 20 other countries of Central and South America. Plasmodium vivax is the predominant species (74.2 %) followed by P. falciparum (25.7 %) and P. malariae (0.1%), and no less than 10 Anopheles species have been identified as primary or secondary malaria vectors. Rapid deforestation and agricultural practices are directly related to increases in Anopheles species diversity and abundance, as well as in the number of malaria cases. Additionally, climate changes profoundly affect malaria transmission and are responsible for malaria epidemics in some regions of South America. Parasite drug resistance is increasing, but due to bio-geographic barriers there is extraordinary genetic differentiation of parasites with limited dispersion. Although the clinical spectrum ranges from uncomplicated to severe malaria cases, due to the generally low to middle transmission intensity, features such as severe anemia, cerebral malaria and other complications appear to be less frequent than in other endemic regions and asymptomatic infections are a common feature. Although the National Malaria Control Programs (NMCP) of different countries differ in their control activities these are all directed to reduce morbidity and mortality by using strategies like health promotion, vector control and impregnate bed nets among others. Recently, international initiatives such as the Malaria Control Program in Andean-country Border Regions (PAMAFRO) (implemented by the Andean Organism for Health (ORAS) and sponsored by The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)) and The Amazon Network for the Surveillance of Antimalarial Drug Resistance (RAVREDA

  4. Malaria in selected non-Amazonian countries of Latin America.

    PubMed

    Arevalo-Herrera, Myriam; Quiñones, Martha Lucia; Guerra, Carlos; Céspedes, Nora; Giron, Sandra; Ahumada, Martha; Piñeros, Juan Gabriel; Padilla, Norma; Terrientes, Zilka; Rosas, Angel; Padilla, Julio Cesar; Escalante, Ananias A; Beier, John C; Herrera, Socrates

    2012-03-01

    Approximately 170 million inhabitants of the American continent live at risk of malaria transmission. Although the continent's contribution to the global malaria burden is small, at least 1-1.2 million malaria cases are reported annually. Sixty percent of the malaria cases occur in Brazil and the other 40% are distributed in 20 other countries of Central and South America. Plasmodium vivax is the predominant species (74.2%) followed by P. falciparum (25.7%) and P. malariae (0.1%), and no less than 10 Anopheles species have been identified as primary or secondary malaria vectors. Rapid deforestation and agricultural practices are directly related to increases in Anopheles species diversity and abundance, as well as in the number of malaria cases. Additionally, climate changes profoundly affect malaria transmission and are responsible for malaria epidemics in some regions of South America. Parasite drug resistance is increasing, but due to bio-geographic barriers there is extraordinary genetic differentiation of parasites with limited dispersion. Although the clinical spectrum ranges from uncomplicated to severe malaria cases, due to the generally low to middle transmission intensity, features such as severe anemia, cerebral malaria and other complications appear to be less frequent than in other endemic regions and asymptomatic infections are a common feature. Although the National Malaria Control Programs (NMCP) of different countries differ in their control activities these are all directed to reduce morbidity and mortality by using strategies like health promotion, vector control and impregnate bed nets among others. Recently, international initiatives such as the Malaria Control Program in Andean-country Border Regions (PAMAFRO) (implemented by the Andean Organism for Health (ORAS) and sponsored by The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)) and The Amazon Network for the Surveillance of Antimalarial Drug Resistance (RAVREDA) (sponsored by

  5. Biodiversity Can Help Prevent Malaria Outbreaks in Tropical Forests

    PubMed Central

    Laporta, Gabriel Zorello; de Prado, Paulo Inácio Knegt Lopez; Kraenkel, Roberto André; Coutinho, Renato Mendes; Sallum, Maria Anice Mureb

    2013-01-01

    Background Plasmodium vivax is a widely distributed, neglected parasite that can cause malaria and death in tropical areas. It is associated with an estimated 80–300 million cases of malaria worldwide. Brazilian tropical rain forests encompass host- and vector-rich communities, in which two hypothetical mechanisms could play a role in the dynamics of malaria transmission. The first mechanism is the dilution effect caused by presence of wild warm-blooded animals, which can act as dead-end hosts to Plasmodium parasites. The second is diffuse mosquito vector competition, in which vector and non-vector mosquito species compete for blood feeding upon a defensive host. Considering that the World Health Organization Malaria Eradication Research Agenda calls for novel strategies to eliminate malaria transmission locally, we used mathematical modeling to assess those two mechanisms in a pristine tropical rain forest, where the primary vector is present but malaria is absent. Methodology/Principal Findings The Ross–Macdonald model and a biodiversity-oriented model were parameterized using newly collected data and data from the literature. The basic reproduction number () estimated employing Ross–Macdonald model indicated that malaria cases occur in the study location. However, no malaria cases have been reported since 1980. In contrast, the biodiversity-oriented model corroborated the absence of malaria transmission. In addition, the diffuse competition mechanism was negatively correlated with the risk of malaria transmission, which suggests a protective effect provided by the forest ecosystem. There is a non-linear, unimodal correlation between the mechanism of dead-end transmission of parasites and the risk of malaria transmission, suggesting a protective effect only under certain circumstances (e.g., a high abundance of wild warm-blooded animals). Conclusions/Significance To achieve biological conservation and to eliminate Plasmodium parasites in human populations

  6. Tool for Ranking Research Options

    NASA Technical Reports Server (NTRS)

    Ortiz, James N.; Scott, Kelly; Smith, Harold

    2005-01-01

    Tool for Research Enhancement Decision Support (TREDS) is a computer program developed to assist managers in ranking options for research aboard the International Space Station (ISS). It could likely also be adapted to perform similar decision-support functions in industrial and academic settings. TREDS provides a ranking of the options, based on a quantifiable assessment of all the relevant programmatic decision factors of benefit, cost, and risk. The computation of the benefit for each option is based on a figure of merit (FOM) for ISS research capacity that incorporates both quantitative and qualitative inputs. Qualitative inputs are gathered and partly quantified by use of the time-tested analytical hierarchical process and used to set weighting factors in the FOM corresponding to priorities determined by the cognizant decision maker(s). Then by use of algorithms developed specifically for this application, TREDS adjusts the projected benefit for each option on the basis of levels of technical implementation, cost, and schedule risk. Based partly on Excel spreadsheets, TREDS provides screens for entering cost, benefit, and risk information. Drop-down boxes are provided for entry of qualitative information. TREDS produces graphical output in multiple formats that can be tailored by users.

  7. The increase of imported malaria acquired in Haiti among US travelers in 2010.

    PubMed

    Agarwal, Aarti; McMorrow, Meredith; Arguin, Paul M

    2012-01-01

    From 2004 to 2009, the number of malaria cases reported in Haiti increased nearly fivefold. The effect of the 2010 earthquake and its aftermath on malaria transmission in Haiti is not known. Imported malaria cases in the United States acquired in Haiti tripled from 2009 to 2010, likely reflecting both the increased number of travelers arriving from Haiti and the increased risk of acquiring malaria infection in Haiti. The demographics of travelers and the proportion of severe cases are similar to those statistics reported in previous years. Non-adherence to malaria chemoprophylaxis remains a nearly universal modifiable risk factor among these cases.

  8. Remotely Sensed Environmental Conditions and Malaria Mortality in Three Malaria Endemic Regions in Western Kenya

    PubMed Central

    Ahlm, Clas; Rocklöv, Joacim

    2016-01-01

    Background Malaria is an important cause of morbidity and mortality in malaria endemic countries. The malaria mosquito vectors depend on environmental conditions, such as temperature and rainfall, for reproduction and survival. To investigate the potential for weather driven early warning systems to prevent disease occurrence, the disease relationship to weather conditions need to be carefully investigated. Where meteorological observations are scarce, satellite derived products provide new opportunities to study the disease patterns depending on remotely sensed variables. In this study, we explored the lagged association of Normalized Difference Vegetation Index (NVDI), day Land Surface Temperature (LST) and precipitation on malaria mortality in three areas in Western Kenya. Methodology and Findings The lagged effect of each environmental variable on weekly malaria mortality was modeled using a Distributed Lag Non Linear Modeling approach. For each variable we constructed a natural spline basis with 3 degrees of freedom for both the lag dimension and the variable. Lag periods up to 12 weeks were considered. The effect of day LST varied between the areas with longer lags. In all the three areas, malaria mortality was associated with precipitation. The risk increased with increasing weekly total precipitation above 20 mm and peaking at 80 mm. The NDVI threshold for increased mortality risk was between 0.3 and 0.4 at shorter lags. Conclusion This study identified lag patterns and association of remote- sensing environmental factors and malaria mortality in three malaria endemic regions in Western Kenya. Our results show that rainfall has the most consistent predictive pattern to malaria transmission in the endemic study area. Results highlight a potential for development of locally based early warning forecasts that could potentially reduce the disease burden by enabling timely control actions. PMID:27115874

  9. Impact of Schistosoma mansoni on Malaria Transmission in Sub-Saharan Africa

    PubMed Central

    Ndeffo Mbah, Martial L.; Skrip, Laura; Greenhalgh, Scott; Hotez, Peter; Galvani, Alison P.

    2014-01-01

    Background Sub-Saharan Africa harbors the majority of the global burden of malaria and schistosomiasis infections. The co-endemicity of these two tropical diseases has prompted investigation into the mechanisms of coinfection, particularly the competing immunological responses associated with each disease. Epidemiological studies have shown that infection with Schistosoma mansoni is associated with a greater malaria incidence among school-age children. Methodology We developed a co-epidemic model of malaria and S. mansoni transmission dynamics which takes into account key epidemiological interaction between the two diseases in terms of elevated malaria incidence among individuals with S. mansoni high egg output. The model was parameterized for S. mansoni high-risk endemic communities, using epidemiological and clinical data of the interaction between S. mansoni and malaria among children in sub-Saharan Africa. We evaluated the potential impact of the S. mansoni–malaria interaction and mass treatment of schistosomiasis on malaria prevalence in co-endemic communities. Principal Findings Our results suggest that in the absence of mass drug administration of praziquantel, the interaction between S. mansoni and malaria may reduce the effectiveness of malaria treatment for curtailing malaria transmission, in S. mansoni high-risk endemic communities. However, when malaria treatment is used in combination with praziquantel, mass praziquantel administration may increase the effectiveness of malaria control intervention strategy for reducing malaria prevalence in malaria- S. mansoni co-endemic communities. Conclusions/Significance Schistosomiasis treatment and control programmes in regions where S. mansoni and malaria are highly prevalent may have indirect benefits on reducing malaria transmission as a result of disease interactions. In particular, mass praziquantel administration may not only have the direct benefit of reducing schistosomiasis infection, it may also

  10. Attitudes, Knowledge, and Practices Regarding Malaria Prevention and Treatment among Pregnant Women in Eastern India

    PubMed Central

    Sabin, Lora L.; Rizal, Abanish; Brooks, Mohamad I.; Singh, Mrigendra P.; Tuchman, Jordan; Wylie, Blair J.; Joyce, Katherine M.; Yeboah-Antwi, Kojo; Singh, Neeru; Hamer, Davidson H.

    2010-01-01

    We explored views toward and use of malaria prevention and treatment measures among pregnant women in Jharkhand, India. We conducted 32 in-depth interviews and six focus group discussions (total = 73 respondents) with pregnant women in urban, semi-urban, and rural locations in a region with moderate intensity malaria transmission. Most respondents ranked malaria as an important health issue affecting pregnant women, had partially correct understanding of malaria transmission and prevention, and reported using potentially effective prevention methods, usually untreated bed nets. However, most conveyed misinformation and described using unproven prevention and/or treatment methods. Many described using different ineffective traditional malaria remedies. The majority also showed willingness to try new prevention methods and take medications if doctor-prescribed. Misconceptions and use of unproven prevention and treatment methods are common among pregnant women in eastern India. Policy makers should focus on improving knowledge and availability of effective malaria control strategies in this population. PMID:20519593

  11. Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in Eastern India.

    PubMed

    Sabin, Lora L; Rizal, Abanish; Brooks, Mohamad I; Singh, Mrigendra P; Tuchman, Jordan; Wylie, Blair J; Joyce, Katherine M; Yeboah-Antwi, Kojo; Singh, Neeru; Hamer, Davidson H

    2010-06-01

    We explored views toward and use of malaria prevention and treatment measures among pregnant women in Jharkhand, India. We conducted 32 in-depth interviews and six focus group discussions (total = 73 respondents) with pregnant women in urban, semi-urban, and rural locations in a region with moderate intensity malaria transmission. Most respondents ranked malaria as an important health issue affecting pregnant women, had partially correct understanding of malaria transmission and prevention, and reported using potentially effective prevention methods, usually untreated bed nets. However, most conveyed misinformation and described using unproven prevention and/or treatment methods. Many described using different ineffective traditional malaria remedies. The majority also showed willingness to try new prevention methods and take medications if doctor-prescribed. Misconceptions and use of unproven prevention and treatment methods are common among pregnant women in eastern India. Policy makers should focus on improving knowledge and availability of effective malaria control strategies in this population.

  12. Hierarchical Rank Aggregation with Applications to Nanotoxicology

    PubMed Central

    Telesca, Donatello; Rallo, Robert; George, Saji; Xia, Tian; Nel, André E.

    2014-01-01

    The development of high throughput screening (HTS) assays in the field of nanotoxicology provide new opportunities for the hazard assessment and ranking of engineered nanomaterials (ENMs). It is often necessary to rank lists of materials based on multiple risk assessment parameters, often aggregated across several measures of toxicity and possibly spanning an array of experimental platforms. Bayesian models coupled with the optimization of loss functions have been shown to provide an effective framework for conducting inference on ranks. In this article we present various loss-function-based ranking approaches for comparing ENM within experiments and toxicity parameters. Additionally, we propose a framework for the aggregation of ranks across different sources of evidence while allowing for differential weighting of this evidence based on its reliability and importance in risk ranking. We apply these methods to high throughput toxicity data on two human cell-lines, exposed to eight different nanomaterials, and measured in relation to four cytotoxicity outcomes. This article has supplementary material online. PMID:24839387

  13. [New approaches of malaria prevention for travelers].

    PubMed

    Voumard, Rachel; Berthod, Delphine; Rochat, Laurence; D'Acremont, Valérie; Genton, Blaise; De Vallière, Serge

    2016-05-01

    Malaria is declining in many tropical countries. This reduction challenges our usual preventive strategies. In moderate to low risk areas, the Swiss guidelines recommend a stand-by emergency treatment. Controversies between experts are numerous though. Professionals at the Travel Clinic in Lausanne has explored shared-decision making through three clinical studies. The first showed that travelers visiting moderate to low risk malaria areas prefer a standby emergency treatment rather than chemoprophylaxis. The second study investigates the use of rapid diagnostic tests by travelers. The third focuses on the prospects of tropical telemedicine. Involving the traveler into the debate is a priority, until a vaccine becomes available.

  14. Malaria or Kalimbe: how to choose?

    PubMed

    Carme, Bernard

    2009-12-04

    Should the Kalimbe (a traditional Amerindian loincloth) be banned, based on its association with an increased risk of malaria? Studies on malaria conducted on Amerindian children in the Oyapock region, French Guiana suggest that there is an argument for replacing the Kalimbe with a modern alternative. However, the wider issue of how the positive (risk reduction and related benefits) and negative effects (exacerbation of acculturation processes and associated consequences) should be assessed needs to be considered before suggesting a change in ancestral behaviour for medical purposes. A multidisciplinary approach is needed, together with caution and humility from epidemiologists.

  15. Applying Rank Sum Ratio (RSR) to the Evaluation of Feeding Practices Behaviors, and Its Associations with Infant Health Risk in Rural Lhasa, Tibet.

    PubMed

    Wang, Zhenjie; Dang, Shaonong; Xing, Yuan; Li, Qiang; Yan, Hong

    2015-12-01

    To evaluate the status of feeding practices and analyze the association between feeding practice and health status among Tibetan infants, a cross-sectional survey of 386 women with children aged under 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were selected using simple random sampling and were interviewed face-to-face by trained interviewers. Mothers were interviewed to collect information on their feeding practices. A feeding practices index was created using the rank sum ratio method. Most of the infants had been or were being breastfed at the time of the interview. The feeding practices index was significantly and inversely associated with the prevalence of acute upper respiratory infection, and the odds ratio for the qualified feeding practices index vs. the non-qualified feeding practices index was 0.43 (95% confidence interval: 0.20-0.94). There were no measurable associations observed between acute upper respiratory infection, diarrhea, and the feeding practices index after controlling for selected factors. The method of rank sum ratio provides a flexible way to evaluate feeding practices and is easy to understand. Furthermore, appropriate infant feeding practices might play a protective role in Tibetan infants' health.

  16. Malaria in the Era of Food Fortification With Folic Acid.

    PubMed

    Nzila, Alexis; Okombo, John; Hyde, John

    2016-06-01

    Food fortified with folic acid has been available for consumption in North America for over a decade. This strategy has led to an increase in folate levels in the general population and, more importantly, a significant decrease in the incidence of neural tube defects. However, this increase in folate intake has been associated with a greater risk of cancer disease. Many African countries are now embracing this concept; however, because folate promotes malaria parasite division, as it does in cancer cells, there is a possibility of malaria exacerbation if folate intake is increased. A precedent for such a concern is the now compelling evidence showing that an increase in iron intake can lead to a higher malaria risk; as a result, mass administration of iron in malaria-endemic areas is not recommended. In this article, we review work on the effect of folate on malaria parasites. Although this topic has received little research attention, the available data suggest that the increase in folate concentration could be associated with an increase in malaria infection. Thus, the introduction of food fortification with folic acid in malaria-endemic areas should be attended by precautionary programs to monitor the risk of malaria.

  17. The pathophysiology of vivax malaria.

    PubMed

    Anstey, Nicholas M; Russell, Bruce; Yeo, Tsin W; Price, Ric N

    2009-05-01

    Long considered a benign infection, Plasmodium vivax is now recognized as a cause of severe and fatal malaria, despite its low parasite biomass, the increased deformability of vivax-infected red blood cells and an apparent paucity of parasite sequestration. Severe anemia is associated with recurrent bouts of hemolysis of predominantly uninfected erythrocytes with increased fragility, and lung injury is associated with inflammatory increases in alveolar-capillary membrane permeability. Although rare, vivax-associated coma challenges our understanding of pathobiology caused by Plasmodium spp. Host and parasite factors contribute to the risk of severe disease, and comorbidities might contribute to vivax mortality. In this review, we discuss potential mechanisms underlying the syndromes of uncomplicated and severe vivax malaria, identifying key areas for future research.

  18. IASM: A System for the Intelligent Active Surveillance of Malaria

    PubMed Central

    Yang, Bo; Chen, Hechang; Gu, Xiao; Bai, Yuan

    2016-01-01

    Malaria, a life-threatening infectious disease, spreads rapidly via parasites. Malaria prevention is more effective and efficient than treatment. However, the existing surveillance systems used to prevent malaria are inadequate, especially in areas with limited or no access to medical resources. In this paper, in order to monitor the spreading of malaria, we develop an intelligent surveillance system based on our existing algorithms. First, a visualization function and active surveillance were implemented in order to predict and categorize areas at high risk of infection. Next, socioeconomic and climatological characteristics were applied to the proposed prediction model. Then, the redundancy of the socioeconomic attribute values was reduced using the stepwise regression method to improve the accuracy of the proposed prediction model. The experimental results indicated that the proposed IASM predicted malaria outbreaks more close to the real data and with fewer variables than other models. Furthermore, the proposed model effectively identified areas at high risk of infection. PMID:27563343

  19. IASM: A System for the Intelligent Active Surveillance of Malaria.

    PubMed

    Wang, Xinlei; Yang, Bo; Huang, Jing; Chen, Hechang; Gu, Xiao; Bai, Yuan; Du, Zhanwei

    2016-01-01

    Malaria, a life-threatening infectious disease, spreads rapidly via parasites. Malaria prevention is more effective and efficient than treatment. However, the existing surveillance systems used to prevent malaria are inadequate, especially in areas with limited or no access to medical resources. In this paper, in order to monitor the spreading of malaria, we develop an intelligent surveillance system based on our existing algorithms. First, a visualization function and active surveillance were implemented in order to predict and categorize areas at high risk of infection. Next, socioeconomic and climatological characteristics were applied to the proposed prediction model. Then, the redundancy of the socioeconomic attribute values was reduced using the stepwise regression method to improve the accuracy of the proposed prediction model. The experimental results indicated that the proposed IASM predicted malaria outbreaks more close to the real data and with fewer variables than other models. Furthermore, the proposed model effectively identified areas at high risk of infection. PMID:27563343

  20. Quantifying the impact of decay in bed-net efficacy on malaria transmission.

    PubMed

    Ngonghala, Calistus N; Del Valle, Sara Y; Zhao, Ruijun; Mohammed-Awel, Jemal

    2014-12-21

    Insecticide-treated nets (ITNs) are at the forefront of malaria control programs and even though the percentage of households in sub-Saharan Africa that owned nets increased from 3% in 2000 to 53% in 2012, many children continue to die from malaria. The potential impact of ITNs on reducing malaria transmission is limited due to inconsistent or improper use, as well as physical decay in effectiveness. Most mathematical models for malaria transmission have assumed a fixed effectiveness rate for bed-nets, which can overestimate the impact of nets on malaria control. We develop a model for malaria spread that captures the decrease in ITN effectiveness due to physical and chemical decay, as well as human behavior as a function of time. We perform uncertainty and sensitivity analyses to identify and rank parameters that play a critical role in malaria transmission. These analyses show that the basic reproduction number R0, and the infectious human population are most sensitive to bed-net coverage and the biting rate of mosquitoes. Our results show the existence of a backward bifurcation for the case in which ITN efficacy is constant over time, which occurs for some range of parameters and is characterized by high malaria mortality in humans. This result implies that bringing R0 to less than one is not enough for malaria elimination but rather additional efforts will be necessary to control the disease. For the case in which ITN efficacy decays over time, we determine coverage levels required to control malaria for different ITN efficacies and demonstrate that ITNs with longer useful lifespans perform better in malaria control. We conclude that malaria control programs should focus on increasing bed-net coverage, which can be achieved by enhancing malaria education and increasing bed-net distribution in malaria endemic regions. PMID:25158163

  1. Ranking Information in Networks

    NASA Astrophysics Data System (ADS)

    Eliassi-Rad, Tina; Henderson, Keith

    Given a network, we are interested in ranking sets of nodes that score highest on user-specified criteria. For instance in graphs from bibliographic data (e.g. PubMed), we would like to discover sets of authors with expertise in a wide range of disciplines. We present this ranking task as a Top-K problem; utilize fixed-memory heuristic search; and present performance of both the serial and distributed search algorithms on synthetic and real-world data sets.

  2. MALARIA: A GENERAL MINIREVIEW WITH REFERENCE TO EGYPT.

    PubMed

    Ahmad Saleh, Ahmad Megahed; Adam, Samia Mohammad; Ibrahim, Abeer Mohammad Abdallah; Morsy, Tosson A

    2016-04-01

    The majority of world's population-live in areas at risk of malaria transmission. Malaria is a serious Anopheles-borne disease that pauses symptoms like the flu, as a high fever, chills, and muscle pain also, anemia, bloody stools, coma, convulsion, fever, headache, jaundice, nausea, sweating and vomiting. Symptoms tend to come and go in cycles. Apart from Anopheles vector, malaria could be transmitted nosocomial, blood transfusion or needle-stick injury Some types of malaria may cause more serious damage problems to heart, lungs, kidneys, or brain. These types can be deadly. The primary factors contributing to the resurgence of malaria are the appearance of drug-resistant strains of the parasite, the spread of insecticide-resistant strains of the mosquito and the lack of licensed malaria vaccines of proven efficacy. In rare cases, people can get malaria if they come into contact with infected blood as in blood transfusion or needle-stick injury also nosocomial and congenital malaria was reported. This is a mini-review of malaria with information on the lethal to humans, Plasmodium falciparum, together with other recent developments in the field. PMID:27363039

  3. Socio-Demographics and the Development of Malaria Elimination Strategies in the Low Transmission Setting

    PubMed Central

    Chuquiyauri, Raul; Paredes, Maribel; Peñataro, Pablo; Torres, Sonia; Marin, Silvia; Tenorio, Alexander; Brouwer, Kimberly C.; Abeles, Shira; Llanos-Cuentas, Alejandro; Gilman, Robert H.; Kosek, Margaret; Vinetz, Joseph M.

