1921
Volume 84, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Recent reports of reductions in malaria transmission in several African countries have resulted in optimism that malaria can be eliminated in parts of Africa where it is currently endemic. It is not known whether these trends are global or whether they are also present in areas where political instability has hindered effective malaria control. We determined malaria parasite carriage and age-dependent antibody responses to antigens in cross-sectional surveys in Apac, northern Uganda that was affected by political unrest. Under-five parasite prevalence was 55.8% (115/206) by microscopy and 71.9% (41/57) by polymerase chain reaction. alone, or as a co-infection, was detected in 8.6% (12/139) and in 4.3% (6/139) of the infections. Age seroprevalence curves gave no indication of recent changes in malaria transmission intensity. Malaria control remains a tremendous challenge in areas that have not benefited from large-scale interventions, illustrated here by the district of Apac.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2011.10-0498
2011-05-05
2018-12-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/84/5/830.html?itemId=/content/journals/10.4269/ajtmh.2011.10-0498&mimeType=html&fmt=ahah

References

  1. Barnes KI, 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.[Crossref] [Google Scholar]
  2. 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.[Crossref] [Google Scholar]
  3. Kleinschmidt I, Schwabe C, Benavente L, Torrez M, Ridl FC, Segura JL, Ehmer P, Nchama GN, , 2009. Marked increase in child survival after four years of intensive malaria control. Am J Trop Med Hyg 80: 882888. [Google Scholar]
  4. O'Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton CR, Marsh K, , 2008. Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet 372: 15551562.[Crossref] [Google Scholar]
  5. Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ, , 2008. Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Lancet 372: 15451554.[Crossref] [Google Scholar]
  6. Graves PM, Osgood DE, Thomson MC, Sereke K, Araia A, Zerom M, Ceccato P, Bell M, Del Corral J, Ghebreselassie S, Brantly EP, Ghebremeskel T, , 2008. Effectiveness of malaria control during changing climate conditions in Eritrea, 1998–2003. Trop Med Int Health 13: 218228.[Crossref] [Google Scholar]
  7. Barnes KI, Chanda P, Ab Barnabas G, , 2009. Impact of the large-scale deployment of artemether/lumefantrine on the malaria disease burden in Africa: case studies of South Africa, Zambia and Ethiopia. Malar J 8 (Suppl 1): S8.[Crossref] [Google Scholar]
  8. O'Meara WP, Mangeni JN, Steketee R, Greenwood B, , 2010. Changes in the burden of malaria in sub-Saharan Africa. Lancet Infect Dis 10: 545555.[Crossref] [Google Scholar]
  9. World Health Organization, 2009. World Malaria Report 2009. Geneva, Switzerland: WHO. [Google Scholar]
  10. Hay SI, Guerra CA, Tatem AJ, Atkinson PM, Snow RW, , 2005. Urbanization, malaria transmission and disease burden in Africa. Nat Rev Microbiol 3: 8190.[Crossref] [Google Scholar]
  11. Roberts L, , 2010. Shrinking the malaria map from the outside in. Science 328: 849851.[Crossref] [Google Scholar]
  12. Coghlan B, Brennan RJ, Ngoy P, Dofara D, Otto B, Clements M, Stewart T, , 2006. Mortality in the Democratic Republic of Congo: a nationwide survey. Lancet 367: 4451.[Crossref] [Google Scholar]
  13. Salama P, Spiegel P, Talley L, Waldman R, , 2004. Lessons learned from complex emergencies over past decade. Lancet 364: 18011813.[Crossref] [Google Scholar]
  14. Hawkes M, Katsuva JP, Masumbuko CK, , 2009. Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo. Malar J 8: 308.[Crossref] [Google Scholar]
  15. Gayer M, Legros D, Formenty P, Connolly MA, , 2007. Conflict and emerging infectious diseases. Emerg Infect Dis 13: 16251631.[Crossref] [Google Scholar]
  16. World Health Organization, 2005. Malaria control in complex emergencies. An Inter-Agency Field Handbook. Geneva, Switzerland: WHO. [Google Scholar]
  17. Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, D'Alessandro U, Coosemans M, , 2006. Variation in malaria transmission intensity in seven sites throughout Uganda. Am J Trop Med Hyg 75: 219225. [Google Scholar]
