Journal articles: 'Malaria – Zambia'

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Steury, Elinda Enright. "Malaria Prevention in Zambia." Journal of Transcultural Nursing 24, no. 2 (January 22, 2013): 189–94. http://dx.doi.org/10.1177/1043659612472061.

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Chanda, Emmanuel, Mulakwa Kamuliwo, Richard W. Steketee, Michael B. Macdonald, Olusegun Babaniyi, and Victor M. Mukonka. "An Overview of the Malaria Control Programme in Zambia." ISRN Preventive Medicine 2013 (December 9, 2013): 1–8. http://dx.doi.org/10.5402/2013/495037.

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The Zambian national malaria control programme has made great progress in the fight against Malaria. The country has solid, consistent, and coordinated policies, strategies, and guidelines for malaria control, with government prioritizing malaria in both the National Health Strategic Plan and the National Development Plan. This has translated into high coverage of proven and effective key preventive, curative, and supportive interventions with concomitant marked reduction in both malaria cases and deaths. The achievements attained can be attributed to increased advocacy, communication and behaviour changes, efficient partnership coordination including strong community engagement, increased financial resources, and evidence-based deployment of key technical interventions in accordance with the national malaria control programme policy and strategic direction. The three-ones strategy has been key for increased and successful public-private sector partner coordination, strengthening, and mobilization. However, maintaining the momentum and the gains is critical as the programme strives to achieve universal coverage of evidence-based and proven interventions. The malaria control programme’s focus is to maintain the accomplishments, by mobilizing more resources and partners, increasing the government funding towards malaria control, scaling up and directing interventions based on epidemiological evidence, and strengthen active malaria surveillance and response to reduce transmission and to begin considering elimination.

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Shimaponda-Mataa, Nzooma M., Enala Tembo-Mwase, Michael Gebreslasie, and Samson Mukaratirwa. "Knowledge, attitudes and practices in the control and prevention of malaria in four endemic provinces of Zambia." Southern African Journal of Infectious Diseases 32, no. 1 (March 31, 2017): 29–39. http://dx.doi.org/10.4102/sajid.v32i1.67.

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This study sought to determine malaria knowledge levels, attitudes and practices of the communities in four malaria endemic provinces of Zambia. A cross-sectional survey on knowledge, attitude and practices (KAP) on malaria transmission, prevention and control was conducted among 584 household heads of randomly selected communities in Luapula, Lusaka, north-western and western provinces in Zambia. Data analysis was performed by both descriptive and inferential statistics. Knowledge levels in malaria with regards to the mosquito being the vector and the capacity of malaria to kill were high in all the provinces and did not vary statistically. The two main sources of malaria information by weighted analysis were health facility and community health workers (CHWs). From the regression analysis, pain killer use was associated with high incomes, employment, secondary education, or higher, and the knowledge of fever as a sign for malaria. Additionally, the source of malaria information was related to education levels. There is a need to enhance information through available channels such as health facilities and CHWs and tailor them according to general education levels of a community.

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Phiri, James S. "Malaria Control in Zambia and Southern Africa." Environmental Health Perspectives 103, no. 7/8 (July 1995): 644. http://dx.doi.org/10.2307/3432851.

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Phiri, J. S. "Malaria control in Zambia and southern Africa." Environmental Health Perspectives 103, no. 7-8 (January 1995): 644–45. http://dx.doi.org/10.1289/ehp.95103644b.

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Singer, Emily. "International partnership launches malaria model in Zambia." Nature Medicine 11, no. 7 (July 2005): 695. http://dx.doi.org/10.1038/nm0705-695b.

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Kupferschmidt, K. "Zambia fights to sustain its malaria success." Science 345, no. 6202 (September 11, 2014): 1270–71. http://dx.doi.org/10.1126/science.345.6202.1270.

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Butler, Declan. "Zambia to wage ‘scientific’ war on malaria." Nature 435, no. 7041 (May 2005): 395. http://dx.doi.org/10.1038/435395a.

