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Volume 80, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In 2005, São Tomé e Príncipe began an initiative aimed at reducing malaria-related mortality to zero. The program included mass coverage with two antivector intervention methods (indoor residual spraying and long-lasting insecticidal nets), artemisinin-based combination therapy, and intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine. At the end of 2007, three years after intensified interventions began, malaria-attributed outpatient consultations, hospitalizations, and deaths decreased by more than 85%, 80%, and 95%, respectively, in all age groups. Mean prevalence of parasitemia and splenomegaly were also significantly reduced to 2.1% ( < 0.0001) and 0.3% ( < 0.0001) after two rounds of spraying from baseline prevalences of 30.5% and 48.8%, respectively. The dramatic reduction in malaria morbidity and mortality now enable serious consideration of new goals and strategies aimed at completely interrupting malaria transmission on these islands. We report evidence of the program’s impact and the feasibility of and potential strategies for eliminating malaria from São Tomé e Príncipe.

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2009-01-01
2017-09-26
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References

  1. Ceita JG, 1986. Malaria in São Tomé and Príncipe. Proceedings of the Conference on Malaria in Africa. Washington, DC:American Institute of Biological Sciences, 142–155.
  2. Loureiro LF, Cesário AM, Franco AS, Rosário VE, 1996. Malaria in São Tomé and Principe: prevalence and drug-susceptibility. Ann Trop Med Parasitol 90 : 223–224.
  3. Baptista JL, Das Neves I, D’Alessandro U, Hendrix L, Wéry M, 1997. Plasmodium falciparum chloroquine and quinine sensitivity in asymptomatic and symptomatic children in São Tomé Island. Trop Med Int Health 2 : 582–588.
  4. Lopes D, Nogueira F, Gil JP, Ferreira C, do Rosário VE, Cravo P, 2002. pfcrt and pfmdr1 mutations and chloroquine resistance in Plasmodium falciparum from São Tomé and Príncipe, West Africa. Ann Trop Med Parasitol 96 : 831–834.
  5. Martet G, Da Conceicao S, Cordoliani G, Delolme H, Raphenon G, Hovette P, Doury JC, Baudon D, Touze JE, Lecamus JL, 1991. Malaria in the republic of São Tomé and Principe. Epidemiologic evaluation and chemoresistance of P. falciparum. Bull Soc Pathol Exot 84 : 273–280.
  6. Centro National de Endemias, 2004. National Strategic Plan for Roll Back Malaria in São Tomé and Principe, 2004–2010. São Tomé e Principe: Ministerio da Saude Centro Nacional de Endemias.
  7. Teklehaimanot A, Singer B, Spielman A, Tozan Y, Schapira A, 2005. Coming to Grips with Malaria in the New Millennium. London: Earthscan.
  8. Pinto J, Sousa CA, Gil V, Gonçalves L, Lopes D, do Rosário VE, Charlwood JD, 2000. Mixed-species malaria infections in the human population of São Tomé island, west Africa. Trans R Soc Trop Med Hyg 94 : 256–257.
  9. Pinto J, Sousa CA, Gil V, Ferreira C, Gonçalves L, Lopes D, Petrarca V, Charlwood JD, do Rosário VE, 2000. Malaria in São Tomé and Príncipe: parasite prevalences and vector densities. Acta Trop 76 : 185–193.
  10. Ribeiro H, Ramos HC, Janz JG, 1992. The feeding and resting behaviour of Anopheles gambiae on the islands of São Tomé and Principe, West Africa. Bull Soc Vector Ecol 17 : 25–27.
  11. Ferreira ID, Martinelli A, Ferreira C, do Rosário VE, Cravo P, 2007. In vitro assessment of artesunate, artemether and amodiaquine susceptibility and molecular analysis of putative resistance-associated mutations of Plasmodium falciparum from São Tomé and Príncipe. Trop Med Int Health 12 : 353–362.
  12. Centro National de Endemias, 2006. Avaliacao do Conhecimento, Atitude e Pratica da Populacao em Relacao ao Mosquiteiro (Fundo Global). São Tomé e Principe: Ministerio da Saude Centro Nacional de Endemias.
  13. Cravo P, Figueiredo S, Nogueira F, Lopes D, Ferreira ID, Ferreira C, Gil JP, do Rosario VE, 2004. High frequency of SP resistance-associated genetic polymorphisms in P. falciparum from STP (West Africa). Ann Trop Med Parasitol 98 : 293–296.
  14. Tseng LF, Chang WC, Ferreira MC, Wu CH, Rampão HS, Jih CL, 2008. Short report: rapid control of malaria by means of indoor residual spraying of alphacypermethrin in the Democratic Republic of São Tomé and Principe. Am J Trop Med Hyg 78 : 248–250.
  15. Centro National de Endemias, 2006. Ensaios de Susceptibilidade do Anopheles gambiae ao Insecticida Alfacipermetrina Relatorio. São Tomé e Principe: Minsterio da Saude Centro Nacional de Endemias.
  16. International Cooperation and Development Fund, 2006. Report on the Malaria Control Project initiated in the Democratic Republic of São Tomé and Principe for the First Term of Three Years (July 2003–June 2006): The Anti-Malaria Team of Taiwan in DRSTP. Medical Mission to São Tomé and Principe.