  18. Apio B, Nalunkuma A, Okello D, Riley E, Egwang TG, , 2000. Human IgG subclass antibodies to the 19 kilodalton carboxy terminal fragment of Plasmodium falciparum merozoite surface protein 1 (MSP1(19)) and predominance of the MAD20 allelic type of MSP1 in Uganda. East Afr Med J 77: 189193. [Google Scholar]
  19. Egwang TG, Apio B, Riley E, Okello D, , 2000. Plasmodium falciparum malariometric indices in Apac district, northern Uganda. East Afr Med J 77: 413416. [Google Scholar]
  20. Accorsi S, Fabiani M, Lukwiya M, Ravera M, Costanzi A, Ojom L, Paze E, Manenti F, Anguzu P, Dente MG, Declich S, , 2001. Impact of insecurity, the AIDS epidemic, and poverty on population health: disease patterns and trends in northern Uganda. Am J Trop Med Hyg 64: 214221. [Google Scholar]
  21. World Health Organization, 2004. Disaster update: report 15110. Available at: http://www.who.int/disasters/repo/15110.pdf. Accessed July 15, 2009. [Google Scholar]
  22. Drakeley CJ, Corran PH, Coleman PG, Tongren JE, McDonald SL, Carneiro I, Malima R, Lusingu J, Manjurano A, Nkya WM, Lemnge MM, Cox J, Reyburn H, Riley EM, , 2005. Estimating medium- and long-term trends in malaria transmission by using serological markers of malaria exposure. Proc Natl Acad Sci USA 102: 51085113.[Crossref] [Google Scholar]
  23. Stewart L, Gosling R, Griffin J, Gesase S, Campo J, Hashim R, Masika P, Mosha J, Bousema T, Shekalaghe S, Cook J, Corran P, Ghani A, Riley EM, Drakeley C, , 2009. Rapid assessment of malaria transmission using age-specific sero-conversion rates. PLoS ONE 4: e6083.[Crossref] [Google Scholar]
  24. Cook J, Reid H, Iavro J, Kuwahata M, Taleo G, Clements A, McCarthy J, Vallely A, Drakeley C, , 2010. Using serological measures to monitor changes in malaria transmission in Vanuatu. Malar J 9: 169.[Crossref] [Google Scholar]
  25. Corran P, Coleman P, Riley E, Drakeley C, , 2007. Serology: a robust indicator of malaria transmission intensity? Trends Parasitol 23: 575582.[Crossref] [Google Scholar]
  26. World Health Organization, 2008. Malaria Rapid Diagnostic Test Performance. Results of WHO product testing of malaria RDTs, Round 1. doi:10.2471/TDR.09.978-924-1598071. [Google Scholar]
  27. Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE, , 1995. Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. Am J Trop Med Hyg 52: 565568. [Google Scholar]
  28. Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, , 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61: 315320.[Crossref] [Google Scholar]
  29. Padley D, Moody AH, Chiodini PL, Saldanha J, , 2003. Use of a rapid, single-round, multiplex PCR to detect malarial parasites and identify the species present. Ann Trop Med Parasitol 97: 131137.[Crossref] [Google Scholar]
  30. Corran PH, Cook J, Lynch C, Leendertse H, Manjurano A, Griffin J, Cox J, Abeku T, Bousema T, Ghani AC, Drakeley C, Riley E, , 2008. Dried blood spots as a source of anti-malarial antibodies for epidemiological studies. Malar J 7: 195.[Crossref] [Google Scholar]
  31. Talisuna AO, Langi P, Mutabingwa TK, Van Marck E, Speybroeck N, Egwang TG, Watkins WW, Hastings IM, D'Alessandro U, , 2003. Intensity of transmission and spread of gene mutations linked to chloroquine and sulphadoxine-pyrimethamine resistance in falciparum malaria. Int J Parasitol 33: 10511058.[Crossref] [Google Scholar]
  32. Malaria Atlas Project. Available at: http://www.map.ox.ac.uk/. Accessed July 13, 2009. [Google Scholar]
  33. Okell LC, Ghani AC, Lyons E, Drakeley CJ, , 2009. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis 200: 15091517.[Crossref] [Google Scholar]
  34. Steenkeste N, Rogers WO, Okell L, Jeanne I, Incardona S, Duval L, Chy S, Hewitt S, Chou M, Socheat D, Babin FX, Ariey F, Rogier C, , 2010. Sub-microscopic malaria cases and mixed malaria infection in a remote area of high malaria endemicity in Rattanakiri province, Cambodia: implication for malaria elimination. Malar J 9: 108.[Crossref] [Google Scholar]
  35. Ouedraogo AL, Schneider P, de Kruijf M, Nebie I, Verhave JP, Cuzin-Ouattara N, Sauerwein RW, , 2007. Age-dependent distribution of Plasmodium falciparum gametocytes quantified by Pfs25 real-time QT-NASBA in a cross-sectional study in Burkina Faso. Am J Trop Med Hyg 76: 626630. [Google Scholar]
  36. Shekalaghe SA, Bousema JT, Kunei KK, Lushino P, Masokoto A, Wolters LR, Mwakalinga S, Mosha FW, Sauerwein RW, Drakeley CJ, , 2007. Submicroscopic Plasmodium falciparum gametocyte carriage is common in an area of low and seasonal transmission in Tanzania. Trop Med Int Health 12: 547553.[Crossref] [Google Scholar]
