Distribution of Plasmodium falciparum gametocytes and malaria-attributable fraction of fever episodes along an altitudinal transect in Western Cameroon

Tchuinkam, Timoléon; Nyih-Kong, Bridget; Fopa, François; Simard, Frédéric; Antonio-Nkondjio, Christophe; Awono-Ambene, Herman Parfait; Guidone, Laura; Mbida, Mpoame

doi:10.1186/s12936-015-0594-6

Cited by 17 publications

(14 citation statements)

References 47 publications

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“…The RDT positivity rate was indeed higher, by almost three-fold, among those recommended for RDT testing than among those not recommended for RDT testing by the first step of the algorithm. Studies that examined the effect of seasonality found a higher malaria-attributable fraction during the rainy season [ 7 , 9 ] and studies that looked at the effect of transmission intensity found that a higher proportion of fevers in higher transmission zones were due to malaria [ 5 , 6 , 8 ], as was found in Senegal. These assumptions were generally confirmed by the proportion of positive tests by season and transmission zone.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the utility of a symptom-based algorithm for identifying febrile patients for malaria diagnostic testing in Senegal

Thwing

Diaby

et al. 2017

Malar J

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BackgroundMalaria rapid diagnostic tests (RDTs) enable point-of-care testing to be nearly as sensitive and specific as reference microscopy. The Senegal National Malaria Control Programme introduced RDTs in 2007, along with a case management algorithm for uncomplicated febrile illness, in which the first step stipulates that if a febrile patient of any age has symptoms indicative of febrile illness other than malaria (e.g., cough or rash), they would not be tested for malaria, but treated for the apparent illness and receive an RDT for malaria only if they returned in 48 h without improvement.MethodsA year-long study in 16 health posts was conducted to determine the algorithm’s capacity to identify patients with Plasmodium falciparum infection identifiable by RDT. Health post personnel enrolled patients of all ages with fever (≥37.5 °C) or history of fever in the previous 2 days. After clinical assessment, a nurse staffing the health post determined whether a patient should receive an RDT according to the diagnostic algorithm, but performed an RDT for all enrolled patients.ResultsOver 1 year, 6039 patients were enrolled and 58% (3483) were determined to require an RDT according to the algorithm. Overall, 23% (1373/6039) had a positive RDT, 34% (1130/3376) during rainy season and 9% (243/2661) during dry season. The first step of the algorithm identified only 78% of patients with a positive RDT, varying by transmission season (rainy 80%, dry 70%), malaria transmission zone (high 75%, low 95%), and age group (under 5 years 68%, 5 years and older 84%).ConclusionsIn all but the lowest malaria transmission zone, use of the algorithm excludes an unacceptably large proportion of patients with malaria from receiving an RDT at their first visit, denying them timely diagnosis and treatment. While the algorithm was adopted within a context of malaria control and scarce resources, with the goal of treating patients with symptomatic malaria, Senegal has now adopted a policy of universal diagnosis of patients with fever or history of fever. In addition, in the current context of malaria elimination, the paradigm of case management needs to shift towards the identification and treatment of all patients with malaria infection.

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Section: Discussionmentioning

confidence: 99%

Assessment of the utility of a symptom-based algorithm for identifying febrile patients for malaria diagnostic testing in Senegal

Thwing

Diaby

et al. 2017

Malar J

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“…Studies on malaria and altitude dynamics reveal that a fall in temperature is not conducive for vectors that transmit malaria [29,30], but in our study there is a direct association between altitude and prevalence of malaria–this may be mainly due to the fact that the range of altitude variation in this study settings is quite narrow, rather acts more as a proxy to forest dwelling for food habits, lesser acceptance of preventive measures leading to uninterrupted malaria transmission [31–34].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of afebrile malaria and development of risk-scores for gradation of villages: A study from a hot-spot in Odisha