    2011-01-01

    This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9,000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis. PMID:22100446

  4. Socio-demographics and the development of malaria elimination strategies in the low transmission setting.

    PubMed

    Chuquiyauri, Raul; Paredes, Maribel; Peñataro, Pablo; Torres, Sonia; Marin, Silvia; Tenorio, Alexander; Brouwer, Kimberly C; Abeles, Shira; Llanos-Cuentas, Alejandro; Gilman, Robert H; Kosek, Margaret; Vinetz, Joseph M

    2012-03-01

    This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis.

  5. Glucose-6-phosphate dehydrogenase deficiency and the risk of malaria and other diseases in children in Kenya: a case-control and a cohort study

    PubMed Central

    Uyoga, Sophie; Ndila, Carolyne M; Macharia, Alex W; Nyutu, Gideon; Shah, Shivang; Peshu, Norbert; Clarke, Geraldine M; Kwiatkowski, Dominic P; Rockett, Kirk A; Williams, Thomas N

    2015-01-01

    Summary Background The global prevalence of X-linked glucose-6-phosphate dehydrogenase (G6PD) deficiency is thought to be a result of selection by malaria, but epidemiological studies have yielded confusing results. We investigated the relationships between G6PD deficiency and both malaria and non-malarial illnesses among children in Kenya. Methods We did this study in Kilifi County, Kenya, where the G6PD c.202T allele is the only significant cause of G6PD deficiency. We tested the associations between G6PD deficiency and severe and complicated Plasmodium falciparum malaria through a case-control study of 2220 case and 3940 control children. Cases were children aged younger than 14 years, who visited the high dependency ward of Kilifi County Hospital with severe malaria between March 1, 1998, and Feb 28, 2010. Controls were children aged between 3–12 months who were born within the same study area between August 2006, and September 2010. We assessed the association between G6PD deficiency and both uncomplicated malaria and other common diseases of childhood in a cohort study of 752 children aged younger than 10 years. Participants of this study were recruited from a representative sample of households within the Ngerenya and Chonyi areas of Kilifi County between Aug 1, 1998, and July 31, 2001. The primary outcome measure for the case-control study was the odds ratio for hospital admission with severe malaria (computed by logistic regression) while for the cohort study it was the incidence rate ratio for uncomplicated malaria and non-malaria illnesses (computed by Poisson regression), by G6PD deficiency category. Findings 2863 (73%) children in the control group versus 1643 (74%) in the case group had the G6PD normal genotype, 639 (16%) versus 306 (14%) were girls heterozygous for G6PD c.202T, and 438 (11%) versus 271 (12%) children were either homozygous girls or hemizygous boys. Compared with boys and girls without G6PD deficiency, we found significant

  6. Human movement data for malaria control and elimination strategic planning.

    PubMed

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-06-18

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  7. Human movement data for malaria control and elimination strategic planning

    PubMed Central

    2012-01-01

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements. PMID:22703541

  8. Human movement data for malaria control and elimination strategic planning.

    PubMed

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-01-01

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements. PMID:22703541

  9. A rapid malaria appraisal in the Venezuelan Amazon

    PubMed Central

    2009-01-01

    Background While the federal state of Amazonas bears the highest risk for malaria in Venezuela (2007: 68.4 cases/1000 inhabitants), little comprehensive information about the malaria situation is available from this area. The purpose of this rapid malaria appraisal (RMA) was to provide baseline data about malaria and malaria control in Amazonas. Methods The RMA methodology corresponds to a rapid health impact assessment (HIA) as described in the 1999 Gothenburg consensus. In conjunction with the actors of the malaria surveillance system, all useful data and information, which were accessible within a limited time-frame of five visits to Amazonas, were collected, analysed and interpreted. Results Mortality from malaria is low (< 1 in 105) and slide positivity rates have stayed at the same level for the last two decades (15% ± 6% (SD)). Active case detection accounts for ca. 40% of slides taken. The coverage of the censured population with malaria notification points (NPs) has been achieved in recent years. The main parasite is Plasmodium vivax (84% of cases). The proportion of Plasmodium falciparum is on the decline, possibly driven by the introduction of cost-free artemisinin-based combination therapy (ACT) (1988: 33.4%; 2007: 15.4%). Monitoring and documentation is complete, systematic and consistent, but poorly digitalized. Malaria transmission displayed a visible lag behind rainfall in the capital municipality of Atures, but not in the other municipalities. In comparison to reference microscopy, quality of field microscopy and rapid diagnostic tests (RDTs) is suboptimal (kappa < 0.75). Hot spots of malaria risk were seen in some indigenous ethnic groups. Conflicting strategies in respect of training of community health workers (CHW) and the introduction of new diagnostic tools (RDTs) were observed. Conclusion Malaria control is possible, even in tropical rain forest areas, if the health system is working adequately. Interventions have to be carefully designed

  10. Malaria in Britain: past, present, and future.

    PubMed

    Kuhn, Katrin Gaardbo; Campbell-Lendrum, Diarmid H; Armstrong, Ben; Davies, Clive R

    2003-08-19

    There has been much recent speculation that global warming may allow the reestablishment of malaria transmission in previously endemic areas such as Europe and the United States. In this report we analyze temporal trends in malaria in Britain between 1840 and 1910, to assess the potential for reemergence of the disease. Our results demonstrate that at least 20% of the drop-off in malaria was due to increasing cattle population and decreasing acreage of marsh wetlands. Although both rainfall and average temperature were associated with year-to-year variability in death rates, there was no evidence for any association with the long-term malaria trend. Model simulations for future scenarios in Britain suggest that the change in temperature projected to occur by 2050 is likely to cause a proportional increase in local malaria transmission of 8-14%. The current risk is negligible, as >52,000 imported cases since 1953 have not led to any secondary cases. The projected increase in proportional risk is clearly insufficient to lead to the reestablishment of endemicity.

  11. Where the Colleges Rank.

    ERIC Educational Resources Information Center

    College Rater, Inc., Allentown, PA.

    This document presents a composite index that numerically ranks the nation's leading undergraduate colleges and universities based on seven criteria. The criteria include admission standards; number of recent recipients of Rhodes, Danforth, and National Science Foundation awards; proportion of recent graduates entering graduate or professional…

  12. Diversifying customer review rankings.

    PubMed

    Krestel, Ralf; Dokoohaki, Nima

    2015-06-01

    E-commerce Web sites owe much of their popularity to consumer reviews accompanying product descriptions. On-line customers spend hours and hours going through heaps of textual reviews to decide which products to buy. At the same time, each popular product has thousands of user-generated reviews, making it impossible for a buyer to read everything. Current approaches to display reviews to users or recommend an individual review for a product are based on the recency or helpfulness of each review. In this paper, we present a framework to rank product reviews by optimizing the coverage of the ranking with respect to sentiment or aspects, or by summarizing all reviews with the top-K reviews in the ranking. To accomplish this, we make use of the assigned star rating for a product as an indicator for a review's sentiment polarity and compare bag-of-words (language model) with topic models (latent Dirichlet allocation) as a mean to represent aspects. Our evaluation on manually annotated review data from a commercial review Web site demonstrates the effectiveness of our approach, outperforming plain recency ranking by 30% and obtaining best results by combining language and topic model representations.

  13. Diversifying customer review rankings.

    PubMed

    Krestel, Ralf; Dokoohaki, Nima

    2015-06-01

    E-commerce Web sites owe much of their popularity to consumer reviews accompanying product descriptions. On-line customers spend hours and hours going through heaps of textual reviews to decide which products to buy. At the same time, each popular product has thousands of user-generated reviews, making it impossible for a buyer to read everything. Current approaches to display reviews to users or recommend an individual review for a product are based on the recency or helpfulness of each review. In this paper, we present a framework to rank product reviews by optimizing the coverage of the ranking with respect to sentiment or aspects, or by summarizing all reviews with the top-K reviews in the ranking. To accomplish this, we make use of the assigned star rating for a product as an indicator for a review's sentiment polarity and compare bag-of-words (language model) with topic models (latent Dirichlet allocation) as a mean to represent aspects. Our evaluation on manually annotated review data from a commercial review Web site demonstrates the effectiveness of our approach, outperforming plain recency ranking by 30% and obtaining best results by combining language and topic model representations. PMID:25795511

  14. World Malaria Day 2016 in the Kingdom of Cambodia: high-level governmental support embodies the WHO call for "political will to end malaria".

    PubMed

    Canavati, Sara E; Quintero, Cesia E; Bou, Thavrin; Khieu, Virak; Leang, Rithea; Lek, Dysoley; Ly, Po; Muth, Sinuon; Lim, Kim Seng; Tuseo, Luciano; Yok, Sovann; Yung, Kunthearith; Richards, Jack S; Rekol, Huy

    2016-01-01

    On World Malaria Day 2016, The Kingdom of Cambodia's National celebrations served as a prime of example of how political will is currently being exercised in Cambodia through high-level governmental support for malaria elimination. The main country event was well-planned and coordinated by the National Programme for Parasitology, Entomology and Malaria Control (CNM), and included key contributions from high-ranking political figures, such as His Excellency (H.E) Mam Bun Heng (Minister of Health), and H.E. Keut Sothea (Governor of Pailin Province). There were more than 1000 attendees, ranging from Village Malaria Workers and high school students to CNM's director and other officials in Pailin Province, Western Cambodia. A strong inter-sectoral participation included attendances from the Ministry of Education and high-level representatives of the Cambodian Armed Forces, as well as Malaria Partners like the World Health Organization.

  15. Development of a malaria knowledge test for student travelers

    PubMed Central

    Hartjes, Laurie B.; Baumann, Linda C.

    2013-01-01

    This paper describes a malaria knowledge test (MKT) developed to evaluate a web-based game for students who increasingly travel to malaria-risk regions of the world. The 18-item MKT was structured according to the dimensions of the self-regulation model (SRM) to measure the accuracy of students’ beliefs about malaria. An experimental design was used to compare three game versions. Students (N=482) participated in 2010 by completing a pre-test, playing a Web-based game simulating student travel to malaria-endemic destinations, and completing a post-test. Study data support the validity and reliability of the MKT for the evaluation of malaria education interventions and for student self-assessment. Use of the MKT to evaluate an educational game about malaria revealed a strong overall learning effect and discrimination by game version, travel experience, and SRM dimension. This 5-min test may also be adapted for educational outreach purposes among health care providers globally, residents of malaria-endemic regions, and other high risk travel groups (e.g., elderly, chronic health conditions, pregnant, or returning to malaria-endemic regions to visit friends/relatives). PMID:24382993

  16. Surveillance and response to drive the national malaria elimination program.

    PubMed

    Feng, Xin-Yu; Xia, Zhi-Gui; Vong, Sirenda; Yang, Wei-Zhong; Zhou, Shui-Sen

    2014-01-01

    The national action plan for malaria elimination in China (2010-2020) was issued by the Chinese Ministry of Health along with other 13 ministries and commissions in 2010. The ultimate goal of the national action plan was to eliminate local transmission of malaria by the end of 2020. Surveillance and response are the most important components driving the whole process of the national malaria elimination programme (NMEP), under the technical guidance used in NMEP. This chapter introduces the evolution of the surveillance from the control to the elimination stages and the current structure of national surveillance system in China. When the NMEP launched, both routine surveillance and sentinel surveillance played critical role in monitoring the process of NMEP. In addition, the current response strategy of NMEP was also reviewed, including the generally developed "1-3-7 Strategy". More effective and sensitive risk assessment tools were introduced, which cannot only predict the trends of malaria, but also are important for the design and adjustment of the surveillance and response systems in the malaria elimination stage. Therefore, this review presents the landscape of malaria surveillance and response in China as well as their contribution to the NMEP, with a focus on activities for early detection of malaria cases, timely control of malaria foci and epidemics, and risk prediction. Furthermore, challenges and recommendations for accelerating NMEP through surveillance are put forward. PMID:25476882

  17. A review of spatial technologies with applications for malaria transmission modelling and control in Africa.

    PubMed

    Gebreslasie, Michael T

    2015-01-01

    Spatial technologies, i.e. geographic information systems, remote sensing, and global positioning systems, offer an opportunity for rapid assessment of malaria endemic areas. These technologies coupled with prevalence/incidence data can provide reliable estimates of population at risk, predict disease distributions in areas that lack baseline data and provide guidance for intervention strategies, so that scarce resources can be allocated in a cost-effective manner. This review focuses on the spatial technology applications that have been used in epidemiology and control of malaria in Africa. Peer-reviewed papers identified through a PubMed search using the following keywords: geospatial technology OR Geographic Information Systems OR Remote Sensing OR Earth Observation OR Global Positioning Systems OR geospatial modelling OR malaria incidence OR malaria prevalence OR malaria risk prediction OR malaria mapping AND malaria AND Africa were used. These included mapping malaria incidence and prevalence, assessing the relationship between malaria and environmental variables as well as applications for malaria early warning systems. The potential of new spatial technology applications utilising emerging satellite information, as they hold promise to further enhance infectious risk mapping and disease prediction, are outlined. We stress current research needs to overcome some of the remaining challenges of spatial technology applications for malaria so that further and sustainable progress can be made to control and eliminate this disease.

  18. Rapid Urban Malaria Appraisal (RUMA) IV: Epidemiology of urban malaria in Cotonou (Benin)

    PubMed Central

    Wang, Shr-Jie; Lengeler, Christian; Smith, Thomas A; Vounatsou, Penelope; Akogbeto, Martin; Tanner, Marcel

    2006-01-01

    Background An estimated 40 % of the population in Benin lives in urban areas. The purpose of the study was to estimate malaria endemicity and the fraction of malaria-attributable fevers in health facilities in Cotonou. Methods A health care system evaluation and a series of school parasitaemia surveys and health facility-based surveys were carried out during the dry season in of 2003, applying standard Rapid Urban Malaria Appraisal (RUMA) methodology. This study was part of a multi-site assessment supported by the Roll Back Malaria Partnership. Results The field work was carried out in February-March 2003. In 2002 and out of 289,342 consultations in the public health facilities of Cotonou there were 100,257 reported simple malaria cases (34.6%) and 12,195 complicated malaria cases (4.2%). In the school parasitaemia surveys, a malaria infection was found in 5.2 % of all samples. The prevalence rates of parasitaemia in the centre, intermediate and periphery zones were 2.6%, 9.0% and 2.5%, respectively. In the health facility surveys the malaria infection rates in presenting fever cases were 0% (under one year old), 6.8% (one to five years old), 0% (> five to 15 years old) and 0.9% (over 15 years old), while these rates in the control group were 1.4%, 2.8%, 1.3% and 2.0%. The malaria-attributable fractions among presenting fever cases were 0.04 in the one to five years old and zero in the three other age groups. Hence, malaria played only a small role in fever episodes at the end of the dry season. In total, 69.2% of patients used a mosquito net the night before the survey and 35.1% used an insecticide-treated net, which was shown to be protective for an infection (OR = 0.23, 95% CI 0.07–0.78). Travelling to a rural area (5.8% of all respondents) did not increase the infection risk. Conclusion The homogenously low malaria prevalence might be associated with urban transformation and/or a high bednet usage. Over-diagnosis of malaria and over-treatment with

  19. Impact of climate change on global malaria distribution

    PubMed Central

    Caminade, Cyril; Kovats, Sari; Rocklov, Joacim; Tompkins, Adrian M.; Morse, Andrew P.; Colón-González, Felipe J.; Stenlund, Hans; Martens, Pim; Lloyd, Simon J.

    2014-01-01

    Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution. PMID:24596427

  20. [Malaria in Iraq].

    PubMed

    Shamo, F J

    2001-01-01

    Malaria control campaign started in Iraq in 1957. This made the country largely free of the disease. Since 1991, following the recent war, Iraq has been affected by serious epidemic of P. vivax malaria that started in 3 autonomous governorates and soon involved other parts of the country. There were 49,840 malaria cases in the country in 1995. The national malaria programme personnel did their best to contain and control the epidemic. Active and passive case detection and treatment were introduced. Free of charge drugs are provided at all levels in the endemic area. Vector control includes environmental management, distribution of Gambusia fish, larviciding, indoor residual spraying with pyrithroids. A total of 4134 malaria cases were recorded in the country in 1999. PMID:11548316

  1. Oral iron supplements for children in malaria-endemic areas

    PubMed Central

    Neuberger, Ami; Okebe, Joseph; Yahav, Dafna; Paul, Mical

    2016-01-01

    Background Iron-deficiency anaemia is common during childhood. Iron administration has been claimed to increase the risk of malaria. Objectives To evaluate the effects and safety of iron supplementation, with or without folic acid, in children living in areas with hyperendemic or holoendemic malaria transmission. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library, MEDLINE (up to August 2015) and LILACS (up to February 2015). We also checked the metaRegister of Controlled Trials (mRCT) and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) up to February 2015. We contacted the primary investigators of all included trials, ongoing trials, and those awaiting assessment to ask for unpublished data and further trials. We scanned references of included trials, pertinent reviews, and previous meta-analyses for additional references. Selection criteria We included individually randomized controlled trials (RCTs) and cluster RCTs conducted in hyperendemic and holoendemic malaria regions or that reported on any malaria-related outcomes that included children younger than 18 years of age. We included trials that compared orally administered iron, iron with folic acid, and iron with antimalarial treatment versus placebo or no treatment. We included trials of iron supplementation or fortification interventions if they provided at least 80% of the Recommended Dietary Allowance (RDA) for prevention of anaemia by age. Antihelminthics could be administered to either group, and micronutrients had to be administered equally to both groups. Data collection and analysis The primary outcomes were clinical malaria, severe malaria, and death from any cause. We assessed the risk of bias in included trials with domain-based evaluation and assessed the quality of the evidence using the Grading of Recommendations Assessment

  2. Modeling Malaria Transmission in Thailand and Indonesia

    NASA Technical Reports Server (NTRS)

    Kiang, Richard; Adimi, Farida; Nigro, Joseph

    2007-01-01

    Malaria Modeling and Surveillance is a project in the NASA Applied Sciences Public Health Applications Program. The main objectives of this project are: 1) identification of the potential breeding sites for major vector species: 2) implementation of a malaria transmission model to identify they key factors that sustain or intensify malaria transmission; and 3) implementation of a risk algorithm to predict the occurrence of malaria and its transmission intensity. Remote sensing and GIs are the essential elements of this project. The NASA Earth science data sets used in this project include AVHRR Pathfinder, TRMM, MODIS, NSIPP and SIESIP. Textural-contextual classifications are used to identify small larval habitats. Neural network methods are used to model malaria cases as a function of precipitation, temperatures, humidity and vegetation. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records. Examples for spatio-temporal modeling of malaria transmissions in Southeast Asia are given. Discrete event simulations were used for modeling the detailed interactions among the vector life cycle, sporogonic cycle and human infection cycle, under the explicit influences of selected extrinsic and intrinsic factors. The output of the model includes the individual infection status and the quantities normally observed in field studies, such as mosquito biting rates, sporozoite infection rates, gametocyte prevalence and incidence. Results are in good agreement with mosquito vector and human malaria data acquired by Coleman et al. over 4.5 years in Kong Mong Tha, a remote village in western Thailand. Application of our models is not restricted to Southeast Asia. The model and techniques are equally applicable to other regions of the world, when appropriate epidemiological and vector ecological parameters are used as input.

  3. Update: malaria, U.S. Armed Forces, 2011.

    PubMed

    2012-01-01

    U.S. service members are at risk of malaria when they are assigned to endemic areas (e.g., Korea), participate in operations in endemic areas (e.g., Afghanistan, Africa) and visit malarious areas during personal travel. In 2011, 124 service members were reported with malaria. Nearly three-fourths of cases were presumably acquired in Afghanistan (n=91) and one-fifth were considered acquired in Africa (n=24). One-quarter of cases were caused by P. vivax and one-fifth by P. falciparum (including 6 Afghanistan-acquired infections); most cases were reported as "unspecified" malaria. Malaria was diagnosed/reported from 51 different medical facilities in the United States, Afghanistan, Kyrgyzstan, Iraq, Germany and Korea. Providers of care to military members should be knowledgeable regarding and vigilant for clinical presentations of malaria outside of endemic areas. PMID:22309389

  4. Mefloquine at the crossroads? Implications for malaria chemoprophylaxis in Europe.

    PubMed

    Schlagenhauf, Patricia; Hatz, Christoph; Behrens, Ron; Visser, Leo; Funk, Maia; Holzer, Benedikt; Beck, Bernhard; Bourquin, Cathérine; Etter, Hermann; Furrer, Hansjakob; Genton, Blaise; Landry, Pierre; Chappuis, Francois; Loutan, Louis; Stössel, Ulrich; Jeschko, Eva; Rossanese, Andrea; Nothdurft, Hans Dieter

    2015-01-01

    Since its introduction to the market in 1985, mefloquine has been used for malaria chemoprophylaxis by more than 35 million travellers. In Europe, in 2014, the European Medicines Agency (EMA) issued recommendations on strengthened warnings, prescribing checklists and updates to the product information of mefloquine. Some malaria prevention advisors question the scientific basis for the restrictions and suggest that this cost-effective, anti-malarial drug will be displaced as a first-line anti-malaria medication with the result that vulnerable groups such as VFR and long-term travellers, pregnant travellers and young children are left without a suitable alternative chemoprophylaxis. This commentary looks at the current position of mefloquine prescribing and the rationale of the new EMA recommendations and restrictions. It also describes the new recommendations for malaria prophylaxis that have been adapted by Switzerland, Germany, Austria and Italy where chemoprophylaxis use is restricted to high-risk malaria-endemic areas. PMID:25825015

  5. Prospects for malaria elimination in non-Amazonian regions of Latin America.

    PubMed

    Herrera, Sócrates; Quiñones, Martha Lucia; Quintero, Juan Pablo; Corredor, Vladimir; Fuller, Douglas O; Mateus, Julio Cesar; Calzada, Jose E; Gutierrez, Juan B; Llanos, Alejandro; Soto, Edison; Menendez, Clara; Wu, Yimin; Alonso, Pedro; Carrasquilla, Gabriel; Galinski, Mary; Beier, John C; Arévalo-Herrera, Myriam

    2012-03-01

    Latin America contributes 1-1.2 million clinical malaria cases to the global malaria burden of about 300 million per year. In 21 malaria endemic countries, the population at risk in this region represents less than 10% of the total population exposed worldwide. Factors such as rapid deforestation, inadequate agricultural practices, climate change, political instability, and both increasing parasite drug resistance and vector resistance to insecticides contribute to malaria transmission. Recently, several malaria endemic countries have experienced a significant reduction in numbers of malaria cases. This is most likely due to actions taken by National Malaria Control Programs (NMCP) with the support from international funding agencies. We describe here the research strategies and activities to be undertaken by the Centro Latino Americano de Investigación en Malaria (CLAIM), a new research center established for the non-Amazonian region of Latin America by the National Institute of Allergy and Infectious Diseases (NIAID). Throughout a network of countries in the region, initially including Colombia, Guatemala, Panama, and Peru, CLAIM will address major gaps in our understanding of changing malaria epidemiology, vector biology and control, and clinical malaria mainly due to Plasmodium vivax. In close partnership with NMCPs, CLAIM seeks to conduct research on how and why malaria is decreasing in many countries of the region as a basis for developing and implementing new strategies that will accelerate malaria elimination.

