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The implication of long-lasting insecticide-treated net use in the resurgence of malaria morbidity in a Senegal malaria endemic village in 2010-2011.

Wotodjo AN, Richard V, Boyer S, Doucoure S, Diagne N, Touré-Baldé A, Tall A, Faye N, Gaudart J, Trape JF, Sokhna C - Parasit Vectors (2015)

Bottom Line: A survey on LLINs use was done every quarter of the year.The study population included 449 individuals corresponding to a total of 2140 observations.LLINs use remains effective to reduce malaria burden.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, IRD198, UM63, CNRS7278, INSERMU1095, Aix-Marseille Université, Campus UCAD-IRD, BP 1386, CP 18524, Dakar, Sénégal. amele-nyedzie.wotodjo@ird.fr.

ABSTRACT

Background: Although the burden of malaria has significantly declined in recent years in sub-Saharan Africa through the widespread use of long-lasting insecticide treated bed-nets (LLINs) and artemisinin-based combination therapy, resurgence of malaria is observed in some settings after several years of LLINs use. This study aimed to assess if LLINs use remains protective against malaria during a period of resurgence of malaria morbidity in Dielmo, a rural village of Senegal.

Methods: In July 2008, LLINs were offered to all villagers and lately in July 2011, LLINs were renewed. A longitudinal study was conducted between July, 2010 and December, 2011 among inhabitants of the village of Dielmo to identify all episodes of fever. Thick smears stained with Giemsa were done for every febrile villager and malaria attacks were treated with combination of Artesunate plus Amodiaquine. Cross-sectional surveys were also conducted at the end of the rainy season (October 2010 and November 2011) to assess asymptomatic carriage. A survey on LLINs use was done every quarter of the year. A random-effect logistic regression was used to assess the effect of LLINs use on the risk of having a malaria attack after adjusting for the main risk factors.

Results: The study population included 449 individuals corresponding to a total of 2140 observations. One hundred and fifteen (115) clinical malaria attacks attributed to P. falciparum (cases) have been recorded over the study period. Most of the malaria cases occurred in October-December 2010 (49/115 i.e. 43%) and among adults aged 15 years and over (50/115, i.e. 43%). During the study period, the use of LLINs was 61% among non-malaria cases and only 42% among malaria clinical cases but differenced according to age group. After adjusting on gender, age, rainfall and LLINs replacement, we found that LLINs use (AOR [95%CI] = 0.40 [0.25; 0.62], p < 0.001) remained a protective factor against malaria attacks during the study period.

Conclusion: LLINs use remains effective to reduce malaria burden. These results highlight the need to pursue LLINs implementation in the current context of malaria elimination and to provide positive incentives to increase its use in the population.

No MeSH data available.


Related in: MedlinePlus

Study observations profile.
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Fig1: Study observations profile.

Mentions: We observed 2186 observations corresponding to 452 individuals during the study period. Among the 2186 observations, we excluded 3 observations among malaria cases because they were not investigated for LLINs surveys and another 43 which were related to pregnant women. We finally obtained 2140 observations corresponding to 449 individuals aged from one month to 100.7 years old with a mean of 23.4 years old and a proportion of 49% of women. Among the 2140 observations, 115 (5.6%) were related to individuals who had at least one malaria attack per trimester between July 2010 and December 2011 and 2025 observations were related to individuals who had no malaria attacks. The profile of the study population was shown in Figure 1.Figure 1


The implication of long-lasting insecticide-treated net use in the resurgence of malaria morbidity in a Senegal malaria endemic village in 2010-2011.

Wotodjo AN, Richard V, Boyer S, Doucoure S, Diagne N, Touré-Baldé A, Tall A, Faye N, Gaudart J, Trape JF, Sokhna C - Parasit Vectors (2015)

Study observations profile.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4489109&req=5

Fig1: Study observations profile.
Mentions: We observed 2186 observations corresponding to 452 individuals during the study period. Among the 2186 observations, we excluded 3 observations among malaria cases because they were not investigated for LLINs surveys and another 43 which were related to pregnant women. We finally obtained 2140 observations corresponding to 449 individuals aged from one month to 100.7 years old with a mean of 23.4 years old and a proportion of 49% of women. Among the 2140 observations, 115 (5.6%) were related to individuals who had at least one malaria attack per trimester between July 2010 and December 2011 and 2025 observations were related to individuals who had no malaria attacks. The profile of the study population was shown in Figure 1.Figure 1

Bottom Line: A survey on LLINs use was done every quarter of the year.The study population included 449 individuals corresponding to a total of 2140 observations.LLINs use remains effective to reduce malaria burden.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, IRD198, UM63, CNRS7278, INSERMU1095, Aix-Marseille Université, Campus UCAD-IRD, BP 1386, CP 18524, Dakar, Sénégal. amele-nyedzie.wotodjo@ird.fr.

ABSTRACT

Background: Although the burden of malaria has significantly declined in recent years in sub-Saharan Africa through the widespread use of long-lasting insecticide treated bed-nets (LLINs) and artemisinin-based combination therapy, resurgence of malaria is observed in some settings after several years of LLINs use. This study aimed to assess if LLINs use remains protective against malaria during a period of resurgence of malaria morbidity in Dielmo, a rural village of Senegal.

Methods: In July 2008, LLINs were offered to all villagers and lately in July 2011, LLINs were renewed. A longitudinal study was conducted between July, 2010 and December, 2011 among inhabitants of the village of Dielmo to identify all episodes of fever. Thick smears stained with Giemsa were done for every febrile villager and malaria attacks were treated with combination of Artesunate plus Amodiaquine. Cross-sectional surveys were also conducted at the end of the rainy season (October 2010 and November 2011) to assess asymptomatic carriage. A survey on LLINs use was done every quarter of the year. A random-effect logistic regression was used to assess the effect of LLINs use on the risk of having a malaria attack after adjusting for the main risk factors.

Results: The study population included 449 individuals corresponding to a total of 2140 observations. One hundred and fifteen (115) clinical malaria attacks attributed to P. falciparum (cases) have been recorded over the study period. Most of the malaria cases occurred in October-December 2010 (49/115 i.e. 43%) and among adults aged 15 years and over (50/115, i.e. 43%). During the study period, the use of LLINs was 61% among non-malaria cases and only 42% among malaria clinical cases but differenced according to age group. After adjusting on gender, age, rainfall and LLINs replacement, we found that LLINs use (AOR [95%CI] = 0.40 [0.25; 0.62], p < 0.001) remained a protective factor against malaria attacks during the study period.

Conclusion: LLINs use remains effective to reduce malaria burden. These results highlight the need to pursue LLINs implementation in the current context of malaria elimination and to provide positive incentives to increase its use in the population.

No MeSH data available.


Related in: MedlinePlus