2019
|
Journal Articles
|
| Engelbert A Nonterah, Palwende R Boua, Kerstin Klipstein-Grobusch, Gershim Asiki, Lisa K Micklesfield, Godfred Agongo, Stuart A Ali, Felistas Mashinya, Herman Sorgho, Seydou Nakanabo-Diallo, Cornelius Debpuur, Catherine Kyobutungi, Marianne Alberts, Shane Norris, Stephen Tollman, Halidou Tinto, Cassandra C Soo, Freedom Mukomana, Scott Hazelhurst, Alisha N Wade, Kathleen Kahn, Abraham R Oduro, Diederick E Grobbee, Osman Sankoh, Mich`ele Ramsay, Michiel L Bots, Nigel J Crowther, members, AWI-Gen, H3Africa Consortium Classical cardiovascular risk factors and HIV are associated with carotid intima-media thickness in adults from sub-Saharan Africa: Findings from H3Africa AWI-Gen study (Journal Article) In: J. Am. Heart Assoc., vol. 8, no. 14, pp. e011506, 2019, ISSN: 2047-9980. @article{Nonterah2019-zz,
title = {Classical cardiovascular risk factors and HIV are associated with carotid intima-media thickness in adults from sub-Saharan Africa: Findings from H3Africa AWI-Gen study},
author = {Engelbert A Nonterah and Palwende R Boua and Kerstin Klipstein-Grobusch and Gershim Asiki and Lisa K Micklesfield and Godfred Agongo and Stuart A Ali and Felistas Mashinya and Herman Sorgho and Seydou Nakanabo-Diallo and Cornelius Debpuur and Catherine Kyobutungi and Marianne Alberts and Shane Norris and Stephen Tollman and Halidou Tinto and Cassandra C Soo and Freedom Mukomana and Scott Hazelhurst and Alisha N Wade and Kathleen Kahn and Abraham R Oduro and Diederick E Grobbee and Osman Sankoh and Mich`ele Ramsay and Michiel L Bots and Nigel J Crowther and members and AWI-Gen and H3Africa Consortium},
doi = {10.1161/JAHA.118.011506},
issn = {2047-9980},
year = {2019},
date = {2019-07-01},
urldate = {2019-07-01},
journal = {J. Am. Heart Assoc.},
volume = {8},
number = {14},
pages = {e011506},
publisher = {Ovid Technologies (Wolters Kluwer Health)},
abstract = {Background Studies on the determinants of carotid intima-media
thickness ( CIMT ), a marker of sub-clinical atherosclerosis,
mostly come from white, Asian, and diasporan black populations.
We present CIMT data from sub-Saharan Africa, which is
experiencing a rising burden of cardiovascular diseases and
infectious diseases. Methods and Results The H3 (Human
Hereditary and Health) in Africa's AWI-Gen (African-Wits-INDEPTH
partnership for Genomic) study is a cross-sectional study
conducted in adults aged 40 to 60 years from Burkina Faso,
Kenya, Ghana, and South Africa. Cardiovascular disease risk and
ultrasonography of the CIMT of right and left common carotids
were measured. Multivariable linear and mixed-effect multilevel
regression modeling was applied to determine factors related to
CIMT. Data included 8872 adults (50.8% men), mean age of
50$pm$6 years with age- and sex-adjusted mean ($pm$SE) CIMT of
640$pm$123$mu$m. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age ($beta$ = 6.77,
95%CI [6.34-7.19]), body mass index (17.6[12.5-22.8]), systolic
blood pressure (7.52[6.21-8.83]), low-density lipoprotein
cholesterol (5.08[2.10-8.06]) and men (10.3[4.75- 15.9]) were
associated with higher CIMT. Smoking was associated with higher
CIMT in men. High-density lipoprotein cholesterol (-12.2 [-17.9-
-6.41]), alcohol consumption (-13.5 [-19.1--7.91]) and HIV
(-8.86 [-15.7--2.03]) were inversely associated with CIMT.
Conclusions Given the rising prevalence of cardiovascular
diseases risk factors in sub-Saharan Africa, atherosclerotic
diseases may become a major pan-African epidemic unless
preventive measures are taken particularly for prevention of
hypertension, obesity, and smoking. HIV -specific studies are
needed to fully understand the association between HIV and CIMT
in sub-Saharan Africa.},
keywords = {cardiovascular disease; carotid intima-media thickness; epidemiological transition; prevention; sub-Saharan Africa},
pubstate = {published},
tppubtype = {article}
}
Background Studies on the determinants of carotid intima-media
thickness ( CIMT ), a marker of sub-clinical atherosclerosis,
mostly come from white, Asian, and diasporan black populations.
We present CIMT data from sub-Saharan Africa, which is
experiencing a rising burden of cardiovascular diseases and
infectious diseases. Methods and Results The H3 (Human
Hereditary and Health) in Africa’s AWI-Gen (African-Wits-INDEPTH
partnership for Genomic) study is a cross-sectional study
conducted in adults aged 40 to 60 years from Burkina Faso,
Kenya, Ghana, and South Africa. Cardiovascular disease risk and
ultrasonography of the CIMT of right and left common carotids
were measured. Multivariable linear and mixed-effect multilevel
regression modeling was applied to determine factors related to
CIMT. Data included 8872 adults (50.8% men), mean age of
50$pm$6 years with age- and sex-adjusted mean ($pm$SE) CIMT of
640$pm$123$mu$m. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age ($beta$ = 6.77,
95%CI [6.34-7.19]), body mass index (17.6[12.5-22.8]), systolic
blood pressure (7.52[6.21-8.83]), low-density lipoprotein
cholesterol (5.08[2.10-8.06]) and men (10.3[4.75- 15.9]) were
associated with higher CIMT. Smoking was associated with higher
CIMT in men. High-density lipoprotein cholesterol (-12.2 [-17.9-
-6.41]), alcohol consumption (-13.5 [-19.1–7.91]) and HIV
(-8.86 [-15.7–2.03]) were inversely associated with CIMT.
Conclusions Given the rising prevalence of cardiovascular
diseases risk factors in sub-Saharan Africa, atherosclerotic
diseases may become a major pan-African epidemic unless
preventive measures are taken particularly for prevention of
hypertension, obesity, and smoking. HIV -specific studies are
needed to fully understand the association between HIV and CIMT
in sub-Saharan Africa. |
| Peter Waiswa, Joseph Akuze, Cheryl Moyer, Doris Kwesiga, Samuelina Arthur, Osman Sankoh, Paul Welaga, Martin Bangha, Jacques Eminas, Sheru Muuo, Abdhalah Ziraba, Kate Kerber, INDEPTH Network MNCH team Status of birth and pregnancy outcome capture in Health Demographic Surveillance Sites in 13 countries (Journal Article) In: Int. J. Public Health, vol. 64, no. 6, pp. 909–920, 2019, ISSN: 1661-8564 1661-8556. @article{Waiswa2019-yw,
title = {Status of birth and pregnancy outcome capture in Health Demographic Surveillance Sites in 13 countries},
author = {Peter Waiswa and Joseph Akuze and Cheryl Moyer and Doris Kwesiga and Samuelina Arthur and Osman Sankoh and Paul Welaga and Martin Bangha and Jacques Eminas and Sheru Muuo and Abdhalah Ziraba and Kate Kerber and INDEPTH Network MNCH team},
doi = {10.1007/s00038-019-01241-0},
issn = {1661-8564 1661-8556},
year = {2019},
date = {2019-07-01},
urldate = {2019-07-01},
journal = {Int. J. Public Health},
volume = {64},
number = {6},
pages = {909--920},
publisher = {Springer Science and Business Media LLC},
abstract = {OBJECTIVES: We compared pregnancy identification methods and
outcome capture across 31 Health Demographic Surveillance System
(HDSS) sites in 14 countries in sub-Saharan Africa and Asia.
METHODS: From 2009 to 2014, details on the sites and
surveillance systems including frequency of update rounds,
characteristics of enumerators and interviewers, acceptable
respondents were collected and compared across sites. RESULTS:
The 31 HDSS had a combined population of over 2,905,602 with
165,820 births for the period. Stillbirth rate ranged from 1.9
to 42.6 deaths per 1000 total births and the neonatal mortality
rate from 2.6 to 41.6 per 1000 live births. Three quarters
(75.3%) of recorded neonatal deaths occurred in the first week
of life. The proportion of infant deaths that occurred in the
neonatal period ranged from 8 to 83%, with a median of 53%.
Sites that registered pregnancies upon locating a live baby in
the routine household surveillance round had lower recorded
mortality rates. CONCLUSIONS: Increased attention and
standardization of pregnancy surveillance and the time of birth
will improve data collection and provide platforms for
evaluations and availability of data for decision-making with
implications for national planning.},
keywords = {Demographic Surveillance Sites; INDEPTH Network; Maternal Newborn Child Health Working Group; Mortality; Neonatal; Perinatal mortality; Stillbirth},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: We compared pregnancy identification methods and
outcome capture across 31 Health Demographic Surveillance System
(HDSS) sites in 14 countries in sub-Saharan Africa and Asia.
METHODS: From 2009 to 2014, details on the sites and
surveillance systems including frequency of update rounds,
characteristics of enumerators and interviewers, acceptable
respondents were collected and compared across sites. RESULTS:
The 31 HDSS had a combined population of over 2,905,602 with
165,820 births for the period. Stillbirth rate ranged from 1.9
to 42.6 deaths per 1000 total births and the neonatal mortality
rate from 2.6 to 41.6 per 1000 live births. Three quarters
(75.3%) of recorded neonatal deaths occurred in the first week
of life. The proportion of infant deaths that occurred in the
neonatal period ranged from 8 to 83%, with a median of 53%.
