On-going malaria transmission in the Gambia despite high coverage of control interventions: a nationwide cross-sectional survey

Julia Mwesigwa; Joseph Okebe; Muna Affara; Gian Luca Di Tanna; Davis Nwakanma; Omar Janha; Kevin Opondo; Koen Peeters Grietens; Jane Achan; Umberto D'Alessandro

doi:10.1186/s12936-015-0829-6

On-going malaria transmission in the Gambia despite high coverage of control interventions: a nationwide cross-sectional survey

Julia Mwesigwa, Joseph Okebe, Muna Affara, Gian Luca Di Tanna, Davis Nwakanma, Omar Janha, Kevin Opondo, Koen Peeters Grietens, Jane Achan, Umberto D'Alessandro

Socio-ecological Health Research

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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Abstract

BACKGROUND: As indicators of burden of malaria have substantially decreased in The Gambia, reaching a pre-elimination status may be attainable. Achieving this goal requires in-depth understanding of the current burden of Plasmodium falciparum infection.

METHODS: A nationwide cross-sectional survey was conducted in 2012 to determine the prevalence of P. falciparum infection, and to describe its heterogeneity and associated risk factors. Finger-prick blood samples were collected for microscopy, species-specific PCR and haemoglobin measurement.

RESULTS: A total of 9,094 participants were included and median age was 11.9 years (IQR 5, 28). Overall prevalence of P. falciparum was 16.01 % with marked heterogeneity between sites (4.32-36.75 %) and within villages in each site (1.63-49.13 %). Across all sites, 51.17 % (745/1,456) of infections were asymptomatic and 35.61 % (448/1,258) were sub-microscopic. The odds of P. falciparum infection were higher in older children; 5-15 years (OR = 1.90; 95 % CI 1.60-2.26), adults (OR = 1.48; 95 % CI 1.24-1.78) and participants with moderate anaemia (OR = 1.62; 95 % CI 1.32-1.99).

CONCLUSIONS: The current malaria control interventions are not sufficient to interrupt transmission in The Gambia as malaria prevalence is still relatively high in the eastern part of the country. New interventions aiming at interrupting transmission are needed and should be urgently evaluated.

Original language	English
Journal	Malaria Journal
Volume	14
Pages (from-to)	314
ISSN	1475-2875
DOIs	https://doi.org/10.1186/s12936-015-0829-6
Publication status	Published - 2015

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10.1186/s12936-015-0829-6Licence: Unspecified

2015mjou0314Final published version, 1.41 MBLicence: CC BY

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title = "On-going malaria transmission in the Gambia despite high coverage of control interventions: a nationwide cross-sectional survey",

abstract = "BACKGROUND: As indicators of burden of malaria have substantially decreased in The Gambia, reaching a pre-elimination status may be attainable. Achieving this goal requires in-depth understanding of the current burden of Plasmodium falciparum infection.METHODS: A nationwide cross-sectional survey was conducted in 2012 to determine the prevalence of P. falciparum infection, and to describe its heterogeneity and associated risk factors. Finger-prick blood samples were collected for microscopy, species-specific PCR and haemoglobin measurement.RESULTS: A total of 9,094 participants were included and median age was 11.9 years (IQR 5, 28). Overall prevalence of P. falciparum was 16.01 % with marked heterogeneity between sites (4.32-36.75 %) and within villages in each site (1.63-49.13 %). Across all sites, 51.17 % (745/1,456) of infections were asymptomatic and 35.61 % (448/1,258) were sub-microscopic. The odds of P. falciparum infection were higher in older children; 5-15 years (OR = 1.90; 95 % CI 1.60-2.26), adults (OR = 1.48; 95 % CI 1.24-1.78) and participants with moderate anaemia (OR = 1.62; 95 % CI 1.32-1.99).CONCLUSIONS: The current malaria control interventions are not sufficient to interrupt transmission in The Gambia as malaria prevalence is still relatively high in the eastern part of the country. New interventions aiming at interrupting transmission are needed and should be urgently evaluated.",

author = "Julia Mwesigwa and Joseph Okebe and Muna Affara and {Di Tanna}, {Gian Luca} and Davis Nwakanma and Omar Janha and Kevin Opondo and {Peeters Grietens}, Koen and Jane Achan and Umberto D'Alessandro",

