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6 results on '"Chisenga, Mukosha"'

4. Subpatent malaria in a low transmission African setting: a cross-sectional study using rapid diagnostic testing (RDT) and loop-mediated isothermal amplification (LAMP) from Zambezi region, Namibia.

Author

McCreesh, Patrick, Mumbengegwi, Davis, Roberts, Kathryn, Tambo, Munyaradzi, Smith, Jennifer, Whittemore, Brooke, Kelly, Gerard, Moe, Caitlin, Murphy, Max, Chisenga, Mukosha, Greenhouse, Bryan, Ntuku, Henry, Kleinschmidt, Immo, Sturrock, Hugh, Uusiku, Petrina, Gosling, Roland, Bennett, Adam, and Hsiang, Michelle S

Subjects
Humans, Malaria, Falciparum, Diagnostic Tests, Routine, Prevalence, Risk Factors, Sensitivity and Specificity, Cross-Sectional Studies, Nucleic Acid Amplification Techniques, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Child, Preschool, Infant, Infant, Newborn, Namibia, Female, Male, Young Adult, Asymptomatic, LAMP, Malaria, Malaria elimination, RDT, Rapid diagnostic test, Subclinical, Submicroscopic, Subpatent, Tropical Medicine, Microbiology, Medical Microbiology, Public Health and Health Services
Abstract

BackgroundSubpatent malaria infections, or low-density infections below the detection threshold of microscopy or standard rapid diagnostic testing (RDT), can perpetuate persistent transmission and, therefore, may be a barrier for countries like Namibia that are pursuing malaria elimination. This potential burden in Namibia has not been well characterized.MethodsUsing a two-stage cluster sampling, cross-sectional design, subjects of all age were enrolled during the end of the 2015 malaria transmission season in Zambezi region, located in northeast Namibia. Malaria RDTs were performed with subsequent gold standard testing by loop-mediated isothermal amplification (LAMP) using dried blood spots. Infection prevalence was measured and the diagnostic accuracy of RDT calculated. Relationships between recent fever, demographics, epidemiological factors, and infection were assessed.ResultsPrevalence of Plasmodium falciparum malaria infection was low: 0.8% (16/1919) by RDT and 2.2% (43/1919) by LAMP. All but one LAMP-positive infection was RDT-negative. Using LAMP as gold standard, the sensitivity and specificity of RDT were 2.3% and 99.2%, respectively. Compared to LAMP-negative infections, a higher portion LAMP-positive infections were associated with fever (45.2% vs. 30.4%, p = 0.04), though 55% of infections were not associated with fever. Agricultural occupations and cattle herding were significantly associated with LAMP-detectable infection (Adjusted ORs 5.02, 95% CI 1.77-14.23, and 11.82, 95% CI 1.06-131.81, respectively), while gender, travel, bed net use, and indoor residual spray coverage were not.ConclusionsThis study presents results from the first large-scale malaria cross-sectional survey from Namibia using molecular testing to characterize subpatent infections. Findings suggest that fever history and standard RDTs are not useful to address this burden. Achievement of malaria elimination may require active case detection using more sensitive point-of-care diagnostics or presumptive treatment and targeted to high-risk groups.

Published
2018

6. Assessing malaria risk at night-time venues in a low-transmission setting: A time-location sampling study in Zambezi, Namibia

Author

Jacobson, Jerry O., Smith, Jennifer L., Cueto, Carmen, Chisenga, Mukosha, Roberts, Kathryn W., Hsiang, M., Gosling, Roly, Mumbengegwi, Davis R., Bennett, Adam, Jacobson, Jerry O., Smith, Jennifer L., Cueto, Carmen, Chisenga, Mukosha, Roberts, Kathryn W., Hsiang, M., Gosling, Roly, Mumbengegwi, Davis R., and Bennett, Adam

Abstract

Background:Identifying efficient and effective strategies to reach and monitor populations at greatest risk of malaria in low-transmission settings is a key challenge for malaria elimination. In Namibia’s Zambezi Region, transmis-sion is ongoing yet its drivers remain poorly understood. A growing literature suggests that night-time social activities may lead to malaria exposure that is beyond the reach of conventional preventive interventions, such as insecticide treated bed nets and indoor residual spraying.Methods:Formative research was conducted with community members in March, 2015 in the catchment areas of six randomly selected health facilities in the western Zambezi Region to identify night-time locations where large numbers of individuals regularly congregate. Using time-location sampling, a survey was conducted between March and May, 2015 at community-identified venues (bars and evening church services) to develop representative esti-mates of the prevalence of parasite infection and risk factors among venue-goers.Results:When compared to a contemporaneous household survey of the general population aged 15 and older (N =1160), venue-goers (N =480) were more likely to have spent the night away from their home recently (17.3% vs. 8.9%, P =0.008), report recent fever (65.2% vs. 36.9%, P < 0.001), and were less likely to have sought care for fever (37.9% vs. 52.1%, P =0.011). Venue-goers had higher, but not significantly different, rates of malaria infection (4.7% vs. 2.8%, P =0.740). Risk factors for malaria infection among venue-goers could not be determined due to the small number of infections identified, however self-reported fever was positively associated with outdoor livelihood activi-ties (adjusted odds ratio [AOR] =1.9, 95% CI 1.0–3.3), not wearing protective measures at the time of the survey (AOR =6.8, 9% CI 1.4–33.6) and having been bothered by mosquitos at the venue (AOR =2.7, 95% CI 1.5–4).Conclusions:Prevention measures and continued surveillance

Published
2011

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