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McClean, Karen L., and A. Senthilselvan. "Mosquito Bed Nets: Implementation in Rural Villages in Zambia and the Effect on Subclinical Parasitaemia and Haemoglobin." Tropical Doctor 32, no. 3 (July 2002): 139–42. http://dx.doi.org/10.1177/004947550203200306.

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Malaria continues to be an increasing health concern in many endemic areas where it remains a major contributor to childhood morbidity and mortality. Chemoprophylaxis and treatment are increasingly compromised by drug resistance. Vaccination for malaria is not yet available outside clinical trials. In clinical trials bed nets have been shown to be effective in reducing malarial morbidity and mortality. Their efficacy outside of the clinical trial setting has been less well documented. We describe our experience with the introduction of bed nets in a remote rural Zambian village and document the effect on malarial parasitaemia, spleen rates and haemoglobin. Children were evaluated at the end of the rainy seasons in April 1998 and April 1999. Insecticide impregnated nets were made available for purchase to the village in July 1998. Rates of parasitaemia and anaemia were significantly reduced.

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Lubinda, Jailos, Yaxin Bi, Busiku Hamainza, Ubydul Haque, and Adrian J. Moore. "Modelling of malaria risk, rates, and trends: A spatiotemporal approach for identifying and targeting sub-national areas of high and low burden." PLOS Computational Biology 17, no. 3 (March 1, 2021): e1008669. http://dx.doi.org/10.1371/journal.pcbi.1008669.

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While mortality from malaria continues to decline globally, incidence rates in many countries are rising. Within countries, spatial and temporal patterns of malaria vary across communities due to many different physical and social environmental factors. To identify those areas most suitable for malaria elimination or targeted control interventions, we used Bayesian models to estimate the spatiotemporal variation of malaria risk, rates, and trends to determine areas of high or low malaria burden compared to their geographical neighbours. We present a methodology using Bayesian hierarchical models with a Markov Chain Monte Carlo (MCMC) based inference to fit a generalised linear mixed model with a conditional autoregressive structure. We modelled clusters of similar spatiotemporal trends in malaria risk, using trend functions with constrained shapes and visualised high and low burden districts using a multi-criterion index derived by combining spatiotemporal risk, rates and trends of districts in Zambia. Our results indicate that over 3 million people in Zambia live in high-burden districts with either high mortality burden or high incidence burden coupled with an increasing trend over 16 years (2000 to 2015) for all age, under-five and over-five cohorts. Approximately 1.6 million people live in high-incidence burden areas alone. Using our method, we have developed a platform that can enable malaria programs in countries like Zambia to target those high-burden areas with intensive control measures while at the same time pursue malaria elimination efforts in all other areas. Our method enhances conventional approaches and measures to identify those districts which had higher rates and increasing trends and risk. This study provides a method and a means that can help policy makers evaluate intervention impact over time and adopt appropriate geographically targeted strategies that address the issues of both high-burden areas, through intensive control approaches, and low-burden areas, via specific elimination programs.

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Hast, Marisa A., Mike Chaponda, Mbanga Muleba, Jean-Bertin Kabuya, James Lupiya, Tamaki Kobayashi, Timothy Shields, et al. "The Impact of 3 Years of Targeted Indoor Residual Spraying With Pirimiphos-Methyl on Malaria Parasite Prevalence in a High-Transmission Area of Northern Zambia." American Journal of Epidemiology 188, no. 12 (May 7, 2019): 2120–30. http://dx.doi.org/10.1093/aje/kwz107.

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Abstract Malaria transmission in northern Zambia has increased in the past decade, despite malaria control activities. Evidence-based intervention strategies are needed to effectively reduce malaria transmission. Zambia’s National Malaria Control Centre conducted targeted indoor residual spraying (IRS) in Nchelenge District, Luapula Province, from 2014 to 2016 using the organophosphate insecticide pirimiphos-methyl. An evaluation of the IRS campaign was conducted by the Southern Africa International Centers of Excellence for Malaria Research using actively detected malaria cases in bimonthly household surveys carried out from April 2012 to July 2017. Changes in malaria parasite prevalence after IRS were assessed by season using Poisson regression models with robust standard errors, controlling for clustering of participants in households and demographic, geographical, and climatological covariates. In targeted areas, parasite prevalence declined approximately 25% during the rainy season following IRS with pirimiphos-methyl but did not decline during the dry season or in the overall study area. Within targeted areas, parasite prevalence declined in unsprayed households, suggesting both direct and indirect effects of IRS. The moderate decrease in parasite prevalence within sprayed areas indicates that IRS with pirimiphos-methyl is an effective malaria control measure, but a more comprehensive package of interventions is needed to effectively reduce the malaria burden in this setting.

