2021 |
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Journal Articles |
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![]() | Koudraogo Bienvenue Yaméogo, Rakiswendé Serge Yerbanga, Seydou Bienvenu Ouattara, Franck A Yao, Thierry Lef`evre, Issaka Zongo, Frederic Niki`ema, Yves Daniel Compaoré, Halidou Tinto, Daniel Chandramohan, Brian Greenwood, Adrien M G Belem, Anna Cohuet, Jean Bosco Ouédraogo Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness Journal Article In: Malar. J., vol. 20, no. 1, pp. 326, 2021, ISSN: 1475-2875, (© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489). Abstract | BibTeX | Tags: Amodiaquine/administration & dosage, Animals, Antimalarials/administration & dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention & control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration & dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration & dosage, Transmission | Links: @article{Yameogo2021-bb, BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P < 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P < 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P < 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P < 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P < 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention. | ||
![]() | Mariken Wit, Matthew Cairns, Yves Daniel Compaoré, Issaka Sagara, Irene Kuepfer, Issaka Zongo, Amadou Barry, Modibo Diarra, Amadou Tapily, Samba Coumare, Ismaila Thera, Frederic Nikiema, R Serge Yerbanga, Rosemonde M Guissou, Halidou Tinto, Alassane Dicko, Daniel Chandramohan, Brian Greenwood, Jean Bosco Ouedraogo Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria Journal Article In: Malar. J., vol. 20, no. 1, pp. 274, 2021, ISSN: 1475-2875, (PMID: 34158054 PMCID: PMC8220741). Abstract | BibTeX | Tags: Acute malnutrition, Antimalarials/administration & dosage, Azithromycin/administration & dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons | Links: @article{De_Wit2021-yi, BACKGROUND: Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson models were created for each nutritional indicator to study the effect of malnutrition on clinical malaria incidence for each country. RESULTS: In both 2015 and 2016, nutritional status prior to the malaria season was poor. The most prevalent form of malnutrition in Burkina Faso was being underweight (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria incidence was 675 per 1000 person-years (95% CI 613-744) in Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) in Mali. There was some evidence that severe stunting was associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen in Burkina Faso. Being moderately underweight tended to be associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in severely affected children, nor consistent between countries. MUAC-for-age was not associated with malaria risk. CONCLUSIONS: Both malnutrition and malaria were common in the study areas, high despite high coverage of seasonal malaria chemoprevention and long-lasting insecticidal nets. However, no strong or consistent evidence was found for an association between any of the nutritional indicators and the subsequent incidence of clinical malaria. |
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