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Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults

BACKGROUND: Mali and Senegal have made important efforts to control malaria. After a period of decline, the number of cases has remained stable for several years. Asymptomatic carriage acting as a reservoir could explain malaria persistence despite malaria control. Mass drug administration (MDA) is...

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Autores principales: Legendre, E, Ndiaye, A, Sougou, N M, L’Ollivier, C, Mehadji, M, Gaudart, J, Ba, E H, Ridde, V, Sagara, I, Landier, J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10596378/
http://dx.doi.org/10.1093/eurpub/ckad160.555
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author Legendre, E
Ndiaye, A
Sougou, N M
L’Ollivier, C
Mehadji, M
Gaudart, J
Ba, E H
Ridde, V
Sagara, I
Landier, J
author_facet Legendre, E
Ndiaye, A
Sougou, N M
L’Ollivier, C
Mehadji, M
Gaudart, J
Ba, E H
Ridde, V
Sagara, I
Landier, J
author_sort Legendre, E
collection PubMed
description BACKGROUND: Mali and Senegal have made important efforts to control malaria. After a period of decline, the number of cases has remained stable for several years. Asymptomatic carriage acting as a reservoir could explain malaria persistence despite malaria control. Mass drug administration (MDA) is a candidate intervention that could help to accelerate the decreasing of malaria transmission if favourable epidemiologic context and good adherence are met. We aimed to update asymptomatic reservoir description along a Sahelian ecological gradient and study MDA acceptability. METHODS: We conducted an open cohort in 8 villages in Mali and Senegal including all household members sampled aged >6 months. We measured P. falciparum infections prevalence by qPCR in 4 surveys: 2 in dry season 2021, 1 in rainy season 2021 and 1 in dry season 2022. We measured prospective acceptability of MDA in cohort aged ≥15 years in Senegal by questionnaire. We explored risk factors associated to asymptomatic infections and acceptability score with multilevel logistic and linear models. RESULTS: We included 168 households and 1428 participants in at least 1 survey. In preliminary results, prevalence of P. falciparum infections was 11% in dry season 2021 in Senegal, 20% in central Mali and 60% in Northern Mali. Young adults between 15 to 24 years old were more likely to carry asymptomatic infections in dry season compared to children <5 years old (OR = 5.74 [2.99;11.04]). MDA presented a good acceptability with a mean score of 3.5 (score between -7 and 7). Young adults had lower acceptability compared to older participants (β=−1.07 [-1.82,-0.32]). CONCLUSIONS: Young adults were important asymptomatic carriers in Senegal and Mali but were less likely to accept to participate in MDA. KEY MESSAGES: • Young adults represent a public health challenge that need to be address to reach malaria elimination. • Specific sensibilization could be implement to improve adherence to malaria control interventions.
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spelling pubmed-105963782023-10-25 Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults Legendre, E Ndiaye, A Sougou, N M L’Ollivier, C Mehadji, M Gaudart, J Ba, E H Ridde, V Sagara, I Landier, J Eur J Public Health Parallel Programme BACKGROUND: Mali and Senegal have made important efforts to control malaria. After a period of decline, the number of cases has remained stable for several years. Asymptomatic carriage acting as a reservoir could explain malaria persistence despite malaria control. Mass drug administration (MDA) is a candidate intervention that could help to accelerate the decreasing of malaria transmission if favourable epidemiologic context and good adherence are met. We aimed to update asymptomatic reservoir description along a Sahelian ecological gradient and study MDA acceptability. METHODS: We conducted an open cohort in 8 villages in Mali and Senegal including all household members sampled aged >6 months. We measured P. falciparum infections prevalence by qPCR in 4 surveys: 2 in dry season 2021, 1 in rainy season 2021 and 1 in dry season 2022. We measured prospective acceptability of MDA in cohort aged ≥15 years in Senegal by questionnaire. We explored risk factors associated to asymptomatic infections and acceptability score with multilevel logistic and linear models. RESULTS: We included 168 households and 1428 participants in at least 1 survey. In preliminary results, prevalence of P. falciparum infections was 11% in dry season 2021 in Senegal, 20% in central Mali and 60% in Northern Mali. Young adults between 15 to 24 years old were more likely to carry asymptomatic infections in dry season compared to children <5 years old (OR = 5.74 [2.99;11.04]). MDA presented a good acceptability with a mean score of 3.5 (score between -7 and 7). Young adults had lower acceptability compared to older participants (β=−1.07 [-1.82,-0.32]). CONCLUSIONS: Young adults were important asymptomatic carriers in Senegal and Mali but were less likely to accept to participate in MDA. KEY MESSAGES: • Young adults represent a public health challenge that need to be address to reach malaria elimination. • Specific sensibilization could be implement to improve adherence to malaria control interventions. Oxford University Press 2023-10-24 /pmc/articles/PMC10596378/ http://dx.doi.org/10.1093/eurpub/ckad160.555 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Parallel Programme
Legendre, E
Ndiaye, A
Sougou, N M
L’Ollivier, C
Mehadji, M
Gaudart, J
Ba, E H
Ridde, V
Sagara, I
Landier, J
Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title_full Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title_fullStr Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title_full_unstemmed Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title_short Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults
title_sort malaria asymptomatic carriage in the sahelian region: the challenge associated to young adults
topic Parallel Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10596378/
http://dx.doi.org/10.1093/eurpub/ckad160.555
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