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doi = "10.1186/s12936-015-0829-6",

language = "English",

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pages = "314",

journal = "Malaria Journal",

issn = "1475-2875",

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}

TY - JOUR

T1 - On-going malaria transmission in the Gambia despite high coverage of control interventions

T2 - a nationwide cross-sectional survey

AU - Mwesigwa, Julia

AU - Okebe, Joseph

AU - Affara, Muna

AU - Di Tanna, Gian Luca

AU - Nwakanma, Davis

AU - Janha, Omar

AU - Opondo, Kevin

AU - Peeters Grietens, Koen

AU - Achan, Jane

AU - D'Alessandro, Umberto

N1 - FTX

PY - 2015

Y1 - 2015

N2 - BACKGROUND: As indicators of burden of malaria have substantially decreased in The Gambia, reaching a pre-elimination status may be attainable. Achieving this goal requires in-depth understanding of the current burden of Plasmodium falciparum infection.METHODS: A nationwide cross-sectional survey was conducted in 2012 to determine the prevalence of P. falciparum infection, and to describe its heterogeneity and associated risk factors. Finger-prick blood samples were collected for microscopy, species-specific PCR and haemoglobin measurement.RESULTS: A total of 9,094 participants were included and median age was 11.9 years (IQR 5, 28). Overall prevalence of P. falciparum was 16.01 % with marked heterogeneity between sites (4.32-36.75 %) and within villages in each site (1.63-49.13 %). Across all sites, 51.17 % (745/1,456) of infections were asymptomatic and 35.61 % (448/1,258) were sub-microscopic. The odds of P. falciparum infection were higher in older children; 5-15 years (OR = 1.90; 95 % CI 1.60-2.26), adults (OR = 1.48; 95 % CI 1.24-1.78) and participants with moderate anaemia (OR = 1.62; 95 % CI 1.32-1.99).CONCLUSIONS: The current malaria control interventions are not sufficient to interrupt transmission in The Gambia as malaria prevalence is still relatively high in the eastern part of the country. New interventions aiming at interrupting transmission are needed and should be urgently evaluated.

AB - BACKGROUND: As indicators of burden of malaria have substantially decreased in The Gambia, reaching a pre-elimination status may be attainable. Achieving this goal requires in-depth understanding of the current burden of Plasmodium falciparum infection.METHODS: A nationwide cross-sectional survey was conducted in 2012 to determine the prevalence of P. falciparum infection, and to describe its heterogeneity and associated risk factors. Finger-prick blood samples were collected for microscopy, species-specific PCR and haemoglobin measurement.RESULTS: A total of 9,094 participants were included and median age was 11.9 years (IQR 5, 28). Overall prevalence of P. falciparum was 16.01 % with marked heterogeneity between sites (4.32-36.75 %) and within villages in each site (1.63-49.13 %). Across all sites, 51.17 % (745/1,456) of infections were asymptomatic and 35.61 % (448/1,258) were sub-microscopic. The odds of P. falciparum infection were higher in older children; 5-15 years (OR = 1.90; 95 % CI 1.60-2.26), adults (OR = 1.48; 95 % CI 1.24-1.78) and participants with moderate anaemia (OR = 1.62; 95 % CI 1.32-1.99).CONCLUSIONS: The current malaria control interventions are not sufficient to interrupt transmission in The Gambia as malaria prevalence is still relatively high in the eastern part of the country. New interventions aiming at interrupting transmission are needed and should be urgently evaluated.

U2 - 10.1186/s12936-015-0829-6

DO - 10.1186/s12936-015-0829-6

M3 - A1: Web of Science-article

C2 - 26268225

SN - 1475-2875

VL - 14

SP - 314

JO - Malaria Journal

JF - Malaria Journal

ER -

On-going malaria transmission in the Gambia despite high coverage of control interventions: a nationwide cross-sectional survey

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