  6. Prospects for malaria elimination in non-Amazonian regions of Latin America.

    PubMed

    Herrera, Sócrates; Quiñones, Martha Lucia; Quintero, Juan Pablo; Corredor, Vladimir; Fuller, Douglas O; Mateus, Julio Cesar; Calzada, Jose E; Gutierrez, Juan B; Llanos, Alejandro; Soto, Edison; Menendez, Clara; Wu, Yimin; Alonso, Pedro; Carrasquilla, Gabriel; Galinski, Mary; Beier, John C; Arévalo-Herrera, Myriam

    2012-03-01

    Latin America contributes 1-1.2 million clinical malaria cases to the global malaria burden of about 300 million per year. In 21 malaria endemic countries, the population at risk in this region represents less than 10% of the total population exposed worldwide. Factors such as rapid deforestation, inadequate agricultural practices, climate change, political instability, and both increasing parasite drug resistance and vector resistance to insecticides contribute to malaria transmission. Recently, several malaria endemic countries have experienced a significant reduction in numbers of malaria cases. This is most likely due to actions taken by National Malaria Control Programs (NMCP) with the support from international funding agencies. We describe here the research strategies and activities to be undertaken by the Centro Latino Americano de Investigación en Malaria (CLAIM), a new research center established for the non-Amazonian region of Latin America by the National Institute of Allergy and Infectious Diseases (NIAID). Throughout a network of countries in the region, initially including Colombia, Guatemala, Panama, and Peru, CLAIM will address major gaps in our understanding of changing malaria epidemiology, vector biology and control, and clinical malaria mainly due to Plasmodium vivax. In close partnership with NMCPs, CLAIM seeks to conduct research on how and why malaria is decreasing in many countries of the region as a basis for developing and implementing new strategies that will accelerate malaria elimination. PMID:21781953

  7. Prospects for malaria elimination in non-Amazonian regions of Latin America

    PubMed Central

    Herrera, Sócrates; Quiñones, Martha Lucia; Quintero, Juan Pablo; Corredor, Vladimir; Fuller, Douglas O.; Mateus, Julio Cesar; Calzada, Jose E.; Gutierrez, Juan B.; Llanos, Alejandro; Soto, Edison; Menendez, Clara; Wu, Yimin; Alonso, Pedro; Carrasquilla, Gabriel; Galinski, Mary; Beier, John C.; Arevalo-Herrera, Myriam

    2011-01-01

    Latin America contributes 1 to 1.2 million clinical malaria cases to the global malaria burden of about 300 million per year. In 21 malaria endemic countries, the population at risk in this region represents less than 10% of the total population exposed worldwide. Factors such as rapid deforestation, inadequate agricultural practices, climate change, political instability, and both increasing parasite drug resistance and vector resistance to insecticides contribute to malaria transmission. Recently, several malaria endemic countries have experienced a significant reduction in numbers of malaria cases. This is most likely due to actions taken by National Malaria Control Programs (NMCP) with the support from international funding agencies. We describe here the research strategies and activities to be undertaken by the Centro Latino Americano de Investigación en Malaria (CLAIM), a new research center established for the non-Amazonian region of Latin America by the National Institute of Allergy and Infectious Diseases (NIAID). Throughout a network of countries in the region, initially including Colombia, Guatemala, Panama, and Peru, CLAIM will address major gaps in our understanding of changing malaria epidemiology, vector biology and control, and clinical malaria mainly due to Plasmodium vivax. In close partnership with NMCPs, CLAIM seeks to conduct research on how and why malaria is decreasing in many countries of the region as a basis for developing and implementing new strategies that will accelerate malaria elimination. PMID:21781953

  8. Barriers to Malaria Control among Marginalized Tribal Communities: A Qualitative Study

    PubMed Central

    Sundararajan, Radhika; Kalkonde, Yogeshwar; Gokhale, Charuta; Greenough, P. Gregg; Bang, Abhay

    2013-01-01

    Background Malaria infection accounts for over one million deaths worldwide annually. India has the highest number of malaria deaths outside Africa, with half among Indian tribal communities. Our study sought to identify barriers to malaria control within tribal populations in malaria-endemic Gadchiroli district, Maharashtra. Methods and Findings This qualitative study was conducted via focus groups and interviews with 84 participants, and included tribal villagers, traditional healers, community health workers (CHWs), medical officers, and district officials. Questions assessed knowledge about malaria, behavior during early stages of infection, and experiences with prevention among tribal villagers and traditional healers. CHWs, medical officers, and district officials were asked about barriers to treating and preventing malaria among tribal populations. Data were inductively analyzed and assembled into broader explanation linking barriers to geographical, cultural and social factors. Findings indicate lack of knowledge regarding malaria symptoms and transmission. Fever cases initially present to traditional healers or informal providers who have little knowledge of malaria or high-risk groups such as children and pregnant women. Tribal adherence with antimalarial medications is poor. Malaria prevention is inadequate, with low-density and inconsistent use of insecticide-treated nets (ITNs). Malaria educational materials are culturally inappropriate, relying on dominant language literacy. Remote villages and lack of transport complicate surveillance by CHWs. Costs of treating malaria outside the village are high. Conclusions Geographic, cultural, and social factors create barriers to malaria control among tribal communities in India. Efforts to decrease malaria burden among these populations must consider such realities. Our results suggest improving community-level knowledge about malaria using culturally-appropriate health education materials; making traditional

  9. A nation-wide malaria knowledge, attitudes and practices survey in Malawi: introduction.

    PubMed

    Wirima, J J

    1994-03-01

    In Malawi malaria is the most frequent cause of morbidity and mortality in children and pertinent hospitalizations have been increasing annually since 1982. In 1990, malaria and malaria-associated anemia constituted the leading cause of outpatient visits for all age groups and the leading cause of pediatric hospitalizations, and pediatric inpatient deaths. The Ministry of Health in Malawi has had a National Malaria Control Plan since 1985. This plan calls for improvement in: 1) awareness of malaria in the population; 2) accurate diagnosis; (3) effective and affordable treatment nationwide; 4) effective prevention for high risk groups; 5) clarification of feasibility of alternative methods of vector control; 6) improved training in diagnosis and management; 7) accurate reporting; 8) effective management at national, regional, and district levels; 9) improved ability to monitor and evaluate progress; and 10) increased government and donor investment in malaria control. The Ministry of Health undertook a national baseline survey to explore deficiencies in current malaria control practices, and also included a cost assessment of household expenditure on malaria. A number of articles document the results of this effort highlighting characteristics of malaria in Malawi and current control methods by the population. These aspects include: 1) malaria is perceived as a very important health problem: 2) prompt treatment with a full dosage of the recommended antimalarials occurs in less than 10% of febrile children; 3) a malaria prevention program based in antenatal clinics could provide affordable malaria prevention for most pregnant women; 4) few households use measures to prevent malaria which is largely associated with poverty: and 5) a high proportion of available household income is spent on malaria treatment or is lost to malaria illness. The Malawian situation is similar to that of neighboring nations, and it is hoped that they also embark on malaria control in their

  10. Knowledge, attitudes and practices of malaria in Colombia

    PubMed Central

    2014-01-01

    Background Although Colombia has witnessed an important decrease in malaria transmission, the disease remains a public health problem with an estimated ~10 million people currently living in areas with malaria risk and ~61,000 cases reported in 2012. This study aimed to determine and compare the level of knowledge, attitudes and practices (KAP) about malaria in three endemic communities of Colombia to provide the knowledge framework for development of new intervention strategies for malaria elimination. Methods A cross-sectional KAP survey was conducted in the municipalities of Tierralta, Buenaventura and Tumaco, categorized according to high risk (HR) and moderate risk (MR) based on the annual parasite index (API). Surveys were managed using REDCap and analysed using MATLAB and GraphPad Prism. Results A total of 267 residents, mostly women (74%) were surveyed. Although no differences were observed on the knowledge of classical malaria symptoms between HR and MR regions, significant differences were found in knowledge and attitudes about transmission mechanisms, anti-malarial use and malaria diagnosis. Most responders in both regions (93.5% in MR, and 94.3% in HR areas) indicated use of insecticide-treated nets (ITNs) to protect themselves from malaria, and 75.5% of responders in HR indicated they did nothing to prevent malaria transmission outdoors. Despite a high level of knowledge in the study regions, significant gaps persisted relating to practices. Self-medication and poor adherence to treatment, as well as lack of both indoor and outdoor vector control measures, were significantly associated with higher malaria risk. Conclusions Although significant efforts are currently being made by the Ministry of Health to use community education as one of the main components of the control strategy, these generic education programmes may not be applicable to all endemic regions of Colombia given the substantial geographic, ethnic and cultural diversity. PMID:24885909

  11. Estimating malaria burden in Nigeria: a geostatistical modelling approach.

    PubMed

    Onyiri, Nnadozie

    2015-01-01

    This study has produced a map of malaria prevalence in Nigeria based on available data from the Mapping Malaria Risk in Africa (MARA) database, including all malaria prevalence surveys in Nigeria that could be geolocated, as well as data collected during fieldwork in Nigeria between March and June 2007. Logistic regression was fitted to malaria prevalence to identify significant demographic (age) and environmental covariates in STATA. The following environmental covariates were included in the spatial model: the normalized difference vegetation index, the enhanced vegetation index, the leaf area index, the land surface temperature for day and night, land use/landcover (LULC), distance to water bodies, and rainfall. The spatial model created suggests that the two main environmental covariates correlating with malaria presence were land surface temperature for day and rainfall. It was also found that malaria prevalence increased with distance to water bodies up to 4 km. The malaria risk map estimated from the spatial model shows that malaria prevalence in Nigeria varies from 20% in certain areas to 70% in others. The highest prevalence rates were found in the Niger Delta states of Rivers and Bayelsa, the areas surrounding the confluence of the rivers Niger and Benue, and also isolated parts of the north-eastern and north-western parts of the country. Isolated patches of low malaria prevalence were found to be scattered around the country with northern Nigeria having more such areas than the rest of the country. Nigeria's belt of middle regions generally has malaria prevalence of 40% and above. PMID:26618305

  12. Tackling Imported Malaria: An Elimination Endgame

    PubMed Central

    Sturrock, Hugh J. W.; Roberts, Kathryn W.; Wegbreit, Jennifer; Ohrt, Colin; Gosling, Roly D.

    2015-01-01

    As countries move toward malaria elimination, imported infections become increasingly significant as they often represent the majority of cases, can sustain transmission, cause resurgences, and lead to mortality. Here we review and critique current methods to prevent malaria importation in countries pursuing elimination and explore methods applied in other transmission settings and to other diseases that could be transferred to support malaria elimination. To improve intervention targeting we need a better understanding of the characteristics of populations importing infections and their patterns of migration, improved methods to reliably classify infections as imported or acquired locally, and ensure early and accurate diagnosis. The potential for onward transmission in the most receptive and vulnerable locations can be predicted through high-resolution risk mapping that can help malaria elimination or prevention of reintroduction programs target resources. Cross border and regional initiatives can be highly effective when based on an understanding of human and parasite movement. Ultimately, determining the optimal combinations of approaches to address malaria importation will require an evaluation of their impact, cost effectiveness, and operational feasibility. PMID:26013369

  13. EMIRA: Ecologic Malaria Reduction for Africa – innovative tools for integrated malaria control

    PubMed Central

    Dambach, Peter; Traoré, Issouf; Becker, Norbert; Kaiser, Achim; Sié, Ali; Sauerborn, Rainer

    2014-01-01

    Background Malaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticide treated nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). A third pillar in the fight against the malaria vector, larval source management (LSM), has virtually not been used in Africa since the ban of DDT in the 1960s. Within the light of recent WHO recommendations for Bacillus thuringiensis israelensis (Bti) use against malaria and other vector species, larval source management could see a revival in the upcoming years. In this project we analyze the ecologic and health impacts as well as the cost effectiveness of larval source management under different larviciding scenarios in a health district in Burkina Faso. Methods The project is designed as prospective intervention study with duration of three years (2013–2015). Its spatial scale includes three arms of interventions and control, comprising a total of 127 villages and the district capital Nouna in the extended HDSS (Health Demographic Surveillance System) of the Kossi province. Baseline data on mosquito abundance, parasitemia in U5 children, and malaria related morbidity and mortality are gathered over the project duration. Besides the outcome on ecologic and health parameters, the economic costs are seized and valued against the achieved health benefits. Conclusions Risk map based, guided larvicide application might be a possibility to further decrease economic cost of LSM and facilitate its faster incorporation to integrated malaria control programs. Given the limited resources in many malaria endemic countries, it is of utmost importance to relate the costs of novel strategies for malaria prevention to their effect on the burden of the disease. Occurring costs and the impact on the health situation will be made comparable to other, existing intervention strategies, allowing stakeholders and

  14. Inpatient Mortality in Children With Clinically Diagnosed Malaria As Compared With Microscopically Confirmed Malaria

    PubMed Central

    Opoka, Robert O.; Xia, Zongqi; Bangirana, Paul; John, Chandy C.

    2008-01-01

    Background Inpatient treatment for malaria without microscopic confirmation of the diagnosis occurs commonly in sub-Saharan Africa. Differences in mortality in children who are tested by microscopy for Plasmodium falciparum infection as compared with those not tested are not well characterized. Methods A retrospective chart review was conducted of all children up to 15 years of age admitted to Mulago Hospital, Kampala, Uganda from January 2002 to July 2005, with a diagnosis of malaria and analyzed according to microscopy testing for P. falciparum. Results A total of 23,342 children were treated for malaria during the study period, 991 (4.2%) of whom died. Severe malarial anemia in 7827 (33.5%) and cerebral malaria in 1912 (8.2%) were the 2 common causes of malaria-related admissions. Children who did not receive microscopy testing had a higher case fatality rate than those with a positive blood smear (7.5% versus 3.2%, P < 0.001). After adjustment for age, malaria complications, and comorbid conditions, children who did not have microscopy performed or had a negative blood smear had a higher risk of death than those with a positive blood smear [odds ratio (OR): 3.49, 95% confidence interval (CI): 2.88–4.22, P < 0.001; and OR: 1.59, 95% CI: 1.29–1.96, P < 0.001, respectively]. Conclusions Diagnosis of malaria in the absence of microscopic confirmation is associated with significantly increased mortality in hospitalized Ugandan children. Inpatient diagnosis of malaria should be supported by microscopic or rapid diagnostic test confirmation. PMID:18316995

  15. A review of malaria transmission dynamics in forest ecosystems.

    PubMed

    Kar, Narayani Prasad; Kumar, Ashwani; Singh, Om P; Carlton, Jane M; Nanda, Nutan

    2014-06-09

    Malaria continues to be a major health problem in more than 100 endemic countries located primarily in tropical and sub-tropical regions around the world. Malaria transmission is a dynamic process and involves many interlinked factors, from uncontrollable natural environmental conditions to man-made disturbances to nature. Almost half of the population at risk of malaria lives in forest areas. Forests are hot beds of malaria transmission as they provide conditions such as vegetation cover, temperature, rainfall and humidity conditions that are conducive to distribution and survival of malaria vectors. Forests often lack infrastructure and harbor tribes with distinct genetic traits, socio-cultural beliefs and practices that greatly influence malaria transmission dynamics. Here we summarize the various topographical, entomological, parasitological, human ecological and socio-economic factors, which are crucial and shape malaria transmission in forested areas. An in-depth understanding and synthesis of the intricate relationship of these parameters in achieving better malaria control in various types of forest ecosystems is emphasized.

  16. Malaria Distribution, Prevalence, Drug Resistance and Control in Indonesia

    PubMed Central

    Elyazar, Iqbal R.F.; Hay, Simon I.; Baird, J. Kevin

    2011-01-01

    Approximately 230 million people live in Indonesia. The country is also home to over 20 anopheline vectors of malaria which transmit all four of the species of Plasmodium that routinely infect humans. A complex mosaic of risk of infection across this 5000-km-long archipelago of thousands of islands and distinctive habitats seriously challenges efforts to control malaria. Social, economic and political dimensions contribute to these complexities. This chapter examines malaria and its control in Indonesia, from the earliest efforts by malariologists of the colonial Netherlands East Indies, through the Global Malaria Eradication Campaign of the 1950s, the tumult following the coup d’état of 1965, the global resurgence of malaria through the 1980s and 1990s and finally through to the decentralization of government authority following the fall of the authoritarian Soeharto regime in 1998. We detail important methods of control and their impact in the context of the political systems that supported them. We examine prospects for malaria control in contemporary decentralized and democratized Indonesia with multidrug-resistant malaria and greatly diminished capacities for integrated malaria control management programs. PMID:21295677

  17. Malaria distribution, prevalence, drug resistance and control in Indonesia.

    PubMed

    Elyazar, Iqbal R F; Hay, Simon I; Baird, J Kevin

    2011-01-01

    Approximately 230 million people live in Indonesia. The country is also home to over 20 anopheline vectors of malaria which transmit all four of the species of Plasmodium that routinely infect humans. A complex mosaic of risk of infection across this 5000-km-long archipelago of thousands of islands and distinctive habitats seriously challenges efforts to control malaria. Social, economic and political dimensions contribute to these complexities. This chapter examines malaria and its control in Indonesia, from the earliest efforts by malariologists of the colonial Netherlands East Indies, through the Global Malaria Eradication Campaign of the 1950s, the tumult following the coup d'état of 1965, the global resurgence of malaria through the 1980s and 1990s and finally through to the decentralization of government authority following the fall of the authoritarian Soeharto regime in 1998. We detail important methods of control and their impact in the context of the political systems that supported them. We examine prospects for malaria control in contemporary decentralized and democratized Indonesia with multidrug-resistant malaria and greatly diminished capacities for integrated malaria control management programs. PMID:21295677

  18. A review of malaria transmission dynamics in forest ecosystems

    PubMed Central

    2014-01-01

    Malaria continues to be a major health problem in more than 100 endemic countries located primarily in tropical and sub-tropical regions around the world. Malaria transmission is a dynamic process and involves many interlinked factors, from uncontrollable natural environmental conditions to man-made disturbances to nature. Almost half of the population at risk of malaria lives in forest areas. Forests are hot beds of malaria transmission as they provide conditions such as vegetation cover, temperature, rainfall and humidity conditions that are conducive to distribution and survival of malaria vectors. Forests often lack infrastructure and harbor tribes with distinct genetic traits, socio-cultural beliefs and practices that greatly influence malaria transmission dynamics. Here we summarize the various topographical, entomological, parasitological, human ecological and socio-economic factors, which are crucial and shape malaria transmission in forested areas. An in-depth understanding and synthesis of the intricate relationship of these parameters in achieving better malaria control in various types of forest ecosystems is emphasized. PMID:24912923

  19. Does malaria epidemiology project Cameroon as 'Africa in miniature'?

    PubMed

    Mbenda, Huguette Gaelle Ngassa; Awasthi, Gauri; Singh, Poonam K; Gouado, Inocent; Das, Aparup

    2014-09-01

    Cameroon, a west-central African country with a ~ 20 million population, is commonly regarded as 'Africa in miniature' due to the extensive biological and cultural diversities of whole Africa being present in a single-country setting. This country is inhabited by ancestral human lineages in unique eco-climatic conditions and diverse topography. Over 90 percent Cameroonians are at risk of malaria infection, and ~ 41 percent have at least one episode of malaria each year. Historically, the rate of malaria infection in Cameroon has fluctuated over the years; the number of cases was about 2 million in 2010 and 2011. The Cameroonian malaria control programme faces an uphill task due to high prevalence of multidrug-resistant parasites and insecticide-resistant malaria vectors. Above all, continued human migration from the rural to urban areas as well as population exchange with adjoining countries, high rate of ecological instabilities caused by deforestation, poor housing, lack of proper sanitation and drainage system might have resulted in the recent increase in incidences of malaria and other vector-borne diseases in Cameroon. The available data on eco-environmental variability and intricate malaria epidemiology in Cameroon reflect the situation in the whole of Africa, and warrant the need for in-depth study by using modern surveillance tools for meaningful basic understanding of the malaria triangle (host-parasite-vector-environment). PMID:25116627

  20. Neurological manifestations of malaria.

    PubMed

    Román, G C; Senanayake, N

    1992-03-01

    The involvement of the nervous system in malaria is reviewed in this paper. Cerebral malaria, the acute encephalopathy which complicates exclusively the infection by Plasmodium falciparum commonly affects children and adolescents in hyperendemic areas. Plugging of cerebral capillaries and venules by clumped, parasitized red cells causing sludging in the capillary circulation is one hypothesis to explain its pathogenesis. The other is a humoral hypothesis which proposes nonspecific, immune-mediated, inflammatory responses with release of vasoactive substances capable of producing endothelial damage and alterations of permeability. Cerebral malaria has a mortality rate up to 50%, and also a considerable longterm morbidity, particularly in children. Hypoglycemia, largely in patients treated with quinine, may complicate the cerebral symptomatology. Other central nervous manifestations of malaria include intracranial hemorrhage, cerebral arterial occlusion, and transient extrapyramidal and neuropsychiatric manifestations. A self-limiting, isolated cerebellar ataxia, presumably caused by immunological mechanisms, in patients recovering from falciparum malaria has been recognized in Sri Lanka. Malaria is a common cause of febrile seizures in the tropics, and it also contributes to the development of epilepsy in later life. Several reports of spinal cord and peripheral nerve involvement are also available. A transient muscle paralysis resembling periodic paralysis during febrile episodes of malaria has been described in some patients. The pathogenesis of these neurological manifestations remains unexplored, but offers excellent perspectives for research at a clinical as well as experimental level. PMID:1307475

  1. The potential effects of climate change on malaria in tropical Africa using regionalised climate projections

    NASA Astrophysics Data System (ADS)

    Ermert, V.; Fink, A. H.; Paeth, H.; Morse, A. P.

    2012-04-01

    The projected climate change will probably alter the range and transmission potential of malaria in Africa. The potential impacts of climate change on the malaria distribution is assessed for tropical Africa. Bias-corrected regional climate projections with a horizontal resolution of 0.5° are used from the Regional Model (REMO), which include land use and land cover changes. The malaria models employed are the 2010 version of the Liverpool Malaria Model (LMM2010), the Garki model, the Plasmodium falciparum infection model from Smith et al. (2005) (S2005), and the Malaria Seasonality Model (MSM) from the Mapping Malaria Risk in Africa project. The results of the models are compared with data from the Malaria Atlas Project (MAP) and novel validation procedures for the LMM2010 and MSM lend more credence to their results. For climate scenarios A1B and B1 and for 2001-2050, REMO projects an overall drying and warming trend in the African malaria belt, that is largely imposed by the man-made degradation of vegetation. As a result, the malaria projections show a decreased malaria spread in West Africa. The northern Sahel is no more suitable for malaria in the projections. More unstable malaria transmission and shorter malaria seasons are expected for various areas farther south. An increase in the malaria epidemic risk is found for more densely populated areas in the southern part of the Sahel. In East Africa, higher temperatures and nearly unchanged precipitation patterns lead to longer transmission seasons and an increase in the area of highland malaria. For altitudes up to 2000 m the malaria transmission stabilises and the epidemic risk is reduced but for higher altitudes the risk of malaria epidemics is increased. The results of the more complex and simple malaria models are similar to each other. However, a different response to the warming of highlands is found for the LMM2010 and MSM. This shows the requirement of a multi model uncertainty analysis for the

  2. University Rankings and Social Science

    ERIC Educational Resources Information Center

    Marginson, Simon

    2014-01-01

    University rankings widely affect the behaviours of prospective students and their families, university executive leaders, academic faculty, governments and investors in higher education. Yet the social science foundations of global rankings receive little scrutiny. Rankings that simply recycle reputation without any necessary connection to real…

  3. Malaria and Vascular Endothelium

    PubMed Central

    de Alencar, Aristóteles Comte; de Lacerda, Marcus Vinícius Guimarães; Okoshi, Katashi; Okoshi, Marina Politi

    2014-01-01

    Involvement of the cardiovascular system in patients with infectious and parasitic diseases can result from both intrinsic mechanisms of the disease and drug intervention. Malaria is an example, considering that the endothelial injury by Plasmodium-infected erythrocytes can cause circulatory disorders. This is a literature review aimed at discussing the relationship between malaria and endothelial impairment, especially its effects on the cardiovascular system. We discuss the implications of endothelial aggression and the interdisciplinarity that should guide the malaria patient care, whose acute infection can contribute to precipitate or aggravate a preexisting heart disease. PMID:25014058

  4. The Validity of Rapid Malaria Test and Microscopy in Detecting Malaria in a Preelimination Region of Egypt

    PubMed Central

    Kamel, Maysa Mohamed; Attia, Samar Sayed; Emam, Gomaa Desoky; Al Sherbiny, Naglaa Abd El Khalek

    2016-01-01

    Background. Malaria is a leading cause of morbidity and mortality worldwide. Rapid and accurate diagnosis of malaria would improve control measures and reduce morbidity and mortality. Objective. The aim of this study was to assess the prevalence of malaria in high risk foci in Egypt and the effectiveness of rapid diagnostic tests in diagnosis and subsequently control of malaria. Methodology. A total number of 600 cases of both sexes with different ages were included in the present study. Cases were included in 2 groups; first group (500 cases) were randomly selected from households in Fayoum Governorate and second group (100 cases) were admitted to Fayoum Fever Hospital with signs suggestive of malaria. Cases were subjected to detailed history taking, clinical examination, microscopic examination of thin and thick blood films, and immunological test to detect plasmodial antigens. Results. A total of 3 positive cases were detected by rapid diagnostic tests (RDTs). Out of these 3 cases, one case was positive for malaria parasite by microscopic examination of blood films. All positive cases in the study had history of travel to malaria endemic areas. Conclusion. RDTs are simple and effective for rapid diagnosis of malaria to help in implication of control measures in different localities. PMID:27088038

  5. Modeling Area-Level Health Rankings

    PubMed Central

    Courtemanche, Charles; Soneji, Samir; Tchernis, Rusty

    2015-01-01

    Objective Rank county health using a Bayesian factor analysis model. Data Sources Secondary county data from the National Center for Health Statistics (through 2007) and Behavioral Risk Factor Surveillance System (through 2009). Study Design Our model builds on the existing county health rankings (CHRs) by using data-derived weights to compute ranks from mortality and morbidity variables, and by quantifying uncertainty based on population, spatial correlation, and missing data. We apply our model to Wisconsin, which has comprehensive data, and Texas, which has substantial missing information. Data Collection Methods The data were downloaded from www.countyhealthrankings.org. Principal Findings Our estimated rankings are more similar to the CHRs for Wisconsin than Texas, as the data-derived factor weights are closer to the assigned weights for Wisconsin. The correlations between the CHRs and our ranks are 0.89 for Wisconsin and 0.65 for Texas. Uncertainty is especially severe for Texas given the state's substantial missing data. Conclusions The reliability of comprehensive CHRs varies from state to state. We advise focusing on the counties that remain among the least healthy after incorporating alternate weighting methods and accounting for uncertainty. Our results also highlight the need for broader geographic coverage in health data. PMID:26256684

  6. Syncytiotrophoblast Functions and Fetal Growth Restriction during Placental Malaria: Updates and Implication for Future Interventions

    PubMed Central

    Kidima, Winifrida B.