  17. Global Fund against AIDS, Tuberculosis and Malaria, 2007. Consolidating Malaria Control Efforts for Malaria Elimination in São Tomé and Principe: The Global Fund to Fight AIDS, Tuberculosis and Malaria, Round 7.
  18. Centro National de Endemias, 2006. Indices Plasmodico e Esplenico em Criancas dos 2 Aos 9 Anos, São Tomé e Principe, 2003–2005. Relatorio: Minsterio da Saude Centro Nacional de Endemias.
  19. 2006. Report on the Malaria control Project Initiated in the Democratic Republic of São Tomé and Principe for the First Term of Three Years (July 2003–June 2006). Team for Malaria Control in DRSTP—Taiwan.
  20. Mabaso ML, Sharp B, Lengeler C, 2004. Historical review of malarial control in southern African with emphasis on the use of indoor residual house-spraying. Trop Med Int Health 9 : 846–856.
  21. Adjuik M, Babiker A, Garner P, Olliaro P, Taylor W, White N, International Artemisinin Study Group, 2004. Artesunate combinations for treatement of malaria: meta-analysis. Lancet 363 : 9–17.
  22. van Vugt M, Leonardi E, Phaipun L, Slight T, Thway KL, McGready R, Brockman A, Villegas L, Looareesuwan S, White NJ, Nosten F, 2002. Treatment of uncomplicated multidrug-resistant falciparum malaria with artesunate-atovaquone-proguanil. Clin Infect Dis 35 : 1498–1504.
  23. Sutherland CJ, Ord R, Dunyo S, Jawara M, Drakeley CJ, Alexander N, Pinder M, Walraven G, Taregett GA, 2005. Reduction of malaria transmission to Anopheles mosquitoes with a six-dose regimen of co-artemether. PLoS Med 2 : e92.
  24. Bhattarai A, Ali AS, Kachur SP, Martensson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF, Molteni F, Abdulla S, Montgomery SM, Kaneko A, Bjorkman A, 2007. Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. PLoS Med 4 : e309.
  25. Alonso PL, Lindsay SW, Armstrong Schellenberg JR, Keita K, Gomez P, Shenton FC, Hill AG, David PH, Fegan G, Cham K, Greenwood BM, 1993. A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, west Africa. 6. The impact of the interventions on mortality and morbidity from malaria. Trans R Soc Trop Med Hyg 87 (Suppl 2): 37–44.
  26. Lengeler C, 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev CD000363.
  27. Barnes KL, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ, White NJ, Sharp BL, 2005. Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med 2 : e330.
  28. Yip K, 2000. Malaria eradication: the Taiwan experience. Parassitologia 42 : 117–126.
  29. Sharma VP, Mehrotra KN, 1986. Malaria resurgence in India: a critical study. Soc Sci Med 22 : 835–845.
  30. Kaneko A, Taleob G, Kalkoab M, Yamarb S, Kobayakawaa T, Bjorkman A, 2000. Malaria eradication on islands. Lancet 356 : 1560–1564.
  31. Onori E, Beales PF, Gilles HM, 1993. From malaria eradication to malaria control: the past, the present, and the future. Gilles HM, Warell DA, eds. Bruce-Chwatt’s Essential Malariology. Third edition. New York: John Wiley and Sons, 267–282.
  32. Charlwood JD, Pinto J, Sousa CA, Ferreira C, Petrarca V, Rosario Vdo E, 2003. A mate or a meal—pre-gravid behaviour of female Anopheles gambiae from the islands of São Tomé and Príncipe, West Africa. Malar J 2 : 9.
  33. Sousa CA, Pinto J, Almeida AP, Ferreira C, do Rosário VE, Charlwood JD, 2001. Dogs as a favored host choice of Anopheles gambiae sensu stricto (Diptera: Culicidae) of São Tomé West Africa. J Med Entomol 38 : 122–125.
  34. Sharp BL, Ridl FC, Govender D, Kuklinski J, Kleinschmidt I, 2007. Malaria vector control by indoor residual insecticide spraying on the tropical island of Bioko, Equatorial Guinea. Malar J 6 : 52.
  35. Liang KC, 1991. Historical review of malaria control program in Taiwan. Gaoxiong Yi Xue Ke Xue Za Zhi 7 : 271–277.
  36. Breman JG, Alilio MS, Mills A, 2004. Conquering the intolerable burden of malaria: what’s new, what’s needed: a summary. Am J Trop Med Hyg 71 : 1–15.
  37. Kelly-Hope LA, Yapabandara AM, Wickramasinghe MB, Perera MD, Karunaratne SH, Fernando WP, Abeyasinghe RR, Siyambalagoda RR, Herath PR, Galappaththy GN, Hemingway J, 2005. Spatiotemporal distribution of insecticide resistance in Anopheles culicifacies and Anopheles subpictus in Sri Lanka. Trans R Soc Trop Med Hyg 99 : 751–761.
  38. Kelly-Hope L, Ranson H, Hemingway J, 2008. Lessons from the past: managing insecticide resistance in malaria control and eradication programmes. Lancet Infect Dis 8 : 387–389.
  39. Fang CT, Chang HL, Hsieh WC, 2001. Malaria eradication on islands. Lancet 357 : 560.
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  • Received : 26 Jul 2008
  • Accepted : 16 Sep 2008

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