et al. 2019

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Introduction Malaria is a public health emergency in India and Odisha. The national malaria elimination programme aims to expedite early identification, treatment and follow-up of malaria cases in hot-spots through a robust health system, besides focusing on efficient vector control. This study, a result of mass screening conducted in a hot-spot in Odisha, aimed to assess prevalence, identify and estimate the risks and develop a management tool for malaria elimination. Methods Through a cross-sectional study and using WHO recommended Rapid Diagnostic Test (RDT), 13221 individuals were screened. Information about age, gender, education and health practices were collected along with blood sample (5 μl) for malaria testing. Altitude, forestation, availability of a village health worker and distance from secondary health center were captured using panel technique. A multi-level poisson regression model was used to analyze association between risk factors and prevalence of malaria, and to estimate risk scores. Results The prevalence of malaria was 5.8% and afebrile malaria accounted for 79 percent of all confirmed cases. Higher proportion of Pv infections were afebrile (81%). We found the prevalence to be 1.38 (1.1664–1.6457) times higher in villages where the Accredited Social Health Activist (ASHA) didn’t stay; the risk increased by 1.38 (1.0428–1.8272) and 1.92 (1.4428–2.5764) times in mid- and high-altitude tertiles. With regard to forest coverage, villages falling under mid- and highest-tertiles were 2.01 times (1.6194–2.5129) and 2.03 times (1.5477–2.6809), respectively, more likely affected by malaria. Similarly, villages of mid tertile and lowest tertile of education had 1.73 times (1.3392–2.2586) and 2.50 times (2.009–3.1244) higher prevalence of malaria. Conclusion Presence of ASHA worker in villages, altitude, forestation, and education emerged as principal predictors of malaria infection in the study area. An easy-to-use risk-scoring system for ranking villages based on these risk factors could facilitate resource prioritization for malaria elimination.

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“…Among the 729 seropositive patients recruited, 119 (16.3%) were febrile (Body Temperature ≥ 38°C and/or other symptoms associated with malaria in this locality, such as: chills, headache, body pains, etc) [4]. Mean temperatures were 38.59°C and 36.72°C in febrile and non-febrile groups respectively (Table 3), with a significant difference (p = 0.001).…”

Section: Comparison Of Febrile and Non-febrile Hiv-positive Participantsmentioning

confidence: 96%

“…In a previous study in the same area, a list of malaria-related manifestations was determined: headache, joint pains, abdominal pains, convulsion and nausea [4]. A comparison of the frequencies of each of these symptoms in the seropositive and seronegative groups was made here, and apart from the abdominal pain whose frequency was higher in the seropositive group, no other symptom's frequency was significantly different between the two groups.…”

Section: Malaria Infections In Seropositive and Seronegative Patientsmentioning

confidence: 99%

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Malaria-attributable fraction of fever episodes among HIV-seropositive patients in the Western highland area of Cameroon

Tchuinkam

Fopa

Doro-Altan

et al. 2019

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Background: Fever is the most frequent symptom for Malaria and HIV/AIDS, but it is non-specific; therefore it can’t be used efficiently in clinical diagnosis of malaria in hyperendemic zones. In hypoendemic areas of malaria, this assertion is not obvious, since people lack naturally acquired immunity. The present study aims at determining the Malaria-attributable fraction of fever episodes (MAFE) among HIV-positive patients in a hypoendemic highland area. Methods: During two-years prospective cross-sectional study, blood samples were collected from outpatients of an HIV/AIDS clinic and examined for the presence and density of malaria parasites. In addition to malaria related symptoms, some other patients’ data were recorded: sexe, age, body mass index (BMI), T-lymphocyte CD4 counts, viral loads, haemograms and transaminases measurements. Results: A total of 729 HIV-seropositive patients were enrolled into the study. Their mean Plasmodial infection rate and parasitaemia were: 0.823% and 1.050 parasites/µl of blood respectively; and were both significantly lower, compared to the control seronegative group, in contrast to our hypothesis. No significant difference was observed when the mean values of transaminases were compared between those with and without plasmodial infection. For the 119 (16.32%) febrile individuals found, the calculated MAFE was almost null (0.15%). Their mean CD4 count, red blood cells (RBC) count and haemoglobin rate were: 226 cell/µl, 3.83x10 6 RBC/µl and 10.4 g/dl respectively; and were all significantly lower than in the non-febrile group. However, malaria parasite infection rates and mean densities were similar in both groups. Likewise, there was no difference between: sex ratios, mean ages, BMI, total white blood cells counts and viral loads between the two groups. Conclusion: HIV infection in spite of the immunodeficiency induced does not enhance the risk of Plasmodium infection in hypoendemic highland settings. Even in the scarce cases of co-infection occurring here, malaria is rarely responsible for fever episodes. These fevers are indeed associated with higher anaemia and immunodeficiency, and likely due instead to opportunistic infectious diseases.

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Distribution of Plasmodium falciparum gametocytes and malaria-attributable fraction of fever episodes along an altitudinal transect in Western Cameroon

Cited by 17 publications

References 47 publications

Assessment of the utility of a symptom-based algorithm for identifying febrile patients for malaria diagnostic testing in Senegal

Assessment of the utility of a symptom-based algorithm for identifying febrile patients for malaria diagnostic testing in Senegal

Prevalence of afebrile malaria and development of risk-scores for gradation of villages: A study from a hot-spot in Odisha

Malaria-attributable fraction of fever episodes among HIV-seropositive patients in the Western highland area of Cameroon

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