    2015-01-01

    Syncytiotrophoblast lines the intervillous space of the placenta and plays important roles in fetus growth throughout gestation. However, perturbations at the maternal-fetal interface during placental malaria may possibly alter the physiological functions of syncytiotrophoblast and therefore growth and development of the embryo in utero. An understanding of the influence of placental malaria on syncytiotrophoblast function is paramount in developing novel interventions for the control of placental pathology associated with placental malaria. In this review, we discuss how malaria changes syncytiotrophoblast function as evidenced from human, animal, and in vitro studies and, further, how dysregulation of syncytiotrophoblast function may impact fetal growth in utero. We also formulate a hypothesis, stemming from epidemiological observations, that nutrition may override pathogenesis of placental malaria-associated-fetal growth restriction. We therefore recommend studies on nutrition-based-interventional approaches for high placental malaria-risk women in endemic areas. More investigations on the role of nutrition on placental malaria pathogenesis are needed. PMID:26587536

  7. Malaria outbreak among French army troops returning from the Ivory Coast.

    PubMed

    Mayet, Aurélie; Lacassagne, David; Juzan, Nicolas; Chaudier, Bernard; Haus-Cheymol, Rachel; Berger, Franck; Romand, Olivier; Ollivier, Lénaick; Verret, Catherine; Deparis, Xavier; Spiegel, André

    2010-01-01

    In 2006, a French Army unit reported 39 malaria cases among service persons returning from Ivory Coast. Thirty, including three serious forms, occurred after the return to France. The risk of post-return malaria was higher than the risk in Ivory Coast. Half of the imported cases had stopped post-return chemoprophylaxis early.

  8. SRS: Site ranking system for hazardous chemical and radioactive waste

    SciTech Connect

    Rechard, R.P.; Chu, M.S.Y.; Brown, S.L.

    1988-05-01

    This report describes the rationale and presents instructions for a site ranking system (SRS). SRS ranks hazardous chemical and radioactive waste sites by scoring important and readily available factors that influence risk to human health. Using SRS, sites can be ranked for purposes of detailed site investigations. SRS evaluates the relative risk as a combination of potentially exposed population, chemical toxicity, and potential exposure of release from a waste site; hence, SRS uses the same concepts found in a detailed assessment of health risk. Basing SRS on the concepts of risk assessment tends to reduce the distortion of results found in other ranking schemes. More importantly, a clear logic helps ensure the successful application of the ranking procedure and increases its versatility when modifications are necessary for unique situations. Although one can rank sites using a detailed risk assessment, it is potentially costly because of data and resources required. SRS is an efficient approach to provide an order-of-magnitude ranking, requiring only readily available data (often only descriptive) and hand calculations. Worksheets are included to make the system easier to understand and use. 88 refs., 19 figs., 58 tabs.

  9. Malaria Early Warning: The MalarSat project

    NASA Astrophysics Data System (ADS)

    Roca, M.; Escorihuela, M. J.; Martínez, D.; Torrent, M.; Aponte, J.; Nunez, F.; Garcia, J.

    2009-04-01

    Malaria is one of the major public health challenges undermining development in the world. The aim of MalarSat Project is to provide a malaria risks infection maps at global scale using Earth Observation data to support and prevent epidemic episodes. The proposed service for creating malaria risk maps would be critically useful to improve the efficiency in insecticide programs, vaccine campaigns and the logistics epidemic treatment. Different teams have already carried out studies in order to exploit the use of Earth Observation (EO) data with epidemiology purposes. In the case of malaria risk maps, it has been shown that meteorological data is not sufficient to fulfill this objective. In particular being able to map the malaria mosquito habitat would increase the accuracy of risk maps. The malaria mosquitoes mainly reproduce in new water puddles of very reduced dimensions (about 1 meter wide). There is no instrument that could detect such small patches of water unless there are many of them spread in an area of several hundreds of meters. MalarSat aims at using the radar altimeter data from the EnviSat, RA-2, to try and build indicators of mosquitoes existence. This presentation will show the scientific objectives and principles of the MalarSat project.

  10. Cost of malaria control in China: Henan's consolidation programme from community and government perspectives.

    PubMed Central

    Jackson, Sukhan; Sleigh, Adrian C.; Liu, Xi-Li

    2002-01-01

    OBJECTIVE: To assist with strategic planning for the eradication of malaria in Henan Province, China, which reached the consolidation phase of malaria control in 1992, when only 318 malaria cases were reported. METHODS: We conducted a prospective two-year study of the costs for Henan's malaria control programme. We used a cost model that could also be applied to other malaria programmes in mainland China, and analysed the cost of the three components of Henan's malaria programme: suspected malaria case management, vector surveillance, and population blood surveys. Primary cost data were collected from the government, and data on suspected malaria patients were collected in two malaria counties (population 2 093 100). We enlisted the help of 260 village doctors in six townships or former communes (population 247 762), and studied all 12 325 reported cases of suspected malaria in their catchment areas in 1994 and 1995. FINDINGS: The average annual government investment in malaria control was estimated to be US$ 111 516 (case-management 59%; active blood surveys 25%; vector surveillance 12%; and contingencies and special projects 4%). The average cost (direct and indirect) for patients seeking treatment for suspected malaria was US$ 3.48, equivalent to 10 days' income for rural residents. Each suspected malaria case cost the government an average of US$ 0.78. CONCLUSION: Further cuts in government funding will increase future costs when epidemic malaria returns; investment in malaria control should therefore continue at least at current levels of US$ 0.03 per person at risk. PMID:12219157

  11. Costs of Eliminating Malaria and the Impact of the Global Fund in 34 Countries

    PubMed Central

    Zelman, Brittany; Kiszewski, Anthony; Cotter, Chris; Liu, Jenny

    2014-01-01

    Background International financing for malaria increased more than 18-fold between 2000 and 2011; the largest source came from The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). Countries have made substantial progress, but achieving elimination requires sustained finances to interrupt transmission and prevent reintroduction. Since 2011, global financing for malaria has declined, fueling concerns that further progress will be impeded, especially for current malaria-eliminating countries that may face resurgent malaria if programs are disrupted. Objectives This study aims to 1) assess past total and Global Fund funding to the 34 current malaria-eliminating countries, and 2) estimate their future funding needs to achieve malaria elimination and prevent reintroduction through 2030. Methods Historical funding is assessed against trends in country-level malaria annual parasite incidences (APIs) and income per capita. Following Kizewski et al. (2007), program costs to eliminate malaria and prevent reintroduction through 2030 are estimated using a deterministic model. The cost parameters are tailored to a package of interventions aimed at malaria elimination and prevention of reintroduction. Results The majority of Global Fund-supported countries experiencing increases in total funding from 2005 to 2010 coincided with reductions in malaria APIs and also overall GNI per capita average annual growth. The total amount of projected funding needed for the current malaria-eliminating countries to achieve elimination and prevent reintroduction through 2030 is approximately US$8.5 billion, or about $1.84 per person at risk per year (PPY) (ranging from $2.51 PPY in 2014 to $1.43 PPY in 2030). Conclusions Although external donor funding, particularly from the Global Fund, has been key for many malaria-eliminating countries, sustained and sufficient financing is critical for furthering global malaria elimination. Projected cost estimates for elimination provide

  12. [Malaria and life at sea: prophylactic regimens on merchant ships].

    PubMed

    Michot, S

    2011-02-01

    The purpose of this article is to describe requirements for protection/treatment of malaria on merchant ships. The first part of the article reviews recent data on the incidence of malaria in seagoing personnel. The second part provides advice on mosquito-bite prevention on merchant ships. The third part presents the most important information on prophylaxis for seafarers working in malarial risk areas. Several regimens are proposed. The last part of the article discusses curative treatment for malaria on merchant ships. PMID:21585106

  13. Cluster of Imported Vivax Malaria in Travelers Returning From Peru.

    PubMed

    Weitzel, Thomas; Labarca, Jaime; Cortes, Claudia P; Rosas, Reinaldo; Balcells, M Elvira; Perret, Cecilia

    2015-01-01

    We report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis. PMID:26354673

  14. Cluster of Imported Vivax Malaria in Travelers Returning From Peru.

    PubMed

    Weitzel, Thomas; Labarca, Jaime; Cortes, Claudia P; Rosas, Reinaldo; Balcells, M Elvira; Perret, Cecilia

    2015-01-01

    We report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis.

  15. Exploring the relationship between malaria, rainfall intermittency, and spatial variation in rainfall seasonality

    NASA Astrophysics Data System (ADS)

    Merkord, C. L.; Wimberly, M. C.; Henebry, G. M.; Senay, G. B.

    2014-12-01

    Malaria is a major public health problem throughout tropical regions of the world. Successful prevention and treatment of malaria requires an understanding of the environmental factors that affect the life cycle of both the malaria pathogens, protozoan parasites, and its vectors, anopheline mosquitos. Because the egg, larval, and pupal stages of mosquito development occur in aquatic habitats, information about the spatial and temporal distribution of rainfall is critical for modeling malaria risk. Potential sources of hydrological data include satellite-derived rainfall estimates (TRMM and GPM), evapotranspiration derived from a simplified surface energy balance, and estimates of soil moisture and fractional water cover from passive microwave imagery. Previous studies have found links between malaria cases and total monthly or weekly rainfall in areas where both are highly seasonal. However it is far from clear that monthly or weekly summaries are the best metrics to use to explain malaria outbreaks. It is possible that particular temporal or spatial patterns of rainfall result in better mosquito habitat and thus higher malaria risk. We used malaria case data from the Amhara region of Ethiopia and satellite-derived rainfall estimates to explore the relationship between malaria outbreaks and rainfall with the goal of identifying the most useful rainfall metrics for modeling malaria occurrence. First, we explored spatial variation in the seasonal patterns of both rainfall and malaria cases in Amhara. Second, we assessed the relative importance of different metrics of rainfall intermittency, including alternation of wet and dry spells, the strength of intensity fluctuations, and spatial variability in these measures, in determining the length and severity of malaria outbreaks. We also explored the sensitivity of our results to the choice of method for describing rainfall intermittency and the spatial and temporal scale at which metrics were calculated. Results

  16. [THE CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF MALARIA CONCURRENT WITH OTHER INFECTIONS AND INVASIONS].

    PubMed

    Kondrashin, A V; Tokmalaev, A K; Morozov, E N; Morozova, L F

    2016-01-01

    The present review considers malaria infection concurrent with different species of helminths, bacterial and viral infections, as well as mixed malaria pathogens in the subtropical and tropical countries of the world, causing the clinical picture and epidemiological situation to be different. Malaria co-infections with different pathogenic micro-organisms, such as HIV, tuberculosis, viral hepatitides, and others, affect almost one third of the planet's population. It is known that people who are at risk for malaria may be also at risk for other parasitic and infectious diseases, most commonly helminthisms. PMID:27405219

  17. Vivax Malaria: A Major Cause of Morbidity in Early Infancy

    PubMed Central

    Poespoprodjo, Jeanne R.; Fobia, Wendelina; Kenangalem, Enny; Lampah, Daniel A.; Hasanuddin, Afdal; Warikar, Noah; Sugiarto, Paulus; Tjitra, Emiliana; Anstey, Nick M.; Price, Ric N.

    2015-01-01

    Background In areas where malaria is endemic, infants aged <3 months appear to be relatively protected from symptomatic and severe Plasmodium falciparum malaria, but less is known about the effect of Plasmodium vivax infection in this age group. Methods To define malaria morbidity in the first year of life in an area where both multidrug-resistant P. falciparum and P. vivax are highly prevalent, data were gathered on all infants attending a referral hospital in Papua, Indonesia, using systematic data forms and hospital computerized records. Additional clinical and laboratory data were prospectively collected from inpatients aged <3 months. Results From April 2004 through April 2008, 4976 infants were admitted to the hospital, of whom 1560 (31%) had malaria, with infection equally attributable to P. falciparum and P. vivax. The case-fatality rate was similar for inpatients with P. falciparum malaria (13 [2.2%] of 599 inpatients died) and P. vivax malaria (6 [1.0%] of 603 died; P = .161), whereas severe malarial anemia was more prevalent among those with P. vivax malaria (193 [32%] of 605 vs. 144 [24%] of 601; P = .025). Of the 187 infants aged <3 months, 102 (56%) had P. vivax malaria, and 55 (30%) had P. falciparum malaria. In these young infants, infection with P. vivax was associated with a greater risk of severe anemia (odds ratio, 2.4; 95% confidence interval, 1.03–5.91; P = .041) and severe thrombocytopenia (odds ratio, 3.3; 95% confidence interval, 1.07–10.6; P = .036) compared with those who have P. falciparum infection. Conclusions P. vivax malaria is a major cause of morbidity in early infancy. Preventive strategies, early diagnosis, and prompt treatment should be initiated in the perinatal period. PMID:19438395

  18. Malaria and Age Variably but Critically Control Hepcidin Throughout Childhood in Kenya

    PubMed Central

    Atkinson, Sarah H.; Uyoga, Sophie M.; Armitage, Andrew E.; Khandwala, Shivani; Mugyenyi, Cleopatra K.; Bejon, Philip; Marsh, Kevin; Beeson, James G.; Prentice, Andrew M.; Drakesmith, Hal; Williams, Thomas N.

    2015-01-01

    Both iron deficiency (ID) and malaria are common among African children. Studies show that the iron-regulatory hormone hepcidin is induced by malaria, but few studies have investigated this relationship longitudinally. We measured hepcidin concentrations, markers of iron status, and antibodies to malaria antigens during two cross-sectional surveys within a cohort of 324 Kenyan children ≤ 8 years old who were under intensive surveillance for malaria and other febrile illnesses. Hepcidin concentrations were the highest in the youngest, and female infants, declined rapidly in infancy and more gradually thereafter. Asymptomatic malaria and malaria antibody titres were positively associated with hepcidin concentrations. Recent episodes of febrile malaria were associated with high hepcidin concentrations that fell over time. Hepcidin concentrations were not associated with the subsequent risk of either malaria or other febrile illnesses. Given that iron absorption is impaired by hepcidin, our data suggest that asymptomatic and febrile malaria contribute to the high burden of ID seen in African children. Further, the effectiveness of iron supplementation may be sub-optimal in the presence of asymptomatic malaria. Thus, strategies to prevent and eliminate malaria may have the added benefit of addressing an important cause of ID for African children. PMID:26629542

  19. Early detection and monitoring of Malaria

    NASA Astrophysics Data System (ADS)

    Rahman, Md Z.; Roytman, Leonid; Kadik, Abdelhamid; Miller, Howard; Rosy, Dilara A.

    2015-05-01

    Global Earth Observation Systems of Systems (GEOSS) are bringing vital societal benefits to people around the globe. In this research article, we engage undergraduate students in the exciting area of space exploration to improve the health of millions of people globally. The goal of the proposed research is to place students in a learning environment where they will develop their problem solving skills in the context of a world crisis (e.g., malaria). Malaria remains one of the greatest threats to public health, particularly in developing countries. The World Health Organization has estimated that over one million die of Malaria each year, with more than 80% of these found in Sub-Saharan Africa. The mosquitoes transmit malaria. They breed in the areas of shallow surface water that are suitable to the mosquito and parasite development. These environmental factors can be detected with satellite imagery, which provide high spatial and temporal coverage of the earth's surface. We investigate on moisture, thermal and vegetation stress indicators developed from NOAA operational environmental satellite data. Using these indicators and collected epidemiological data, it is possible to produce a forecast system that can predict the risk of malaria for a particular geographical area with up to four months lead time. This valuable lead time information provides an opportunity for decision makers to deploy the necessary preventive measures (spraying, treated net distribution, storing medications and etc) in threatened areas with maximum effectiveness. The main objective of the proposed research is to study the effect of ecology on human health and application of NOAA satellite data for early detection of malaria.

  20. The burden of malaria in pregnancy in malaria-endemic areas.

    PubMed

    Steketee, R W; Nahlen, B L; Parise, M E; Menendez, C

    2001-01-01

    Pregnant women in malarious areas may experience a variety of adverse consequences from malaria infection including maternal anemia, placental accumulation of parasites, low birth weight (LBW) from prematurity and intrauterine growth retardation (IUGR), fetal parasite exposure and congenital infection, and infant mortality (IM) linked to preterm-LBW and IUGR-LBW. We reviewed studies between 1985 and 2000 and summarized the malaria population attributable risk (PAR) that accounts for both the prevalence of the risk factors in the population and the magnitude of the associated risk for anemia, LBW, and IM. Consequences from anemia and human immunodeficiency virus infection in these studies were also considered. Population attributable risks were substantial: malaria was associated with anemia (PAR range = 3-15%), LBW (8-14%), preterm-LBW (8-36%), IUGR-LBW (13-70%), and IM (3-8%). Human immunodeficiency virus was associated with anemia (PAR range = 12-14%), LBW (11-38%), and direct transmission in 20-40% of newborns, with direct mortality consequences. Maternal anemia was associated with LBW (PAR range = 7-18%), and fetal anemia was associated with increased IM (PAR not available). We estimate that each year 75,000 to 200,000 infant deaths are associated with malaria infection in pregnancy. The failure to apply known effective antimalarial interventions through antenatal programs continues to contribute substantially to infant deaths globally.

  1. A co-infection model of malaria and cholera diseases with optimal control.

    PubMed

    Okosun, K O; Makinde, O D

    2014-12-01

    In this paper we formulate a mathematical model for malaria-cholera co-infection in order to investigate their synergistic relationship in the presence of treatments. We first analyze the single infection steady states, calculate the basic reproduction number and then investigate the existence and stability of equilibria. We then analyze the co-infection model, which is found to exhibit backward bifurcation. The impact of malaria and its treatment on the dynamics of cholera is further investigated. Secondly, we incorporate time dependent controls, using Pontryagin's Maximum Principle to derive necessary conditions for the optimal control of the disease. We found that malaria infection may be associated with an increased risk of cholera but however, cholera infection is not associated with an increased risk for malaria. Therefore, to effectively control malaria, the malaria intervention strategies by policy makers must at the same time also include cholera control.

  2. Importance of adequate local spatiotemporal transmission measures in malaria cohort studies: application to the relation between placental malaria and first malaria infection in infants.

    PubMed

    Le Port, Agnès; Cottrell, Gilles; Chandre, Fabrice; Cot, Michel; Massougbodji, Achille; Garcia, André

    2013-07-01

    According to several studies, infants whose mothers had a malaria-infected placenta (MIP) at delivery are at increased risk of a first malaria infection. Immune tolerance caused by intrauterine contact with the parasite could explain this phenomenon, but it is also known that infants who are highly exposed to Anopheles mosquitoes infected with Plasmodium are at greater risk of contracting malaria. Consequently, local malaria transmission must be taken into account to demonstrate the immune tolerance hypothesis. From data collected between 2007 and 2010 on 545 infants followed from birth to age 18 months in southern Benin, we compared estimates of the effect of MIP on time to first malaria infection obtained through different Cox models. In these models, MIP was adjusted for either 1) "village-like" time-independent exposure variables or 2) spatiotemporal exposure prediction derived from local climatic, environmental, and behavioral factors. Only the use of exposure prediction improved the model's goodness of fit (Bayesian Information Criterion) and led to clear conclusions regarding the effect of placental infection, whereas the models using the village-like variables were less successful than the univariate model. This demonstrated clearly the benefit of adequately taking transmission into account in cohort studies of malaria.

  3. A malaria vaccine for travelers and military personnel: Requirements and top candidates.

    PubMed

    Teneza-Mora, Nimfa; Lumsden, Joanne; Villasante, Eileen

    2015-12-22

    Malaria remains an important health threat to non-immune travelers with the explosive growth of global travel. Populations at high risk of acquiring malaria infections include once semi-immune travelers who visit friends and relatives, military forces, business travelers and international tourists with destinations to sub-Saharan Africa, where malaria transmission intensity is high. Most malaria cases have been associated with poor compliance with existing preventive measures, including chemoprophylaxis. High risk groups would benefit immensely from an efficacious vaccine to protect them against malaria infection and together make up a sizable market for such a vaccine. The attributes of an ideal malaria vaccine for non-immune travelers and military personnel include a protective efficacy of 80% or greater, durability for at least 6 months, an acceptable safety profile and compatibility with existing preventive measures. It is very likely that a malaria vaccine designed to effectively prevent infection and clinical disease in the non-immune traveler and military personnel will also protect semi-immune residents of malaria-endemic areas and contribute to malaria elimination by reducing or blocking malaria transmission. The RTS,S vaccine (GlaxoSmithKline) and the PfSPZ Vaccine (Sanaria Inc) are the leading products that would make excellent vaccine candidates for these vulnerable populations.

  4. On the ranking of chemicals based on their PBT characteristics: comparison of different ranking methodologies using selected POPs as an illustrative example.

    PubMed

    Sailaukhanuly, Yerbolat; Zhakupbekova, Arai; Amutova, Farida; Carlsen, Lars

    2013-01-01

    Knowledge of the environmental behavior of chemicals is a fundamental part of the risk assessment process. The present paper discusses various methods of ranking of a series of persistent organic pollutants (POPs) according to the persistence, bioaccumulation and toxicity (PBT) characteristics. Traditionally ranking has been done as an absolute (total) ranking applying various multicriteria data analysis methods like simple additive ranking (SAR) or various utility functions (UFs) based rankings. An attractive alternative to these ranking methodologies appears to be partial order ranking (POR). The present paper compares different ranking methods like SAR, UF and POR. Significant discrepancies between the rankings are noted and it is concluded that partial order ranking, as a method without any pre-assumptions concerning possible relation between the single parameters, appears as the most attractive ranking methodology. In addition to the initial ranking partial order methodology offers a wide variety of analytical tools to elucidate the interplay between the objects to be ranked and the ranking parameters. In the present study is included an analysis of the relative importance of the single P, B and T parameters. PMID:22955049

  5. Wikipedia ranking of world universities

    NASA Astrophysics Data System (ADS)

    Lages, José; Patt, Antoine; Shepelyansky, Dima L.

    2016-03-01

    We use the directed networks between articles of 24 Wikipedia language editions for producing the wikipedia ranking of world Universities (WRWU) using PageRank, 2DRank and CheiRank algorithms. This approach allows to incorporate various cultural views on world universities using the mathematical statistical analysis independent of cultural preferences. The Wikipedia ranking of top 100 universities provides about 60% overlap with the Shanghai university ranking demonstrating the reliable features of this approach. At the same time WRWU incorporates all knowledge accumulated at 24 Wikipedia editions giving stronger highlights for historically important universities leading to a different estimation of efficiency of world countries in university education. The historical development of university ranking is analyzed during ten centuries of their history.