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Baume, Carol, Deborah Helitzer, and S. Patrick Kachur. "Patterns of care for childhood malaria in Zambia." Social Science & Medicine 51, no. 10 (November 2000): 1491–503. http://dx.doi.org/10.1016/s0277-9536(00)00049-6.

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Chaponda, M., and M. Mulenga. "Failure of malaria control in Nchelenge District, Zambia." International Journal of Infectious Diseases 21 (April 2014): 111. http://dx.doi.org/10.1016/j.ijid.2014.03.657.

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Sinclair, J. R., D. A. K. Watters, and A. Bagshaw. "Non-Traumatic Coma in Zambia." Tropical Doctor 19, no. 1 (January 1989): 6–10. http://dx.doi.org/10.1177/004947558901900103.

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A series of 170 patients with non-traumatic coma seen over a 16-month period is reported. The Glasgow coma scale significantly correlated with outcome ( P<0.001). The diagnosis was also important in determining outcome. Hospital mortality was lowest in patients with cerebral malaria (22.7%), eclamptic coma (36.4%), and organophosphorous poisoning (30.4%). A diagnostic approach to non-traumatic coma is outlined and the management of the different causes is discussed. Most hospitals in tropical Africa should be able to diagnose up to 90% of cases with non-traumatic coma and simple therapy is likely to be effective in the majority of cases.

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Riedel, Nadine, Penelope Vounatsou, John M. Miller, Laura Gosoniu, Elizabeth Chizema-Kawesha, Victor Mukonka, and Rick W. Steketee. "Geographical patterns and predictors of malaria risk in Zambia: Bayesian geostatistical modelling of the 2006 Zambia national malaria indicator survey (ZMIS)." Malaria Journal 9, no. 1 (2010): 37. http://dx.doi.org/10.1186/1475-2875-9-37.

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Koekemoer, L. L., E. A. Misiani, R. H. Hunt, R. J. Kent, D. E. Norris, and M. Coetzee. "Cryptic species within Anopheles longipalpis from southern Africa and phylogenetic comparison with members of the An. funestus group." Bulletin of Entomological Research 99, no. 1 (August 21, 2008): 41–49. http://dx.doi.org/10.1017/s0007485308006123.

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AbstractHouse-resting Anopheles mosquitoes are targeted for vector control interventions; however, without proper species identification, the importance of these Anopheles to malaria transmission is unknown. Anopheles longipalpis, a non-vector species, has been found in significant numbers resting indoors in houses in southern Zambia, potentially impacting on the utilization of scarce resources for vector control. The identification of An. longipalpis is currently based on classical morphology using minor characteristics in the adult stage and major ones in the larval stage. The close similarity to the major malaria vector An. funestus led to investigations into the development of a molecular assay for identification of An. longipalpis. Molecular analysis of An. longipalpis from South Africa and Zambia revealed marked differences in size and nucleotide sequence in the second internal transcribed spacer (ITS2) region of ribosomal DNA between these two populations, leading to the conclusion that more than one species was being analysed. Phylogenetic analysis showed the Zambian samples aligned with An. funestus, An. vaneedeni and An. parensis, whereas the South African sample aligned with An. leesoni, a species that is considered to be more closely related to the Asian An. minimus subgroup than to the African An. funestus subgroup. Species-specific primers were designed to be used in a multiplex PCR assay to distinguish between these two cryptic species and members of the An. funestus subgroup for which there is already a multiplex PCR assay.

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Das, Smita, Mbanga Muleba, Douglas E. Norris, and Jennifer C. Stevenson. "Habitat Partitioning of Malaria Vectors in Nchelenge District, Zambia." American Journal of Tropical Medicine and Hygiene 94, no. 6 (June 1, 2016): 1234–44. http://dx.doi.org/10.4269/ajtmh.15-0735.

