Thursday, 12th of July 2012 |
THREE ON MALARIA
Dohyeong Kim*, Kristen Fedak and Randall Kramer
Am J Trop Med Hyg 2012 vol. 87 no. 1 117-124
Abstract below; full text is at
http://www.ajtmh.org/content/87/1/117.full.pdf+html
Indoor residual spraying (IRS) has become an increasingly popular method of insecticide use for malaria control, and many recent studies have reported on its effectiveness in reducing malaria burden in a single community or region. There is a need for systematic review and integration of the published literature on IRS and the contextual determining factors of its success in controlling malaria. This study reports the findings of a meta-regression analysis based on 13 published studies, which were chosen from more than 400 articles through a systematic search and selection process. The summary relative risk for reducing malaria prevalence was 0.38 (95% confidence interval = 0.31–0.46), which indicated a risk reduction of 62%. However, an excessive degree of heterogeneity was found between the studies. The meta-regression analysis indicates that IRS is more effective with high initial prevalence, multiple rounds of spraying, use of DDT, and in regions with a combination of Plasmodium falciparum and P. vivax malaria.
Clinical Infectious Diseasescid.oxfordjournals.org
First published online: March 22, 2012
ANTENATAL RECEIPT OF SULFADOXINE-PYRIMETHAMINE DOES NOT EXACERBATE PREGNANCY-ASSOCIATED MALARIA DESPITE THE EXPANSION OF DRUG-RESISTANT PLASMODIUM FALCIPARUM
Clin Infect Dis. (2012) 55 (1): 42-50.
Malcolm E. Molyneux, Feiko O. ter Kuile, Steven R. Meshnick, and Stephen J. Rogerson
Abstract below and at http://cid.oxfordjournals.org/content/55/1/42.abstract
Full text available to journal subscribers
Background. Antenatal intermittent preventive therapy with 2 doses of sulfadoxine-pyrimethamine (IPTp-SP) is the mainstay of efforts in sub-Saharan Africa to prevent pregnancy-associated malaria (PAM). Recent studies report that drug resistance may cause IPTp-SP to exacerbate PAM morbidity, raising fears that current policies will cause harm as resistance spreads.
Methods. We conducted a serial, cross-sectional analysis of the relationships between IPTp-SP receipt, SP-resistant Plasmodium falciparum, and PAM morbidity in delivering women during a period of 9 years at a single site in Malawi. PAM morbidity was assessed by parasite densities, placental histology, and birth outcomes.
Results. The prevalence of parasites with highly SP-resistant haplotypes increased from 17% to 100% (P < .001), and the proportion of women receiving full IPTp (≥2 doses) increased from 25% to 82% (P < .001). Women who received full IPTp with SP had lower peripheral (P = .018) and placental (P < .001) parasite densities than women who received suboptimal IPTp (<2 doses). This effect was not significantly modified by the presence of highly SP-resistant haplotypes. After adjustment for covariates, the receipt of SP in the presence of SP-resistant P. falciparum did not exacerbate any parasitologic, histologic, or clinical measures of PAM morbidity.
Conclusions. In this longitudinal study of malaria at delivery, the receipt of SP as IPTp did not potentiate PAM morbidity despite the increasing prevalence and fixation of SP-resistant P. falciparum haplotypes. Even when there is substantial resistance, SP may be used in modified IPTp regimens as a component of comprehensive antenatal care.
PLoS One. 2011;6(11):e24871. Epub 2011 Nov 3.
Full text is at http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0024871
Coverage, adherence and costs of intermittent preventive treatment of malaria in children employing different delivery strategies in Jasikan, Ghana
Patouillard E, Conteh L, Webster J, Kweku M, Chandramohan D, Greenwood B.
Source
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, England. Edith.Patouillard@lshtm.ac.uk
Abstract
BACKGROUND:
Intermittent preventive treatment of malaria in children (IPTc) involves the administration of a course of anti-malarial drugs at specified time intervals to children at risk of malaria regardless of whether or not they are known to be infected. IPTc provides a high level of protection against uncomplicated and severe malaria, with monthly sulphadoxine-pyrimethamine plus amodiaquine (SP&AQ) and sulphadoxine-pyrimethamine plus piperaquine being the most efficacious regimens. A key challenge is the identification of a cost-effective delivery strategy.
METHODS:
A community randomized trial was undertaken in Jasikan district, Ghana to assess IPTc effectiveness and costs using SP&AQ delivered in three different ways. Twelve villages were randomly selected to receive IPTc from village health workers (VHWs) or facility-based nurses working at health centres' outpatient departments (OPD) or EPI outreach clinics. Children aged 3 to 59 months-old received one IPT course (three doses) in May, June, September and October. Effectiveness was measured in terms of children covered and adherent to a course and delivery costs were calculated in financial and economic terms using an ingredient approach from the provider perspective.
RESULTS:
The economic cost per child receiving at least the first dose of all 4 courses was US$4.58 when IPTc was delivered by VHWs, US$4.93 by OPD nurses and US$ 5.65 by EPI nurses. The unit economic cost of receiving all 3 doses of all 4 courses was US$7.56 and US$8.51 when IPTc was delivered by VHWs or facility-based nurses respectively. The main cost driver for the VHW delivery was supervision, reflecting resources used for travelling to more remote communities rather than more intense supervision, and for OPD and EPI delivery, it was the opportunity cost of the time spent by nurses in dispensing IPTc.
CONCLUSIONS:
VHWs achieve higher IPTc coverage and adherence at lower costs than facility-based nurses in Jasikan district, Ghana.
Are three drugs for malaria better than two?
Friday, 24th of April 2020 |
Public health Interventions and epidemic intensity during the 1918 influenza pandemic
Thursday, 16th of April 2020 |
Chloroquine and hydroxychloroquine as available weapons to fight COVID-19
Tuesday, 17th of March 2020 |
Using models to shape measles control and elimination strategies in low- and middle-income countries: A review of recent applications
Monday, 17th of February 2020 |
Immunization Agenda 2030
Tuesday, 11th of February 2020 |
41153598 |
www.measlesinitiative.org www.technet21.org www.polioeradication.org www.globalhealthlearning.org www.who.int/bulletin allianceformalariaprevention.com www.malariaworld.org http://www.panafrican-med-journal.com/ |