  6. Low-rank coal research

    SciTech Connect

    Weber, G. F.; Laudal, D. L.

    1989-01-01

    This work is a compilation of reports on ongoing research at the University of North Dakota. Topics include: Control Technology and Coal Preparation Research (SO{sub x}/NO{sub x} control, waste management), Advanced Research and Technology Development (turbine combustion phenomena, combustion inorganic transformation, coal/char reactivity, liquefaction reactivity of low-rank coals, gasification ash and slag characterization, fine particulate emissions), Combustion Research (fluidized bed combustion, beneficiation of low-rank coals, combustion characterization of low-rank coal fuels, diesel utilization of low-rank coals), Liquefaction Research (low-rank coal direct liquefaction), and Gasification Research (hydrogen production from low-rank coals, advanced wastewater treatment, mild gasification, color and residual COD removal from Synfuel wastewaters, Great Plains Gasification Plant, gasifier optimization).

  7. Monkey malaria kills four humans.

    PubMed

    Galinski, Mary R; Barnwell, John W

    2009-05-01

    Four human deaths caused by Plasmodium knowlesi, a simian malaria species, are stimulating a surge of public health interest and clinical vigilance in vulnerable areas of Southeast Asia. We, and other colleagues, emphasize that these cases, identified in Malaysia, are a clear warning that health facilities and clinicians must rethink the diagnosis and treatment of malaria cases presumed to be caused by a less virulent human malaria species, Plasmodium malariae.

  8. Oceanic influence on seasonal malaria outbreaks over Senegal and Sahel

    NASA Astrophysics Data System (ADS)

    Diouf, Ibrahima; Rodríguez de Fonseca, Belen; Deme, Abdoulaye; Cisse Cisse, Moustapha; Ndione Ndione, Jaques-Andre; Gaye, Amadou T.; Suarez, Roberto

    2015-04-01

    Beyond assessment and analysis of observed and simulated malaria parameters, this study is furthermore undertaken in the framework of predictability of malaria outbreaks in Senegal and remote regions in Sahel, which are found to take place two months after the rainy season. The predictors are the sea surface temperature anomalous patterns at different ocean basins mainly over the Pacific and Atlantic as they are related to changes in air temperature, humidity, rainfall and wind. A relationship between El Niño and anomalous malaria parameters is found. The malaria parameters are calculated with the Liverpool Malaria Model (LMM) using meteorological datasets from different reanalysis products. A hindcast of these parameters is performed using the Sea Surface temperature based Statistical Seasonal ForeCAST (S4CAST) model developed at UCM in order to predict malaria parameters some months in advance. The results of this work will be useful for decision makers to better access to climate forecasts and application on malaria transmission risk.

  9. An outbreak of Plasmodium falciparum malaria in the Torres Strait.

    PubMed

    Preston-Thomas, Annie; Gair, Richard W; Hosking, Kelly A; Devine, Gregor J; Donohue, Steven D

    2012-06-01

    This report describes the largest outbreak of Plasmodium falciparum malaria in the Torres Strait for more than 25 years. It details factors that may have contributed to the outbreak, the public health response and implications for the broader region. Eight cases of locally-acquired falciparum malaria occurred on Saibai and Dauan islands during March and April 2011. Including imports, there were 17 P. falciparum notifications between February and May 2011. Three cases of pure P. vivax malaria that might have been locally acquired have been omitted from this report. Malaria is endemic on the nearby coast of Papua New Guinea (PNG), and regularly imported to the Torres Strait where a competent vector exists in sufficient numbers to transmit the disease to the local population. The most common malaria vectors in northern Australia and Torres Strait are the Anopheles farauti complex. Factors contributing to the outbreak may include an increase in travel between the outer islands and PNG, inadequate local vector control and late or missed diagnoses of malaria. Outbreak management involved intensive case finding and treatment, vector control and health promotion. Reducing the risk of future outbreaks requires studies of vector behaviour, ecology and management, health promotion, improvements to protective infrastructure, and clinical guideline revision. Further malaria outbreaks are likely in the Torres Strait and elsewhere in northern Australia. It is important to maintain awareness and be prepared to respond rapidly. PMID:23186217

  10. Malaria in Tunisian Military Personnel after Returning from External Operation

    PubMed Central

    Ajili, Faïda; Battikh, Riadh; Laabidi, Janet; Abid, Rim; Bousetta, Najeh; Jemli, Bouthaina; Ben abdelhafidh, Nadia; Bassem, Louzir; Gargouri, Saadia; Othmani, Salah

    2013-01-01

    Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites. PMID:23766922

  11. Urinary schistosomiasis and malaria associated anemia in Ethiopia

    PubMed Central

    Deribew, Ketema; Tekeste, Zinaye; Petros, Beyene

    2013-01-01

    Objective To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases. Methods Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia. Results The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P<0.05). The mean hemoglobin concentration between Plasmodium falciparum and S. haematobium infected children showed no significant difference (P>0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53). Conclusions The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community. PMID:23620856

  12. Malaria: prevention in travellers

    PubMed Central

    2007-01-01

    Introduction Malaria transmission occurs most frequently in environments with humidity over 60% and ambient temperature of 25-30 °C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10-14 days but can be up to 18 months depending on the strain of parasite. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in adult travellers? What are the effects of drug prophylaxis in adult travellers? What are the effects of antimalaria vaccines in travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 69 systematic reviews, RCTs, or observational studies that met our inclusion criteria. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acoustic buzzers, aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone-proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), doxycycline, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vaporising mats, primaquine, pyrimethamine-dapsone, pyrimethamine-sulfadoxine, smoke, topical (skin-applied) insect repellents, and vaccines. PMID:19450348

  13. Malaria: prevention in travellers

    PubMed Central

    2010-01-01

    Introduction Malaria transmission occurs most frequently in environments with humidity greater than 60% and ambient temperature of 25 °C to 30 °C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10 to 14 days but can be up to 18 months depending on the strain of parasite. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in non-pregnant adult travellers? What are the effects of drug prophylaxis in non-pregnant adult travellers? What are the effects of antimalaria vaccines in adult and child travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone–proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), dietary supplementation, doxycycline, electronic mosquito repellents, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vapourising mats, primaquine, pyrimethamine–dapsone, pyrimethamine–sulfadoxine, smoke

  14. Rank Xerox--management revolution.

    PubMed

    Walker, R

    1992-02-01

    For 20 years Rank Xerox dominated the photocopier market until the Japanese entered the market in the late 1970s. Rank Xerox responded to the competitive challenge by instituting competitive benchmarking, and subsequently the Leadership Through Quality Strategy. The author describes the changes in the management philosophy and the organizational structure which enabled Rank Xerox to win back market share from the Japanese. Rank Xerox is now market led with sharp customer focus. It is strongly business led and has a team working culture to support it.

  15. Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries.

    PubMed

    Stoney, Rhett J; Chen, Lin H; Jentes, Emily S; Wilson, Mary E; Han, Pauline V; Benoit, Christine M; MacLeod, William B; Hamer, Davidson H; Barnett, Elizabeth D

    2016-01-01

    We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malaria-endemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2-4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel. Adherence was not affected by weekly versus daily chemoprophylaxis, travel purpose, or duration of travel. Reasons for nonadherence included forgetfulness, side effects, and not seeing mosquitoes. Main reasons for declining to take prescribed chemoprophylaxis were peer advice, low perceived risk, and not seeing mosquitoes. Of 368 travelers, 79% used insect repellent, 46% used a bed net, and 61% slept in air conditioning at least once. Because travelers may be persuaded to stop taking medication by peer pressure, not seeing mosquitoes, and adverse reactions to medications, clinicians should be prepared to address these barriers and to empower travelers with strategies to manage common side effects of antimalarial medications. PMID:26483125

  16. Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries.

    PubMed

    Stoney, Rhett J; Chen, Lin H; Jentes, Emily S; Wilson, Mary E; Han, Pauline V; Benoit, Christine M; MacLeod, William B; Hamer, Davidson H; Barnett, Elizabeth D

    2016-01-01

    We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malaria-endemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2-4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel. Adherence was not affected by weekly versus daily chemoprophylaxis, travel purpose, or duration of travel. Reasons for nonadherence included forgetfulness, side effects, and not seeing mosquitoes. Main reasons for declining to take prescribed chemoprophylaxis were peer advice, low perceived risk, and not seeing mosquitoes. Of 368 travelers, 79% used insect repellent, 46% used a bed net, and 61% slept in air conditioning at least once. Because travelers may be persuaded to stop taking medication by peer pressure, not seeing mosquitoes, and adverse reactions to medications, clinicians should be prepared to address these barriers and to empower travelers with strategies to manage common side effects of antimalarial medications.

  17. Re-Emerging Malaria Vectors in Rural Sahel (nouna, Burkina Faso): the Paluclim Project

    NASA Astrophysics Data System (ADS)

    Vignolles, Cécile; Sauerborn, Rainer; Dambach, Peter; Viel, Christian; Soubeyroux, Jean-Michel; Sié, Ali; Rogier, Christophe; Tourre, Yves M.

    2016-06-01

    The Paluclim project applied the tele-epidemiology approach, linking climate, environment and public health (CNES, 2008), to rural malaria in Nouna (Burkina Faso). It was to analyze the climate impact on vectorial risks, and its consequences on entomological risks forecast. The objectives were to: 1) produce entomological risks maps in the Nouna region, 2) produce dynamic maps on larvae sites and their productivity, 3) study the climate impact on malaria risks, and 4) evaluate the feasibility of strategic larviciding approach.

  18. Vaccines against malaria.

    PubMed

    Hill, Adrian V S

    2011-10-12

    There is no licenced vaccine against any human parasitic disease and Plasmodium falciparum malaria, a major cause of infectious mortality, presents a great challenge to vaccine developers. This has led to the assessment of a wide variety of approaches to malaria vaccine design and development, assisted by the availability of a safe challenge model for small-scale efficacy testing of vaccine candidates. Malaria vaccine development has been at the forefront of assessing many new vaccine technologies including novel adjuvants, vectored prime-boost regimes and the concept of community vaccination to block malaria transmission. Most current vaccine candidates target a single stage of the parasite's life cycle and vaccines against the early pre-erythrocytic stages have shown most success. A protein in adjuvant vaccine, working through antibodies against sporozoites, and viral vector vaccines targeting the intracellular liver-stage parasite with cellular immunity show partial efficacy in humans, and the anti-sporozoite vaccine is currently in phase III trials. However, a more effective malaria vaccine suitable for widespread cost-effective deployment is likely to require a multi-component vaccine targeting more than one life cycle stage. The most attractive near-term approach to develop such a product is to combine existing partially effective pre-erythrocytic vaccine candidates. PMID:21893544

  19. Molecular Epidemiology of Malaria

    PubMed Central

    Conway, David J.

    2007-01-01

    Malaria persists as an undiminished global problem, but the resources available to address it have increased. Many tools for understanding its biology and epidemiology are well developed, with a particular richness of comparative genome sequences. Targeted genetic manipulation is now effectively combined with in vitro culture assays on the most important human parasite, Plasmodium falciparum, and with in vivo analysis of rodent and monkey malaria parasites in their laboratory hosts. Studies of the epidemiology, prevention, and treatment of human malaria have already been influenced by the availability of molecular methods, and analyses of parasite polymorphisms have long had useful and highly informative applications. However, the molecular epidemiology of malaria is currently undergoing its most substantial revolution as a result of the genomic information and technologies that are available in well-resourced centers. It is a challenge for research agendas to face the real needs presented by a disease that largely exists in extremely resource-poor settings, but it is one that there appears to be an increased willingness to undertake. To this end, developments in the molecular epidemiology of malaria are reviewed here, emphasizing aspects that may be current and future priorities. PMID:17223628

  20. Land cover, land use and malaria in the Amazon: a systematic literature review of studies using remotely sensed data

    PubMed Central

    2013-01-01

    The nine countries sharing the Amazon forest accounted for 89% of all malaria cases reported in the Americas in 2008. Remote sensing can help identify the environmental determinants of malaria transmission and their temporo-spatial evolution. Seventeen studies characterizing land cover or land use features, and relating them to malaria in the Amazon subregion, were identified. These were reviewed in order to improve the understanding of the land cover/use class roles in malaria transmission. The indicators affecting the transmission risk were summarized in terms of temporal components, landscape fragmentation and anthropic pressure. This review helps to define a framework for future studies aiming to characterize and monitor malaria. PMID:23758827

  1. [Vaccinations and malaria prophylaxis for international travelers].

    PubMed

    Alberer, Martin; Löscher, Thomas

    2015-05-01

    The prevention of infectious diseases by vaccination and by counselling about malaria prophylaxis is a central aspect of travel medicine. Besides mandatory vaccinations required for entry to certain countries various vaccinations may be indicated depending on destination and type of travel as well as on individual risks of the traveler. In addition, pre-travel counselling should always include a check-up of standard vaccinations. Protection against mosquito bites is the basis of malaria prophylaxis. The addition of chemoprophylaxis is warranted in high risk areas. When regular chemoprophylaxis is not applied it is recommended to carry an appropriate antimalarial drug which can be used for emergency stand-by treatment in case of unexplained fever and when medical attention is not available within 24 hours. Travelers should realize that self-treatment is a first-aid measure and that they should still seek medical advice as soon as possible.

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

    PubMed Central

    2014-01-01

    Background Malaria 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. Methods Malariometric 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. Results The 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. Conclusions Based 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

  3. Malaria transmission and climate change in Australia.

    PubMed

    Bryan, J H; Foley, D H; Sutherst, R W

    1996-03-18

    Although endemic malaria was eradicated from Australia by 1981, the vectors remain and transmission from imported cases still occurs. Climate modelling shows that global warming will enlarge the potential range of the main vector, Anopheles farauti sensu stricto; by the year 2030 it could extend along the Queensland coast to Gladstone, 800 km south of its present limit. Vigilance and a dispassionate assessment of risk are needed to meet this challenge.

  4. Do post-disaster public health interventions impede malaria eradication?

    PubMed

    Weinstein, Philip; Goff, James; Skelly, Chris

    2010-03-01

    In this paper, we hypothesise that public health interventions aimed at controlling post-disaster malaria epidemics may in fact impede malaria eradication efforts in the longer term. A major factor hampering malaria eradication efforts is the development of resistance to antimalarial drugs in the Plasmodium parasite. Following natural disasters such as flooding, public health responses includes a massive influx of antimalarial drugs that may facilitate the development of resistance. Resistance is common in areas with frequent natural disasters, and if such an association could be shown to be generalisable and causative, there may be direct implications for the way that future disaster-related malaria risks are managed. Because the frequency and severity of climate-associated disasters is likely to increase with global warming, it is timely to study the possibility that well intentioned public health action may in fact exacerbate the disease burden from the very parasites that it sets out to control.

  5. Mobile phones and malaria: modeling human and parasite travel

    PubMed Central

    Buckee, Caroline O.; Wesolowski, Amy; Eagle, Nathan; Hansen, Elsa; Snow, Robert W.

    2013-01-01

    Human mobility plays an important role in the dissemination of malaria parasites between regions of variable transmission intensity. Asymptomatic individuals can unknowingly carry parasites to regions where mosquito vectors are available, for example, undermining control programs and contributing to transmission when they travel. Understanding how parasites are imported between regions in this way is therefore an important goal for elimination planning and the control of transmission, and would enable control programs to target the principal sources of malaria. Measuring human mobility has traditionally been difficult to do on a population scale, but the widespread adoption of mobile phones in low-income settings presents a unique opportunity to directly measure human movements that are relevant to the spread of malaria. Here, we discuss the opportunities for measuring human mobility using data from mobile phones, as well as some of the issues associated with combining mobility estimates with malaria infection risk maps to meaningfully estimate routes of parasite importation. PMID:23478045

  6. University Rankings in Critical Perspective

    ERIC Educational Resources Information Center

    Pusser, Brian; Marginson, Simon

    2013-01-01

    This article addresses global postsecondary ranking systems by using critical-theoretical perspectives on power. This research suggests rankings are at once a useful lens for studying power in higher education and an important instrument for the exercise of power in service of dominant norms in global higher education. (Contains 1 table and 1…

  7. University Ranking as Social Exclusion

    ERIC Educational Resources Information Center

    Amsler, Sarah S.; Bolsmann, Chris

    2012-01-01

    In this article we explore the dual role of global university rankings in the creation of a new, knowledge-identified, transnational capitalist class and in facilitating new forms of social exclusion. We examine how and why the practice of ranking universities has become widely defined by national and international organisations as an important…

  8. Obsession with Rankings Goes Global

    ERIC Educational Resources Information Center

    Labi, Aisha

    2008-01-01

    A Chinese list of the world's top universities would seem an unlikely concern for French politicians. But this year, France's legislature took aim at the annual rankings produced by Shanghai Jiao Tong University, which claims to list the 500 best universities in the world. The highest-ranked French entry, Universite Pierre et Marie Curie, comes in…

  9. Longitudinal Visuomotor Development in a Malaria Endemic Area: Cerebral Malaria and Beyond

    PubMed Central

    MacCormick, Ian J. C.; Mbale, Emme; Malewa, Macpherson; Czanner, Gabriela; Harding, Simon P.

    2016-01-01

    rate was also confirmed in the older, healthy Malawian participants from the cross sectional study. Our observation of similar oculomotor performance in cerebral malaria and control groups at long follow-up periods suggests that cerebral malaria survivors are not at a generally increased risk of persistent cognitive deficits. Our data raise questions about the prevailing hypothesis that cerebral malaria has gross impacts on the development of processes such as attention and behavioural inhibition. More importantly, our novel finding of a clear difference in antisaccade performance between all of the Malawi participants and published data suggests that the Malawian paediatric population as a whole faces serious challenges to cognitive development beyond cerebral malaria. PMID:27764173

  10. Notes from the Field: Imported Cases of Malaria--Puerto Rico, July-October 2015.

    PubMed

    Dirlikov, Emilio; Rodríguez, Carmen; Morales, Shirley; Martínez, Laura Castro; Mendez, Juan B; Sanchez, Anibal Cruz; Burgos, Jesús Hernández; Santiago, Zobeida; Cuevas-Ruis, Rosa Ivette; Camacho, Sheila Adorno; Mercado, Enid Román; Guzmán, Jessica Falcón; Ryff, Kyle; Luna-Pinto, Carolina; Arguin, Paul M; Chenet, Stella M; Silva-Flannery, Luciana; Ljolje, Dragan; Velázquez, Julio Cadiz; Thomas, Dana; Garcia, Brenda Rivera

    2016-04-01

    On July 16 2015, the Puerto Rico Department of Health (PRDH) was notified of a case of malaria, diagnosed by a hospital parasitology laboratory in a student who had traveled to Punta Cana, Dominican Republic, during late June for a school-organized graduation trip. Malaria is a mosquito-borne parasitic infection, characterized by fever, shaking chills, headaches, muscle pains, nausea, general malaise, and vomiting (1). Malaria can be clinically difficult to distinguish from other acute febrile illnesses, and a definitive diagnosis requires demonstration of malaria parasites using microscopy or molecular diagnostic tests. The student's initial diagnosis on July 10 was suspected dengue virus infection. Puerto Rico eliminated local malaria transmission during the mid-1950s (2); however, reintroduction remains a risk because of the presence of a competent vector (Anopheles albimanus) and ease of travel to areas where the disease is endemic, including Hispaniola, the island shared by the Dominican Republic and Haiti, and the only island in the Caribbean with endemic malaria (3). During 2014, the Dominican Republic reported 496 confirmed malaria cases and four associated deaths; Haiti reported 17,662 confirmed cases and nine deaths (4). During 2000-2014, Puerto Rico reported a total of 35 imported malaria cases (range = 0-7 per year); three cases were imported from Hispaniola. During June-August 2015, eight confirmed malaria cases among travelers to the Dominican Republic were reported to CDC's National Malaria Surveillance System (CDC, unpublished data, 2015).

  11. Notes from the Field: Imported Cases of Malaria--Puerto Rico, July-October 2015.

    PubMed

    Dirlikov, Emilio; Rodríguez, Carmen; Morales, Shirley; Martínez, Laura Castro; Mendez, Juan B; Sanchez, Anibal Cruz; Burgos, Jesús Hernández; Santiago, Zobeida; Cuevas-Ruis, Rosa Ivette; Camacho, Sheila Adorno; Mercado, Enid Román; Guzmán, Jessica Falcón; Ryff, Kyle; Luna-Pinto, Carolina; Arguin, Paul M; Chenet, Stella M; Silva-Flannery, Luciana; Ljolje, Dragan; Velázquez, Julio Cadiz; Thomas, Dana; Garcia, Brenda Rivera

    2016-01-01

    On July 16 2015, the Puerto Rico Department of Health (PRDH) was notified of a case of malaria, diagnosed by a hospital parasitology laboratory in a student who had traveled to Punta Cana, Dominican Republic, during late June for a school-organized graduation trip. Malaria is a mosquito-borne parasitic infection, characterized by fever, shaking chills, headaches, muscle pains, nausea, general malaise, and vomiting (1). Malaria can be clinically difficult to distinguish from other acute febrile illnesses, and a definitive diagnosis requires demonstration of malaria parasites using microscopy or molecular diagnostic tests. The student's initial diagnosis on July 10 was suspected dengue virus infection. Puerto Rico eliminated local malaria transmission during the mid-1950s (2); however, reintroduction remains a risk because of the presence of a competent vector (Anopheles albimanus) and ease of travel to areas where the disease is endemic, including Hispaniola, the island shared by the Dominican Republic and Haiti, and the only island in the Caribbean with endemic malaria (3). During 2014, the Dominican Republic reported 496 confirmed malaria cases and four associated deaths; Haiti reported 17,662 confirmed cases and nine deaths (4). During 2000-2014, Puerto Rico reported a total of 35 imported malaria cases (range = 0-7 per year); three cases were imported from Hispaniola. During June-August 2015, eight confirmed malaria cases among travelers to the Dominican Republic were reported to CDC's National Malaria Surveillance System (CDC, unpublished data, 2015). PMID:27030910

  12. Research toward Malaria Vaccines

    NASA Astrophysics Data System (ADS)

    Miller, Louis H.; Howard, Russell J.; Carter, Richard; Good, Michael F.; Nussenzweig, Victor; Nussenzweig, Ruth S.

    1986-12-01

    Malaria exacts a toll of disease to people in the Tropics that seems incomprehensible to those only familiar with medicine and human health in the developed world. The methods of molecular biology, immunology, and cell biology are now being used to develop an antimalarial vaccine. The Plasmodium parasites that cause malaria have many stages in their life cycle. Each stage is antigenically distinct and potentially could be interrupted by different vaccines. However, achieving complete protection by vaccination may require a better understanding of the complexities of B- and T-cell priming in natural infections and the development of an appropriate adjuvant for use in humans.

  13. Mosquito larval source management for controlling malaria

    PubMed Central

    Tusting, Lucy S; Thwing, Julie; Sinclair, David; Fillinger, Ulrike; Gimnig, John; Bonner, Kimberly E; Bottomley, Christian; Lindsay, Steven W

    2015-01-01

    Background Malaria is an important cause of illness and death in people living in many parts of the world, especially sub-Saharan Africa. Long-lasting insecticide treated bed nets (LLINs) and indoor residual spraying (IRS) reduce malaria transmission by targeting the adult mosquito vector and are key components of malaria control programmes. However, mosquito numbers may also be reduced by larval source management (LSM), which targets mosquito larvae as they mature in aquatic habitats. This is conducted by permanently or temporarily reducing the availability of larval habitats (habitat modification and habitat manipulation), or by adding substances to standing water that either kill or inhibit the development of larvae (larviciding). Objectives To evaluate the effectiveness of mosquito LSM for preventing malaria. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CABS Abstracts; and LILACS up to 24 October 2012. We handsearched the Tropical Diseases Bulletin from 1900 to 2010, the archives of the World Health Organization (up to 11 February 2011), and the literature database of the Armed Forces Pest Management Board (up to 2 March 2011). We also contacted colleagues in the field for relevant articles. Selection criteria We included cluster randomized controlled trials (cluster-RCTs), controlled before-and-after trials with at least one year of baseline data, and randomized cross-over trials that compared LSM with no LSM for malaria control. We excluded trials that evaluated biological control of anopheline mosquitoes with larvivorous fish. Data collection and analysis At least two authors assessed each trial for eligibility. We extracted data and at least two authors independently determined the risk of bias in the included studies. We resolved all disagreements through discussion with a third author. We analyzed the data using Review Manager 5 software

  14. US dermatology residency program rankings.

    PubMed

    Aquino, Lisa L; Wen, Ge; Wu, Jashin J

    2014-10-01

    Unlike many other adult specialties, US News & World Report does not rank dermatology residency programs annually. We conducted a study to rank individual US dermatology residency programs based on set criteria. For each residency program, data from 2008 related to a number of factors were collected, including annual amount of National Institutes of Health (NIH) and Dermatology Foundation (DF) funding received; number of publications from full-time faculty members; number of faculty lectures given at 5 annual society meetings; and number of full-time faculty members who were on the editorial boards of 6 dermatology journals with the highest impact factors. Most of the data were obtained through extensive Internet searches, and missing data were obtained by contacting individual residency programs. The programs were ranked based on the prior factors according to a weighted ranking algorithm. A list of overall rankings also was created.