Sites that registered pregnancies upon locating a live baby in
the routine household surveillance round had lower recorded
mortality rates. CONCLUSIONS: Increased attention and
standardization of pregnancy surveillance and the time of birth
will improve data collection and provide platforms for
evaluations and availability of data for decision-making with
implications for national planning. |
| Daniel Chandramohan, Alassane Dicko, Issaka Zongo, Issaka Sagara, Matthew Cairns, Irene Kuepfer, Modibo Diarra, Amadou Barry, Amadou Tapily, Frederic Nikiema, Serge Yerbanga, Samba Coumare, Ismaila Thera, Abdourhamane Traore, Paul Milligan, Halidou Tinto, Ogobara Doumbo, Jean-Bosco Ouedraogo, Brian Greenwood Effect of adding azithromycin to seasonal malaria chemoprevention (Journal Article) In: N. Engl. J. Med., vol. 380, no. 23, pp. 2197–2206, 2019, ISSN: 1533-4406 0028-4793. @article{Chandramohan2019-ec,
title = {Effect of adding azithromycin to seasonal malaria chemoprevention},
author = {Daniel Chandramohan and Alassane Dicko and Issaka Zongo and Issaka Sagara and Matthew Cairns and Irene Kuepfer and Modibo Diarra and Amadou Barry and Amadou Tapily and Frederic Nikiema and Serge Yerbanga and Samba Coumare and Ismaila Thera and Abdourhamane Traore and Paul Milligan and Halidou Tinto and Ogobara Doumbo and Jean-Bosco Ouedraogo and Brian Greenwood},
doi = {10.1056/NEJMoa1811400},
issn = {1533-4406 0028-4793},
year = {2019},
date = {2019-06-01},
urldate = {2019-06-01},
journal = {N. Engl. J. Med.},
volume = {380},
number = {23},
pages = {2197--2206},
abstract = {BACKGROUND: Mass administration of azithromycin for trachoma
control led to a sustained reduction in all-cause mortality among
Ethiopian children. Whether the addition of azithromycin to the
monthly sulfadoxine-pyrimethamine plus amodiaquine used for
seasonal malaria chemoprevention could reduce mortality and
morbidity among African children was unclear. METHODS: We
randomly assigned children 3 to 59 months of age, according to
household, to receive either azithromycin or placebo, together
with sulfadoxine-pyrimethamine plus amodiaquine, during the
annual malaria-transmission season in Burkina Faso and Mali. The
drug combinations were administered in four 3-day cycles, at
monthly intervals, for three successive seasons. The primary end
point was death or hospital admission for at least 24 hours that
was not due to trauma or elective surgery. Data were recorded by
means of active and passive surveillance. RESULTS: In July 2014,
a total of 19,578 children were randomly assigned to receive
seasonal malaria chemoprevention plus either azithromycin (9735
children) or placebo (9843 children); each year, children who
reached 5 years of age exited the trial and new children were
enrolled. In the intention-to-treat analysis, the overall number
of deaths and hospital admissions during three
malaria-transmission seasons was 250 in the azithromycin group
and 238 in the placebo group (events per 1000 child-years at
risk, 24.8 vs. 23.5; incidence rate ratio, 1.1; 95% confidence
interval [CI], 0.88 to 1.3). Results were similar in the
per-protocol analysis. The following events occurred less
frequently with azithromycin than with placebo: gastrointestinal
infections (1647 vs. 1985 episodes; incidence rate ratio, 0.85;
95% CI, 0.79 to 0.91), upper respiratory tract infections (4893
vs. 5763 episodes; incidence rate ratio, 0.85; 95% CI, 0.81 to
0.90), and nonmalarial febrile illnesses (1122 vs. 1424 episodes;
incidence rate ratio, 0.79; 95% CI, 0.73 to 0.87). The
prevalence of malaria parasitemia and incidence of adverse events
were similar in the two groups. CONCLUSIONS: Among children in
Burkina Faso and Mali, the addition of azithromycin to the
antimalarial agents used for seasonal malaria chemoprevention did
not result in a lower incidence of death or hospital admission
that was not due to trauma or surgery than antimalarial agents
plus placebo, although a lower disease burden was noted with
azithromycin than with placebo. (Funded by the Joint Global
Health Trials scheme; ClinicalTrials.gov number, NCT02211729.).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Mass administration of azithromycin for trachoma
control led to a sustained reduction in all-cause mortality among
Ethiopian children. Whether the addition of azithromycin to the
monthly sulfadoxine-pyrimethamine plus amodiaquine used for
seasonal malaria chemoprevention could reduce mortality and
morbidity among African children was unclear. METHODS: We
randomly assigned children 3 to 59 months of age, according to
household, to receive either azithromycin or placebo, together
with sulfadoxine-pyrimethamine plus amodiaquine, during the
annual malaria-transmission season in Burkina Faso and Mali. The
drug combinations were administered in four 3-day cycles, at
monthly intervals, for three successive seasons. The primary end
point was death or hospital admission for at least 24 hours that
was not due to trauma or elective surgery. Data were recorded by
means of active and passive surveillance. RESULTS: In July 2014,
a total of 19,578 children were randomly assigned to receive
seasonal malaria chemoprevention plus either azithromycin (9735
children) or placebo (9843 children); each year, children who
reached 5 years of age exited the trial and new children were
enrolled. In the intention-to-treat analysis, the overall number
of deaths and hospital admissions during three
malaria-transmission seasons was 250 in the azithromycin group
and 238 in the placebo group (events per 1000 child-years at
risk, 24.8 vs. 23.5; incidence rate ratio, 1.1; 95% confidence
interval [CI], 0.88 to 1.3). Results were similar in the
per-protocol analysis. The following events occurred less
frequently with azithromycin than with placebo: gastrointestinal
infections (1647 vs. 1985 episodes; incidence rate ratio, 0.85;
95% CI, 0.79 to 0.91), upper respiratory tract infections (4893
vs. 5763 episodes; incidence rate ratio, 0.85; 95% CI, 0.81 to
0.90), and nonmalarial febrile illnesses (1122 vs. 1424 episodes;
incidence rate ratio, 0.79; 95% CI, 0.73 to 0.87). The
prevalence of malaria parasitemia and incidence of adverse events
were similar in the two groups. CONCLUSIONS: Among children in
Burkina Faso and Mali, the addition of azithromycin to the
antimalarial agents used for seasonal malaria chemoprevention did
not result in a lower incidence of death or hospital admission
that was not due to trauma or surgery than antimalarial agents
plus placebo, although a lower disease burden was noted with
azithromycin than with placebo. (Funded by the Joint Global
Health Trials scheme; ClinicalTrials.gov number, NCT02211729.). |
| Annelies Post, Berenger Kaboré, Isaie J Reuling, Joel Bognini, Wouter Heijden, Salou Diallo, Palpouguini Lompo, Basile Kam, Natacha Herssens, Kjerstin Lanke, Teun Bousema, Robert W Sauerwein, Halidou Tinto, Jan Jacobs, Quirijn Mast, Andre J Ven The XN-30 hematology analyzer for rapid sensitive detection of malaria: a diagnostic accuracy study (Journal Article) In: BMC Med., vol. 17, no. 1, pp. 103, 2019, ISSN: 1741-7015. @article{Post2019-iz,
title = {The XN-30 hematology analyzer for rapid sensitive detection of malaria: a diagnostic accuracy study},
author = {Annelies Post and Berenger Kabor\'{e} and Isaie J Reuling and Joel Bognini and Wouter Heijden and Salou Diallo and Palpouguini Lompo and Basile Kam and Natacha Herssens and Kjerstin Lanke and Teun Bousema and Robert W Sauerwein and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andre J Ven},
doi = {10.1186/s12916-019-1334-5},
issn = {1741-7015},
year = {2019},
date = {2019-05-01},
urldate = {2019-05-01},
journal = {BMC Med.},
volume = {17},
number = {1},
pages = {103},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Accurate and timely diagnosis of malaria is
essential for disease management and surveillance. Thin and
thick blood smear microscopy and malaria rapid diagnostic tests
(RDTs) are standard malaria diagnostics, but both methods have
limitations. The novel automated hematology analyzer XN-30
provides standard complete blood counts (CBC) as well as
quantification of malaria parasitemia at the price of a CBC.
This study assessed the accuracy of XN-30 for malaria detection
in a controlled human malaria infection (CHMI) study and a phase
3 diagnostic accuracy study in Burkina Faso. METHODS: Sixteen
healthy, malaria-naive CHMI participants were challenged with
five Plasmodium falciparum-infected mosquitoes. Blood was
sampled daily for XN-30, blood smear microscopy, and malaria
qPCR. The accuracy study included patients aged \> 3 months
presenting with acute febrile illness. XN-30, microscopy, and
rapid diagnostic tests (HRP-2/pLDH) were performed on site; qPCR
was done in retrospect. The malaria reference standard was
microscopy, and results were corrected for sub-microscopic
cases. RESULTS: All CHMI participants became parasitemic by qPCR and XN-30 with a strong correlation for parasite density (R2 =
0.91; p \< .0001). The XN-30 accurately monitored treatment and
allowed detection of recrudescence. Out of 908 patients in the
accuracy study, 241 had microscopic malaria (density 24-491,802
parasites/$mu$L). The sensitivity and specificity of XN-30 compared to microscopy were 98.7% and 99.4% (PPV = 98.7},
keywords = {Burkina Faso; Diagnosis; Malaria; Sensitivity; Specificity},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Accurate and timely diagnosis of malaria is
essential for disease management and surveillance. Thin and
thick blood smear microscopy and malaria rapid diagnostic tests
(RDTs) are standard malaria diagnostics, but both methods have
limitations. The novel automated hematology analyzer XN-30
provides standard complete blood counts (CBC) as well as
quantification of malaria parasitemia at the price of a CBC.
This study assessed the accuracy of XN-30 for malaria detection
in a controlled human malaria infection (CHMI) study and a phase
3 diagnostic accuracy study in Burkina Faso. METHODS: Sixteen
healthy, malaria-naive CHMI participants were challenged with
five Plasmodium falciparum-infected mosquitoes. Blood was
sampled daily for XN-30, blood smear microscopy, and malaria
qPCR. The accuracy study included patients aged > 3 months
presenting with acute febrile illness. XN-30, microscopy, and
rapid diagnostic tests (HRP-2/pLDH) were performed on site; qPCR
was done in retrospect. The malaria reference standard was
microscopy, and results were corrected for sub-microscopic
cases. RESULTS: All CHMI participants became parasitemic by qPCR and XN-30 with a strong correlation for parasite density (R2 =
0.91; p < .0001). The XN-30 accurately monitored treatment and
allowed detection of recrudescence. Out of 908 patients in the
accuracy study, 241 had microscopic malaria (density 24-491,802
parasites/$mu$L). The sensitivity and specificity of XN-30 compared to microscopy were 98.7% and 99.4% (PPV = 98.7 |
| Carlota Doba no, H`ector Sanz, Hermann Sorgho, David Dosoo, Maximilian Mpina, Itziar Ubillos, Ruth Aguilar, Tom Ford, N’uria D’iez-Padrisa, Nana Aba Williams, Aintzane Ayestaran, Ousmane Traore, Augusto J Nhabomba, Chenjerai Jairoce, John Waitumbi, Selidji Todagbe Agnandji, Simon Kariuki, Salim Abdulla, John J Aponte, Benjamin Mordmüller, Kwaku Poku Asante, Seth Owusu-Agyei, Halidou Tinto, Joseph J Campo, Gemma Moncunill, Ben Gyan, Clarissa Valim, Claudia Daubenberger Concentration and avidity of antibodies to different circumsporozoite epitopes correlate with RTS,S/AS01E malaria vaccine efficacy (Journal Article) In: Nat. Commun., vol. 10, no. 1, pp. 2174, 2019, ISSN: 2041-1723. @article{Dobano2019-il,
title = {Concentration and avidity of antibodies to different circumsporozoite epitopes correlate with RTS,S/AS01E malaria vaccine efficacy},
author = {Carlota Doba no and H`ector Sanz and Hermann Sorgho and David Dosoo and Maximilian Mpina and Itziar Ubillos and Ruth Aguilar and Tom Ford and N'uria D'iez-Padrisa and Nana Aba Williams and Aintzane Ayestaran and Ousmane Traore and Augusto J Nhabomba and Chenjerai Jairoce and John Waitumbi and Selidji Todagbe Agnandji and Simon Kariuki and Salim Abdulla and John J Aponte and Benjamin Mordm\"{u}ller and Kwaku Poku Asante and Seth Owusu-Agyei and Halidou Tinto and Joseph J Campo and Gemma Moncunill and Ben Gyan and Clarissa Valim and Claudia Daubenberger},
doi = {10.1038/s41467-019-10195-z},
issn = {2041-1723},
year = {2019},
date = {2019-05-01},
urldate = {2019-05-01},
journal = {Nat. Commun.},
volume = {10},
number = {1},
pages = {2174},
publisher = {Springer Science and Business Media LLC},
abstract = {RTS,S/AS01E has been tested in a phase 3 malaria vaccine study
with partial efficacy in African children and infants. In a
cohort of 1028 subjects from one low (Bagomoyo) and two high
(Nanoro, Kintampo) malaria transmission sites, we analysed IgG
plasma/serum concentration and avidity to CSP (NANP-repeat and
C-terminal domains) after a 3-dose vaccination against time to
clinical malaria events during 12-months. Here we report that
RTS,S/AS01E induces substantial increases in IgG levels from
pre- to post-vaccination (p \< 0.001), higher in NANP than
C-terminus (2855 vs 1297 proportional change between means), and
higher concentrations and avidities in children than infants (p
\< 0.001). Baseline CSP IgG levels are elevated in malaria cases
than controls (p \< 0.001). Both, IgG magnitude to NANP (hazard
ratio [95% confidence interval] 0.61 [0.48-0.76]) and avidity
to C-terminus (0.07 [0.05-0.90]) post-vaccination are
significantly associated with vaccine efficacy. IgG avidity to
the C-terminus emerges as a significant contributor to
RTS,S/AS01E-mediated protection.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
RTS,S/AS01E has been tested in a phase 3 malaria vaccine study
with partial efficacy in African children and infants. In a
cohort of 1028 subjects from one low (Bagomoyo) and two high
(Nanoro, Kintampo) malaria transmission sites, we analysed IgG
plasma/serum concentration and avidity to CSP (NANP-repeat and
C-terminal domains) after a 3-dose vaccination against time to
clinical malaria events during 12-months. Here we report that
RTS,S/AS01E induces substantial increases in IgG levels from
pre- to post-vaccination (p < 0.001), higher in NANP than
C-terminus (2855 vs 1297 proportional change between means), and
higher concentrations and avidities in children than infants (p
< 0.001). Baseline CSP IgG levels are elevated in malaria cases
than controls (p < 0.001). Both, IgG magnitude to NANP (hazard
ratio [95% confidence interval] 0.61 [0.48-0.76]) and avidity
to C-terminus (0.07 [0.05-0.90]) post-vaccination are
significantly associated with vaccine efficacy. IgG avidity to
the C-terminus emerges as a significant contributor to
RTS,S/AS01E-mediated protection. |
| Bernard Brabin, Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Adama Kazienga, Loretta Brabin, Sayouba Ouedraogo, Halidou Tinto Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso (Journal Article) In: Malar. J., vol. 18, no. 1, pp. 161, 2019, ISSN: 1475-2875. @article{Brabin2019-tw,
title = {Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso},
author = {Bernard Brabin and Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Adama Kazienga and Loretta Brabin and Sayouba Ouedraogo and Halidou Tinto},
doi = {10.1186/s12936-019-2797-8},
issn = {1475-2875},
year = {2019},
date = {2019-05-01},
urldate = {2019-05-01},
journal = {Malar. J.},
volume = {18},
number = {1},
pages = {161},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Iron supplementation before a first pregnancy may
improve the future health of mother and baby by reducing
maternal anaemia. Iron supplementation could, however, increase
malaria infections, notably in primigravidae who are most
susceptible. The pathogenicity of other iron-utilizing pathogens
could also increase, causing inflammation leading to increased
risk of adverse birth outcomes. This paper reports pre-specified
secondary birth outcomes from a safety trial in Burkina Faso in
an area of high malaria endemicity. Primary outcomes from that
trial had investigated effects of long-term weekly iron
supplementation on malaria and genital tract infections in
non-pregnant and pregnant women. METHODS: A double-blind,
randomized controlled trial. Nulliparous, mainly adolescent
women, were individually randomized periconceptionally to
receive weekly either 60 mg elemental iron and 2.8 mg folic
acid, or 2.8 mg folic acid alone, continuing up to the first
antenatal visit for those becoming pregnant. Secondary outcomes
were ultrasound-dated gestational age, fetal growth, placental
malaria, chorioamnionitis and iron biomarkers. Seasonal effects
were assessed. Analysis was by intention to treat. RESULTS: 478
pregnancies occurred to 1959 women: 258/980 women assigned iron
and folic acid and 220/979 women assigned folic acid alone.
