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Reference Manager
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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: 1051–1058.
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Continuing Intense Malaria Transmission in Northern Uganda
Carla Proietti
Carla Proietti
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Davide D. Pettinato
Davide D. Pettinato
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Bernard N. Kanoi
Bernard N. Kanoi
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Edward Ntege
Edward Ntege
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Andrea Crisanti
Andrea Crisanti
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Eleanor M. Riley
Eleanor M. Riley
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Thomas G. Egwang
Thomas G. Egwang
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Chris Drakeley
Chris Drakeley
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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Teun Bousema
Teun Bousema
Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy
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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 Plasmodium falciparum 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. Plasmodium ovale alone, or as a co-infection, was detected in 8.6% (12/139) and Plasmodium malariae 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.
Author Notes
Financial support: This study was supported by the FIGHTMAL project, receiving funding from the European Community's Seventh Framework Programme [FP7/2007-2013] under grant agreement PIAP-GA-2008-218164.
Authors' addresses: Carla Proietti, Eleanor M. Riley, Chris Drakeley, and Teun Bousema, London School of Hygiene and Tropical Medicine, Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London, UK, E-mails: carla.proietti@lshtm.ac.uk, eleanor.riley@lshtm.ac.uk, chris.drakeley@lshtm.ac.uk, and teun.bousema@lshtm.ac.uk. Davide D. Pettinato and Andrea Crisanti, Imperial College London, Division of Cell and Molecular Biology, London, UK, E-mails: davidepettinato@googlemail.com and crisanti@unipg.it. Bernard N. Kanoi, Edward Ntege, and Thomas G. Egwang, Medical Biotech Laboratories, Kampala, Uganda, E-mails: bnkanoi@gmail.com, edwardsdoc@yahoo.com, and director.mbl@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
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.
-
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.
-
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: 882–888.
-
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: 1555–1562.
-
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: 1545–1554.
-
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: 218–228.
-
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.
-
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: 545–555.
-
9.
World Health Organization, 2009. World Malaria Report 2009. Geneva, Switzerland: WHO.
-
10.
Hay SI, Guerra CA, Tatem AJ, Atkinson PM, Snow RW, 2005. Urbanization, malaria transmission and disease burden in Africa. Nat Rev Microbiol 3: 81–90.
-
11.
Roberts L, 2010. Shrinking the malaria map from the outside in. Science 328: 849–851.
-
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: 44–51.
-
13.
Salama P, Spiegel P, Talley L, Waldman R, 2004. Lessons learned from complex emergencies over past decade. Lancet 364: 1801–1813.
-
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.
-
15.
Gayer M, Legros D, Formenty P, Connolly MA, 2007. Conflict and emerging infectious diseases. Emerg Infect Dis 13: 1625–1631.
-
16.
World Health Organization, 2005. Malaria control in complex emergencies. An Inter-Agency Field Handbook. Geneva, Switzerland: WHO.
-
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: 219–225.
-
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: 189–193.
-
19.
Egwang TG, Apio B, Riley E, Okello D, 2000. Plasmodium falciparum malariometric indices in Apac district, northern Uganda. East Afr Med J 77: 413–416.
-
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: 214–221.
-
21.
World Health Organization, 2004. Disaster update: report 15110. Available at: http://www.who.int/disasters/repo/15110.pdf. Accessed July 15, 2009.
-
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: 5108–5113.
-
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.
-
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.
-
25.
Corran P, Coleman P, Riley E, Drakeley C, 2007. Serology: a robust indicator of malaria transmission intensity? Trends Parasitol 23: 575–582.
-
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.
-
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: 565–568.
-
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: 315–320.
-
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: 131–137.
-
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.
-
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: 1051–1058.
-
32.
Malaria Atlas Project. Available at: http://www.map.ox.ac.uk/. Accessed July 13, 2009.
-
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: 1509–1517.
-
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.
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