Rapid Epidemiological and Entomological Survey for Validation of Reported Indicators and Characterization of Local Malaria Transmission in Guinea, 2017

Alioune Camara National Malaria Control Program, Conakry, Guinea;

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Timothée Guilavogui National Malaria Control Program, Conakry, Guinea;

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Kalil Keita National Malaria Control Program, Conakry, Guinea;

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Mohamed Dioubaté National Malaria Control Program, Conakry, Guinea;

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Yaya Barry National Malaria Control Program, Conakry, Guinea;

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Denka Camara National Malaria Control Program, Conakry, Guinea;

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Zaoro Loua National Malaria Control Program, Conakry, Guinea;

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Ibrahima Kaba National Malaria Control Program, Conakry, Guinea;

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Ibrahima Bah Catholic Relief Services, Conakry, Guinea;

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Moriba-Pé Haba National Malaria Control Program, Conakry, Guinea;

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Zézé Koivogui National Malaria Control Program, Conakry, Guinea;

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Mohamed Conde RTI International, Conakry, Guinea;

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Aissata Fofana RTI International, Conakry, Guinea;

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Étienne Loua Plan Guinée, N’Zérékoré, Guinea;

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Siriman Camara World Health Organization, Conakry, Guinea;

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Abdoulaye Sarr Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention (CDC), Conakry, Guinea;

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Seth R. Irish Entomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia

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Mateusz M. Plucinski Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia

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DOI:
https://doi.org/10.4269/ajtmh.18-0479
Volume/Issue:
Volume 99: Issue 5
Page(s):
1134–1144
Restricted access
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To confirm and investigate possible explanations for unusual trends in malaria indicators, a protocol for rapid, focal assessment of malaria transmission and control interventions was piloted in N’Zérékoré and Macenta Prefectures, which each reported surprisingly low incidence of malaria during the peak transmission months during 2017 in holoendemic Forested Guinea. In each prefecture, epidemiological and entomological cross-sectional surveys were conducted in two sub-prefectures reporting high incidence and one sub-prefecture reporting low incidence. Investigators visited six health facilities and 356 households, tested 476 children, performed 14 larval breeding site transects, and conducted 12 nights of human landing catches during the 2-week investigation. Rapid diagnostic test positivity in the community sample of children under five ranged from 23% to 68% by subprefecture. Only 38% of persons with fever reported seeking care in the public health sector; underutilization was confirmed by verification of health facility and community healthcare worker (CHW) registries. High numbers of Anopheles mosquitoes were collected in human landing collections in N’Zérékoré (38 per night in combined indoor and outdoor collections) and Macenta (87). Most of the detected breeding sites positive for Anopheles larvae (83%) were shallow roadside puddles. In the investigated prefectures, malaria rates remain high and the low reported incidence likely reflects low utilization of the public health-care sector. Strengthening the CHW program to rapidly identify and treat malaria cases and elimination of roadside puddles as part of routine cleanup campaigns should be considered. Systematic joint epidemiological/entomological investigations in areas reporting anomalous signals in routine data can allow control programs to respond with tailored local interventions.

Author Notes

Address correspondence to Mateusz M. Plucinski, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd., Atlanta, GA 30329. E-mail: mplucinski@cdc.gov

Financial support: This activity was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Participation of A. S., S. I., and M. M. P. was funded by the United States President’s Malaria Initiative (PMI).

Ethics approval and consent to participate: The protocol was reviewed and classified as a non-research program evaluation by the CDC Center for Global Health Office of the Associate Director for Science (2017-347) and the Guinea Ministry of the Health. All interviewed persons provided verbal informed consent. Participants or guardians of participants undergoing RDT testing during the household surveys gave written informed consent.

Authors’ addresses: Alioune Camara, Timothée Guilavogui, Kalil Keita, Mohamed Dioubaté, Yaya Barry, Denka Camara, Zaoro Loua, Ibrahima Kaba, Moriba-Pé Haba, and Zézé Koivogui, National Malaria Control Program, Ministry of Health, Conakry, Guinea, E-mails: aliounec@gmail.com, gui_timothee@yahoo.fr, kalil_keita@yahoo.fr, piazzacentre@yahoo.fr, barryyaya66@yahoo.fr, denkacamara@yahoo.fr, zaoroloua80@gmail.com, kabahibrahim2@yahoo.fr, moribapehaba@gmail.com, and koivoguimoise6@gmail.com. Ibrahima Bah, Catholic Relief Services, NA, Conakry, Guinea, E-mail: ibrahima.bah@crs.org. Mohamed Conde and Aissata Fofana, RTI International, Conakry, Guinea, E-mails: mohsaran@rti.org and afofana@rti.org. Étienne Loua, Plan Guinée, N’Zérékoré, Guinea, E-mail: etienne.loua@plan-international.org. Siriman Camara, World Health Organization, Conakry, Guinea, E-mail: camaras@who.int. Abdoulaye Sarr, Malaria Branch, Centers for Disease Control and Prevention, Conakry, Guinea, E-mail: asarr@usaid.gov. Seth R. Irish and Mateusz M. Plucinski, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: xjs7@cdc.gov and mplucinski@cdc.gov.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2018
Received:
07 Jun 2018
|
Accepted:
03 Jul 2018
|
Published Online:
20 Aug 2018
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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