Malaria prevalence at the first antenatal visit was 53% (iron)
and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213},
keywords = {Adolescents; Burkina Faso; Fetal growth; Iron supplements; Malaria; Preterm birth},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Iron supplementation before a first pregnancy may
improve the future health of mother and baby by reducing
maternal anaemia. Iron supplementation could, however, increase
malaria infections, notably in primigravidae who are most
susceptible. The pathogenicity of other iron-utilizing pathogens
could also increase, causing inflammation leading to increased
risk of adverse birth outcomes. This paper reports pre-specified
secondary birth outcomes from a safety trial in Burkina Faso in
an area of high malaria endemicity. Primary outcomes from that
trial had investigated effects of long-term weekly iron
supplementation on malaria and genital tract infections in
non-pregnant and pregnant women. METHODS: A double-blind,
randomized controlled trial. Nulliparous, mainly adolescent
women, were individually randomized periconceptionally to
receive weekly either 60 mg elemental iron and 2.8 mg folic
acid, or 2.8 mg folic acid alone, continuing up to the first
antenatal visit for those becoming pregnant. Secondary outcomes
were ultrasound-dated gestational age, fetal growth, placental
malaria, chorioamnionitis and iron biomarkers. Seasonal effects
were assessed. Analysis was by intention to treat. RESULTS: 478
pregnancies occurred to 1959 women: 258/980 women assigned iron
and folic acid and 220/979 women assigned folic acid alone.
Malaria prevalence at the first antenatal visit was 53% (iron)
and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213 |
| Yolanda Guerra Mendoza, Elodie Garric, Amanda Leach, Marc Lievens, Opokua Ofori-Anyinam, Jean-Yves Pirc con, Jens-Ulrich Stegmann, Pascale Vandoolaeghe, Lucas Otieno, Walter Otieno, Seth Owusu-Agyei, Jahit Sacarlal, Nahya Salim Masoud, Hermann Sorgho, Marcel Tanner, Halidou Tinto, Innocent Valea, Ali Takadir Mtoro, Patricia Njuguna, Martina Oneko, Godfrey Allan Otieno, Kephas Otieno, Samwel Gesase, Mary J Hamel, Irving Hoffman, Seyram Kaali, Portia Kamthunzi, Peter Kremsner, Miguel Lanaspa, Bertrand Lell, John Lusingu, Anangisye Malabeja, Pedro Aide, Pauline Akoo, Daniel Ansong, Kwaku Poku Asante, James A Berkley, Samuel Adjei, Tsiri Agbenyega, Selidji Todagbe Agnandji, Lode Schuerman Safety profile of the RTS,S/AS01 malaria vaccine in infants and children: additional data from a phase III randomized controlled trial in sub-Saharan Africa (Journal Article) In: Hum. Vaccin. Immunother., vol. 15, no. 10, pp. 2386–2398, 2019, ISSN: 2164-554X 2164-5515. @article{Guerra_Mendoza2019-at,
title = {Safety profile of the RTS,S/AS01 malaria vaccine in infants and children: additional data from a phase III randomized controlled trial in sub-Saharan Africa},
author = {Yolanda Guerra Mendoza and Elodie Garric and Amanda Leach and Marc Lievens and Opokua Ofori-Anyinam and Jean-Yves Pirc con and Jens-Ulrich Stegmann and Pascale Vandoolaeghe and Lucas Otieno and Walter Otieno and Seth Owusu-Agyei and Jahit Sacarlal and Nahya Salim Masoud and Hermann Sorgho and Marcel Tanner and Halidou Tinto and Innocent Valea and Ali Takadir Mtoro and Patricia Njuguna and Martina Oneko and Godfrey Allan Otieno and Kephas Otieno and Samwel Gesase and Mary J Hamel and Irving Hoffman and Seyram Kaali and Portia Kamthunzi and Peter Kremsner and Miguel Lanaspa and Bertrand Lell and John Lusingu and Anangisye Malabeja and Pedro Aide and Pauline Akoo and Daniel Ansong and Kwaku Poku Asante and James A Berkley and Samuel Adjei and Tsiri Agbenyega and Selidji Todagbe Agnandji and Lode Schuerman},
doi = {10.1080/21645515.2019.1586040},
issn = {2164-554X 2164-5515},
year = {2019},
date = {2019-04-01},
urldate = {2019-04-01},
journal = {Hum. Vaccin. Immunother.},
volume = {15},
number = {10},
pages = {2386--2398},
publisher = {Informa UK Limited},
abstract = {A phase III, double-blind, randomized, controlled trial
(NCT00866619) in sub-Saharan Africa showed RTS,S/AS01 vaccine
efficacy against malaria. We now present in-depth safety results
from this study. 8922 children (enrolled at 5-17 months) and
6537 infants (enrolled at 6-12 weeks) were 1:1:1-randomized to
receive 4 doses of RTS,S/AS01 (R3R) or non-malaria control
vaccine (C3C), or 3 RTS,S/AS01 doses plus control (R3C).
Aggregate safety data were reviewed by a multi-functional team.
Severe malaria with Blantyre Coma Score $\leq$2 (cerebral
malaria [CM]) and gender-specific mortality were assessed
post-hoc. Serious adverse event (SAE) and fatal SAE incidences
throughout the study were 24.2%-28.4% and 1.5%-2.5%,
respectively across groups; 0.0%-0.3% of participants reported
vaccination-related SAEs. The incidence of febrile convulsions
in children was higher during the first 2-3 days
post-vaccination with RTS,S/AS01 than with control vaccine,
consistent with the time window of post-vaccination febrile
reactions in this study (mostly the day after vaccination). A
statistically significant numerical imbalance was observed for
meningitis cases in children (R3R: 11, R3C: 10, C3C: 1) but not
in infants. CM cases were more frequent in RTS,S/AS01-vaccinated
children (R3R: 19, R3C: 24, C3C: 10) but not in infants.
All-cause mortality was higher in RTS,S/AS01-vaccinated versus
control girls (2.4% vs 1.3%, all ages) in our setting with low
overall mortality. The observed meningitis and CM signals are
considered likely chance findings, that - given their severity -
warrant further evaluation in phase IV studies and WHO-led pilot
implementation programs to establish the RTS,S/AS01 benefit-risk
profile in real-life settings.},
keywords = {(5-10): Malaria; RTS, S/AS01 vaccine; cerebral malaria; febrile convulsions; meningitis; safety},
pubstate = {published},
tppubtype = {article}
}
A phase III, double-blind, randomized, controlled trial
(NCT00866619) in sub-Saharan Africa showed RTS,S/AS01 vaccine
efficacy against malaria. We now present in-depth safety results
from this study. 8922 children (enrolled at 5-17 months) and
6537 infants (enrolled at 6-12 weeks) were 1:1:1-randomized to
receive 4 doses of RTS,S/AS01 (R3R) or non-malaria control
vaccine (C3C), or 3 RTS,S/AS01 doses plus control (R3C).
Aggregate safety data were reviewed by a multi-functional team.
Severe malaria with Blantyre Coma Score $łeq$2 (cerebral
malaria [CM]) and gender-specific mortality were assessed
post-hoc. Serious adverse event (SAE) and fatal SAE incidences
throughout the study were 24.2%-28.4% and 1.5%-2.5%,
respectively across groups; 0.0%-0.3% of participants reported
vaccination-related SAEs. The incidence of febrile convulsions
in children was higher during the first 2-3 days
post-vaccination with RTS,S/AS01 than with control vaccine,
consistent with the time window of post-vaccination febrile
reactions in this study (mostly the day after vaccination). A
statistically significant numerical imbalance was observed for
meningitis cases in children (R3R: 11, R3C: 10, C3C: 1) but not
in infants. CM cases were more frequent in RTS,S/AS01-vaccinated
children (R3R: 19, R3C: 24, C3C: 10) but not in infants.
All-cause mortality was higher in RTS,S/AS01-vaccinated versus
control girls (2.4% vs 1.3%, all ages) in our setting with low
overall mortality. The observed meningitis and CM signals are
considered likely chance findings, that – given their severity –
warrant further evaluation in phase IV studies and WHO-led pilot
implementation programs to establish the RTS,S/AS01 benefit-risk
profile in real-life settings. |
| Michael Nambozi, Halidou Tinto, Victor Mwapasa, Harry Tagbor, Jean-Bertin Bukasa Kabuya, Sebastian Hachizovu, Maminata Traoré, Innocent Valea, Marc Christian Tahita, Gifty Ampofo, Jozefien Buyze, Raffaella Ravinetto, Diana Arango, Kamala Thriemer, Modest Mulenga, Jean-Pierre Geertruyden, Umberto D’Alessandro Artemisinin-based combination therapy during pregnancy: outcome of pregnancy and infant mortality: a cohort study (Journal Article) In: Malar. J., vol. 18, no. 1, pp. 105, 2019, ISSN: 1475-2875. @article{Nambozi2019-dg,
title = {Artemisinin-based combination therapy during pregnancy: outcome of pregnancy and infant mortality: a cohort study},
author = {Michael Nambozi and Halidou Tinto and Victor Mwapasa and Harry Tagbor and Jean-Bertin Bukasa Kabuya and Sebastian Hachizovu and Maminata Traor\'{e} and Innocent Valea and Marc Christian Tahita and Gifty Ampofo and Jozefien Buyze and Raffaella Ravinetto and Diana Arango and Kamala Thriemer and Modest Mulenga and Jean-Pierre Geertruyden and Umberto D'Alessandro},
doi = {10.1186/s12936-019-2737-7},
issn = {1475-2875},
year = {2019},
date = {2019-03-01},
urldate = {2019-03-01},
journal = {Malar. J.},
volume = {18},
number = {1},
pages = {105},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: The World Health Organization (WHO) recommendation
of treating uncomplicated malaria during the second and third
trimester of pregnancy with an artemisinin-based combination
therapy (ACT) has already been implemented by all sub-Saharan
African countries. However, there is limited knowledge on the
effect of ACT on pregnancy outcomes, and on newborn and infant's
health. METHODS: Pregnant women with malaria in four countries
(Burkina Faso, Ghana, Malawi and Zambia) were treated with
either artemether-lumefantrine (AL), amodiaquine-artesunate
(ASAQ), mefloquine-artesunate (MQAS), or
dihydroartemisinin-piperaquine (DHA-PQ); 3127 live new-borns
(822 in the AL, 775 in the ASAQ, 765 in the MQAS and 765 in the
DHAPQ arms) were followed-up until their first birthday.