  15. [Monkey malaria (Plasmodium knowlesi infection) after travelling to Thailand].

    PubMed

    Kroidl, Inge; Seilmaier, Michael; Berens-Riha, Nicole; Bretzel, Gisela; Wendtner, Clemens; Löscher, Thomas

    2015-05-01

    A case of malaria caused by Plasmodium knowlesi is described in a 52-year-old female German traveler after returning from Thailand. P. knowlesi is a parasite of macaques in Southeast Asia and has been recognized in recent years as an important and probably increasing cause of human malaria in some areas. At least 16 cases in international travelers have been published so far. This includes four cases imported to Germany. All German patients visited forested areas in Southern Thailand inhabited by the natural monkey host prior to their illness. Most cases diagnosed in endemic areas present as mild disease. However in some patients P. knowlesi may take a severe and life-threatening course. Diagnosis is usually is based on microscopy whereas rapid tests are not reliable. However, microscopic differentiation of P. knowlesi from other plasmodium species (eg, P. malariae, P. falciparum) is difficult, especially when parasitemia is low. Thus PCR methods are required for definite species determination. Changing endemicity as well as changing tourism patterns such as the trend towards eco-tourism might increase the risk of infection for travelers even in areas which are considered as low endemic for malaria. Malaria has to be considered in all febrile patients returning from endemic areas. In Southeast Asia this has to include Plasmodium knowlesi infection. Especially if microscopy suggests P. falciparum/P. malariae double infection, or when results indicate P. malariae but the clinical presentation differs from that of quartan malaria (eg, daily fever), diagnostic procedures for P. knowlesi should be initiated. Currently available rapid diagnostic tests are not reliable for the detection of P. knowlesi. The definite diagnosis of P. knowlesi infection usually requires PCR techniques Changing tourism patterns such as the trend towards eco-tourism might increase the risk of infection for travelers even in low prevalence areas. PMID:26080720

  16. Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa

    PubMed Central

    Wang, Shr-Jie; Lengeler, Christian; Smith, Thomas A; Vounatsou, Penelope; Cissé, Guéladio; Diallo, Diadie A; Akogbeto, Martin; Mtasiwa, Deo; Teklehaimanot, Awash; Tanner, Marcel

    2005-01-01

    Background The rapid urban malaria appraisal (RUMA) methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan), Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1) a literature review, 2) the collection of available health statistics, 3) a risk mapping, 4) school parasitaemia surveys, 5) health facility-based surveys and 6) a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics) was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures. PMID:16153298

  17. Malaria Modeling using Remote Sensing and GIS Technologies

    NASA Technical Reports Server (NTRS)

    Kiang, Richard

    2004-01-01

    Malaria has been with the human race since the ancient time. In spite of the advances of biomedical research and the completion of genomic mapping of Plasmodium falciparum, the exact mechanisms of how the various strains of parasites evade the human immune system and how they have adapted and become resistant to multiple drugs remain elusive. Perhaps because of these reasons, effective vaccines against malaria are still not available. Worldwide, approximately one to three millions deaths are attributed to malaria annually. With the increased availability of remotely sensed data, researchers in medical entomology, epidemiology and ecology have started to associate environmental and ecological variables with malaria transmission. In several studies, it has been shown that transmission correlates well with certain environmental and ecological parameters, and that remote sensing can be used to measure these determinants. In a NASA project, we have taken a holistic approach to examine how remote sensing and GIs can contribute to vector and malaria controls. To gain a better understanding of the interactions among the possible promoting factors, we have been developing a habitat model, a transmission model, and a risk prediction model, all using remote sensing data as input. Our objectives are: 1) To identify the potential breeding sites of major vector species and the locations for larvicide and insecticide applications in order to reduce costs, lessen the chance of developing pesticide resistance, and minimize the damage to the environment; 2) To develop a malaria transmission model characterizing the interactions among hosts, vectors, parasites, landcover and environment in order to identify the key factors that sustain or intensify malaria transmission, and 3) To develop a risk model to predict the occurrence of malaria and its transmission intensity using epidemiological data and satellite-derived or ground-measured environmental and meteorological data.

  18. Diagnostic approaches to malaria in Zambia, 2009-2014.

    PubMed

    Mukonka, Victor M; Chanda, Emmanuel; Kamuliwo, Mulakwa; Elbadry, Maha A; Wamulume, Pauline K; Mwanza-Ingwe, Mercy; Lubinda, Jailos; Laytner, Lindsey A; Zhang, Wenyi; Mushinge, Gabriel; Haque, Ubydul

    2015-01-01

    Malaria is an important health burden in Zambia with proper diagnosis remaining as one of the biggest challenges. The need for reliable diagnostics is being addressed through the introduction of rapid diagnostic tests (RDTs). However, without sufficient laboratory amenities in many parts of the country, diagnosis often still relies on non-specific, clinical symptoms. In this study, geographical information systems were used to both visualize and analyze the spatial distribution and the risk factors related to the diagnosis of malaria. The monthly reported, district-level number of malaria cases from January 2009 to December 2014 were collected from the National Malaria Control Center (NMCC). Spatial statistics were used to reveal cluster tendencies that were subsequently linked to possible risk factors, using a non-spatial regression model. Significant, spatio-temporal clusters of malaria were spotted while the introduction of RDTs made the number of clinically diagnosed malaria cases decrease by 33% from 2009 to 2014. The limited access to road network(s) was found to be associated with higher levels of malaria, which can be traced by the expansion of health promotion interventions by the NMCC, indicating enhanced diagnostic capability. The capacity of health facilities has been strengthened with the increased availability of proper diagnostic tools and through retraining of community health workers. To further enhance spatial decision support systems, a multifaceted approach is required to ensure mobilization and availability of human, infrastructural and technological resources. Surveillance based on standardized geospatial or other analytical methods should be used by program managers to design, target, monitor and assess the spatio-temporal dynamics of malaria diagnostic resources country-wide.

  19. The Stateville penitentiary malaria experiments: a case study in retrospective ethical assessment.

    PubMed

    Miller, Franklin G

    2013-01-01

    During World War II, malaria research was conducted in prisons. A notable example was the experiments at Stateville Penitentiary in Illinois, in which prisoner-subjects were infected with malaria for the purpose of testing the safety and efficacy of novel anti-malaria drugs. Over time, commentators have shifted from viewing the malaria research at Stateville as a model of ethical clinical research to seeing the experiments as paradigmatic of abusive human experimentation. This essay undertakes a retrospective ethical assessment of the Stateville malaria research during the 1940s in light of basic ethical principles and the Nuremberg Code, as well as contemporary malaria research. In addition to its historical interest, this case study provides a rich context for addressing basic issues of research ethics, including the voluntariness of consent, the justification of risks, and the exploitation of vulnerable subjects. PMID:24769747

  20. [Epidemiological situation of malaria in Poland--past, present and future].

    PubMed

    Dzbeński, Tadeusz H

    2008-01-01

    In Poland malaria was endemic up to the middle of 60th years of the 20th century. After eradication a total of 11 to 38 imported cases are reported each year, however, no secondary cases or airport malaria have ever been observed in Poland. Is the present favourable epidemiological situation likely to change as a result of global warming and predicted risk of uncontrollable resurgence of malaria in Europe? An epidemiological analysis of past and present malaria situation in Poland allows to conclude, that global warming alone will not be enough to reintroduce malaria into this country. However, re-establishment of endemic malaria will be possible under condition of mass disorganization of public services and mass migration caused usually by wars or natural calamities.

  1. Intent-to-adhere and adherence to malaria prevention recommendations in two travel clinics.

    PubMed

    Goldstein, Irit; Grefat, Rami; Ephros, Moshe; Rishpon, Shmuel

    2015-01-01

    Malaria infects 30,000 travelers annually worldwide. At greatest risk are those who travel for long duration. Prevention of malaria includes chemoprophylaxis. This prospective study on 121 travelers who visited two travel clinics shows that adherence to prophylactic treatment was low, especially in long duration trips, and that adherence rate could be predicted by the much more available intent-to-adhere rate.

  2. Modelling climate change and malaria transmission.

    PubMed

    Parham, Paul E; Michael, Edwin

    2010-01-01

    The impact of climate change on human health has received increasing attention in recent years, with potential impacts due to vector-borne diseases only now beginning to be understood. As the most severe vector-borne disease, with one million deaths globally in 2006, malaria is thought most likely to be affected by changes in climate variables due to the sensitivity of its transmission dynamics to environmental conditions. While considerable research has been carried out using statistical models to better assess the relationship between changes in environmental variables and malaria incidence, less progress has been made on developing process-based climate-driven mathematical models with greater explanatory power. Here, we develop a simple model of malaria transmission linked to climate which permits useful insights into the sensitivity of disease transmission to changes in rainfall and temperature variables. Both the impact of changes in the mean values of these key external variables and importantly temporal variation in these values are explored. We show that the development and analysis of such dynamic climate-driven transmission models will be crucial to understanding the rate at which P. falciparum and P. vivax may either infect, expand into or go extinct in populations as local environmental conditions change. Malaria becomes endemic in a population when the basic reproduction number R0 is greater than unity and we identify an optimum climate-driven transmission window for the disease, thus providing a useful indicator for determing how transmission risk may change as climate changes. Overall, our results indicate that considerable work is required to better understand ways in which global malaria incidence and distribution may alter with climate change. In particular, we show that the roles of seasonality, stochasticity and variability in environmental variables, as well as ultimately anthropogenic effects, require further study. The work presented here

  3. Declining incidence of imported malaria in the Netherlands, 2000-2007

    PubMed Central

    2010-01-01

    Background To describe the epidemiology and trends of imported malaria in the Netherlands from 2000 through 2007. Methods Based on national surveillance data regarding all reported infections of imported malaria, diagnosed 2000 through 2007, incidence and trends of imported malaria in the Netherlands were estimated. Travellers statistics were used to estimate incidence, and data on malaria chemoprophylaxis prescriptions were used to estimate the number of unprotected travellers. Results Importation of malaria to the Netherlands is declining even as more travellers visit malaria-endemic countries. On average, 82% were acquired in sub-Saharan Africa, and 75% were caused by Plasmodium falciparum. The overall incidence in imported falciparum malaria fell from 21.5 to 6.6/10,000 of unprotected travellers. The percentage of unprotected travellers rose from 47% to 52% of all travellers. The incidence of imported falciparum infections is greatest from Middle and West Africa, and decreased from 121.3 to 36.5/10,000 travellers. The import of malaria from this region by immigrants visiting friends and relatives (VFR) decreased from 138 infections in 2000, to 69 infections in 2007. Conclusion The annual number of imported malaria shows a continuing declining trend, even with an increasing number of travellers visiting malaria endemic countries. VFR import less malaria than previously, and contribute largely to the declining incidence seen. The decline is not readily explained by increased use of chemoprophylaxis and may reflect a reduced risk of infection due to decreasing local malaria transmission as observed in some malaria endemic areas. Nevertheless, the increasing number of unprotected travellers remains worrisome. PMID:21029424

  4. [Epidemiological stratification of malaria in Madagascar].

    PubMed

    Mouchet, J; Blanchy, S; Rakotonjanabelo, A; Ranaivoson, G; Rajaonarivelo, E; Laventure, S; Rossella, M; Aknouche, F

    1993-01-01

    malarious areas of the coast, where the migrants are exposed to high risk. In spite of 40 years of uncontrolled use, chloroquine can still cure most, if not all, of malaria cases. Control measures appropriated to the different areas of Madagascar are discussed.

  5. Universal scaling in sports ranking

    NASA Astrophysics Data System (ADS)

    Deng, Weibing; Li, Wei; Cai, Xu; Bulou, Alain; Wang, Qiuping A.

    2012-09-01

    Ranking is a ubiquitous phenomenon in human society. On the web pages of Forbes, one may find all kinds of rankings, such as the world's most powerful people, the world's richest people, the highest-earning tennis players, and so on and so forth. Herewith, we study a specific kind—sports ranking systems in which players' scores and/or prize money are accrued based on their performances in different matches. By investigating 40 data samples which span 12 different sports, we find that the distributions of scores and/or prize money follow universal power laws, with exponents nearly identical for most sports. In order to understand the origin of this universal scaling we focus on the tennis ranking systems. By checking the data we find that, for any pair of players, the probability that the higher-ranked player tops the lower-ranked opponent is proportional to the rank difference between the pair. Such a dependence can be well fitted to a sigmoidal function. By using this feature, we propose a simple toy model which can simulate the competition of players in different matches. The simulations yield results consistent with the empirical findings. Extensive simulation studies indicate that the model is quite robust with respect to the modifications of some parameters.

  6. The dynamics of malaria.

    PubMed

    Macdonald, G; Cuellar, C B; Foll, C V

    1968-01-01

    Previous studies on dynamic systems of transmission of malaria, and of eradication of infection following the interruption of transmission, have now been adapted for advanced techniques using the facilities offered by computers.The computer programmes have been designed for a deterministic model suitable for a large community and also for a stochastic model relevant to small populations in which infections reach very low finite numbers. In this model, new infections and recoveries are assessed by the daily inoculation rate and are subject to laws of chance. Such a representation is closer than previous models to natural happenings in the process of malaria eradication. Further refinements of the new approach include the seasonal transmission and simulation of mass chemotherapy aimed at a cure of P. falciparum infections.These programmes present models on which the actual or expected results of changes due to various factors can be studied by the analysis of specific malaria situations recorded in the field. The value of control methods can also be tested by the study of such hypothetical epidemiological models and by trying out various procedures.Two specific malaria situations (in a pilot project in Northern Nigeria and in an outbreak in Syria) were studied by this method and provided some interesting results of operational value. The attack measures in the pilot project in Northern Nigeria were carried out according to the theoretical model derived from the basic data obtained in the field. PMID:5303328

  7. Influence of Deforestation, Logging, and Fire on Malaria in the Brazilian Amazon

    PubMed Central

    Hahn, Micah B.; Gangnon, Ronald E.; Barcellos, Christovam; Asner, Gregory P.; Patz, Jonathan A.

    2014-01-01

    Malaria is a significant public health threat in the Brazilian Amazon. Previous research has shown that deforestation creates breeding sites for the main malaria vector in Brazil, Anopheles darlingi, but the influence of selective logging, forest fires, and road construction on malaria risk has not been assessed. To understand these impacts, we constructed a negative binomial model of malaria counts at the municipality level controlling for human population and social and environmental risk factors. Both paved and unpaved roadways and fire zones in a municipality increased malaria risk. Within the timber production states where 90% of deforestation has occurred, compared with areas without selective logging, municipalities where 0–7% of the remaining forests were selectively logged had the highest malaria risk (1.72, 95% CI 1.18–2.51), and areas with higher rates of selective logging had the lowest risk (0.39, 95% CI 0.23–0.67). We show that roads, forest fires, and selective logging are previously unrecognized risk factors for malaria in the Brazilian Amazon and highlight the need for regulation and monitoring of sub-canopy forest disturbance. PMID:24404206

  8. Influence of deforestation, logging, and fire on malaria in the Brazilian Amazon.

    PubMed

    Hahn, Micah B; Gangnon, Ronald E; Barcellos, Christovam; Asner, Gregory P; Patz, Jonathan A

    2014-01-01

    Malaria is a significant public health threat in the Brazilian Amazon. Previous research has shown that deforestation creates breeding sites for the main malaria vector in Brazil, Anopheles darlingi, but the influence of selective logging, forest fires, and road construction on malaria risk has not been assessed. To understand these impacts, we constructed a negative binomial model of malaria counts at the municipality level controlling for human population and social and environmental risk factors. Both paved and unpaved roadways and fire zones in a municipality increased malaria risk. Within the timber production states where 90% of deforestation has occurred, compared with areas without selective logging, municipalities where 0-7% of the remaining forests were selectively logged had the highest malaria risk (1.72, 95% CI 1.18-2.51), and areas with higher rates of selective logging had the lowest risk (0.39, 95% CI 0.23-0.67). We show that roads, forest fires, and selective logging are previously unrecognized risk factors for malaria in the Brazilian Amazon and highlight the need for regulation and monitoring of sub-canopy forest disturbance. PMID:24404206

  9. Influence of deforestation, logging, and fire on malaria in the Brazilian Amazon.

    PubMed

    Hahn, Micah B; Gangnon, Ronald E; Barcellos, Christovam; Asner, Gregory P; Patz, Jonathan A

    2014-01-01

    Malaria is a significant public health threat in the Brazilian Amazon. Previous research has shown that deforestation creates breeding sites for the main malaria vector in Brazil, Anopheles darlingi, but the influence of selective logging, forest fires, and road construction on malaria risk has not been assessed. To understand these impacts, we constructed a negative binomial model of malaria counts at the municipality level controlling for human population and social and environmental risk factors. Both paved and unpaved roadways and fire zones in a municipality increased malaria risk. Within the timber production states where 90% of deforestation has occurred, compared with areas without selective logging, municipalities where 0-7% of the remaining forests were selectively logged had the highest malaria risk (1.72, 95% CI 1.18-2.51), and areas with higher rates of selective logging had the lowest risk (0.39, 95% CI 0.23-0.67). We show that roads, forest fires, and selective logging are previously unrecognized risk factors for malaria in the Brazilian Amazon and highlight the need for regulation and monitoring of sub-canopy forest disturbance.

  10. Nanomedicine against malaria.

    PubMed

    Urbán, Patricia; Fernàndez-Busquets, Xavier

    2014-01-01

    Malaria is arguably one of the main medical concerns worldwide because of the numbers of people affected, the severity of the disease and the complexity of the life cycle of its causative agent, the protist Plasmodium sp. The clinical, social and economic burden of malaria has led for the last 100 years to several waves of serious efforts to reach its control and eventual eradication, without success to this day. With the advent of nanoscience, renewed hopes have appeared of finally obtaining the long sought-after magic bullet against malaria in the form of a nanovector for the targeted delivery of antimalarial drugs exclusively to Plasmodium-infected cells. Different types of encapsulating structure, targeting molecule, and antimalarial compound will be discussed for the assembly of Trojan horse nanocapsules capable of targeting with complete specificity diseased cells and of delivering inside them their antimalarial cargo with the objective of eliminating the parasite with a single dose. Nanotechnology can also be applied to the discovery of new antimalarials through single-molecule manipulation approaches for the identification of novel drugs targeting essential molecular components of the parasite. Finally, methods for the diagnosis of malaria can benefit from nanotools applied to the design of microfluidic-based devices for the accurate identification of the parasite's strain, its precise infective load, and the relative content of the different stages of its life cycle, whose knowledge is essential for the administration of adequate therapies. The benefits and drawbacks of these nanosystems will be considered in different possible scenarios, including cost-related issues that might be hampering the development of nanotechnology-based medicines against malaria with the dubious argument that they are too expensive to be used in developing areas.

  11. Can plant biotechnology help break the HIV-malaria link?

    PubMed

    Vamvaka, E; Twyman, R M; Christou, P; Capell, T

    2014-01-01

    The population of sub-Saharan Africa is at risk from multiple, poverty-related endemic diseases. HIV and malaria are the most prevalent, but they disproportionately affect different groups of people, i.e. HIV predominantly affects sexually-active adults whereas malaria has a greater impact on children and pregnant women. Nevertheless, there is a significant geographical and epidemiological overlap which results in bidirectional and synergistic interactions with important consequences for public health. The immunosuppressive effects of HIV increase the risk of infection when individuals are exposed to malaria parasites and also the severity of malaria symptoms. Similarly, acute malaria can induce a temporary increase in the HIV viral load. HIV is associated with a wide range of opportunistic infections that can be misdiagnosed as malaria, resulting in the wasteful misuse of antimalarial drugs and a failure to address the genuine cause of the disease. There is also a cumulative risk of toxicity when antiretroviral and antimalarial drugs are given to the same patients. Synergistic approaches involving the control of malaria as a strategy to fight HIV/AIDS and vice versa are therefore needed in co-endemic areas. Plant biotechnology has emerged as a promising approach to tackle poverty-related diseases because plant-derived drugs and vaccines can be produced inexpensively in developing countries and may be distributed using agricultural infrastructure without the need for a cold chain. Here we explore some of the potential contributions of plant biotechnology and its integration into broader multidisciplinary public health programs to combat the two diseases in developing countries. PMID:24607600

  12. Can plant biotechnology help break the HIV-malaria link?

    PubMed

    Vamvaka, E; Twyman, R M; Christou, P; Capell, T

    2014-01-01

    The population of sub-Saharan Africa is at risk from multiple, poverty-related endemic diseases. HIV and malaria are the most prevalent, but they disproportionately affect different groups of people, i.e. HIV predominantly affects sexually-active adults whereas malaria has a greater impact on children and pregnant women. Nevertheless, there is a significant geographical and epidemiological overlap which results in bidirectional and synergistic interactions with important consequences for public health. The immunosuppressive effects of HIV increase the risk of infection when individuals are exposed to malaria parasites and also the severity of malaria symptoms. Similarly, acute malaria can induce a temporary increase in the HIV viral load. HIV is associated with a wide range of opportunistic infections that can be misdiagnosed as malaria, resulting in the wasteful misuse of antimalarial drugs and a failure to address the genuine cause of the disease. There is also a cumulative risk of toxicity when antiretroviral and antimalarial drugs are given to the same patients. Synergistic approaches involving the control of malaria as a strategy to fight HIV/AIDS and vice versa are therefore needed in co-endemic areas. Plant biotechnology has emerged as a promising approach to tackle poverty-related diseases because plant-derived drugs and vaccines can be produced inexpensively in developing countries and may be distributed using agricultural infrastructure without the need for a cold chain. Here we explore some of the potential contributions of plant biotechnology and its integration into broader multidisciplinary public health programs to combat the two diseases in developing countries.

  13. [Importation of malaria to Lombardy. I - Analysis of reported cases].

    PubMed

    Carosi, G; Giannico, L; Maccabruni, A; Parisi, A; Fraschini, G; Comelli, M

    1983-03-31

    The comparative analysis of the cases of imported malaria in Lombardy and in Italy during 1976-1980, shows that the prevalent factors of risk are, in both, the male sex, the young age, the stay in endemic areas of tropical Africa where P. falciparum is greatly prevalent. The only very significant difference is represented by the prevalence of touristic motivation of the stay among the cases of Lombardy. The efficacy of prophylaxis against these factors of risk allowed to note, in the two last years considered (1979-1980), a sharp reduction of the annual number of cases in opposition to the trend of European cases of malaria. PMID:6639773

  14. Malaria on the move: human population movement and malaria transmission.

    PubMed Central

    Martens, P.; Hall, L.

    2000-01-01

    Reports of malaria are increasing in many countries and in areas thought free of the disease. One of the factors contributing to the reemergence of malaria is human migration. People move for a number of reasons, including environmental deterioration, economic necessity, conflicts, and natural disasters. These factors are most likely to affect the poor, many of whom live in or near malarious areas. Identifying and understanding the influence of these population movements can improve prevention measures and malaria control programs. PMID:10756143

  15. Malaria in Britain: 1977-86

    PubMed Central

    Phillips-Howard, P A; Bradley, D J; Blaze, M; Hurn, M

    1988-01-01

    The incidence of malaria in Britain as reported to the Malaria Reference Laboratory during the past decade has increased by 51%, from 1529 to 2309 cases, and infection with Plasmodium falciparum has increased from one fifth to one third of all cases. The case fatality rate for P falciparum infections declined from 2·7% to 0·5%. Of the 67 persons who died, 54 were of British origin, nine of Asian descent, and four African. Sixteen had taken chemoprophylaxis; of these, nine had taken pyrimethamine alone. The pattern of infection shows that resident ethnic minority groups, temporary residents from west Africa, and tourists who visit Kenya are particularly at high risk. The calculated attack rates suggest that men, children, and young adults are at greater risk of malaria than women and older people. Rates are highest in immigrants who have settled in Britain who visit relatives: 316 and 331 per 100 000 for Africa and Asia respectively, 120 and 39 in tourists to those same regions, and 228 and 38 in business travellers to those regions. PMID:3124901

  16. [Malaria and children who travel - prophylaxis and therapy].