  37. Schellenberg JR, Smith T, Alonso PL, Hayes RJ, , 1994. What is clinical malaria? Finding case definitions for field research in highly endemic areas. Parasitol Today 10: 439442.[Crossref] [Google Scholar]
  38. Koram KA, Molyneux ME, , 2007. When is “malaria” malaria? The different burdens of malaria infection, malaria disease, and malaria-like illnesses. Am J Trop Med Hyg 77: 15. [Google Scholar]
  39. Delley V, Bouvier P, Breslow N, Doumbo O, Sagara I, Diakite M, Mauris A, Dolo A, Rougemont A, , 2000. What does a single determination of malaria parasite density mean? A longitudinal survey in Mali. Trop Med Int Health 5: 404412.[Crossref] [Google Scholar]
  40. Kinyanjui SM, Mwangi T, Bull PC, Newbold CI, Marsh K, , 2004. Protection against clinical malaria by heterologous immunoglobulin G antibodies against malaria-infected erythrocyte variant surface antigens requires interaction with asymptomatic infections. J Infect Dis 190: 15271533.[Crossref] [Google Scholar]
  41. Bull PC, Lowe BS, Kaleli N, Njuga F, Kortok M, Ross A, Ndungu F, Snow RW, Marsh K, , 2002. Plasmodium falciparum infections are associated with agglutinating antibodies to parasite-infected erythrocyte surface antigens among healthy Kenyan children. J Infect Dis 185: 16881691.[Crossref] [Google Scholar]
  42. Akpogheneta OJ, Duah NO, Tetteh KK, Dunyo S, Lanar DE, Pinder M, Conway DJ, , 2008. Duration of naturally acquired antibody responses to blood-stage Plasmodium falciparum is age dependent and antigen specific. Infect Immun 76: 17481755.[Crossref] [Google Scholar]
  43. Giha HA, Nasr A, Iriemenam NC, Balogun HA, Arnot D, Theander TG, Troye-Blomberg M, Berzins K, ElGhazali G, , 2010. Age-dependent association between IgG2 and IgG3 subclasses to Pf332-C231 antigen and protection from malaria, and induction of protective antibodies by sub-patent malaria infections, in Daraweesh. Vaccine 28: 17321739.[Crossref] [Google Scholar]
  44. Shekalaghe S, Alifrangis M, Mwanziva C, Enevold A, Mwakalinga S, Mkali H, Kavishe R, Manjurano A, Sauerwein R, Drakeley C, Bousema T, , 2009. Low density parasitaemia, red blood cell polymorphisms and Plasmodium falciparum specific immune responses in a low endemic area in northern Tanzania. BMC Infect Dis 9: 69.[Crossref] [Google Scholar]
  45. Kinyanjui SM, Bejon P, Osier FH, Bull PC, Marsh K, , 2009. What you see is not what you get: implications of the brevity of antibody responses to malaria antigens and transmission heterogeneity in longitudinal studies of malaria immunity. Malar J 8: 242.[Crossref] [Google Scholar]
  46. Ndyomugyenyi R, Magnussen P, , 2004. Trends in malaria-attributable morbidity and mortality among young children admitted to Ugandan hospitals, for the period 1990–2001. Ann Trop Med Parasitol 98: 315327.[Crossref] [Google Scholar]
  47. Mabiala-Babela JR, Samba-Louaka C, Mouko A, Senga P, , 2003. Morbidity in a pediatric department (University Hospital of Brazzaville): 12 years later (1989–2001). Arch Pediatr 10: 650652.[Crossref] [Google Scholar]
  48. Himeidan YE, Hamid EE, Thalib L, Elbashir MI, Adam I, , 2007. Climatic variables and transmission of falciparum malaria in New Halfa, eastern Sudan. East Mediterr Health J 13: 1724. [Google Scholar]
  49. Okiro EA, Alegana VA, Noor AM, Mutheu JJ, Juma E, Snow RW, , 2009. Malaria pediatric hospitalization between 1999 and 2008 across Kenya. BMC Med 7: 75.[Crossref] [Google Scholar]
  50. Kleinschmidt I, Torrez M, Schwabe C, Benavente L, Seocharan I, Jituboh D, Nseng G, Sharp B, , 2007. Factors influencing the effectiveness of malaria control in Bioko Island, equatorial Guinea. Am J Trop Med Hyg 76: 10271032. [Google Scholar]
  51. Zurovac D, Tibenderana JK, Nankabirwa J, Ssekitooleko J, Njogu JN, Rwakimari JB, Meek S, Talisuna A, Snow RW, , 2008. Malaria case-management under artemether-lumefantrine treatment policy in Uganda. Malar J 7: 181.[Crossref] [Google Scholar]
  52. Lewis K, , 2008. DDT stalemate stymies malaria control initiative. CMAJ 179: 9991000.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2011.10-0498
Loading
/content/journals/10.4269/ajtmh.2011.10-0498
Loading

Data & Media loading...

  • Received : 08 Sep 2010
  • Accepted : 15 Dec 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error