RESULTS: Prevalence of placental malaria and low birth weight
were 28.0% (738/2646) and 16.0% (480/2999), respectively, with
no significant differences between treatment arms. No differences in congenital malformations (p = 0.35), perinatal mortality (p = 0.77), neonatal mortality (p = 0.21), and infant mortality (p = 0.96) were found. CONCLUSIONS: Outcome of
pregnancy and infant survival were similar between treatment
arms indicating that any of the four artemisinin-based
combinations could be safely used during the second and third
trimester of pregnancy without any adverse effect on the baby.
Nevertheless, smaller safety differences between
artemisinin-based combinations cannot be excluded; country-wide
post-marketing surveillance would be very helpful to confirm
such findings. Trial registration ClinicalTrials.gov,
NCT00852423, Registered on 27 February 2009,
https://clinicaltrials.gov/ct2/show/NCT00852423.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: The World Health Organization (WHO) recommendation
of treating uncomplicated malaria during the second and third
trimester of pregnancy with an artemisinin-based combination
therapy (ACT) has already been implemented by all sub-Saharan
African countries. However, there is limited knowledge on the
effect of ACT on pregnancy outcomes, and on newborn and infant’s
health. METHODS: Pregnant women with malaria in four countries
(Burkina Faso, Ghana, Malawi and Zambia) were treated with
either artemether-lumefantrine (AL), amodiaquine-artesunate
(ASAQ), mefloquine-artesunate (MQAS), or
dihydroartemisinin-piperaquine (DHA-PQ); 3127 live new-borns
(822 in the AL, 775 in the ASAQ, 765 in the MQAS and 765 in the
DHAPQ arms) were followed-up until their first birthday.
RESULTS: Prevalence of placental malaria and low birth weight
were 28.0% (738/2646) and 16.0% (480/2999), respectively, with
no significant differences between treatment arms. No differences in congenital malformations (p = 0.35), perinatal mortality (p = 0.77), neonatal mortality (p = 0.21), and infant mortality (p = 0.96) were found. CONCLUSIONS: Outcome of
pregnancy and infant survival were similar between treatment
arms indicating that any of the four artemisinin-based
combinations could be safely used during the second and third
trimester of pregnancy without any adverse effect on the baby.
Nevertheless, smaller safety differences between
artemisinin-based combinations cannot be excluded; country-wide
post-marketing surveillance would be very helpful to confirm
such findings. Trial registration ClinicalTrials.gov,
NCT00852423, Registered on 27 February 2009,
https://clinicaltrials.gov/ct2/show/NCT00852423. |
| Sofia Birgersson, Innocent Valea, Halidou Tinto, Maminata Traore-Coulibaly, Laeticia C Toe, Richard M Hoglund, Jean-Pierre Van Geertruyden, Stephen A Ward, Umberto D’Alessandro, Angela Abelö, Joel Tarning Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum malaria in Burkina Faso: an open label trial (Journal Article) In: Wellcome Open Res., vol. 4, pp. 45, 2019, ISSN: 2398-502X. @article{Birgersson2019-ri,
title = {Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum malaria in Burkina Faso: an open label trial},
author = {Sofia Birgersson and Innocent Valea and Halidou Tinto and Maminata Traore-Coulibaly and Laeticia C Toe and Richard M Hoglund and Jean-Pierre Van Geertruyden and Stephen A Ward and Umberto D'Alessandro and Angela Abel\"{o} and Joel Tarning},
doi = {10.12688/wellcomeopenres.14849.2},
issn = {2398-502X},
year = {2019},
date = {2019-03-01},
urldate = {2019-03-01},
journal = {Wellcome Open Res.},
volume = {4},
pages = {45},
publisher = {F1000 Research Ltd},
abstract = {Background: Malaria during pregnancy is a major health risk for
both the mother and the foetus. Pregnancy has been shown to
influence the pharmacokinetics of a number of different
antimalarial drugs. This might lead to an under-exposure in
these patients which could increase the risk of treatment
failure and the development of drug resistance. The study aim
was to evaluate the pharmacokinetics of artesunate and
dihydroartemisinin in pregnant and non-pregnant patients using a
population modelling approach. Methods: Twenty-four women in
their second and third trimester of pregnancy and twenty-four
paired non-pregnant women, all with uncomplicated P. falciparum
malaria, were enrolled in this study. Treatment was a fixed-dose
combination of oral artesunate and mefloquine once daily for
three days. Frequent blood samples were collected and
concentration-time data for artesunate and dihydroartemisinin
were analysed simultaneously using nonlinear mixed-effects
modelling. Results: Artesunate pharmacokinetics was best
described by a transit-compartment absorption model followed by
a one-compartment disposition model under the assumption of
complete in vivo conversion of artesunate into
dihydroartemisinin. Dihydroartemisinin pharmacokinetics was best
described by a one-compartment disposition model with
first-order elimination. Pregnant women had a 21% higher
elimination clearance of dihydroartemisinin, compared to
non-pregnant women, resulting in proportionally lower drug
exposure. In addition, initial parasitaemia and liver status
(alanine aminotransferase) were found to affect the relative
bioavailability of artesunate. Conclusions: Results presented
here show a substantially lower drug exposure to the
antimalarial drug dihydroartemisinin during pregnancy after
standard oral treatment of artesunate and mefloquine. This might
result in an increased risk of treatment failure and drug
resistance development, especially in low transmission settings
where relative immunity is lower. Trial registration:
ClinicalTrials.gov NCT00701961 (19/06/2008).},
keywords = {Artemisinin-based combination therapy; Artesunate; Dihydroartemisinin; Malaria; Mefloquine; NONMEM; Population pharmacokinetics; Pregnancy},
pubstate = {published},
tppubtype = {article}
}
Background: Malaria during pregnancy is a major health risk for
both the mother and the foetus. Pregnancy has been shown to
influence the pharmacokinetics of a number of different
antimalarial drugs. This might lead to an under-exposure in
these patients which could increase the risk of treatment
failure and the development of drug resistance. The study aim
was to evaluate the pharmacokinetics of artesunate and
dihydroartemisinin in pregnant and non-pregnant patients using a
population modelling approach. Methods: Twenty-four women in
their second and third trimester of pregnancy and twenty-four
paired non-pregnant women, all with uncomplicated P. falciparum
malaria, were enrolled in this study. Treatment was a fixed-dose
combination of oral artesunate and mefloquine once daily for
three days. Frequent blood samples were collected and
concentration-time data for artesunate and dihydroartemisinin
were analysed simultaneously using nonlinear mixed-effects
modelling. Results: Artesunate pharmacokinetics was best
described by a transit-compartment absorption model followed by
a one-compartment disposition model under the assumption of
complete in vivo conversion of artesunate into
dihydroartemisinin. Dihydroartemisinin pharmacokinetics was best
described by a one-compartment disposition model with
first-order elimination. Pregnant women had a 21% higher
elimination clearance of dihydroartemisinin, compared to
non-pregnant women, resulting in proportionally lower drug
exposure. In addition, initial parasitaemia and liver status
(alanine aminotransferase) were found to affect the relative
bioavailability of artesunate. Conclusions: Results presented
here show a substantially lower drug exposure to the
antimalarial drug dihydroartemisinin during pregnancy after
standard oral treatment of artesunate and mefloquine. This might
result in an increased risk of treatment failure and drug
resistance development, especially in low transmission settings
where relative immunity is lower. Trial registration:
ClinicalTrials.gov NCT00701961 (19/06/2008). |
| Toussaint Rouamba, Paul Sondo, Isidore W Yerbanga, Adelaide Compaore, Maminata Traore-Coulibaly, Franck S Hien, Nassirou A Diande, Daniel Valia, Innocent Valea, Patricia Akweongo, Rita Baiden, Fred Binka, Fati Kirakoya-Samadoulougou, Halidou Tinto High adherence level to artemisinin-based combination therapies in rural settlement 11 years after their introduction in the health system, Nanoro, Burkina Faso (Journal Article) In: Patient Prefer. Adherence, vol. 13, pp. 371–380, 2019, ISSN: 1177-889X. @article{Rouamba2019-xv,
title = {High adherence level to artemisinin-based combination therapies in rural settlement 11 years after their introduction in the health system, Nanoro, Burkina Faso},
author = {Toussaint Rouamba and Paul Sondo and Isidore W Yerbanga and Adelaide Compaore and Maminata Traore-Coulibaly and Franck S Hien and Nassirou A Diande and Daniel Valia and Innocent Valea and Patricia Akweongo and Rita Baiden and Fred Binka and Fati Kirakoya-Samadoulougou and Halidou Tinto},
doi = {10.2147/PPA.S190927},
issn = {1177-889X},
year = {2019},
date = {2019-02-01},
urldate = {2019-02-01},
journal = {Patient Prefer. Adherence},
volume = {13},
pages = {371--380},
publisher = {Dove Medical Press Ltd.},
abstract = {Purpose: In 2005, Burkina Faso changed its first-line treatment
for uncomplicated malaria from chloroquine to artemisinin-based
combination therapies (ACTs). Patient adherence to ACTs regimen
is a keystone to achieve the expected therapeutic outcome and
prevent the emergence and spread of parasite resistance. Eleven
years after the introduction of ACTs in the health system, this
study aimed to measure adherence level of patients in rural
settlement and investigate the determinants of nonadherence.
Patients and methods: The study was carried out at public
peripheral health facilities from May 2017 to August 2017 in
Nanoro health district, Burkina Faso. An electronic
semi-structured questionnaire was used for data collection from
patients with an ACT prescription at their medical consultation
exit visit and during home visit at day 5$pm$2. Adherence level
was measured through self-report and pill counts. Logistic
regression was performed to identify factors for nonadherence.
Results: The analysis was conducted on 199 outpatients who
received ACT as prescription. About 92.5% of ACT prescriptions
included artemether-lumefantrine tablets. Adherence level was
measured in 97.0% of included patients at day 5$pm$2. Of
these, 86.0% were classified as ``complete adherent'' and
14.0% as ``nonadherent''. In univariate analysis,
patients/caregivers who considered that affordability of ACTs
was easy seemed to be less adherent to the treatment regimen
(OR: 0.26; 95% CI: 0.07-0.70). In univariate and multivariable
analyses, patients/caregivers who did not receive advices from
health care workers (HCWs) were more likely to be nonadherent to
the prescribed ACTs (adjusted OR: 3.21; 95% CI: 1.13-9.12).
Conclusion: This study demonstrates that majority of those who
get an ACT prescription comply with the recommended regimen.