    PubMed

    Schlagenhauf, Patricia; Haller, Sabine; Wagner, Noémie; Chappuis, François

    2013-06-01

    Children account for between 15 - 20 % of all imported malaria cases worldwide. Immigrant children visiting their families in the country of origin in sub-Saharan Africa are at highest risk. Prevention of malaria in children who travel to endemic areas is guided by the ABCD principles - Awareness of risk, Bite prevention, Chemoprophylaxis for high risk areas and rapid Diagnosis and treatment when malaria is suspected. The use of anti-malarial medication in small children is hampered by a paucity of dosage, pharmcokinetic and tolerability data. In the pre-travel consultation parents should be provided with practical advice on anti-mosquito measures, exact, (weight-based) dosages of chemoprophylaxis medication and/or stand-by treatment as indicated. A paediatric formulation is available for daily atovaquone-proguanil chemoprophylaxis (children > 11 kg) and mefloquine is a cost-effective, once weekly prophylaxis that is useful for children > 5 kg who travel for longer periods. The bitter taste of mefloquine should be disguised to increase adherence. When a Stand-by Emergency Treatment (SBET) is indicated, artemether-lumefantrine cherry flavoured dispersible tablets are a good choice for small children. Post-travel to endemic areas, malaria should always be suspected if a child becomes ill. Paediatric malaria is an emergency requiring prompt diagnosis and appropriate treatment.

  17. Spatial analysis of land cover determinants of malaria incidence in the Ashanti Region, Ghana.

    PubMed

    Krefis, Anne Caroline; Schwarz, Norbert Georg; Nkrumah, Bernard; Acquah, Samuel; Loag, Wibke; Oldeland, Jens; Sarpong, Nimako; Adu-Sarkodie, Yaw; Ranft, Ulrich; May, Jürgen

    2011-01-01

    Malaria belongs to the infectious diseases with the highest morbidity and mortality worldwide. As a vector-borne disease malaria distribution is strongly influenced by environmental factors. The aim of this study was to investigate the association between malaria risk and different land cover classes by using high-resolution multispectral Ikonos images and Poisson regression analyses. The association of malaria incidence with land cover around 12 villages in the Ashanti Region, Ghana, was assessed in 1,988 children <15 years of age. The median malaria incidence was 85.7 per 1,000 inhabitants and year (range 28.4-272.7). Swampy areas and banana/plantain production in the proximity of villages were strong predictors of a high malaria incidence. An increase of 10% of swampy area coverage in the 2 km radius around a village led to a 43% higher incidence (relative risk [RR] = 1.43, p<0.001). Each 10% increase of area with banana/plantain production around a village tripled the risk for malaria (RR = 3.25, p<0.001). An increase in forested area of 10% was associated with a 47% decrease of malaria incidence (RR = 0.53, p = 0.029). Distinct cultivation in the proximity of homesteads was associated with childhood malaria in a rural area in Ghana. The analyses demonstrate the usefulness of satellite images for the prediction of malaria endemicity. Thus, planning and monitoring of malaria control measures should be assisted by models based on geographic information systems.

  18. Iron Deficiency Protects Against Severe Plasmodium falciparum Malaria and Death in Young Children

    PubMed Central

    Gwamaka, Moses; Kurtis, Jonathan D.; Sorensen, Bess E.; Holte, Sarah; Morrison, Robert; Mutabingwa, Theonest K.; Fried, Michal

    2012-01-01

    (See the Editorial Commentary by Awah and Kaneko, on pages 1145–7.) Background. Iron supplementation may increase malaria morbidity and mortality, but the effect of naturally occurring variation in iron status on malaria risk is not well studied. Methods. A total of 785 Tanzanian children living in an area of intense malaria transmission were enrolled at birth, and intensively monitored for parasitemia and illness including malaria for up to 3 years, with an average of 47 blood smears. We assayed plasma samples collected at routine healthy-child visits, and evaluated the impact of iron deficiency (ID) on future malaria outcomes and mortality. Results. ID at routine, well-child visits significantly decreased the odds of subsequent parasitemia (23% decrease, P < .001) and subsequent severe malaria (38% decrease, P = .04). ID was also associated with 60% lower all-cause mortality (P = .04) and 66% lower malaria-associated mortality (P = .11). When sick visits as well as routine healthy-child visits are included in analyses (average of 3 iron status assays/child), ID reduced the prevalence of parasitemia (6.6-fold), hyperparasitemia (24.0-fold), and severe malaria (4.0-fold) at the time of sample collection (all P < .001). Conclusions. Malaria risk is influenced by physiologic iron status, and therefore iron supplementation may have adverse effects even among children with ID. Future interventional studies should assess whether treatment for ID coupled with effective malaria control can mitigate the risks of iron supplementation for children in areas of malaria transmission. PMID:22354919

  19. Spatial analysis of land cover determinants of malaria incidence in the Ashanti Region, Ghana.

    PubMed

    Krefis, Anne Caroline; Schwarz, Norbert Georg; Nkrumah, Bernard; Acquah, Samuel; Loag, Wibke; Oldeland, Jens; Sarpong, Nimako; Adu-Sarkodie, Yaw; Ranft, Ulrich; May, Jürgen

    2011-01-01

    Malaria belongs to the infectious diseases with the highest morbidity and mortality worldwide. As a vector-borne disease malaria distribution is strongly influenced by environmental factors. The aim of this study was to investigate the association between malaria risk and different land cover classes by using high-resolution multispectral Ikonos images and Poisson regression analyses. The association of malaria incidence with land cover around 12 villages in the Ashanti Region, Ghana, was assessed in 1,988 children <15 years of age. The median malaria incidence was 85.7 per 1,000 inhabitants and year (range 28.4-272.7). Swampy areas and banana/plantain production in the proximity of villages were strong predictors of a high malaria incidence. An increase of 10% of swampy area coverage in the 2 km radius around a village led to a 43% higher incidence (relative risk [RR] = 1.43, p<0.001). Each 10% increase of area with banana/plantain production around a village tripled the risk for malaria (RR = 3.25, p<0.001). An increase in forested area of 10% was associated with a 47% decrease of malaria incidence (RR = 0.53, p = 0.029). Distinct cultivation in the proximity of homesteads was associated with childhood malaria in a rural area in Ghana. The analyses demonstrate the usefulness of satellite images for the prediction of malaria endemicity. Thus, planning and monitoring of malaria control measures should be assisted by models based on geographic information systems. PMID:21448277

  20. The current and potential role of satellite remote sensing in the campaign against malaria

    NASA Astrophysics Data System (ADS)

    Kazansky, Yaniv; Wood, Danielle; Sutherlun, Jacob

    2016-04-01

    Malaria and other vector borne diseases claim lives and cause illness, especially in less developed countries. Although well understood methods, such as spraying and insecticidal nets, are identified as effective deterrents to malaria transmission by mosquitoes, the nations that have the greatest burden from the disease also struggle to deploy such measures sufficiently. More targeted and up to date information is needed to identify which regions of malaria-endemic countries are most likely to be at risk of malaria in the near future. This will allow national governments, local officials and public health workers to deploy protective equipment and personnel where they are most needed. This paper explores the role of environmental data generated via satellite remote sensing as an ingredient to a Malaria Early Warning System. Data from remote sensing satellites can cover broad geographical areas frequently and consistently. Much of the relevant data may be accessed by malaria-endemic countries at minimal cost via international data sharing polices. While previous research studies have demonstrated the potential to assign malaria risk to a geographic region based on indicators from satellites and other sources, there is still a need to deploy such tools in a broader and more operational manner to inform decision making on malaria management. This paper describes current research on the use of satellite-based environmental data to predict malaria risk and examines the barriers and opportunities for implementing Malaria Early Warning Systems enabled by satellite remote sensing. A Systems Architecture Framework analyses the components of a Malaria Early Warning System and highlights the need for effective coordination across public and private sector organizations.

  1. Spatial Analysis of Land Cover Determinants of Malaria Incidence in the Ashanti Region, Ghana

    PubMed Central

    Krefis, Anne Caroline; Schwarz, Norbert Georg; Nkrumah, Bernard; Acquah, Samuel; Loag, Wibke; Oldeland, Jens; Sarpong, Nimako; Adu-Sarkodie, Yaw; Ranft, Ulrich; May, Jürgen

    2011-01-01

    Malaria belongs to the infectious diseases with the highest morbidity and mortality worldwide. As a vector-borne disease malaria distribution is strongly influenced by environmental factors. The aim of this study was to investigate the association between malaria risk and different land cover classes by using high-resolution multispectral Ikonos images and Poisson regression analyses. The association of malaria incidence with land cover around 12 villages in the Ashanti Region, Ghana, was assessed in 1,988 children <15 years of age. The median malaria incidence was 85.7 per 1,000 inhabitants and year (range 28.4–272.7). Swampy areas and banana/plantain production in the proximity of villages were strong predictors of a high malaria incidence. An increase of 10% of swampy area coverage in the 2 km radius around a village led to a 43% higher incidence (relative risk [RR] = 1.43, p<0.001). Each 10% increase of area with banana/plantain production around a village tripled the risk for malaria (RR = 3.25, p<0.001). An increase in forested area of 10% was associated with a 47% decrease of malaria incidence (RR = 0.53, p = 0.029). Distinct cultivation in the proximity of homesteads was associated with childhood malaria in a rural area in Ghana. The analyses demonstrate the usefulness of satellite images for the prediction of malaria endemicity. Thus, planning and monitoring of malaria control measures should be assisted by models based on geographic information systems. PMID:21448277

  2. Influence Analysis of Ranking Data.

    ERIC Educational Resources Information Center

    Poon, Wai-Yin; Chan, Wai

    2002-01-01

    Developed diagnostic measures to identify observations in Thurstonian models for ranking data that unduly influence parameter estimates obtained by the partition maximum likelihood approach of W. Chan and P. Bender (1998). (SLD)

  3. Climatic warming and increased malaria incidence in Rwanda.

    PubMed

    Loevinsohn, M E

    1994-03-19

    Global climatic change is expected to increase the incidence of vector-borne diseases, especially malaria. This study assessed the contribution of climate to a malaria epidemic in Rwanda, focusing on the catchment area of one health centre where diagnosis was consistent and non-climatic variables well monitored. In late 1987 malaria incidence in the area increased by 337% over the 3 previous years. The increase was greatest in groups with little acquired immunity--children under 2 years (564%) and people in high-altitude areas (501%). Case-fatality rose significantly (relative risk = 4.85, p < 0.001). 1987 also saw record high temperatures and rainfall. An autoregressive equation including lagged effects of these two variables explained 80% of the variance in monthly malaria incidence. Temperature (especially mean minimum) predicted incidence best at higher altitudes where malaria had increased most. Empirically derived relations were consistent with the estimated generation time of the disease and with the known sensitivity of the plasmodium parasite to temperature. The patterns of climatic warming between day and night and among seasons will be critical to the effect on malaria. These findings are most relevant to regions near the altitude or latitude limits of the disease, where several epidemics have lately been reported.

  4. Optimal temperature for malaria transmission is dramaticallylower than previously predicted

    USGS Publications Warehouse

    Mordecai, Eerin A.; Paaijmans, Krijin P.; Johnson, Leah R.; Balzer, Christian; Ben-Horin, Tal; de Moor, Emily; McNally, Amy; Pawar, Samraat; Ryan, Sadie J.; Smith, Thomas C.; Lafferty, Kevin D.

    2013-01-01

    The ecology of mosquito vectors and malaria parasites affect the incidence, seasonal transmission and geographical range of malaria. Most malaria models to date assume constant or linear responses of mosquito and parasite life-history traits to temperature, predicting optimal transmission at 31 °C. These models are at odds with field observations of transmission dating back nearly a century. We build a model with more realistic ecological assumptions about the thermal physiology of insects. Our model, which includes empirically derived nonlinear thermal responses, predicts optimal malaria transmission at 25 °C (6 °C lower than previous models). Moreover, the model predicts that transmission decreases dramatically at temperatures > 28 °C, altering predictions about how climate change will affect malaria. A large data set on malaria transmission risk in Africa validates both the 25 °C optimum and the decline above 28 °C. Using these more accurate nonlinear thermal-response models will aid in understanding the effects of current and future temperature regimes on disease transmission.

  5. The role of antimalarial treatment in the elimination of malaria.

    PubMed

    Gosling, R D; Okell, L; Mosha, J; Chandramohan, D

    2011-11-01

    With declining transmission of malaria in several regions of the world and renewed interest in the elimination of malaria, strategies for malaria control using antimalarial drugs are being revisited. Drug-based strategies to reduce transmission of malaria need to target the asymptomatic carriers of infection. Drugs that are effective against gametocytes are few in number, but it may be possible to reduce gametocyte production by killing the asexual stages, for which more drugs are available. Drugs for use in large-scale programmes must be safe and tolerable. Strategies include improving access to treatment for malaria with an efficacious drug, intermittent-treatment programmes, and mass drug administration, with and without screening for malaria. Recent proposals have targeted high-risk groups for interventions. None of the strategies has been rigorously tested with appropriate control groups for comparison. Because of the lack of field evidence, modelling has been used. Models have shown, first, that for long-lasting effects, drug administration programmes should be linked with vector control, and second, that if elimination is the aim, programmes are likely to be more successful when applied to smaller populations of a few thousand or less. In order to sustain the gains following the scaling up of vector control and use of artemisinin combination therapies (ACTs), strategies that use antimalarials effectively need to be devised and evidence generated for the most cost-efficient way forward.

  6. The distinctive features of Indian malaria parasites.

    PubMed

    Das, Aparup

    2015-03-01

    Malaria and factors driving malaria are heterogeneous in India, unlike in other countries, and the epidemiology of malaria therefore is considered 'highly complex'. This complexity is primarily attributed to several unique features of the malaria parasites, mosquito vectors, malaria-susceptible populations, and ecoclimatic variables in India. Recent research on the genetic epidemiology of Indian malaria parasites has been successful in partly unraveling the mysteries underlying these complexities.

  7. The unexpected importance of mosquito oviposition behaviour for malaria: non-productive larval habitats can be sources for malaria transmission

    PubMed Central

    Menach, Arnaud Le; McKenzie, F Ellis; Flahault, Antoine; Smith, David L

    2005-01-01

    Background Mosquitoes commute between blood-meal hosts and water. Thus, heterogeneity in human biting reflects underlying spatial heterogeneity in the distribution and suitability of larval habitat as well as inherent differences in the attractiveness, suitability and distribution of blood-meal hosts. One of the possible strategies of malaria control is to identify local vector species and then attack water bodies that contain their larvae. Methods Biting and host seeking, not oviposition, have been the focus of most previous studies of mosquitoes and malaria transmission. This study presents a mathematical model that incorporates mosquito oviposition behaviour. Results The model demonstrates that oviposition is one potential factor explaining heterogeneous biting and vector distribution in a landscape with a heterogeneous distribution of larval habitat. Adult female mosquitoes tend to aggregate around places where they oviposit, thereby increasing the risk of malaria, regardless of the suitability of the habitat for larval development. Thus, a water body may be unsuitable for adult mosquito emergence, but simultaneously, be a source for human malaria. Conclusion Larval density may be a misleading indicator of a habitat's importance for malaria control. Even if mosquitoes could be lured to oviposit in sprayed larval habitats, this would not necessarily mitigate – and might aggravate – the risk of malaria transmission. Forcing mosquitoes to fly away from humans in search of larval habitat may be a more efficient way to reduce the risk of malaria than killing larvae. Thus, draining, fouling, or filling standing water where mosquitoes oviposit can be more effective than applying larvicide. PMID:15892886

  8. RANK and RANK ligand expression in primary human osteosarcoma.

    PubMed

    Branstetter, Daniel; Rohrbach, Kathy; Huang, Li-Ya; Soriano, Rosalia; Tometsko, Mark; Blake, Michelle; Jacob, Allison P; Dougall, William C

    2015-09-01

    Receptor activator of nuclear factor kappa-B ligand (RANKL) is an essential mediator of osteoclast formation, function and survival. In patients with solid tumor metastasis to the bone, targeting the bone microenvironment by inhibition of RANKL using denosumab, a fully human monoclonal antibody (mAb) specific to RANKL, has been demonstrated to prevent tumor-induced osteolysis and subsequent skeletal complications. Recently, a prominent functional role for the RANKL pathway has emerged in the primary bone tumor giant cell tumor of bone (GCTB). Expression of both RANKL and RANK is extremely high in GCTB tumors and denosumab treatment was associated with tumor regression and reduced tumor-associated bone lysis in GCTB patients. In order to address the potential role of the RANKL pathway in another primary bone tumor, this study assessed human RANKL and RANK expression in human primary osteosarcoma (OS) using specific mAbs, validated and optimized for immunohistochemistry (IHC) or flow cytometry. Our results demonstrate RANKL expression was observed in the tumor element in 68% of human OS using IHC. However, the staining intensity was relatively low and only 37% (29/79) of samples exhibited≥10% RANKL positive tumor cells. RANK expression was not observed in OS tumor cells. In contrast, RANK expression was clearly observed in other cells within OS samples, including the myeloid osteoclast precursor compartment, osteoclasts and in giant osteoclast cells. The intensity and frequency of RANKL and RANK staining in OS samples were substantially less than that observed in GCTB samples. The observation that RANKL is expressed in OS cells themselves suggests that these tumors may mediate an osteoclastic response, and anti-RANKL therapy may potentially be protective against bone pathologies in OS. However, the absence of RANK expression in primary human OS cells suggests that any autocrine RANKL/RANK signaling in human OS tumor cells is not operative, and anti-RANKL therapy

  9. Rapid diagnostic tests for malaria.

    PubMed

    Visser, Theodoor; Daily, Jennifer; Hotte, Nora; Dolkart, Caitlin; Cunningham, Jane; Yadav, Prashant

    2015-12-01

    Maintaining quality, competitiveness and innovation in global health technology is a constant challenge for manufacturers, while affordability, access and equity are challenges for governments and international agencies. In this paper we discuss these issues with reference to rapid diagnostic tests for malaria. Strategies to control and eliminate malaria depend on early and accurate diagnosis. Rapid diagnostic tests for malaria require little training and equipment and can be performed by non-specialists in remote settings. Use of these tests has expanded significantly over the last few years, following recommendations to test all suspected malaria cases before treatment and the implementation of an evaluation programme to assess the performance of the malaria rapid diagnostic tests. Despite these gains, challenges exist that, if not addressed, could jeopardize the progress made to date. We discuss recent developments in rapid diagnostic tests for malaria, highlight some of the challenges and provide suggestions to address them.

  10. Rapid diagnostic tests for malaria

    PubMed Central

    Daily, Jennifer; Hotte, Nora; Dolkart, Caitlin; Cunningham, Jane; Yadav, Prashant

    2015-01-01

    Abstract Maintaining quality, competitiveness and innovation in global health technology is a constant challenge for manufacturers, while affordability, access and equity are challenges for governments and international agencies. In this paper we discuss these issues with reference to rapid diagnostic tests for malaria. Strategies to control and eliminate malaria depend on early and accurate diagnosis. Rapid diagnostic tests for malaria require little training and equipment and can be performed by non-specialists in remote settings. Use of these tests has expanded significantly over the last few years, following recommendations to test all suspected malaria cases before treatment and the implementation of an evaluation programme to assess the performance of the malaria rapid diagnostic tests. Despite these gains, challenges exist that, if not addressed, could jeopardize the progress made to date. We discuss recent developments in rapid diagnostic tests for malaria, highlight some of the challenges and provide suggestions to address them. PMID:26668438

  11. [Assessment of malaria screening management in blood donation control in the French Military Blood Institute].

    PubMed

    Pouget, T; Garcia-Hejl, C; Bouzard, S; Roche, C; Sailliol, A; Martinaud, C

    2014-06-01

    The French Military Blood Institute is responsible for the entire blood supply chain in the French Armed Forces. Considering, the high exposition rate of military to malaria risk, blood donation screening of plasmodium infection must be as efficient as possible. The main aim of our study was to assess our malaria testing strategy based on a single Elisa test compared with a two-step strategy implying immunofluorescence testing as confirmation test. The second goal was to describe characteristic of malaria Elisa positive donors. We conducted a prospective study: every malaria Elisa positive test was implemented by immunofluorescence testing and demographical data were recorded as usual by our medical software. We showed a significant risk of malaria ELISA positive tests among donor born in endemic area and we estimate the number of abusively 3-year rejected donors. However, based on our estimations, the two-step strategy is not relevant since the number of additionally collected blood products will be low. PMID:24948206

  12. Malaria outbreak in a malaria-free region in Oman 1998: unknown impact of civil war in Africa.

    PubMed

    Baomar, A; Mohamed, A

    2000-11-01

    Beginning in April 1998, the surveillance system in Dhofar region, Oman, detected malaria cases among individuals who had no risk factors for the acquisition of malaria. An investigation was conducted to describe the outbreak and to identify its possible causes. A malaria case was defined as an unexplained fever (>38 degrees C) in a resident of the Dhofar region from April to September 1998. The investigation consisted of enhanced passive case detection, active case finding through contact screening, mass blood survey and school survey. Also an entomological survey was conducted and meteorological data was reviewed. Over a period of seven months, 1279 patients with fever were examined for malaria parasites. Sixty-five cases were positive; 60 (92%) males and 5 (8%) females. Cases occurred in all age groups (range: 2-63 years, median 25 years). Most cases were among illegal Somali immigrants (28, 43%) followed by Omanis (20, 31%). Out of the 2323 slides collected from the community and 2487 from school children, 21 slides were positive. All of them were from illegal immigrants. The entomological survey detected three vectors, previously found in the region: A. d'thali, A. sergenti and A. stephensi. Although the region is classified as a malaria-free region, it has the potential for malaria introduction. This outbreak most likely occurred due to the influx of hundreds of illegal Somali immigrants due to the civil war into the Dhofar region, providing a sufficient number of gametocyte carriers for local anopheline mosquitoes to feed on.

