RSS news feeds

EY Lukianova-Hleb et al. Hemozoin-generated vapor nanobubbles for transdermal reagent- and needle-free detection of malaria. Proc Natl Acad Sci U S A

High Impact Journal from Malaria Portal - 31 December 2014 - 12:00am
Successful diagnosis, screening, and elimination of malaria critically depend on rapid and sensitive detection of this dangerous infection, preferably transdermally and without sophisticated reagents or blood drawing. . . .
Categories: malaria news feeds

KJ Vogel et al. Phylogenetic investigation of Peptide hormone and growth factor receptors in five dipteran genomes. Front Endocrinol (Lausanne)

High Impact Journal from Malaria Portal - 31 December 2014 - 12:00am
Peptide hormones and growth factors bind to membrane receptors and regulate a myriad of processes in insects and other metazoans. . . .
Categories: malaria news feeds

J Rydzak et al. Human erythrocyte glycophorin C as the receptor for EBA-140 Plasmodium falciparum merozoite ligand. Postepy Hig Med Dosw (Online)

High Impact Journal from Malaria Portal - 31 December 2014 - 12:00am
Erythrocyte invasion by the blood-stage Plasmodium falciparum parasites is a multistep process involving specific interactions between parasites and red blood cells. . . .
Categories: malaria news feeds

R Sundararajan et al. Barriers to Malaria Control among Marginalized Tribal Communities: A Qualitative Study. PLoS One

High Impact Journal from Malaria Portal - 30 December 2014 - 12:00am
Malaria infection accounts for over one million deaths worldwide annually. . . .
Categories: malaria news feeds

DV Canyon et al. Insights in public health: systems thinking: basic constructs, application challenges, misuse in health, and how public health leaders can pave the way forward. Hawaii J Med Public Health

High Impact Journal from Malaria Portal - 30 December 2014 - 12:00am
The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. . . .
Categories: malaria news feeds

Serological markers for monitoring historical changes in malaria transmission intensity in a highly endemic region of Western Kenya, 1994-2009

Malaria Journal - 22 November 2014 - 12:00am
Background: Monitoring local malaria transmission intensity is essential for planning evidence-based control strategies and evaluating their impact over time. Anti-malarial antibodies provide information on cumulative exposure and have proven useful, in areas where transmission has dropped to low sustained levels, for retrospectively reconstructing the timing and magnitude of transmission reduction. It is unclear whether serological markers are also informative in high transmission settings, where interventions may reduce transmission, but to a level where considerable exposure continues. Methods: This study was conducted through ongoing KEMRI and CDC collaboration. Asembo, in Western Kenya, is an area where intense malaria transmission was drastically reduced during a 1997-1999 community-randomized, controlled insecticide-treated net (ITN) trial. Two approaches were taken to reconstruct malaria transmission history during the period from 1994 to 2009. First, point measurements were calculated for seroprevalence, mean antibody titre, and seroconversion rate (SCR) against three Plasmodium falciparum antigens (AMA-1, MSP-119, and CSP) at five time points for comparison against traditional malaria indices (parasite prevalence and entomological inoculation rate). Second, within individual post-ITN years, age-stratified seroprevalence data were analysed retrospectively for an abrupt drop in SCR by fitting alternative reversible catalytic conversion models that allowed for change in SCR. Results: Generally, point measurements of seroprevalence, antibody titres and SCR produced consistent patterns indicating that a gradual but substantial drop in malaria transmission (46-70%) occurred from 1994 to 2007, followed by a marginal increase beginning in 2008 or 2009. In particular, proportionate changes in seroprevalence and SCR point estimates (relative to 1994 baseline values) for AMA-1 and CSP, but not MSP-119, correlated closely with trends in parasite prevalence throughout the entire 15-year study period. However, retrospective analyses using datasets from 2007, 2008 and 2009 failed to detect any abrupt drop in transmission coinciding with the timing of the 1997-1999 ITN trial. Conclusions: In this highly endemic area, serological markers were useful for generating accurate point estimates of malaria transmission intensity, but not for retrospective analysis of historical changes. Further investigation, including exploration of different malaria antigens and/or alternative models of population seroconversion, may yield serological tools that are more informative in high transmission settings.
Categories: malaria news feeds

The genome of the simian and human malaria parasite Plasmodium knowlesi.