This emphasizes that in rural settings where ACTs are provided
free of charge or at a subsidized price, patient adherence to
ACTs is high, thus minimizing the risk of subtherapeutic
concentrations of the drug in blood which is known to increase
resistance and susceptibility to new infections. Therefore, to
address the problem of patient nonadherence, strategy to
strengthen communication between HCWs and patients should be
given greater consideration.},
keywords = {amodiaquine-artesunate; artemether-lumefantrine; drug prescription; hyperendemic area; malaria},
pubstate = {published},
tppubtype = {article}
}
Purpose: In 2005, Burkina Faso changed its first-line treatment
for uncomplicated malaria from chloroquine to artemisinin-based
combination therapies (ACTs). Patient adherence to ACTs regimen
is a keystone to achieve the expected therapeutic outcome and
prevent the emergence and spread of parasite resistance. Eleven
years after the introduction of ACTs in the health system, this
study aimed to measure adherence level of patients in rural
settlement and investigate the determinants of nonadherence.
Patients and methods: The study was carried out at public
peripheral health facilities from May 2017 to August 2017 in
Nanoro health district, Burkina Faso. An electronic
semi-structured questionnaire was used for data collection from
patients with an ACT prescription at their medical consultation
exit visit and during home visit at day 5$pm$2. Adherence level
was measured through self-report and pill counts. Logistic
regression was performed to identify factors for nonadherence.
Results: The analysis was conducted on 199 outpatients who
received ACT as prescription. About 92.5% of ACT prescriptions
included artemether-lumefantrine tablets. Adherence level was
measured in 97.0% of included patients at day 5$pm$2. Of
these, 86.0% were classified as “complete adherent” and
14.0% as “nonadherent”. In univariate analysis,
patients/caregivers who considered that affordability of ACTs
was easy seemed to be less adherent to the treatment regimen
(OR: 0.26; 95% CI: 0.07-0.70). In univariate and multivariable
analyses, patients/caregivers who did not receive advices from
health care workers (HCWs) were more likely to be nonadherent to
the prescribed ACTs (adjusted OR: 3.21; 95% CI: 1.13-9.12).
Conclusion: This study demonstrates that majority of those who
get an ACT prescription comply with the recommended regimen.
This emphasizes that in rural settings where ACTs are provided
free of charge or at a subsidized price, patient adherence to
ACTs is high, thus minimizing the risk of subtherapeutic
concentrations of the drug in blood which is known to increase
resistance and susceptibility to new infections. Therefore, to
address the problem of patient nonadherence, strategy to
strengthen communication between HCWs and patients should be
given greater consideration. |
| Toussaint Rouamba, Seydou Nakanabo-Diallo, Karim Derra, Eli Rouamba, Adama Kazienga, Yasuko Inoue, Ernest K Ouédraogo, Moussa Waongo, Sokhna Dieng, Abdoulaye Guindo, Boukary Ouédraogo, Kankoé Lévi Sallah, Seydou Barro, Pascal Yaka, Fati Kirakoya-Samadoulougou, Halidou Tinto, Jean Gaudart Socioeconomic and environmental factors associated with malaria hotspots in the Nanoro demographic surveillance area, Burkina Faso (Journal Article) In: BMC Public Health, vol. 19, no. 1, pp. 249, 2019, ISSN: 1471-2458. @article{Rouamba2019-el,
title = {Socioeconomic and environmental factors associated with malaria hotspots in the Nanoro demographic surveillance area, Burkina Faso},
author = {Toussaint Rouamba and Seydou Nakanabo-Diallo and Karim Derra and Eli Rouamba and Adama Kazienga and Yasuko Inoue and Ernest K Ou\'{e}draogo and Moussa Waongo and Sokhna Dieng and Abdoulaye Guindo and Boukary Ou\'{e}draogo and Kanko\'{e} L\'{e}vi Sallah and Seydou Barro and Pascal Yaka and Fati Kirakoya-Samadoulougou and Halidou Tinto and Jean Gaudart},
doi = {10.1186/s12889-019-6565-z},
issn = {1471-2458},
year = {2019},
date = {2019-02-01},
urldate = {2019-02-01},
journal = {BMC Public Health},
volume = {19},
number = {1},
pages = {249},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: With limited resources and spatio-temporal
heterogeneity of malaria in developing countries, it is still
difficult to assess the real impact of socioeconomic and
environmental factors in order to set up targeted campaigns
against malaria at an accurate scale. Our goal was to detect
malaria hotspots in rural area and assess the extent to which
household socioeconomic status and meteorological recordings may
explain the occurrence and evolution of these hotspots. METHODS:
Data on malaria cases from 2010 to 2014 and on socioeconomic and
meteorological factors were acquired from four health facilities
within the Nanoro demographic surveillance area. Statistical
cross correlation was used to quantify the temporal association
between weekly malaria incidence and meteorological factors.
Local spatial autocorrelation analysis was performed and
restricted to each transmission period using Kulldorff's
elliptic spatial scan statistic. Univariate and multivariable
analysis were used to assess the principal socioeconomic and
meteorological determinants of malaria hotspots using a
Generalized Estimating Equation (GEE) approach. RESULTS:
Rainfall and temperature were positively and significantly
associated with malaria incidence, with a lag time of 9 and 14
weeks, respectively. Spatial analysis showed a spatial
autocorrelation of malaria incidence and significant hotspots
which was relatively stable throughout the study period.
Furthermore, low socioeconomic status households were strongly associated with malaria hotspots (aOR = 1.21, 95% confidence
interval: 1.03-1.40). CONCLUSION: These fine-scale findings
highlight a relatively stable spatio-temporal pattern of malaria
risk and indicate that social and environmental factors play an
important role in malaria incidence. Integrating data on these
factors into existing malaria struggle tools would help in the
development of sustainable bottleneck strategies adapted to the
local context for malaria control.},
keywords = {Bottleneck strategies; Hotspots; Lag time; Malaria; Meteorological factors; Socioeconomic status; Spatial epidemiology; Spatio-temporal analysis},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: With limited resources and spatio-temporal
heterogeneity of malaria in developing countries, it is still
difficult to assess the real impact of socioeconomic and
environmental factors in order to set up targeted campaigns
against malaria at an accurate scale. Our goal was to detect
malaria hotspots in rural area and assess the extent to which
household socioeconomic status and meteorological recordings may
explain the occurrence and evolution of these hotspots. METHODS:
Data on malaria cases from 2010 to 2014 and on socioeconomic and
meteorological factors were acquired from four health facilities
within the Nanoro demographic surveillance area. Statistical
cross correlation was used to quantify the temporal association
between weekly malaria incidence and meteorological factors.
Local spatial autocorrelation analysis was performed and
restricted to each transmission period using Kulldorff’s
elliptic spatial scan statistic. Univariate and multivariable
analysis were used to assess the principal socioeconomic and
meteorological determinants of malaria hotspots using a
Generalized Estimating Equation (GEE) approach. RESULTS:
Rainfall and temperature were positively and significantly
associated with malaria incidence, with a lag time of 9 and 14
weeks, respectively. Spatial analysis showed a spatial
autocorrelation of malaria incidence and significant hotspots
which was relatively stable throughout the study period.
Furthermore, low socioeconomic status households were strongly associated with malaria hotspots (aOR = 1.21, 95% confidence
interval: 1.03-1.40). CONCLUSION: These fine-scale findings
highlight a relatively stable spatio-temporal pattern of malaria
risk and indicate that social and environmental factors play an
important role in malaria incidence. Integrating data on these
factors into existing malaria struggle tools would help in the
development of sustainable bottleneck strategies adapted to the
local context for malaria control. |
| Francois Kiemde, Massa Dit Achille Bonko, Marc Christian Tahita, Petra F Mens, Halidou Tinto, Henk D F H Schallig, Michael Boele Hensbroek Algorithms for sequential interpretation of a malaria rapid diagnostic test detecting two different targets of Plasmodium species to improve diagnostic accuracy in a rural setting (Nanoro, Burkina Faso) (Journal Article) In: PLoS One, vol. 14, no. 2, pp. e0211801, 2019, ISSN: 1932-6203. @article{Kiemde2019-ub,
title = {Algorithms for sequential interpretation of a malaria rapid diagnostic test detecting two different targets of Plasmodium species to improve diagnostic accuracy in a rural setting (Nanoro, Burkina Faso)},
author = {Francois Kiemde and Massa Dit Achille Bonko and Marc Christian Tahita and Petra F Mens and Halidou Tinto and Henk D F H Schallig and Michael Boele Hensbroek},
doi = {10.1371/journal.pone.0211801},
issn = {1932-6203},
year = {2019},
date = {2019-02-01},
urldate = {2019-02-01},
journal = {PLoS One},
volume = {14},
number = {2},
pages = {e0211801},
publisher = {Public Library of Science (PLoS)},
abstract = {BACKGROUND: Malaria rapid diagnostic tests (RDT) have
limitations due to the persistence of histidine-rich protein 2
(HRP2) antigen after treatment and low sensitivity of Plasmodium
lactate dehydrogenase (pLDH) based RDTs. To improve the
diagnosis of malaria in febrile children, two diagnostic
algorithms, based on sequential interpretation of a malaria
rapid diagnostic test detecting two different targets of
Plasmodium species and followed by expert microscopy, were
evaluated. METHODS: Two diagnostic algorithms were evaluated
using 407 blood samples collected between April and October 2016
from febrile children and the diagnostic accuracy of both
algorithms was determined. Algorithm 1: The result of line
T1-HRP2 were read first; if negative, malaria infection was
considered to be absent. If positive, confirmation was done with
the line T2-pLDH. If T2-pLDH test was negative, the malaria
diagnosis was considered as ``inconclusive'' and microscopy was
performed; Algorithm 2: The result of line T2-pLDH were read
first; if positive, malaria infection was considered to be
present. If negative, confirmation was done with the line
T1-HRP2. If T1-HRP2 was positive the malaria diagnosis was
considered as ``inconclusive'' and microscopy was performed. In
absence of malaria microscopy, a malaria infection was ruled out
in children with an inconclusive diagnostic test result when
previous antimalarial treatment was reported. RESULTS: For
single interpretation, the sensitivity of PfHRP2 was 98.4% and
the specificity was 74.2%, and for the pLDH test the
sensitivity was 89.3% and the specificity was 98.8%. Malaria
was accurately diagnosed using both algorithms in 84.5%
children. The algorithms with the two-line malaria RDT
classified the test results into two groups: conclusive and
inconclusive results. The diagnostic accuracy for conclusive
results was 98.3% using diagnostic algorithm 1 and 98.6% using
algorithm 2. The sensitivity and specificity for the conclusive
results were 98.2% and 98.4% for algorithm 1, and 98.6% and
98.4% for algorithm 2, respectively. There were 63 (15.5%)
children who had an ``inconclusive'' result for whom expert
microscopy was needed. In children with inconclusive results
(PfHRP2+/pLDH- only) previous antimalarial treatment was
reported in 16 children with malaria negative microscopy (16/40;
40%) and 1 child with malaria positive microscopy (1/23;
4.3%). CONCLUSION: The strategy of sequential interpretation of
two-line malaria RDT can improve the diagnosis of malaria.
However, some cases will still require confirmative testing with
microscopy or additional investigations on previous antimalarial
treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Malaria rapid diagnostic tests (RDT) have
limitations due to the persistence of histidine-rich protein 2
(HRP2) antigen after treatment and low sensitivity of Plasmodium
lactate dehydrogenase (pLDH) based RDTs. To improve the
diagnosis of malaria in febrile children, two diagnostic
algorithms, based on sequential interpretation of a malaria
rapid diagnostic test detecting two different targets of
Plasmodium species and followed by expert microscopy, were
evaluated. METHODS: Two diagnostic algorithms were evaluated
using 407 blood samples collected between April and October 2016
from febrile children and the diagnostic accuracy of both
algorithms was determined. Algorithm 1: The result of line
T1-HRP2 were read first; if negative, malaria infection was
considered to be absent. If positive, confirmation was done with
the line T2-pLDH. If T2-pLDH test was negative, the malaria
diagnosis was considered as “inconclusive” and microscopy was
performed; Algorithm 2: The result of line T2-pLDH were read
first; if positive, malaria infection was considered to be
present. If negative, confirmation was done with the line
T1-HRP2. If T1-HRP2 was positive the malaria diagnosis was
considered as “inconclusive” and microscopy was performed. In
absence of malaria microscopy, a malaria infection was ruled out
in children with an inconclusive diagnostic test result when
previous antimalarial treatment was reported. RESULTS: For
single interpretation, the sensitivity of PfHRP2 was 98.4% and
the specificity was 74.2%, and for the pLDH test the
sensitivity was 89.3% and the specificity was 98.8%. Malaria
was accurately diagnosed using both algorithms in 84.5%
children. The algorithms with the two-line malaria RDT
classified the test results into two groups: conclusive and
inconclusive results. The diagnostic accuracy for conclusive
results was 98.3% using diagnostic algorithm 1 and 98.6% using
algorithm 2. The sensitivity and specificity for the conclusive
results were 98.2% and 98.4% for algorithm 1, and 98.6% and
98.4% for algorithm 2, respectively. There were 63 (15.5%)
children who had an “inconclusive” result for whom expert
microscopy was needed. In children with inconclusive results
(PfHRP2+/pLDH- only) previous antimalarial treatment was
reported in 16 children with malaria negative microscopy (16/40;
40%) and 1 child with malaria positive microscopy (1/23;
4.3%). CONCLUSION: The strategy of sequential interpretation of
two-line malaria RDT can improve the diagnosis of malaria.
