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Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?

BACKGROUND: The malaria burden has decreased significantly in recent years in Africa through the widespread use of artemisinin-based combination therapy (ACT) and long-lasting insecticide-treated nets (LLINs). However, the occurrence of malaria resurgences, the loss of immunity of exposed population...

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Autores principales: Wotodjo, Amélé Nyedzie, Doucoure, Souleymane, Gaudart, Jean, Diagne, Nafissatou, Diene Sarr, Fatoumata, Faye, Ngor, Tall, Adama, Raoult, Didier, Sokhna, Cheikh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497975/
https://www.ncbi.nlm.nih.gov/pubmed/28678846
http://dx.doi.org/10.1371/journal.pone.0179528
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author Wotodjo, Amélé Nyedzie
Doucoure, Souleymane
Gaudart, Jean
Diagne, Nafissatou
Diene Sarr, Fatoumata
Faye, Ngor
Tall, Adama
Raoult, Didier
Sokhna, Cheikh
author_facet Wotodjo, Amélé Nyedzie
Doucoure, Souleymane
Gaudart, Jean
Diagne, Nafissatou
Diene Sarr, Fatoumata
Faye, Ngor
Tall, Adama
Raoult, Didier
Sokhna, Cheikh
author_sort Wotodjo, Amélé Nyedzie
collection PubMed
description BACKGROUND: The malaria burden has decreased significantly in recent years in Africa through the widespread use of artemisinin-based combination therapy (ACT) and long-lasting insecticide-treated nets (LLINs). However, the occurrence of malaria resurgences, the loss of immunity of exposed populations constitute among other factors, serious concerns about the future of malaria elimination efforts. This study investigated the evolution of malaria morbidity in Dielmo (Senegal) before and after the implementation of LLINs. METHODS: A longitudinal study was carried out in Dielmo over eight years, from July 2007 to July 2015. In July 2008, LLINs were offered to all villagers, and in July 2011 and August 2014 the LLINs were renewed. A survey on LLINs use was done each quarter of the year. Thick smears stained with Giemsa, a rapid diagnostic test (RDT) and quantitative polymerase chain reaction (PCR) methods were performed for all cases of fever to assess malaria clinical attacks. Malaria cases were treated with ACT since June 2006. RESULTS: Malaria morbidity has decreased significantly since the implementation of LLINs in Dielmo, together with ACT. However, malaria resurgences have occurred twice during the seven years of LLINs use. These resurgences occurred the first time during the third year after the introduction of LLINs (aIRR (adjusted incidence-rate ratio) [95%CI] = 5.90 [3.53; 9.88] p< 0.001) and a second time during the third year after the renewal of LLINs (aIRR [95%CI] = 5.60 [3.34; 9.39] p< 0.001). Sixty-nine percent (69%) of the nets tested for their long-lasting insecticidal activity remained effective after 3 years of use. CONCLUSION: Good management of malaria cases by the use of ACT as first-line treatment against malaria in addition to the use of LLINs has significantly reduced malaria in Dielmo and allowed to reach the phase of pre-elimination of the disease. However, the occurrence of malaria resurgences raised serious concerns about malaria elimination, which would require additional tools in this village.
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spelling pubmed-54979752017-07-25 Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets? Wotodjo, Amélé Nyedzie Doucoure, Souleymane Gaudart, Jean Diagne, Nafissatou Diene Sarr, Fatoumata Faye, Ngor Tall, Adama Raoult, Didier Sokhna, Cheikh PLoS One Research Article BACKGROUND: The malaria burden has decreased significantly in recent years in Africa through the widespread use of artemisinin-based combination therapy (ACT) and long-lasting insecticide-treated nets (LLINs). However, the occurrence of malaria resurgences, the loss of immunity of exposed populations constitute among other factors, serious concerns about the future of malaria elimination efforts. This study investigated the evolution of malaria morbidity in Dielmo (Senegal) before and after the implementation of LLINs. METHODS: A longitudinal study was carried out in Dielmo over eight years, from July 2007 to July 2015. In July 2008, LLINs were offered to all villagers, and in July 2011 and August 2014 the LLINs were renewed. A survey on LLINs use was done each quarter of the year. Thick smears stained with Giemsa, a rapid diagnostic test (RDT) and quantitative polymerase chain reaction (PCR) methods were performed for all cases of fever to assess malaria clinical attacks. Malaria cases were treated with ACT since June 2006. RESULTS: Malaria morbidity has decreased significantly since the implementation of LLINs in Dielmo, together with ACT. However, malaria resurgences have occurred twice during the seven years of LLINs use. These resurgences occurred the first time during the third year after the introduction of LLINs (aIRR (adjusted incidence-rate ratio) [95%CI] = 5.90 [3.53; 9.88] p< 0.001) and a second time during the third year after the renewal of LLINs (aIRR [95%CI] = 5.60 [3.34; 9.39] p< 0.001). Sixty-nine percent (69%) of the nets tested for their long-lasting insecticidal activity remained effective after 3 years of use. CONCLUSION: Good management of malaria cases by the use of ACT as first-line treatment against malaria in addition to the use of LLINs has significantly reduced malaria in Dielmo and allowed to reach the phase of pre-elimination of the disease. However, the occurrence of malaria resurgences raised serious concerns about malaria elimination, which would require additional tools in this village. Public Library of Science 2017-07-05 /pmc/articles/PMC5497975/ /pubmed/28678846 http://dx.doi.org/10.1371/journal.pone.0179528 Text en © 2017 Wotodjo et al http://creativecommons.org/licenses/by/4.0/ 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 Research Article
Wotodjo, Amélé Nyedzie
Doucoure, Souleymane
Gaudart, Jean
Diagne, Nafissatou
Diene Sarr, Fatoumata
Faye, Ngor
Tall, Adama
Raoult, Didier
Sokhna, Cheikh
Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title_full Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title_fullStr Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title_full_unstemmed Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title_short Malaria in Dielmo, a Senegal village: Is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
title_sort malaria in dielmo, a senegal village: is its elimination possible after seven years of implementation of long-lasting insecticide-treated nets?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497975/
https://www.ncbi.nlm.nih.gov/pubmed/28678846
http://dx.doi.org/10.1371/journal.pone.0179528
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