CiteULike malaria tags - 21 November 2014 - 6:10pm
Nature, Vol. 455, No. 7214. (October 2008), pp. 799-803, doi:10.1038/nature07306

Plasmodium knowlesi is an intracellular malaria parasite whose natural vertebrate host is Macaca fascicularis (the 'kra' monkey); however, it is now increasingly recognized as a significant cause of human malaria, particularly in southeast Asia. Plasmodium knowlesi was the first malaria parasite species in which antigenic variation was demonstrated, and it has a close phylogenetic relationship to Plasmodium vivax, the second most important species of human malaria parasite (reviewed in ref. 4). Despite their relatedness, there are important phenotypic differences between them, such as host blood cell preference, absence of a dormant liver stage or 'hypnozoite' in P. knowlesi, and length of the asexual cycle (reviewed in ref. 4). Here we present an analysis of the P. knowlesi (H strain, Pk1(A+) clone) nuclear genome sequence. This is the first monkey malaria parasite genome to be described, and it provides an opportunity for comparison with the recently completed P. vivax genome and other sequenced Plasmodium genomes. In contrast to other Plasmodium genomes, putative variant antigen families are dispersed throughout the genome and are associated with intrachromosomal telomere repeats. One of these families, the KIRs, contains sequences that collectively match over one-half of the host CD99 extracellular domain, which may represent an unusual form of molecular mimicry.
A Pain, U Böhme, AE Berry, K Mungall, RD Finn, AP Jackson, T Mourier, J Mistry, EM Pasini, MA Aslett, S Balasubrammaniam, K Borgwardt, K Brooks, C Carret, TJ Carver, I Cherevach, T Chillingworth, TG Clark, MR Galinski, N Hall, D Harper, D Harris, H Hauser, A Ivens, CS Janssen, T Keane, N Larke, S Lapp, M Marti, S Moule, IM Meyer, D Ormond, N Peters, M Sanders, S Sanders, TJ Sargeant, M Simmonds, F Smith, R Squares, S Thurston, AR Tivey, D Walker, B White, E Zuiderwijk, C Churcher, MA Quail, AF Cowman, Turner, MA Rajandream, Kocken, AW Thomas, CI Newbold, BG Barrell, M Berriman
Categories: malaria news feeds

Genome sequence of the human malaria parasite Plasmodium falciparum.

CiteULike malaria tags - 21 November 2014 - 6:10pm
Nature, Vol. 419, No. 6906. (October 2002), pp. 498-511, doi:10.1038/nature01097

The parasite Plasmodium falciparum is responsible for hundreds of millions of cases of malaria, and kills more than one million African children annually. Here we report an analysis of the genome sequence of P. falciparum clone 3D7. The 23-megabase nuclear genome consists of 14 chromosomes, encodes about 5,300 genes, and is the most (A + T)-rich genome sequenced to date. Genes involved in antigenic variation are concentrated in the subtelomeric regions of the chromosomes. Compared to the genomes of free-living eukaryotic microbes, the genome of this intracellular parasite encodes fewer enzymes and transporters, but a large proportion of genes are devoted to immune evasion and host-parasite interactions. Many nuclear-encoded proteins are targeted to the apicoplast, an organelle involved in fatty-acid and isoprenoid metabolism. The genome sequence provides the foundation for future studies of this organism, and is being exploited in the search for new drugs and vaccines to fight malaria.
Malcolm Gardner, Neil Hall, Eula Fung, Owen White, Matthew Berriman, Richard Hyman, Jane Carlton, Arnab Pain, Karen Nelson, Sharen Bowman, Ian Paulsen, Keith James, Jonathan Eisen, Kim Rutherford, Steven Salzberg, Alister Craig, Sue Kyes, Man Chan, Vishvanath Nene, Shamira Shallom, Bernard Suh, Jeremy Peterson, Sam Angiuoli, Mihaela Pertea, Jonathan Allen, Jeremy Selengut, Daniel Haft, Michael Mather, Akhil Vaidya, David Martin, Alan Fairlamb, Martin Fraunholz, David Roos, Stuart Ralph, Geoffrey McFadden, Leda Cummings, Mani Subramanian, Chris Mungall, Craig Venter, Daniel Carucci, Stephen Hoffman, Chris Newbold, Ronald Davis, Claire Fraser, Bart Barrell
Categories: malaria news feeds