However, some cases will still require confirmative testing with
microscopy or additional investigations on previous antimalarial
treatment. |
| COSMIC Consortium Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: A multicenter (The Gambia, Burkina Faso, and Benin) cluster-randomized controlled trial (Journal Article) In: Clin. Infect. Dis., vol. 68, no. 4, pp. 586–596, 2019, ISSN: 1537-6591. @article{COSMIC_Consortium2019-co,
title = {Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: A multicenter (The Gambia, Burkina Faso, and Benin) cluster-randomized controlled trial},
author = {COSMIC Consortium},
doi = {10.1093/cid/ciy522},
issn = {1537-6591},
year = {2019},
date = {2019-02-01},
urldate = {2019-02-01},
journal = {Clin. Infect. Dis.},
volume = {68},
number = {4},
pages = {586--596},
abstract = {Background: We investigated whether adding community scheduled
malaria screening and treatment (CSST) with
artemether-lumefantrine by community health workers (CHWs) to
standard intermittent preventive treatment in pregnancy with
sulfadoxine-pyrimethamine (IPTp-SP) would improve maternal and
infant health. Methods: In this 2-arm cluster-randomized,
controlled trial, villages in Burkina Faso, The Gambia, and Benin
were randomized to receive CSST plus IPTp-SP or IPTp-SP alone.
CHWs in the intervention arm performed monthly CSST during
pregnancy. At each contact, filter paper and blood slides were
collected, and at delivery, a placental biopsy was collected.
Primary and secondary endpoints were the prevalence of placental
malaria, maternal anemia, maternal peripheral infection, low
birth weight, antenatal clinic (ANC) attendance, and IPTp-SP
coverage. Results: Malaria infection was detected at least once
for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in
Burkina Faso. There was no difference between study arms in terms
of placenta malaria after adjusting for birth season, parity, and
IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78-1.44]; P = .72). No difference between the study
arms was found for peripheral maternal infection, anemia, and
adverse pregnancy outcomes. ANC attendance was significantly
higher in the intervention arm in Burkina Faso but not in The
Gambia and Benin. Increasing number of IPTp-SP doses was
associated with a significantly lower risk of placenta malaria,
anemia at delivery, and low birth weight. Conclusions: Adding
CSST to existing IPTp-SP strategies did not reduce malaria in
pregnancy. Increasing the number of IPTp-SP doses given during
pregnancy is a priority. Clinical Trials Registration:
NCT01941264; ISRCTN37259296.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: We investigated whether adding community scheduled
malaria screening and treatment (CSST) with
artemether-lumefantrine by community health workers (CHWs) to
standard intermittent preventive treatment in pregnancy with
sulfadoxine-pyrimethamine (IPTp-SP) would improve maternal and
infant health. Methods: In this 2-arm cluster-randomized,
controlled trial, villages in Burkina Faso, The Gambia, and Benin
were randomized to receive CSST plus IPTp-SP or IPTp-SP alone.
CHWs in the intervention arm performed monthly CSST during
pregnancy. At each contact, filter paper and blood slides were
collected, and at delivery, a placental biopsy was collected.
Primary and secondary endpoints were the prevalence of placental
malaria, maternal anemia, maternal peripheral infection, low
birth weight, antenatal clinic (ANC) attendance, and IPTp-SP
coverage. Results: Malaria infection was detected at least once
for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in
Burkina Faso. There was no difference between study arms in terms
of placenta malaria after adjusting for birth season, parity, and
IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78-1.44]; P = .72). No difference between the study
arms was found for peripheral maternal infection, anemia, and
adverse pregnancy outcomes. ANC attendance was significantly
higher in the intervention arm in Burkina Faso but not in The
Gambia and Benin. Increasing number of IPTp-SP doses was
associated with a significantly lower risk of placenta malaria,
anemia at delivery, and low birth weight. Conclusions: Adding
CSST to existing IPTp-SP strategies did not reduce malaria in
pregnancy. Increasing the number of IPTp-SP doses given during
pregnancy is a priority. Clinical Trials Registration:
NCT01941264; ISRCTN37259296. |
| Palwende Romuald Boua, Jean-Tristan Brandenburg, Ananyo Choudhury, Scott Hazelhurst, Dhriti Sengupta, Godfred Agongo, Engelbert A Nonterah, Abraham R Oduro, Halidou Tinto, Christopher G Mathew, Hermann Sorgho, Mich`ele Ramsay Novel and known gene-smoking interactions with cIMT identified as potential drivers for atherosclerosis risk in West-African populations of the AWI-gen study (Journal Article) In: Front. Genet., vol. 10, pp. 1354, 2019. @article{Boua2019-um,
title = {Novel and known gene-smoking interactions with cIMT identified as potential drivers for atherosclerosis risk in West-African populations of the AWI-gen study},
author = {Palwende Romuald Boua and Jean-Tristan Brandenburg and Ananyo Choudhury and Scott Hazelhurst and Dhriti Sengupta and Godfred Agongo and Engelbert A Nonterah and Abraham R Oduro and Halidou Tinto and Christopher G Mathew and Hermann Sorgho and Mich`ele Ramsay},
doi = {10.3389/fgene.2019.01354},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Front. Genet.},
volume = {10},
pages = {1354},
publisher = {Frontiers Media SA},
abstract = {Introduction: Atherosclerosis is a key contributor to the burden
of cardiovascular diseases (CVDs) and many epidemiological
studies have reported on the effect of smoking on carotid
intima-media thickness (cIMT) and its subsequent effect on CVD
risk. Gene-environment interaction studies have contributed
towards understanding some of the missing heritability of
genome-wide association studies. Gene-smoking interactions on
cIMT have been studied in non-African populations (European,
Latino-American, and African American) but no comparable African
research has been reported. Our aim was to investigate
smoking-SNP interactions on cIMT in two West African populations
by genome-wide analysis. Materials and methods: Only male participants from Burkina Faso (Nanoro = 993) and Ghana (Navrongo = 783) were included, as smoking was extremely rare
among women. Phenotype and genotype data underwent stringent QC
and genotype imputation was performed using the Sanger African
Imputation Panel. Smoking prevalence among men was 13.3% in
Nanoro and 42.5% in Navrongo. We analyzed gene-smoking
interactions with PLINK after adjusting for covariates: age and
6 PCs (Model 1); age, BMI, blood pressure, fasting glucose,
cholesterol levels, MVPA, and 6 PCs (Model 2). All analyses were
performed at site level and for the combined data set. Results:
In Nanoro, we identified new gene-smoking interaction variants
for cIMT within the previously described RCBTB1 region (rs112017404, rs144170770, and rs4941649) (Model 1: p = 1.35E-07; Model 2: p = 3.08E-08). In the combined sample, two
novel intergenic interacting variants were identified, rs1192824 in the regulatory region of TBC1D8 (p = 5.90E-09) and rs77461169 (p = 4.48E-06) located in an upstream region of open chromatin.
In silico functional analysis suggests the involvement of genes
implicated in biological processes related to cell or biological
adhesion and regulatory processes in gene-smoking interactions
with cIMT (as evidenced by chromatin interactions and eQTLs).
Discussion: This is the first gene-smoking interaction study for
cIMT, as a risk factor for atherosclerosis, in sub-Saharan
African populations. In addition to replicating previously known
signals for RCBTB1, we identified two novel genomic regions
(TBC1D8, near BCHE) involved in this gene-environment
interaction.},
keywords = {GWIS; atherosclerosis; carotid intima-media thickness; gene-environment interactions; smoking},
pubstate = {published},
tppubtype = {article}
}
Introduction: Atherosclerosis is a key contributor to the burden
of cardiovascular diseases (CVDs) and many epidemiological
studies have reported on the effect of smoking on carotid
intima-media thickness (cIMT) and its subsequent effect on CVD
risk. Gene-environment interaction studies have contributed
towards understanding some of the missing heritability of
genome-wide association studies. Gene-smoking interactions on
cIMT have been studied in non-African populations (European,
Latino-American, and African American) but no comparable African
research has been reported. Our aim was to investigate
smoking-SNP interactions on cIMT in two West African populations
by genome-wide analysis. Materials and methods: Only male participants from Burkina Faso (Nanoro = 993) and Ghana (Navrongo = 783) were included, as smoking was extremely rare
among women. Phenotype and genotype data underwent stringent QC
and genotype imputation was performed using the Sanger African
Imputation Panel. Smoking prevalence among men was 13.3% in
Nanoro and 42.5% in Navrongo. We analyzed gene-smoking
interactions with PLINK after adjusting for covariates: age and
6 PCs (Model 1); age, BMI, blood pressure, fasting glucose,
cholesterol levels, MVPA, and 6 PCs (Model 2). All analyses were
performed at site level and for the combined data set. Results:
In Nanoro, we identified new gene-smoking interaction variants
for cIMT within the previously described RCBTB1 region (rs112017404, rs144170770, and rs4941649) (Model 1: p = 1.35E-07; Model 2: p = 3.08E-08). In the combined sample, two
novel intergenic interacting variants were identified, rs1192824 in the regulatory region of TBC1D8 (p = 5.90E-09) and rs77461169 (p = 4.48E-06) located in an upstream region of open chromatin.
In silico functional analysis suggests the involvement of genes
implicated in biological processes related to cell or biological
adhesion and regulatory processes in gene-smoking interactions
with cIMT (as evidenced by chromatin interactions and eQTLs).
Discussion: This is the first gene-smoking interaction study for
cIMT, as a risk factor for atherosclerosis, in sub-Saharan
African populations. In addition to replicating previously known
signals for RCBTB1, we identified two novel genomic regions
(TBC1D8, near BCHE) involved in this gene-environment
interaction. |
| Massa Dit Achille Bonko, Francois Kiemde, Marc Christian Tahita, Palpouguini Lompo, Athanase M Some, Halidou Tinto, Michael Boele Hensbroek, Petra F Mens, Henk D F H Schallig The effect of malaria rapid diagnostic tests results on antimicrobial prescription practices of health care workers in Burkina Faso (Journal Article) In: Ann. Clin. Microbiol. Antimicrob., vol. 18, no. 1, pp. 5, 2019, ISSN: 1476-0711. @article{Bonko2019-kx,
title = {The effect of malaria rapid diagnostic tests results on antimicrobial prescription practices of health care workers in Burkina Faso},
author = {Massa Dit Achille Bonko and Francois Kiemde and Marc Christian Tahita and Palpouguini Lompo and Athanase M Some and Halidou Tinto and Michael Boele Hensbroek and Petra F Mens and Henk D F H Schallig},
doi = {10.1186/s12941-019-0304-2},
issn = {1476-0711},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Ann. Clin. Microbiol. Antimicrob.},
volume = {18},
number = {1},
pages = {5},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Malaria rapid diagnostic tests (RDT) are widely used
in endemic areas in order to comply with the recommendation that
malaria treatment should only be given after the clinical
diagnosis has been confirmed by RDT or microscopy. However, the
overestimation of malaria infection with the use of PfHRP2 based
RDT, makes the management of febrile illnesses more challenging.
