The Epidemiology of Plasmodium falciparum Malaria in the Bijagos Islands of Guinea-Bissau

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  • 1 Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom;
  • 2 Region Sanitaria Bolama-Bijagós, Bubaque, Guinea-Bissau;
  • 3 Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom

Distribution of long-lasting insecticide-treated nets (LLINs), passive detection and treatment with artemisinin-based combination therapy (ACT), and intermittent preventive treatment in pregnancy (IPTp) are the mainstay malaria control measures of Guinea-Bissau’s national control programme. This study aimed to estimate the prevalence of Plasmodium falciparum on Bubaque, the most populous island of the country’s remote Bijagos archipelago. A cross-sectional survey was performed at the start of the rainy season in August 2017. Participants were recruited using systematic random sampling in a two-stage stratified cluster design. Malaria parasitemia was detected using rapid diagnostic tests (RDTs) and quantitative PCR (qPCR). Data on housing, education, larval source management, socioeconomic status, anemia, and malaria preventive measures were collected. Multivariable logistic regression models were constructed to identify associations with P. falciparum infection. Four hundred four persons (aged 6 months–79 years, median 17 years) were enrolled in the study. The prevalence of P. falciparum parasitemia was 5.8% by RDT (95% CI: 3.55–9.33) and 16.9% by qPCR (95% CI: 13.09–21.71). The prevalence of anemia was 74.3% (95% CI: 69.04–78.85) as defined by the WHO criteria. All sampled houses were found to have open eaves; 99.5% of the surveyed population reported sleeping under a bednet (95% CI: 97.8–99.9). Although reported LLIN use is high, there remains an appreciable prevalence of malaria, suggesting that transmission is ongoing and further tools are required to reduce the burden of the disease.

Author Notes

Address correspondence to Anna Last, Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel St., London WC1E 7HT, United Kingdom. E-mail: coulibalyd@icermali.org

Financial support: This study was supported by the MRC Global Challenges Research Fund and the London School of Hygiene and Tropical Medicine Trust Fund.

Authors’ addresses: David McGregor, Adriana Goncalves, Hristina Vasileva, David Mabey, and Anna Last, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mails: david.mcgregor1@lshtm.ac.uk, adriana.goncalves@lshtm.ac.uk, hristina.vasileva@lshtm.ac.uk, david.mabey@lshtm.ac.uk, and anna.last@lshtm.ac.uk. Eunice Texeira da Silva, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom, and Region Sanitaria Bolama-Bijagós, Bubaque, Guinea-Bissau, E-mail: eunitxsil@gmail.com. Lynn Grignard, Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: lynn.grignard@lshtm.ac.uk.

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