Genetic polymorphism and amino acid sequence variation in Plasmodium falciparum GLURP R2 repeat region in Assam, India, at an interval of five years

Malaria Journal - 21 November 2014 - 12:00am
Background: The R2 repeat region of GLURP has been reported as a good genetic marker for Plasmodium falciparum genotyping. Proper knowledge of the extent and nature of P. falciparum genetic diversity using highly immunogenic R2 repeat region in malaria-endemic areas is a crucial element to understand various aspects related to immunity acquisition and disease pathogenesis. Methods: Population diversity of P. falciparum GLURP and amino acid sequence repeats in GLURP R2 region was studied in malaria-endemic Assam state, northeast India and compared at an interval of five years during 2005 (Group-A) and 2011 (Group-B). Results: Of the 66 samples, a total of 55 samples showed positive PCR bands for GLURP R2 region and altogether ten types of alleles with size ranging from 501 bp to 1,050 bp (50 bp bin) were observed and coded as genotypes I-X. In Group-A (n = 29), 24 samples were found infected with single, four with double and one with triple P. falciparum genotype, while in Group-B (n = 26), single genotype was found in 23 samples, double in two samples and triple in one sample. Genotype IV showed significant increase (p = 0.002) during 2011 (Group-B). Genotypes I to V were more common in Group-B (62%), however genotypes VI to X were more frequently distributed in Group-A. The expected heterozygosity was found slightly higher in Group-A (HE = 0.87) than Group-B (HE = 0.85), whereas multiplicity of infection (MOI) in Group-A (MOI = 1.21 +/- 0.49) and Group-B (MOI = 1.12 +/- 0.43) did not display significant variation. The amino acid repeat sequence unit (AAU) DKNEKGQHEIVEVEEILPE (called 'a') was more frequent in the well-conserved part of R2 repeat region. Conclusion: The present study is the first extensive study in India which has generated substantial data for understanding the type and distribution of naturally evolved genetic polymorphism at amino acid sequence level in GLURP R2 repeat region in P. falciparum. There was decrease in the PCR amplicon size as well as the number of AAU [amino acid repeat unit] in Group-B displaying the bottleneck effect. The present study described a new type of AAU 'd' which varied from the other previous known AAUs.
Categories: malaria news feeds

Does socio-economic status explain the differentials in malaria parasite prevalence? Evidence from The Gambia

Malaria Journal - 21 November 2014 - 12:00am
Background: Malaria is commonly associated with poverty. Macro-level estimates show strong links between malaria and poverty, and increasing evidence suggests that the causal link between malaria and poverty runs in both directions. However, micro-level (household and population) analyses on the linkages between malaria and poverty have often produced mixed results. Methods: The Gambia Malaria Indicator Survey (MIS) 2010/11 was carried out between November 2010 and January 2011. Laboratory-confirmed malaria and wealth quintiles were used to assess the association of socio-economic status and malaria infection in children and the general population. Simple and multiple logistic regressions and survey data analysis procedures, including linearized standard errors to account for cluster sampling and unequal selection probabilities were applied. Results: Children (six to 59 months) from the second, third, fourth and richest quintiles were significantly less likely to have malaria compared to children from the poorest quintiles. Children (five to 14 years) from the fourth and richest quintiles were also significantly less likely to have malaria compared to to those from the poorest quintiles. The malaria burden has shifted from the under-five children (six to 59 months) to children aged five to 14 years. Malaria prevalence was significantly higher in the Central River Region compared to the Upper River Region; and males bear the malaria brunt more than females. Children (six to 59 months) and children (five to 14 years) living in houses with poor walls, floors, roofs and windows were significant associated with higher prevalence of malaria. However, in the general population, only poor wall housing materials were associated with higher prevalence of malaria. Conclusions: Investments in strategies that address socio-economic disparities and improvements in the quality of housing could, in the long term, significantly reduce the malaria burden in the poorest communities.
Categories: malaria news feeds