This study aimed to assess the effect of the use of malaria RDT
on antimicrobial prescription practices. METHODS: A prospective
study was conducted among febrile children under-5 years of age
attending four health facilities and the referral hospital in
the Nanoro Health District (Burkina Faso). To assess the effect
of malaria RDT testing on the prescriptions of antimicrobials in
febrile children, the initial diagnosis and antimicrobial
prescriptions following a malaria RDT testing were recorded. The
necessity of these prescriptions was subsequently checked by
assessing the actual cause of fever by expert malaria microscopy
and a microbiology analysis of blood, urine, stool and
nasopharynx swabs that were collected from febrile cases to
determine the actual cause of the fever episode. RESULTS:
Malaria was diagnosed by nurses, who are the primary health care
providers, with a malaria RDT in 72.7% (798/1098) of febrile
children, but only 53.7% (589/1097) cases could be confirmed by
expert microscopy. Health care workers were likely to prescribe
antimalarials to malaria positive RDT compared to malaria negative RDT (RR = 7.7},
keywords = {Antibiotic; Antimicrobial; Bacteria and parasites; Fever; Malaria; Prescription},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Malaria rapid diagnostic tests (RDT) are widely used
in endemic areas in order to comply with the recommendation that
malaria treatment should only be given after the clinical
diagnosis has been confirmed by RDT or microscopy. However, the
overestimation of malaria infection with the use of PfHRP2 based
RDT, makes the management of febrile illnesses more challenging.
This study aimed to assess the effect of the use of malaria RDT
on antimicrobial prescription practices. METHODS: A prospective
study was conducted among febrile children under-5 years of age
attending four health facilities and the referral hospital in
the Nanoro Health District (Burkina Faso). To assess the effect
of malaria RDT testing on the prescriptions of antimicrobials in
febrile children, the initial diagnosis and antimicrobial
prescriptions following a malaria RDT testing were recorded. The
necessity of these prescriptions was subsequently checked by
assessing the actual cause of fever by expert malaria microscopy
and a microbiology analysis of blood, urine, stool and
nasopharynx swabs that were collected from febrile cases to
determine the actual cause of the fever episode. RESULTS:
Malaria was diagnosed by nurses, who are the primary health care
providers, with a malaria RDT in 72.7% (798/1098) of febrile
children, but only 53.7% (589/1097) cases could be confirmed by
expert microscopy. Health care workers were likely to prescribe
antimalarials to malaria positive RDT compared to malaria negative RDT (RR = 7.7 |
| Paul Sondo, Karim Derra, Thierry Lefevre, Seydou Diallo-Nakanabo, Zekiba Tarnagda, Odile Zampa, Adama Kazienga, Innocent Valea, Hermann Sorgho, Jean-Bosco Ouedraogo, Tinga Robert Guiguemde, Halidou Tinto Genetically diverse Plasmodium falciparum infections, within-host competition and symptomatic malaria in humans (Journal Article) In: Sci. Rep., vol. 9, no. 1, pp. 127, 2019, ISSN: 2045-2322. @article{Sondo2019-lf,
title = {Genetically diverse Plasmodium falciparum infections, within-host competition and symptomatic malaria in humans},
author = {Paul Sondo and Karim Derra and Thierry Lefevre and Seydou Diallo-Nakanabo and Zekiba Tarnagda and Odile Zampa and Adama Kazienga and Innocent Valea and Hermann Sorgho and Jean-Bosco Ouedraogo and Tinga Robert Guiguemde and Halidou Tinto},
doi = {10.1038/s41598-018-36493-y},
issn = {2045-2322},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Sci. Rep.},
volume = {9},
number = {1},
pages = {127},
publisher = {Springer Science and Business Media LLC},
abstract = {There is a large genetic diversity of Plasmodium falciparum
strains that infect people causing diverse malaria symptoms.
This study was carried out to explore the effect of mixed-strain
infections and the extent to which some specific P. falciparum
variants are associated with particular malaria symptoms. P.
falciparum isolates collected during pharmacovigilance study in
Nanoro, Burkina Faso were used to determine allelic variation in
two polymorphic antigens of the merozoite surface (msp1 and
msp2). Overall, parasite density did not increase with
additional strains, suggesting the existence of within-host
competition. Parasite density was influenced by msp1 allelic
families with highest parasitaemia observed in MAD20 allelic
family. However, when in mixed infections with allelic family
K1, MAD20 could not grow to the same levels as it would alone,
suggesting competitive suppression in these mixed infections.
Host age was associated with parasite density. Overall, older
patients exhibited lower parasite densities than younger
patients, but this effect varied with the genetic composition of
the isolates for the msp1 gene. There was no effect of msp1 and
msp2 allelic family variation on body temperature. Haemoglobin
level was influenced by msp2 family with patients harboring the
FC27 allele showing lower haemoglobin level than mono-infected
individuals by the 3D7 allele. This study provides evidence that
P. falciparum genetic diversity influenced the severity of
particular malaria symptoms and supports the existence of
within-host competition in genetically diverse P. falciparum.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There is a large genetic diversity of Plasmodium falciparum
strains that infect people causing diverse malaria symptoms.
This study was carried out to explore the effect of mixed-strain
infections and the extent to which some specific P. falciparum
variants are associated with particular malaria symptoms. P.
falciparum isolates collected during pharmacovigilance study in
Nanoro, Burkina Faso were used to determine allelic variation in
two polymorphic antigens of the merozoite surface (msp1 and
msp2). Overall, parasite density did not increase with
additional strains, suggesting the existence of within-host
competition. Parasite density was influenced by msp1 allelic
families with highest parasitaemia observed in MAD20 allelic
family. However, when in mixed infections with allelic family
K1, MAD20 could not grow to the same levels as it would alone,
suggesting competitive suppression in these mixed infections.
Host age was associated with parasite density. Overall, older
patients exhibited lower parasite densities than younger
patients, but this effect varied with the genetic composition of
the isolates for the msp1 gene. There was no effect of msp1 and
msp2 allelic family variation on body temperature. Haemoglobin
level was influenced by msp2 family with patients harboring the
FC27 allele showing lower haemoglobin level than mono-infected
individuals by the 3D7 allele. This study provides evidence that
P. falciparum genetic diversity influenced the severity of
particular malaria symptoms and supports the existence of
within-host competition in genetically diverse P. falciparum. |
| Holger Unger, Kamala Thriemer, Benedikt Ley, Halidou Tinto, Maminata Traoré, Innocent Valea, Harry Tagbor, Gifty Antwi, Prosper Gbekor, Michael Nambozi, Jean-Bertin Bukasa Kabuya, Modest Mulenga, Victor Mwapasa, Gertrude Chapotera, Mwayiwawo Madanitsa, Stephen Rulisa, Maaike Crop, Yves Claeys, Raffaella Ravinetto, Umberto D’Alessandro The assessment of gestational age: a comparison of different methods from a malaria pregnancy cohort in sub-Saharan Africa (Journal Article) In: BMC Pregnancy Childbirth, vol. 19, no. 1, pp. 12, 2019, ISSN: 1471-2393. @article{Unger2019-af,
title = {The assessment of gestational age: a comparison of different methods from a malaria pregnancy cohort in sub-Saharan Africa},
author = {Holger Unger and Kamala Thriemer and Benedikt Ley and Halidou Tinto and Maminata Traor\'{e} and Innocent Valea and Harry Tagbor and Gifty Antwi and Prosper Gbekor and Michael Nambozi and Jean-Bertin Bukasa Kabuya and Modest Mulenga and Victor Mwapasa and Gertrude Chapotera and Mwayiwawo Madanitsa and Stephen Rulisa and Maaike Crop and Yves Claeys and Raffaella Ravinetto and Umberto D'Alessandro},
doi = {10.1186/s12884-018-2128-z},
issn = {1471-2393},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {BMC Pregnancy Childbirth},
volume = {19},
number = {1},
pages = {12},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Determining gestational age in resource-poor
settings is challenging because of limited availability of
ultrasound technology and late first presentation to antenatal
clinic. Last menstrual period (LMP), symphysio-pubis fundal
height (SFH) and Ballard Score (BS) at delivery are therefore
often used. We assessed the accuracy of LMP, SFH, and BS to
estimate gestational age at delivery and preterm birth compared
to ultrasound (US) using a large dataset derived from a
randomized controlled trial in pregnant malaria patients in four
African countries. METHODS: Mean and median gestational age for
US, LMP, SFH and BS were calculated for the entire study
population and stratified by country. Correlation coefficients
were calculated using Pearson's rho, and Bland Altman plots were
used to calculate mean differences in findings with 95% limit
of agreements. Sensitivity, specificity, positive predictive
value and negative predictive value were calculated considering
US as reference method to identify term and preterm babies.
RESULTS: A total of 1630 women with P. falciparum infection and
a gestational age \> 24 weeks determined by ultrasound at
enrolment were included in the analysis. The mean gestational
age at delivery using US was 38.7 weeks (95%CI: 38.6-38.8), by
LMP, 38.4 weeks (95%CI: 38.0-38.9), by SFH, 38.3 weeks (95%CI:
38.2-38.5), and by BS 38.0 weeks (95%CI: 37.9-38.1) (p \<
0.001). Correlation between US and any of the other three
methods was poor to moderate. Sensitivity and specificity to
determine prematurity were 0.63 (95%CI 0.50-0.75) and 0.72
(95%CI, 0.66-0.76) for LMP, 0.80 (95%CI 0.74-0.85) and 0.74
(95%CI 0.72-0.76) for SFH and 0.42 (95%CI 0.35-0.49) and 0.77
(95%CI 0.74-0.79) for BS. CONCLUSIONS: In settings with limited
access to ultrasound, and in women who had been treated with P.
falciparum malaria, SFH may be the most useful antenatal tool to
date a pregnancy when women present first in second and third
trimester. The Ballard postnatal maturation assessment has a
limited role and lacks precision. Improving ultrasound
facilities and skills, and early attendance, together with the
development of new technologies such as automated image analysis
and new postnatal methods to assess gestational age, are
essential for the study and management of preterm birth in
low-income settings.},
keywords = {Ballard score; Gestational age; Last menstrual period; Low income country; Methods; Pregnancy; Symphysio-pubis fundal height; Ultrasound},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Determining gestational age in resource-poor
settings is challenging because of limited availability of
ultrasound technology and late first presentation to antenatal
clinic. Last menstrual period (LMP), symphysio-pubis fundal
height (SFH) and Ballard Score (BS) at delivery are therefore
often used. We assessed the accuracy of LMP, SFH, and BS to
estimate gestational age at delivery and preterm birth compared
to ultrasound (US) using a large dataset derived from a
randomized controlled trial in pregnant malaria patients in four
African countries. METHODS: Mean and median gestational age for
US, LMP, SFH and BS were calculated for the entire study
population and stratified by country. Correlation coefficients
were calculated using Pearson’s rho, and Bland Altman plots were
used to calculate mean differences in findings with 95% limit
of agreements. Sensitivity, specificity, positive predictive
value and negative predictive value were calculated considering
US as reference method to identify term and preterm babies.
