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Epidemiology and Control of Plasmodium vivax in Afghanistan

Around half of the population of Afghanistan resides in areas at risk of malaria transmission. Two species of malaria (Plasmodium vivax and Plasmodium falciparum) account for a high burden of disease—in 2011, there were more than 300,000 confirmed cases. Around 80–95% of malaria is P. vivax. Transmi...

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Detalles Bibliográficos
Autores principales: Leslie, Toby, Nahzat, Sami, Sediqi, Walid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201225/
https://www.ncbi.nlm.nih.gov/pubmed/27708189
http://dx.doi.org/10.4269/ajtmh.16-0172
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author Leslie, Toby
Nahzat, Sami
Sediqi, Walid
author_facet Leslie, Toby
Nahzat, Sami
Sediqi, Walid
author_sort Leslie, Toby
collection PubMed
description Around half of the population of Afghanistan resides in areas at risk of malaria transmission. Two species of malaria (Plasmodium vivax and Plasmodium falciparum) account for a high burden of disease—in 2011, there were more than 300,000 confirmed cases. Around 80–95% of malaria is P. vivax. Transmission is seasonal and focal, below 2,000 m in altitude, and in irrigated areas which allow breeding of anopheline mosquito vectors. Malaria risk is stratified to improve targeting of interventions. Sixty-three of 400 districts account for ∼85% of cases, and are the target of more intense control efforts. Pressure on the disease is maintained through case management, surveillance, and use of long-lasting insecticide-treated nets. Plasmodium vivax treatment is hampered by the inability to safely treat latent hypnozoites with primaquine because G6PD deficiency affects up to 10% of males in some ethnic groups. The risk of vivax malaria recurrence (which may be as a result of reinfection or relapse) is around 30–45% in groups not treated with primaquine but 3–20% in those given 14-day or 8-week courses of primaquine. Greater access to G6PD testing and radical treatment would reduce the number of incident cases, reduce the infectious reservoir in the population, and has the potential to reduce transmission as a result. Alongside the lack of G6PD testing, under-resourcing and poor security hamper the control of malaria. Recent gains in reducing the burden of disease are fragile and at risk of reversal if pressure on the disease is not maintained.
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spelling pubmed-52012252017-01-05 Epidemiology and Control of Plasmodium vivax in Afghanistan Leslie, Toby Nahzat, Sami Sediqi, Walid Am J Trop Med Hyg Articles Around half of the population of Afghanistan resides in areas at risk of malaria transmission. Two species of malaria (Plasmodium vivax and Plasmodium falciparum) account for a high burden of disease—in 2011, there were more than 300,000 confirmed cases. Around 80–95% of malaria is P. vivax. Transmission is seasonal and focal, below 2,000 m in altitude, and in irrigated areas which allow breeding of anopheline mosquito vectors. Malaria risk is stratified to improve targeting of interventions. Sixty-three of 400 districts account for ∼85% of cases, and are the target of more intense control efforts. Pressure on the disease is maintained through case management, surveillance, and use of long-lasting insecticide-treated nets. Plasmodium vivax treatment is hampered by the inability to safely treat latent hypnozoites with primaquine because G6PD deficiency affects up to 10% of males in some ethnic groups. The risk of vivax malaria recurrence (which may be as a result of reinfection or relapse) is around 30–45% in groups not treated with primaquine but 3–20% in those given 14-day or 8-week courses of primaquine. Greater access to G6PD testing and radical treatment would reduce the number of incident cases, reduce the infectious reservoir in the population, and has the potential to reduce transmission as a result. Alongside the lack of G6PD testing, under-resourcing and poor security hamper the control of malaria. Recent gains in reducing the burden of disease are fragile and at risk of reversal if pressure on the disease is not maintained. The American Society of Tropical Medicine and Hygiene 2016-12-28 /pmc/articles/PMC5201225/ /pubmed/27708189 http://dx.doi.org/10.4269/ajtmh.16-0172 Text en © The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Leslie, Toby
Nahzat, Sami
Sediqi, Walid
Epidemiology and Control of Plasmodium vivax in Afghanistan
title Epidemiology and Control of Plasmodium vivax in Afghanistan
title_full Epidemiology and Control of Plasmodium vivax in Afghanistan
title_fullStr Epidemiology and Control of Plasmodium vivax in Afghanistan
title_full_unstemmed Epidemiology and Control of Plasmodium vivax in Afghanistan
title_short Epidemiology and Control of Plasmodium vivax in Afghanistan
title_sort epidemiology and control of plasmodium vivax in afghanistan
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201225/
https://www.ncbi.nlm.nih.gov/pubmed/27708189
http://dx.doi.org/10.4269/ajtmh.16-0172
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