First imported relapse case of Plasmodium vivax malaria and analysis of its origin by CSP sequencing in Henan Province, China

Malaria Journal - 21 November 2014 - 12:00am
In recent years, there has been a substantial increase of imported Plasmodium vivax incidence in Henan Province. As China is in a pre-elimination phase, the surveillance of imported malaria is essential, but there is no good way to distinguish imported cases from indigenous cases. This paper reports a case of a 39-year-old man who acquired P. vivax while staying in Indonesia for one month in 2013, and relapsed in Henan, China in 2014. This was diagnosed as vivax malaria based on rapid diagnostic test, Giemsa-stained peripheral blood smear and Plasmodium species-specific nested PCR. The genetic sequence for the circumsporozoite protein genes was analysed and the genetic variations were compared with a previously constructed database of Chinese isolates. The results from the circumsporozoite protein (CSP) gene sequence analysis centered on the repeat patterns showed that the imported cases had completely different sequences from any subtypes from Chinese isolates, but well matched with the countries travelled by the patient. The imported vivax cases were able to clearly distinguish from the indigenous vivax cases by detecting the CSP gene and were able to confim its origin by genotyping.
Categories: malaria news feeds

Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study

Malaria Journal - 21 November 2014 - 12:00am
Background: Despite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country's highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria's National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity. Methods: A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received WHO/NMCP recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment. Results: Overall, 76.7% of children were brought to treatment--45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received WHO/NMCP recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with WHO/NMCP recommended treatment. Lastly, children 7-59 months old were at 1.74 (p=0.003) greater odds of receiving treatment than children <=6 months. Conclusions: Northern Nigeria's coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.
Categories: malaria news feeds

Are topical insect repellents effective against malaria in endemic populations? A systematic review and meta-analysis

Malaria Journal - 21 November 2014 - 12:00am
Background: Recommended vector control tools against malaria, such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), mainly target mosquitoes that rest and feed on human hosts indoors. However, in some malaria-endemic areas, such as Southeast Asia and South America, malaria vectors primarily bite outdoors meaning that LLINs and IRS may be less effective. In these situations the use of topical insect repellents may reduce outdoor biting and morbidity from malaria. A systematic review and meta-analysis was conducted to assess the efficacy of topical insect repellents against malaria. Methods: Studies were identified using database searches (MEDLINE, EMBASE, Web of Science and clinical trials registers), as well as reference list searches and contact with researchers. Randomized and non-randomized controlled trials were included that assessed the effect of topical repellents (all active ingredients and concentrations) on Plasmodium falciparum or Plasmodium vivax malaria or infection in malaria-endemic populations. Meta-analysis of clinical data was conducted in order to generate summary risk ratios. Results: Ten trials met the inclusion criteria. Studies varied in terms of repellent active ingredient and formulation, co-interventions, study population, compliance, and follow-up period. Topical repellents showed an 18% protective efficacy against P. falciparum malaria, although this was not significant (95% CI: -8%, 38%). Similarly, the average protective efficacy of topical repellents against P. vivax malaria did not reach significance (protective efficacy: 20%, 95% CI: -37%, 53%). Exclusion of non-randomized trials from the meta-analysis did not alter the findings. Conclusions: Although topical repellents can provide individual protection against mosquitoes, the results of this meta-analysis indicate that topical repellents are unlikely to provide effective protection against malaria. However, there was substantial heterogeneity between studies included and the relatively small number of studies meant that this heterogeneity could not be fully explored in the analysis. Further well-designed trials of topical repellents at appropriate doses and alternative modes of repellent delivery, such as spatial repellents and long-lasting insecticide-treated clothing, are required.
Categories: malaria news feeds

The independent effect of living in malaria hotspots on future malaria infection: an observational study from Misungwi, Tanzania