RESULTS: A total of 1630 women with P. falciparum infection and
a gestational age > 24 weeks determined by ultrasound at
enrolment were included in the analysis. The mean gestational
age at delivery using US was 38.7 weeks (95%CI: 38.6-38.8), by
LMP, 38.4 weeks (95%CI: 38.0-38.9), by SFH, 38.3 weeks (95%CI:
38.2-38.5), and by BS 38.0 weeks (95%CI: 37.9-38.1) (p <
0.001). Correlation between US and any of the other three
methods was poor to moderate. Sensitivity and specificity to
determine prematurity were 0.63 (95%CI 0.50-0.75) and 0.72
(95%CI, 0.66-0.76) for LMP, 0.80 (95%CI 0.74-0.85) and 0.74
(95%CI 0.72-0.76) for SFH and 0.42 (95%CI 0.35-0.49) and 0.77
(95%CI 0.74-0.79) for BS. CONCLUSIONS: In settings with limited
access to ultrasound, and in women who had been treated with P.
falciparum malaria, SFH may be the most useful antenatal tool to
date a pregnancy when women present first in second and third
trimester. The Ballard postnatal maturation assessment has a
limited role and lacks precision. Improving ultrasound
facilities and skills, and early attendance, together with the
development of new technologies such as automated image analysis
and new postnatal methods to assess gestational age, are
essential for the study and management of preterm birth in
low-income settings. |
| Georgina S Humphreys, Halidou Tinto, Karen I Barnes Strength in numbers: The WWARN case study of purpose-driven data sharing (Journal Article) In: Am. J. Trop. Med. Hyg., vol. 100, no. 1, pp. 13–15, 2019, ISSN: 1476-1645. @article{Humphreys2019-gh,
title = {Strength in numbers: The WWARN case study of purpose-driven data sharing},
author = {Georgina S Humphreys and Halidou Tinto and Karen I Barnes},
doi = {10.4269/ajtmh.18-0649},
issn = {1476-1645},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {Am. J. Trop. Med. Hyg.},
volume = {100},
number = {1},
pages = {13--15},
publisher = {American Society of Tropical Medicine and Hygiene},
abstract = {Data are the basis for all scientific output. The sharing of
data supporting that output is an important aspect of scientific
communication, and is increasingly required by funders and
publishers. Yet, academic advancement seldom recognizes or
rewards data sharing. This article argues that although
mandating data sharing will increase the amount of data
available, this will not necessarily enable or encourage the
secondary analyses needed to achieve its purported public good.
We, therefore, need to build models that maximize the efficiency
of processes for data collation and curation, and genuinely
reward those engaged in data sharing and reuse. The WorldWide
Antimalarial Resistance Network has 10 years of experience as a
data platform, and its study group approach provides an example
of how some of the challenges in equitable and impactful
data-sharing and secondary use can be addressed, with a focus on
the priorities of researchers in resource-limited settings.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Data are the basis for all scientific output. The sharing of
data supporting that output is an important aspect of scientific
communication, and is increasingly required by funders and
publishers. Yet, academic advancement seldom recognizes or
rewards data sharing. This article argues that although
mandating data sharing will increase the amount of data
available, this will not necessarily enable or encourage the
secondary analyses needed to achieve its purported public good.
We, therefore, need to build models that maximize the efficiency
of processes for data collation and curation, and genuinely
reward those engaged in data sharing and reuse. The WorldWide
Antimalarial Resistance Network has 10 years of experience as a
data platform, and its study group approach provides an example
of how some of the challenges in equitable and impactful
data-sharing and secondary use can be addressed, with a focus on
the priorities of researchers in resource-limited settings. |
2018
|
Journal Articles
|
| Mady Ouédraogo, Sékou Samadoulougou, Toussaint Rouamba, Hervé Hien, John E M Sawadogo, Halidou Tinto, Victor A Alegana, Niko Speybroeck, Fati Kirakoya-Samadoulougou Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso (Journal Article) In: Malar. J., vol. 17, no. 1, pp. 460, 2018, ISSN: 1475-2875. @article{Ouedraogo2018-rc,
title = {Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso},
author = {Mady Ou\'{e}draogo and S\'{e}kou Samadoulougou and Toussaint Rouamba and Herv\'{e} Hien and John E M Sawadogo and Halidou Tinto and Victor A Alegana and Niko Speybroeck and Fati Kirakoya-Samadoulougou},
doi = {10.1186/s12936-018-2606-9},
issn = {1475-2875},
year = {2018},
date = {2018-12-01},
urldate = {2018-12-01},
journal = {Malar. J.},
volume = {17},
number = {1},
pages = {460},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: In malaria endemic countries, asymptomatic cases
constitute an important reservoir of infections sustaining
transmission. Estimating the burden of the asymptomatic
population and identifying areas with elevated risk is important
for malaria control in Burkina Faso. This study analysed the
spatial distribution of asymptomatic malaria infection among
children under 5 in 24 health districts in Burkina Faso and
identified the determinants of this distribution. METHODS: The
data used in this study were collected in a baseline survey on
``evaluation of the impact of pay for performance on the quality
of care'' conducted in 24 health districts in Burkina Faso,
between October 2013 and March 2014. This survey involved 7844
households and 1387 community health workers. A Bayesian
hierarchical logistic model that included spatial dependence and
covariates was implemented to identify the determinants of
asymptomatic malaria infection. The posterior probability
distribution of a parameter from the model was summarized using
odds ratio (OR) and 95% credible interval (95% CI). RESULTS:
The overall prevalence of asymptomatic malaria infection in
children under 5 years of age was estimated at 38.2%. However,
significant variation was observed between districts ranging
from 11.1% in the district of Barsalgho to 77.8% in the
district of Gaoua. Older children (48-59 vs \< 6 months: OR: 6.79
[5.62, 8.22]), children from very poor households (Richest vs
poorest: OR: 0.85 [0.74-0.96]), households located more than 5
km from a health facility (\< 5 km vs $geq$ 5 km: OR: 1.14
[1.04-1.25]), in localities with inadequate number of nurses (\<
3 vs $geq$ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67
[1.39-2.01]) and those surveyed in high transmission period of
asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk
for asymptomatic malaria infection. In addition, the spatial
analysis identified the following nine districts that reported
significantly higher risks: Bati\'{e}, Boromo, Dano,
Di\'{e}bougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The
district of Zabr\'{e} reported the lowest risk. CONCLUSION: The
analysis of spatial distribution of infectious reservoir allowed
the identification of risk areas as well as the identification
of individual and contextual factors. Such national spatial
analysis should help to prioritize areas for increased malaria
control activities.},
keywords = {Bayesian; Burkina Faso; Health district; Malaria; Map; Spatial},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: In malaria endemic countries, asymptomatic cases
constitute an important reservoir of infections sustaining
transmission. Estimating the burden of the asymptomatic
population and identifying areas with elevated risk is important
for malaria control in Burkina Faso. This study analysed the
spatial distribution of asymptomatic malaria infection among
children under 5 in 24 health districts in Burkina Faso and
identified the determinants of this distribution. METHODS: The
data used in this study were collected in a baseline survey on
“evaluation of the impact of pay for performance on the quality
of care” conducted in 24 health districts in Burkina Faso,
between October 2013 and March 2014. This survey involved 7844
households and 1387 community health workers. A Bayesian
hierarchical logistic model that included spatial dependence and
covariates was implemented to identify the determinants of
asymptomatic malaria infection. The posterior probability
distribution of a parameter from the model was summarized using
odds ratio (OR) and 95% credible interval (95% CI). RESULTS:
The overall prevalence of asymptomatic malaria infection in
children under 5 years of age was estimated at 38.2%. However,
significant variation was observed between districts ranging
from 11.1% in the district of Barsalgho to 77.8% in the
district of Gaoua. Older children (48-59 vs < 6 months: OR: 6.79
[5.62, 8.22]), children from very poor households (Richest vs
poorest: OR: 0.85 [0.74-0.96]), households located more than 5
km from a health facility (< 5 km vs $geq$ 5 km: OR: 1.14
[1.04-1.25]), in localities with inadequate number of nurses (<
3 vs $geq$ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67
[1.39-2.01]) and those surveyed in high transmission period of
asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk
for asymptomatic malaria infection. In addition, the spatial
analysis identified the following nine districts that reported
significantly higher risks: Batié, Boromo, Dano,
Diébougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The
district of Zabré reported the lowest risk. CONCLUSION: The
analysis of spatial distribution of infectious reservoir allowed
the identification of risk areas as well as the identification
of individual and contextual factors. Such national spatial
analysis should help to prioritize areas for increased malaria
control activities. |
| Francois Kiemde, Massa Dit Achille Bonko, Marc Christian Tahita, Palpouguini Lompo, Halidou Tinto, Petra F Mens, Henk D F H Schallig, Michael Boele Hensbroek Can clinical signs or symptoms combined with basic hematology data be used to predict the presence of bacterial infections in febrile children under – 5 years? (Journal Article) In: BMC Pediatr., vol. 18, no. 1, pp. 370, 2018, ISSN: 1471-2431. @article{Kiemde2018-od,
title = {Can clinical signs or symptoms combined with basic hematology data be used to predict the presence of bacterial infections in febrile children under - 5 years?},
author = {Francois Kiemde and Massa Dit Achille Bonko and Marc Christian Tahita and Palpouguini Lompo and Halidou Tinto and Petra F Mens and Henk D F H Schallig and Michael Boele Hensbroek},
doi = {10.1186/s12887-018-1340-3},
issn = {1471-2431},
year = {2018},
date = {2018-11-01},
urldate = {2018-11-01},
journal = {BMC Pediatr.},
volume = {18},
number = {1},
pages = {370},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Infectious diseases in children living in
resource-limited settings are often presumptively managed on the
basis of clinical signs and symptoms. Malaria is an exception.
However, the interpretation of clinical signs and symptoms in
relation to bacterial infections is often challenging, which may
lead to an over prescription of antibiotics when a malaria
infection is excluded. The present study aims to determine the
association between clinical signs and symptoms and basic
hematology data, with laboratory confirmed bacterial infections.
METHODS: A health survey was done by study nurses to collect
clinical signs/symptoms in febrile (axillary temperature $geq$
37.5 °C) children under - 5 years of age. In addition, blood,
stool and urine specimen were systematically collected from each
child to perform bacterial culture and full blood cell counts.
To determine the association between a bacterial infection with
clinical signs/symptoms, and if possible supported by basic
hematology data (hemoglobin and leucocyte rates), a univariate
analysis was done. This was followed by a multivariate analysis only on those variables with a p-value p 39.5 °C (p = 0.002), diarrhea (p = 0.019) and edema (p = 0.017). There was no
association found between bacterial infections and basic
haematological findings. If diarrhea and edema were absent, a
good negative predictive value (100%) of a bacterial
bloodstream infection was found, but the positive predictive
value was low (33.3%) and the confidence interval was very
large (2.5-100; 7.5-70.1). CONCLUSION: Our study demonstrates
that clinical signs and symptoms, combined with basic hematology
data only, cannot predict bacterial infections in febrile
children under - 5 years of age. The development of practical
and easy deployable diagnostic tools to diagnose bacterial
infections remains a priority.},
keywords = {Bacteria; Children; Fever; Malaria; Signs; Symptoms},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Infectious diseases in children living in
resource-limited settings are often presumptively managed on the
basis of clinical signs and symptoms. Malaria is an exception.
However, the interpretation of clinical signs and symptoms in
relation to bacterial infections is often challenging, which may
lead to an over prescription of antibiotics when a malaria
infection is excluded. The present study aims to determine the
association between clinical signs and symptoms and basic
hematology data, with laboratory confirmed bacterial infections.
METHODS: A health survey was done by study nurses to collect
clinical signs/symptoms in febrile (axillary temperature $geq$
37.5 °C) children under – 5 years of age. In addition, blood,
stool and urine specimen were systematically collected from each
child to perform bacterial culture and full blood cell counts.
To determine the association between a bacterial infection with
clinical signs/symptoms, and if possible supported by basic
hematology data (hemoglobin and leucocyte rates), a univariate
analysis was done. This was followed by a multivariate analysis only on those variables with a p-value p 39.5 °C (p = 0.002), diarrhea (p = 0.019) and edema (p = 0.017). There was no
association found between bacterial infections and basic
haematological findings. If diarrhea and edema were absent, a
good negative predictive value (100%) of a bacterial
bloodstream infection was found, but the positive predictive
value was low (33.3%) and the confidence interval was very
large (2.5-100; 7.5-70.1). CONCLUSION: Our study demonstrates
that clinical signs and symptoms, combined with basic hematology
data only, cannot predict bacterial infections in febrile
children under – 5 years of age. The development of practical
and easy deployable diagnostic tools to diagnose bacterial
infections remains a priority. |