Malariological baseline survey and in vitro antimalarial drug resistance in Gulu district, Northern Uganda

Prugger, Christof; Engl, Michael; Ogwang, Martin D.; Ploner, Franz; Ploner, Martin; Gluderer, Doris; Wernsdorfer, Gunther; Wernsdorfer, Walther H.

doi:10.1007/s00508-008-1037-y

Cited by 3 publications

(3 citation statements)

References 5 publications

(5 reference statements)

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“…As expected, overall malaria prevalence in northern Uganda was high, consistent with the results from previous surveys from that region [20, 34, 35]. In agreement with the earlier studies, the weighted pfPR in the two neighboring regions studied was comparable.…”

Section: Discussionsupporting

confidence: 92%

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Age and geographic patterns of Plasmodium falciparum malaria infection in a representative sample of children living in Burkitt lymphoma-endemic areas of northern Uganda

Maziarz

Kinyera

Otim

et al. 2017

Malar J

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BackgroundFalciparum malaria is an important risk factor for African Burkitt lymphoma (BL), but few studies have evaluated malaria patterns in healthy BL-age children in populations where both diseases are endemic. To obtain accurate current data, patterns of asymptomatic malaria were investigated in northern Uganda, where BL is endemic.MethodsBetween 2011 and 2015, 1150 apparently healthy children under 15 years old were sampled from 100 villages in northern Uganda using a stratified, multi-stage, cluster survey design. Falciparum malaria prevalence (pfPR) was assessed by questionnaire, rapid diagnostic test (RDT) and thick film microscopy (TFM). Weighted pfPR and unadjusted and adjusted associations of prevalence with covariates were calculated using logistic models and survey methods.ResultsBased on 1143 children successfully tested, weighted pfPR was 54.8% by RDT and 43.4% by TFM. RDT sensitivity and specificity were 97.5 and 77.8%, respectively, as compared to TFM, because RDT detect malaria antigens, which persist in peripheral blood after clinical malaria, thus results based on RDT are reported. Weighted pfPR increased from 40% in children aged under 2 years to 61.8% in children aged 6–8 years (odds ratio 2.42, 95% confidence interval (CI) 1.26–4.65), then fell slightly to 49% in those aged 12–15 years. Geometric mean parasite density was 1805.5 parasites/µL (95% CI 1344.6–2424.3) among TFM-positive participants, and it was higher in children aged <5 years at 5092.9/µL (95% CI 2892.7–8966.8) and lower in those aged ≥10 years at 983.8/µL (95% CI 472.7–2047.4; P = 0.001). Weighted pfPR was lower in children residing in sub-regions employing indoor residual spraying (IRS) than in those residing in non-IRS sub-regions (32.8 versus 65.7%; OR 0.26, 95% CI 0.14, 0.46). However, pfPR varied both within IRS (3.2–55.3%) and non-IRS sub-regions (29.8–75.8%; Pheterogeneity <0.001). pfPR was inversely correlated with a child’s mother’s income (P = 0.011) and positively correlated with being enrolled in the wet season (P = 0.076), but sex was irrelevant.ConclusionsThe study observed high but geographically and demographically heterogenous patterns of asymptomatic malaria prevalence among children living in northern Uganda. These results provide important baseline data that will enable precise evaluation of associations between malaria and BL.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1778-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

“…Similar to prior studies from this region [20, 34, 35], there was no difference in the weighted pfPR estimate for the north-central and northwest regions (Fig. 2a).…”

Section: Resultssupporting

confidence: 86%

Age and geographic patterns of Plasmodium falciparum malaria infection in a representative sample of children living in Burkitt lymphoma-endemic areas of northern Uganda

Maziarz

Kinyera

Otim

et al. 2017

Malar J

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“…According to MSF, malaria is the main cause of human morbidity in northern Uganda, both in the population as a whole and among children aged ,5 years, accounting for 47% and 51% of all episodes of illness in these two groups, respectively (www.msf.or.jp/news/ baseline/Baseline.pdf). Although the human malaria in the Gulu area should probably be characterised as holo-endemic (Prugger et al, 2008), there are few reliable data of relevance.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-seeking strategies among displaced children in war-ridden northern Uganda: the case of malaria

Akello-Ayebare

Richters²,

Polderman

et al. 2010

Annals of Tropical Medicine & Parasitology

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A field study was performed to examine suffering and treatment seeking from the perspective of children aged 8-16 years living in war-affected northern Uganda. Various techniques for collecting qualitative and quantitative data were used, including a semi-structured questionnaire about illness experiences and medicine use over a 1-month recall period. The 165 children who were interviewed were attending primary schools for displaced children and/or commuters' night shelters. The children frequently attributed their common febrile ailments to malaria and used a variety of pharmaceuticals and herbal remedies, as self-medication, for their self-diagnosed malarial episodes. Misdiagnosis of febrile illnesses by the children (as well as by the local healthcare providers) and frequent misuse of medicines in the treatment of these illnesses appeared to be very common. Improvement of the health conditions of these children requires a change of focus. Firstly, children above the age of 5 years who are not under adult care and who are often no longer welcome in the local hospital's paediatric ward need to be accepted at the outpatient clinics currently intended for adults. Secondly, the local diagnostic system needs to be improved, not only so that malaria can be reliably diagnosed but also so that alternative diagnoses can be confirmed or rejected, otherwise the current over-consumption of antimalarial drugs may simply be replaced with an over-consumption of antibiotics.

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Global resistance surveillance: ensuring antimalarial efficacy in the future

Guérin¹,

Bates²,

Sibley³

2009

Current Opinion in Infectious Diseases

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Malariological baseline survey and in vitro antimalarial drug resistance in Gulu district, Northern Uganda

Cited by 3 publications

References 5 publications

Age and geographic patterns of Plasmodium falciparum malaria infection in a representative sample of children living in Burkitt lymphoma-endemic areas of northern Uganda

Age and geographic patterns of Plasmodium falciparum malaria infection in a representative sample of children living in Burkitt lymphoma-endemic areas of northern Uganda

Healthcare-seeking strategies among displaced children in war-ridden northern Uganda: the case of malaria

Global resistance surveillance: ensuring antimalarial efficacy in the future

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