Malaria Journal - 21 November 2014 - 12:00am
Background: As malaria transmission declines, continued improvements of prevention and control interventions will increasingly rely on accurate knowledge of risk factors and an ability to define high-risk areas and populations at risk for focal targeting of interventions. This paper explores the independent association between living in a hotspot and prospective risk of malaria infection. Methods: Malaria infection status defined by nPCR and AMA-1 status in year 1 were used to define geographic hotspots using two geospatial statistical methods (SaTScan and Kernel density smoothing). Other malaria risk factors for malaria infection were explored by fitting a multivariable model. Results: This study demonstrated that residing in infection hotspot of malaria transmission is an independent predictor of malaria infection in the future. Conclusion: It is likely that targeting such hotspots with better coverage and improved malaria control strategies will result in more cost-efficient uses of resources to move towards malaria elimination.
Categories: malaria news feeds

Transmission patterns of Plasmodium falciparum by Anopheles gambiae in Benin

Malaria Journal - 21 November 2014 - 12:00am
Background: To better control malaria, the clear and urgent need is for improved data to inform decision makers, but in several African countries, there is a lack of baseline data on vectors and variation in the intensity of malaria transmission. This has resulted in the implementation of vector control efforts that ignore variation in vector behaviour and intensity of transmission, an approach that is most often not cost-effective. This study presents a detailed entomological description of mosquito distribution and variation in potentially transmissible contacts of Plasmodium falciparum following a south to north transect in Benin.MethodThe study was conducted in five locations where environmental parameters were different and malaria prevalence ranged between 14 and 51%. The locations represent the main eco-epidemiological malaria areas in Benin. Mosquitoes were collected using human landing catches, pyrethrum spray catches and windows traps. They were taxonomically and molecularly identified. Head-thoraces of Anopheles gambiae s.l. were tested by enzyme-linked immunosorbent assay. Entomological indicators were estimated following WHO guidelines. Results: The results showed variation between location and period in distribution of Anopheles coluzzii, An. gambiae, and Anopheles arabiensis (p < 0.05). An extension of the reported range of An. arabiensis was also observed. Densities of malaria vectors varied significantly between rural and urban sites, however, indoor/outdoor biting ratios remained constant. Proportions of malaria vectors with circumsporozoite protein of P. falciparum were similar between locations. The entomological inoculation rates ranged between zero and eight bites/man/night with significant variations between areas.Four profiles of human exposure to infectious malaria vector bites were observed and included location with one season of high transmission (June - August), two seasons of lower transmission (March-August; October-November), moderate continuous transmission season, and high continuous transmission season of P. falciparum. Conclusion: The study revealed several entomological patterns in transmission of P. falciparum in Benin. The data could be used for purposes of planning a more cost-effective vector control strategy, by stratifying the country into higher and lower transmission zones. The information could also be used to guide extension of indoor residual spray based on a targeted use of IRS at sites where the duration of insecticidal effect following spraying coincides with the peak transmission period.
Categories: malaria news feeds

Large-scale drivers of malaria and priority areas for prevention and control in the Brazilian Amazon region using a novel multi-pathogen geospatial model