  13. A Novel Malaria Pf/Pv Ab Rapid Diagnostic Test Using a Differential Diagnostic Marker Identified by Network Biology.

    PubMed

    Cho, Sung Jin; Lee, Jihoo; Lee, Hyun Jae; Jo, Hyun-Young; Sinniah, Mangalam; Kim, Hak-Yong; Chong, Chom-Kyu; Song, Hyun-Ok

    2016-01-01

    Rapid diagnostic tests (RDTs) can detect anti-malaria antibodies in human blood. As they can detect parasite infection at the low parasite density, they are useful in endemic areas where light infection and/or re-infection of parasites are common. Thus, malaria antibody tests can be used for screening bloods in blood banks to prevent transfusion-transmitted malaria (TTM), an emerging problem in malaria endemic areas. However, only a few malaria antibody tests are available in the microwell-based assay format and these are not suitable for field application. A novel malaria antibody (Ab)-based RDT using a differential diagnostic marker for falciparum and vivax malaria was developed as a suitable high-throughput assay that is sensitive and practical for blood screening. The marker, merozoite surface protein 1 (MSP1) was discovered by generation of a Plasmodium-specific network and the hierarchical organization of modularity in the network. Clinical evaluation revealed that the novel Malaria Pf/Pv Ab RDT shows improved sensitivity (98%) and specificity (99.7%) compared with the performance of a commercial kit, SD BioLine Malaria P.f/P.v (95.1% sensitivity and 99.1% specificity). The novel Malaria Pf/Pv Ab RDT has potential for use as a cost-effective blood-screening tool for malaria and in turn, reduces TTM risk in endemic areas. PMID:27313496

  14. A Novel Malaria Pf/Pv Ab Rapid Diagnostic Test Using a Differential Diagnostic Marker Identified by Network Biology

    PubMed Central

    Cho, Sung Jin; Lee, Jihoo; Lee, Hyun Jae; Jo, Hyun-Young; Sinniah, Mangalam; Kim, Hak-Yong; Chong, Chom-Kyu; Song, Hyun-Ok

    2016-01-01

    Rapid diagnostic tests (RDTs) can detect anti-malaria antibodies in human blood. As they can detect parasite infection at the low parasite density, they are useful in endemic areas where light infection and/or re-infection of parasites are common. Thus, malaria antibody tests can be used for screening bloods in blood banks to prevent transfusion-transmitted malaria (TTM), an emerging problem in malaria endemic areas. However, only a few malaria antibody tests are available in the microwell-based assay format and these are not suitable for field application. A novel malaria antibody (Ab)-based RDT using a differential diagnostic marker for falciparum and vivax malaria was developed as a suitable high-throughput assay that is sensitive and practical for blood screening. The marker, merozoite surface protein 1 (MSP1) was discovered by generation of a Plasmodium-specific network and the hierarchical organization of modularity in the network. Clinical evaluation revealed that the novel Malaria Pf/Pv Ab RDT shows improved sensitivity (98%) and specificity (99.7%) compared with the performance of a commercial kit, SD BioLine Malaria P.f/P.v (95.1% sensitivity and 99.1% specificity). The novel Malaria Pf/Pv Ab RDT has potential for use as a cost-effective blood-screening tool for malaria and in turn, reduces TTM risk in endemic areas. PMID:27313496

  15. Malaria Transmission, Infection, and Disease at Three Sites with Varied Transmission Intensity in Uganda: Implications for Malaria Control

    PubMed Central

    Kamya, Moses R.; Arinaitwe, Emmanuel; Wanzira, Humphrey; Katureebe, Agaba; Barusya, Chris; Kigozi, Simon P.; Kilama, Maxwell; Tatem, Andrew J.; Rosenthal, Philip J.; Drakeley, Chris; Lindsay, Steve W.; Staedke, Sarah G.; Smith, David L.; Greenhouse, Bryan; Dorsey, Grant

    2015-01-01

    The intensification of control interventions has led to marked reductions in malaria burden in some settings, but not others. To provide a comprehensive description of malaria epidemiology in Uganda, we conducted surveillance studies over 24 months in 100 houses randomly selected from each of three subcounties: Walukuba (peri-urban), Kihihi (rural), and Nagongera (rural). Annual entomological inoculation rate (aEIR) was estimated from monthly Centers for Disease Control and Prevention (CDC) light trap mosquito collections. Children aged 0.5–10 years were provided long-lasting insecticidal nets (LLINs) and followed for measures of parasite prevalence, anemia and malaria incidence. Estimates of aEIR were 2.8, 32.0, and 310 infectious bites per year, and estimates of parasite prevalence 7.4%, 9.3%, and 28.7% for Walukuba, Kihihi, and Nagongera, respectively. Over the 2-year study, malaria incidence per person-years decreased in Walukuba (0.51 versus 0.31, P = 0.001) and increased in Kihihi (0.97 versus 1.93, P < 0.001) and Nagongera (2.33 versus 3.30, P < 0.001). Of 2,582 episodes of malaria, only 8 (0.3%) met criteria for severe disease. The prevalence of anemia was low and not associated with transmission intensity. In our cohorts, where LLINs and prompt effective treatment were provided, the risk of complicated malaria and anemia was extremely low. However, malaria incidence was high and increased over time at the two rural sites, suggesting improved community-wide coverage of LLIN and additional malaria control interventions are needed in Uganda. PMID:25778501

  16. Malaria transmission, infection, and disease at three sites with varied transmission intensity in Uganda: implications for malaria control.

    PubMed

    Kamya, Moses R; Arinaitwe, Emmanuel; Wanzira, Humphrey; Katureebe, Agaba; Barusya, Chris; Kigozi, Simon P; Kilama, Maxwell; Tatem, Andrew J; Rosenthal, Philip J; Drakeley, Chris; Lindsay, Steve W; Staedke, Sarah G; Smith, David L; Greenhouse, Bryan; Dorsey, Grant

    2015-05-01

    The intensification of control interventions has led to marked reductions in malaria burden in some settings, but not others. To provide a comprehensive description of malaria epidemiology in Uganda, we conducted surveillance studies over 24 months in 100 houses randomly selected from each of three subcounties: Walukuba (peri-urban), Kihihi (rural), and Nagongera (rural). Annual entomological inoculation rate (aEIR) was estimated from monthly Centers for Disease Control and Prevention (CDC) light trap mosquito collections. Children aged 0.5-10 years were provided long-lasting insecticidal nets (LLINs) and followed for measures of parasite prevalence, anemia and malaria incidence. Estimates of aEIR were 2.8, 32.0, and 310 infectious bites per year, and estimates of parasite prevalence 7.4%, 9.3%, and 28.7% for Walukuba, Kihihi, and Nagongera, respectively. Over the 2-year study, malaria incidence per person-years decreased in Walukuba (0.51 versus 0.31, P = 0.001) and increased in Kihihi (0.97 versus 1.93, P < 0.001) and Nagongera (2.33 versus 3.30, P < 0.001). Of 2,582 episodes of malaria, only 8 (0.3%) met criteria for severe disease. The prevalence of anemia was low and not associated with transmission intensity. In our cohorts, where LLINs and prompt effective treatment were provided, the risk of complicated malaria and anemia was extremely low. However, malaria incidence was high and increased over time at the two rural sites, suggesting improved community-wide coverage of LLIN and additional malaria control interventions are needed in Uganda.

  17. Ranking nodes in growing networks: When PageRank fails

    PubMed Central

    Mariani, Manuel Sebastian; Medo, Matúš; Zhang, Yi-Cheng

    2015-01-01

    PageRank is arguably the most popular ranking algorithm which is being applied in real systems ranging from information to biological and infrastructure networks. Despite its outstanding popularity and broad use in different areas of science, the relation between the algorithm’s efficacy and properties of the network on which it acts has not yet been fully understood. We study here PageRank’s performance on a network model supported by real data, and show that realistic temporal effects make PageRank fail in individuating the most valuable nodes for a broad range of model parameters. Results on real data are in qualitative agreement with our model-based findings. This failure of PageRank reveals that the static approach to information filtering is inappropriate for a broad class of growing systems, and suggest that time-dependent algorithms that are based on the temporal linking patterns of these systems are needed to better rank the nodes. PMID:26553630

  18. Ranking structures and rank-rank correlations of countries: The FIFA and UEFA cases

    NASA Astrophysics Data System (ADS)

    Ausloos, Marcel; Cloots, Rudi; Gadomski, Adam; Vitanov, Nikolay K.

    2014-04-01

    Ranking of agents competing with each other in complex systems may lead to paradoxes according to the pre-chosen different measures. A discussion is presented on such rank-rank, similar or not, correlations based on the case of European countries ranked by UEFA and FIFA from different soccer competitions. The first question to be answered is whether an empirical and simple law is obtained for such (self-) organizations of complex sociological systems with such different measuring schemes. It is found that the power law form is not the best description contrary to many modern expectations. The stretched exponential is much more adequate. Moreover, it is found that the measuring rules lead to some inner structures in both cases.

  19. Concurrent meningitis and vivax malaria

    PubMed Central

    Santra, Tuhin; Datta, Sumana; Agrawal, Neha; Bar, Mita; Kar, Arnab; Adhikary, Apu; Ranjan, Kunal

    2015-01-01

    Malaria is an endemic infectious disease in India. It is often associated with other infective conditions but concomitant infection of malaria and meningitis are uncommon. We present a case of meningitis with vivax malaria infection in a 24-year-old lady. This case emphasizes the importance of high index of clinical suspicion to detect other infective conditions like meningitis when fever does not improve even after anti-malarial treatment in a patient of malaria before switching therapy suspecting drug resistance, which is quite common in this part of world. PMID:26985423

  20. Malaria elimination: surveillance and response

    PubMed Central

    Bridges, Daniel J; Winters, Anna M; Hamer, Davidson H

    2012-01-01

    In the last decade, substantial progress has been made in reducing malaria-associated morbidity and mortality across the globe. Nevertheless, sustained malaria control is essential to continue this downward trend. In some countries, where aggressive malaria control has reduced malaria to a low burden level, elimination, either nationally or subnationally, is now the aim. As countries or areas with a low malaria burden move towards elimination, there is a transition away from programs of universal coverage towards a strategy of localized detection and response to individual malaria cases. To do so and succeed, it is imperative that a strong surveillance and response system is supported, that community cadres are trained to provide appropriate diagnostics and treatment, and that field diagnostics are further developed such that their sensitivity allows for the detection and subsequent treatment of malaria reservoirs in low prevalence environments. To be certain, there are big challenges on the road to elimination, notably the development of drug and insecticide resistance. Nevertheless, countries like Zambia are making great strides towards implementing systems that support malaria elimination in target areas. Continued development of new diagnostics and antimalarial therapies is needed to support progress in malaria control and elimination. PMID:23265423

  1. Malaria protection measures used by in-flight travelers to South African game parks.

    PubMed

    Waner, S; Durrhiem, D; Braack, L E; Gammon, S

    1999-12-01

    Malaria prevention in travelers depends upon dissemination of accurate information about malaria risk, prevention of mosquito bites, appropriate chemoprophylaxis use and knowledge of the symptoms of malaria. A study was undertaken of travelers to the Kruger National Park and private game parks in Mpumalanga Province, South Africa to investigate travelers knowledge, of malaria, chemoprophylaxis use, and experience of adverse events. In-flight self administered questionnaires were distributed and completed by travelers on flights returning to Johannesburg International Airport, from the malaria areas. The study was conducted during the highest malaria risk period during 1996. The Mpumalanga game parks are those most visited in South Africa and are found in the extreme northeast of the country, which adjoins Mozambique in the east and Zimbabwe in the north. This area is classified by the South African health authorities as being a high risk Malaria area.10 Chloroquine-resistant Plasmodium falciparum malaria has been described in this area.2,3 The Department of Health in South Africa recommends the use of mefloquine alone or the combination of chloroquine and proguanil, (doxycycline is prescribed for travelers in which the former antimalarials cannot be utilized), for visitors to this area during the high risk period for malaria, which extends from October to May.4 For the remainder of the year mosquito avoidance measures are recommended. Little is known about travelers' compliance with these recommendations and their knowledge of malaria. A study to explore these factors was undertaken as a joint initiative between the SAIMR travel clinic, Mpumalanga Department of Health, and the South African National Parks.

  2. Oceanic influence on seasonal malaria outbreaks over Senegal and Sahel. Predictability using S4CAST model

    NASA Astrophysics Data System (ADS)

    Diouf, Ibrahima; Deme, Abdoulaye; Rodriguez-Fonseca, Belen; Suárez-Moreno, Roberto; Cisse, Moustapha; Ndione, Jacques-André; Thierno Gaye, Amadou

    2014-05-01

    Senegal and, in general, West African regions are affected by important outbreaks of diseases with destructive consequences for human population, livestock and country's economy. The vector-borne diseases such as mainly malaria, Rift Valley Fever and dengue are affected by the interanual to decadal variability of climate. Analysis of the spatial and temporal variability of climate parameters and associated oceanic patterns is important in order to assess the climate impact on malaria transmission. In this study, the approach developed to study the malaria-climate link is predefined by the QWeCI project (Quantifying Weather and Climate Impacts on Health in Developing Countries). Preliminary observations and simulations results over Senegal Ferlo region, confirm that the risk of malaria transmission is mainly linked to climate parameters such as rainfall, temperature and relative humidity; and a lag of one to two months between the maximum of malaria and the maximum of climate parameters as rainfall is observed. As climate variables are able to be predicted from oceanic SST variability in remote regions, this study explores seasonal predictability of malaria incidence outbreaks from previous sea surface temperatures conditions in different ocean basins. We have found causal or coincident relationship between El Niño and malaria parameters by coupling LMM UNILIV malaria model and S4CAST statistiscal model with the aim of predicting the malaria parameters with more than 6 months in advance. In particular, El Niño is linked to an important decrease of the number of mosquitoes and the malaria incidence. Results from this research, after assessing the seasonal malaria parameters, are expected to be useful for decision makers to better access to climate forecasts and application on health in the framework of rolling back malaria transmission.

  3. Climatic variables and malaria transmission dynamics in Jimma town, South West Ethiopia

    PubMed Central

    2011-01-01

    Background:- In Ethiopia, malaria is seasonal and unstable, causing frequent epidemics. It usually occurs at altitudes < 2,000 m above sea level. Occasionally, transmission of malaria occurs in areas previously free of malaria, including areas > 2,000 m above sea level. For transmission of malaria parasite, climatic factors are important determinants as well as non-climatic factors that can negate climatic influences. Indeed, there is a scarcity of information on the correlation between climatic variability and malaria transmission risk in Ethiopia in general and in the study area in particular. Therefore, the aim of this study was to determine the level of correlation between meteorological variables and malaria cases. Methods: - Time-series analysis was conducted using data on monthly meteorological variables and monthly total malaria in Jimma town, south west Ethiopia, for the period 2000-2009. All the data were entered and analyzed using SPSS-15 database program. Spearman correlation and linear regression analysis were used to asses association between the variables. Results: - During last ten years (2000-2009), a fluctuating trend of malaria transmission was observed with P.vivax becoming predominant species. Spearman correlation analysis showed that monthly minimum temperature, total rainfall and two measures of relative humidity were positively related with malaria but monthly maximum temperature negatively related. Also regression analysis suggested that monthly minimum (p = 0.008), monthly maximum temperature (p = 0.013) and monthly total rainfall (p = 0.040), at one month lagged effect, were significant meteorological factors for transmission of malaria in the study area. Conclusion: - Malaria incidences in the last decade seem to have a significant association with meteorological variables. In future, prospective and multidisciplinary cooperative research involving researchers from the fields of parasitology, epidemiology, botany, agriculture and

  4. Cerebral Malaria in Children Is Associated With Long-term Cognitive Impairment

    PubMed Central

    John, Chandy C.; Bangirana, Paul; Byarugaba, Justus; Opoka, Robert O.; Idro, Richard; Jurek, Anne M.; Wu, Baolin; Boivin, Michael J.

    2008-01-01

    OBJECTIVE Cerebral malaria affects >785 000 African children every year. We previously documented an increased frequency of cognitive impairment in children with cerebral malaria 6 months after their initial malaria episode. This study was conducted to determine the long-term effects of cerebral malaria on the cognitive function of these children. METHODS Children who were 5 to 12 years of age and presented to Mulago Hospital, Kampala, Uganda, with cerebral malaria (n = 44) or uncomplicated malaria (n = 54), along with healthy, asymptomatic community children (n = 89), were enrolled in a prospective cohort study of cognition. Cognitive testing was performed at enrollment and 2 years later. The primary outcome was presence of a deficit in ≥1 of 3 cognitive areas tested. RESULTS At 2-year follow-up testing, 26.3% of children with cerebral malaria and 12.5% with uncomplicated malaria had cognitive deficits in ≥1 area, as compared with 7.6% of community children. Deficits in children with cerebral malaria were primarily in the area of attention (cerebral malaria, 18.4%, vs community children, 2.5%). After adjustment for age, gender, nutrition, home environment, and school level, children with cerebral malaria had a 3.67-fold increased risk for a cognitive deficit compared with community children. Cognitive impairment at 2-year follow-up was associated with hyporeflexia on admission and neurologic deficits 3 months after discharge. CONCLUSIONS Cerebral malaria is associated with long-term cognitive impairments in 1 of 4 child survivors. Future studies should investigate the mechanisms involved so as to develop interventions aimed at prevention and rehabilitation. PMID:18541616

  5. Malaria control in Tanzania

    SciTech Connect

    Yhdego, M.; Majura, P. )

    1988-01-01

    A review of the malaria control programs and the problem encountered in the United Republic of Tanzania since 1945 to the year 1986 is discussed. Buguruni, one of the squatter areas in the city of Dar es Salaam, is chosen as a case study in order to evaluate the economic advantage of engineering methods for the control of malaria infection. Although the initial capital cost of engineering methods may be high, the cost effectiveness requires a much lower financial burden of only about Tshs. 3 million compared with the conventional methods of larviciding and insecticiding which requires more than Tshs. 10 million. Finally, recommendations for the adoption of engineering methods are made concerning the upgrading of existing roads and footpaths in general with particular emphasis on drainage of large pools of water which serve as breeding sites for mosquitoes.

  6. Pathogenesis of malaria revisited.

    PubMed

    Dasari, Prasad; Bhakdi, Sucharit

    2012-11-01

    Plasmodium falciparum malaria claims 1 million lives around the globe every year. Parasitemia can reach remarkably high levels. The developing parasite digests hemoglobin and converts the waste product to hemozoin alias malaria pigment. These processes occur in a vesicular compartment named the digestive vacuole (DV). Each parasitized cell releases one DV upon rupture. Myriads of DVs thus gain entry into the blood, but whether they trigger pathobiological events has never been investigated. We recently discovered that the DV membrane simultaneously activates the two major enzyme cascades in blood, complement and coagulation. Activation of both is known to occur in patients with severe malaria, so discovery of the common trigger has large consequences. The DV membrane but not the merozoite has the capacity to spontaneously activate the alternative complement and intrinsic clotting pathway. Ejection of merozoites and the DV into the bloodstream, therefore, results in selective opsonization and phagocytosis of the DV, leaving merozoites free to invade new cells. The DV membrane furthermore has the capacity to assemble prothrombinase, the key convertase of the intrinsic clotting pathway. The dual capacity of the DV to activate both complement and coagulation can be suppressed by low-molecular-weight dextran sulfate. This agent protects experimental animals from the detrimental consequences, resulting from intravenous application of purified DVs. Phagocytosis of DVs not only deploys PMN away from merozoites, but also drives the cells into a state of functional exhaustion. This may be one reason for the enhanced susceptibility of patients with severe malaria toward systemic bacterial infections. Together, these findings indicate that the DV may represent a hitherto unrecognized, important determinant of parasite pathogenicity.

  7. Oxidative Stress in Malaria

    PubMed Central

    Percário, Sandro; Moreira, Danilo R.; Gomes, Bruno A. Q.; Ferreira, Michelli E. S.; Gonçalves, Ana Carolina M.; Laurindo, Paula S. O. C.; Vilhena, Thyago C.; Dolabela, Maria F.; Green, Michael D.

    2012-01-01

    Malaria is a significant public health problem in more than 100 countries and causes an estimated 200 million new infections every year. Despite the significant effort to eradicate this dangerous disease, lack of complete knowledge of its physiopathology compromises the success in this enterprise. In this paper we review oxidative stress mechanisms involved in the disease and discuss the potential benefits of antioxidant supplementation as an adjuvant antimalarial strategy. PMID:23208374

  8. Epidemiological and clinical correlates of malaria-helminth co-infections in southern Ethiopia

    PubMed Central

    2013-01-01

    Background In many areas of the world, including Ethiopia, malaria and helminths are co-endemic, therefore, co-infections are common. However, little is known how concurrent infections affect the epidemiology and/or pathogenesis of each other. Therefore, this study was conducted to assess the effects of intestinal helminth infections on the epidemiology and clinical patterns of malaria in southern Ethiopia where both infections are prevalent. Methods A cross-sectional study was conducted in 2006 at Wondo Genet Health Center and Bussa Clinic, southern Ethiopia. Consecutive blood film positive malaria patients (N=230) and malaria negative asymptomatic individuals (N=233) were recruited. Malaria parasite detection and quantification was diagnosed using Giemsa-stained thick and thin blood films, respectively. Helminths were detected using direct microscopy and formol-ether concentration techniques. Coarse quantification of helminths ova was made using Kato Katz method. Results The over all magnitude of intestinal parasitic infection was high irrespective of malaria infection (67% among malaria positive patients versus 53.1% among malaria non-infected asymptomatic individuals). Trichuris trichiura infection was associated with increased malaria prevalence while increased worm burden of helminths as expressed by egg intensity was associated with increased malaria parasitaemia which could be a potential factor for development of severe malarial infection with the course of the disease. Majority (77%) of the subjects had multiple helminths infection. T. trichiura, Ascaris lumbricoides, Schistosoma mansoni, and hookworm infestation accounted for 64.5, 57.7 %, 28.4%, and 12.2% of the infections, respectively. Conclusions Populations in malaria-endemic areas of southern Ethiopia are multi-parasitized with up to four helminths. Mass deworming may be a simple practical approach in endemic areas in reducing the risk of severe malarial attack particularly for those at high risk

  9. [Malaria in hominids].

    PubMed

    Snounou, Georges; Escalante, Ananias; Kasenene, John; Rénia, Laurent; Grüner, Anne-Charlotte; Krief, Sabrina

    2011-11-01

    Malaria parasites (Plasmodium spp) that infect great apes are very poorly documented Malaria was first described in gorillas, chimpanzees and orangutans in the early 20th century, but most studies were confined to a handful of chimpanzees in the 1930-1950s and a few orangutans in the 1970s. The three Plasmodium species described in African great apes were very similar to those infecting humans. The most extensively studied was P reichenowi, because of its close phylogenetic relation to P. falciparum, the predominant parasite in Africa and the most dangerous for humans. In the last three years, independent molecular studies of various chimpanzee and gorilla populations have revealed an unexpected diversity in the Plasmodium species they harbor, which are also phylogenetically close to P falciparum. In addition, cases of non human primate infection by human malaria parasites have been observed. These observations shed fresh light on the origin and evolutionary history of P. falciparum and provide a unique opportunity to probe the biological specificities of this major human parasite.

  10. Imported malaria in pregnancy in Madrid

    PubMed Central

    2012-01-01

    Background Malaria in pregnancy is associated with maternal and foetal morbidity and mortality in endemic areas, but information on imported cases to non-endemic areas is scarce. The aim of this study was to describe the clinical and epidemiological characteristics of malaria in pregnancy in two general hospitals in Madrid, Spain. Methods Retrospective descriptive study of laboratory-confirmed malaria in pregnant women at the Fuenlabrada University Hospital and the Príncipe de Asturias University Hospital, in Madrid, over a six- and 11-year period, respectively. Relevant epidemiological, clinical and laboratory data was obtained from medical records. Results There were 19 pregnant women among 346 malaria cases (5.4%). The average age was 27 years. The gestational age (trimester) was: 53% 3rd, 31% 1st, 16% 2nd. All but one were multigravidae. Three were HIV positive. All were sub-Saharan immigrants: two were recently arrived immigrants and seventeen (89%) had visited friends and relatives. None had taken prophylaxis nor seeked pre-travel advice. Presentation: 16 symptomatic patients (fever in fourteen, asthenia in two), three asymptomatic. Median delay in diagnosis: 7.5 days. Laboratory tests: anaemia (cut off Hb level 11 g/dl) 78.9% (mild 31.6%, moderate 31.6%, severe 15.8%) thrombocytopaenia 73.7%, hypoglycaemia 10.5%. All cases were due to Plasmodium falciparum, one case of hyperparasitaemia. Quinine + clindamycin prescribed in 84%. Outcomes: no severe maternal complications or deaths, two abortions, fifteen term pregnancies, no low-birth-weight newborns, two patients were lost to follow-up. Conclusions Though cases of malaria in pregnancy are uncommon, a most at risk group is clearly defined: young sub-Saharan mothers visiting friends and relatives without pre-travel counselling and recently-arrived immigrants. The most common adverse maternal and foetal effects were anaemia and stillbirth. Given that presentation can be asymptomatic, malaria should always be

  11. What's wrong with hazard-ranking systems? An expository note.

    PubMed

    Cox, Louis Anthony Tony

    2009-07-01

    Two commonly recommended principles for allocating risk management resources to remediate uncertain hazards are: (1) select a subset to maximize risk-reduction benefits (e.g., maximize the von Neumann-Morgenstern expected utility of the selected risk-reducing activities), and (2) assign priorities to risk-reducing opportunities and then select activities from the top of the priority list down until no more can be afforded. When different activities create uncertain but correlated risk reductions, as is often the case in practice, then these principles are inconsistent: priority scoring and ranking fails to maximize risk-reduction benefits. Real-world risk priority scoring systems used in homeland security and terrorism risk assessment, environmental risk management, information system vulnerability rating, business risk matrices, and many other important applications do not exploit correlations among risk-reducing opportunities or optimally diversify risk-reducing investments. As a result, they generally make suboptimal risk managem