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Masaninga, Freddie, Emmanuel Chanda, Pascalina Chanda-Kapata, Busiku Hamainza, Hieronymo T. Masendu, Mulakwa Kamuliwo, Wambinji Kapelwa, et al. "Review of the malaria epidemiology and trends in Zambia." Asian Pacific Journal of Tropical Biomedicine 3, no. 2 (February 2013): 89–94. http://dx.doi.org/10.1016/s2221-1691(13)60030-1.

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Hamer, Davidson H., Micky Ndhlovu, Dejan Zurovac, Matthew Fox, Kojo Yeboah-Antwi, Pascalina Chanda, Naawa Sipilinyambe, Jonathon L. Simon, and Robert W. Snow. "Improved Diagnostic Testing and Malaria Treatment Practices in Zambia." JAMA 297, no. 20 (May 23, 2007): 2227. http://dx.doi.org/10.1001/jama.297.20.2227.

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Kango, M., and K. S. Baboo. "Does the consent of the patients have a role to play in formulating a treatment policy?" Tropical Doctor 38, no. 1 (January 2008): 56–57. http://dx.doi.org/10.1258/td.2006.006340.

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Zambia recently changed its treatment policy for malaria from the failing chloroquine to the more effective artemisinin combination therapy (ACT). A study was conducted to find out if the community accepted the new treatment policy, as a prediction of its success. Following high levels of acceptability, it was not surprising to see high levels of compliance and subsequent reduction in cases of severe malaria and deaths.

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Thuma, P. E., J. van Dijk, R. Bucala, Z. Debebe, S. Nekhai, T. Kuddo, M. Nouraie, G. Weiss, and V. R. Gordeuk. "Distinct Clinical and Immunologic Profiles in Severe Malarial Anemia and Cerebral Malaria in Zambia." Journal of Infectious Diseases 203, no. 2 (December 14, 2010): 211–19. http://dx.doi.org/10.1093/infdis/jiq041.

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Ciubotariu, Ilinca I., Christine M. Jones, Tamaki Kobayashi, Thierry Bobanga, Mbanga Muleba, Julia C. Pringle, Jennifer C. Stevenson, Giovanna Carpi, and Douglas E. Norris. "Genetic Diversity of Anopheles coustani (Diptera: Culicidae) in Malaria Transmission Foci in Southern and Central Africa." Journal of Medical Entomology 57, no. 6 (July 2, 2020): 1782–92. http://dx.doi.org/10.1093/jme/tjaa132.

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Abstract Despite ongoing malaria control efforts implemented throughout sub-Saharan Africa, malaria remains an enormous public health concern. Current interventions such as indoor residual spraying with insecticides and use of insecticide-treated bed nets are aimed at targeting the key malaria vectors that are primarily endophagic and endophilic. Anopheles coustani s.l., an understudied vector of malaria, is a species previously thought to exhibit mostly zoophilic behavior. Like many of these understudied species, An. coustani has greater anthropophilic tendencies than previously appreciated, is often both endophagic and exophagic, and carries Plasmodium falciparum sporozoites. The aim of this study was to explore genetic variation of An. coustani mosquitoes and the potential of this species to contribute to malaria parasite transmission in high transmission settings in Zambia and the Democratic Republic of the Congo (DRC). Morphologically identified An. coustani specimens that were trapped outdoors in these study sites were analyzed by PCR and sequencing for species identification and bloodmeal sources, and malaria parasite infection was determined by ELISA and qPCR. Fifty An. coustani s.s. specimens were confirmed by analysis of mitochondrial DNA cytochrome c oxidase subunit I (COI) and ribosomal internal transcribed spacer region 2 (ITS2). Maximum likelihood phylogenetic analysis of COI and ITS2 sequences revealed two distinct phylogenetic groups within this relatively small regional collection. Our findings indicate that both An. coustani groups have anthropophilic and exophagic habits and come into frequent contact with P. falciparum, suggesting that this potential alternative malaria vector might elude current vector control measures in northern Zambia and southern DRC.