Malaria Journal - 20 November 2014 - 12:00am
Background: Most of the malaria burden in the Americas is concentrated in the Brazilian Amazon but a detailed spatial characterization of malaria risk has yet to be undertaken. Methods: Utilizing 2004-2008 malaria incidence data collected from six Brazilian Amazon states, large-scale spatial patterns of malaria risk were characterized with a novel Bayesian multi-pathogen geospatial model. Data included 2.4 million malaria cases spread across 3.6 million sq km. Remotely sensed variables (deforestation rate, forest cover, rainfall, dry season length, and proximity to large water bodies), socio-economic variables (rural population size, income, and literacy rate, mortality rate for children age under five, and migration patterns), and GIS variables (proximity to roads, hydro-electric dams and gold mining operations) were incorporated as covariates. Results: Borrowing information across pathogens allowed for better spatial predictions of malaria caused by Plasmodium falciparum, as evidenced by a ten-fold cross-validation. Malaria incidence for both Plasmodium vivax and P. falciparum tended to be higher in areas with greater forest cover. Proximity to gold mining operations was another important risk factor, corroborated by a positive association between migration rates and malaria incidence. Finally, areas with a longer dry season and areas with higher average rural income tended to have higher malaria risk. Risk maps reveal striking spatial heterogeneity in malaria risk across the region, yet these mean disease risk surface maps can be misleading if uncertainty is ignored. By combining mean spatial predictions with their associated uncertainty, several sites were consistently classified as hotspots, suggesting their importance as priority areas for malaria prevention and control. Conclusion: This article provides several contributions. From a methodological perspective, the benefits of jointly modelling multiple pathogens for spatial predictions were illustrated. In addition, maps of mean disease risk were contrasted with that of statistically significant disease clusters, highlighting the critical importance of uncertainty in determining disease hotspots. From an epidemiological perspective, forest cover and proximity to gold mining operations were important large-scale drivers of disease risk in the region. Finally, the hotspot in Western Acre was identified as the area that should receive highest priority from the Brazilian national malaria prevention and control programme.
Categories: malaria news feeds

A heavy legacy: offspring of malaria-infected mosquitoes show reduced disease resistance

Malaria Journal - 20 November 2014 - 12:00am
Background: Trans-generational effects of immune stimulation may have either adaptive (trans-generational immune priming) or non-adaptive (fitness costs) effects on offspring ability to fight pathogens. Methods: Anopheles coluzzii and its natural malaria parasite Plasmodium falciparum were used to test how maternal parasite infection affected offspring resistance to the same parasite species. Results: Daughters of exposed mothers had similar qualitative resistance, as measured by their ability to prevent infection, relative to those of control mothers. However, maternal disease exposure altered offspring quantitative resistance, measured as the ability to limit parasite development, with mosquitoes of infected mothers suffering slightly increased parasite intensity compared to controls. In addition, quantitative resistance was minimal in offspring of highly infected mothers, and in offspring issued from eggs produced during the early infection phase. Conclusions: Plasmodium falciparum infection in An. coluzzii can have trans-generational costs, lowering quantitative resistance in offspring of infected mothers. Malaria-exposed mosquitoes might heavily invest in immune defences and thereby produce lower quality offspring that are poorly resistant.
Categories: malaria news feeds

Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu

Malaria Journal - 20 November 2014 - 12:00am
Background: Insecticide-treated nets (ITNs) are an integral piece of any malaria elimination strategy, but compliance remains a challenge and determinants of use vary by location and context. The Health Belief Model (HBM) is a tool to explore perceptions and beliefs about malaria and ITN use. Insights from the model can be used to increase coverage to control malaria transmission in island contexts. Methods: A mixed methods study consisting of a questionnaire and interviews was carried out in July 2012 on two islands of Vanuatu: Ambae Island where malaria transmission continues to occur at low levels, and Aneityum Island, where an elimination programme initiated in 1991 has halted transmission for several years. Results: For most HBM constructs, no significant difference was found in the findings between the two islands: the fear of malaria (99%), severity of malaria (55%), malaria-prevention benefits of ITN use (79%) and willingness to use ITNs (93%). ITN use the previous night on Aneityum (73%) was higher than that on Ambae (68%) though not statistically significant. Results from interviews and group discussions showed that participants on Ambae tended to believe that risk was low due to the perceived absence of malaria, while participants on Aneityum believed that they were still at risk despite the long absence of malaria. On both islands, seasonal variation in perceived risk, thermal discomfort, costs of replacing nets, a lack of money, a lack of nets, nets in poor condition and the inconvenience of hanging had negative influences, while free mass distribution with awareness campaigns and the malaria-prevention benefits had positive influences on ITN use. Conclusions: The results on Ambae highlight the challenges of motivating communities to engage in elimination efforts when transmission continues to occur, while the results from Aneityum suggest the possibility of continued compliance to malaria elimination efforts given the threat of resurgence. Where a high degree of community engagement is possible, malaria elimination programmes may prove successful.
Categories: malaria news feeds

Pages