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Sikalima, Jay, Jessica L. Schue, Sarah E. Hill, Modest Mulenga, Ray Handema, Victor Daka, Justin Chileshe, et al. "House Structure Is Associated with Malaria among Febrile Patients in a High-Transmission Region of Zambia." American Journal of Tropical Medicine and Hygiene 104, no. 6 (June 2, 2021): 2131–38. http://dx.doi.org/10.4269/ajtmh.20-1378.

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Abstract.Since the late nineteenth century, the importance of house structure as a determinant of malaria risk has been recognized. Few studies to date have examined the association of housing and malaria in clinical populations. We conducted a cross-sectional study of febrile patients (n = 282) at two rural health clinics in a high malaria-transmission area of northern Zambia. Participants underwent testing for Plasmodium falciparum infection by PCR. Demographic and other risk factors including house structure, indoor residual spraying (IRS), bed net use, education level, and household income were collected. Data were fitted to logistic regression models for relational and mediation analyses. Residing in a house with a thatch roof was associated with higher odds of malaria than residing in a house with corrugated metal (odds ratio: 2.6; 95% CI: 1.0–6.3, P = 0.04). Lower income and educational attainment were also associated with greater odds of malaria. Living under a thatch roof accounted for 24% (95% CI: 14–82) of the effect of household income on malaria risk, and income accounted for 11% (95% CI: 8–19) of the effect of education. Neither IRS nor bed net use was associated with malaria risk despite large, local investments in these vector control interventions. The findings testify to malaria as a disease of rural poverty and contribute further evidence to the utility of housing improvements in vector control programs.

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Hoffman, Jordan, Ilinca Ciubotariu, Limonty Simubali, Twig Mudenda, William Moss, Giovanna Carpi, Douglas Norris, and Jennifer Stevenson. "Phylogenetic Complexity of Morphologically Identified Anopheles squamosus in Southern Zambia." Insects 12, no. 2 (February 8, 2021): 146. http://dx.doi.org/10.3390/insects12020146.

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Despite dramatic reductions in malaria cases in the catchment area of Macha Hospital, Choma District, Southern Province in Zambia, prevalence has remained near 1–2% by RDT for the past several years. To investigate residual malaria transmission in the area, this study focuses on the relative abundance, foraging behavior, and phylogenetic relationships of Anopheles squamosus specimens. In 2011, higher than expected rates of anthropophily were observed among “zoophilic” An. squamosus, a species that had sporadically been found to contain Plasmodium falciparum sporozoites. The importance of An. squamosus in the region was reaffirmed in 2016 when P. falciparum sporozoites were detected in numerous An. squamosus specimens. This study analyzed Centers for Disease Control (CDC) light trap collections of adult mosquitoes from two collection schemes: one performed as part of a reactive-test-and-treat program and the second performed along a geographical transect. Morphological identification, molecular verification of anopheline species, and blood meal source were determined on individual samples. Data from these collections supported earlier studies demonstrating An. squamosus to be primarily exophagic and zoophilic, allowing them to evade current control measures. The phylogenetic relationships generated from the specimens in this study illustrate the existence of well supported clade structure among An. squamosus specimens, which further emphasizes the importance of molecular identification of vectors. The primarily exophagic behavior of An. squamosus in these collections also highlights that indoor vector control strategies will not be sufficient for elimination of malaria in southern Zambia.

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Chanda, Emmanuel, Janet Hemingway, Immo Kleinschmidt, Andrea M. Rehman, Varsha Ramdeen, Faustina N. Phiri, Sarel Coetzer, et al. "Insecticide Resistance and the Future of Malaria Control in Zambia." PLoS ONE 6, no. 9 (September 6, 2011): e24336. http://dx.doi.org/10.1371/journal.pone.0024336.

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Simooya, O. O., R. M. Mwendapole, S. Siziya, and A. F. Fleming. "Relation between falciparum malaria and HIV seropositivity in Ndola, Zambia." BMJ 297, no. 6640 (July 2, 1988): 30–31. http://dx.doi.org/10.1136/bmj.297.6640.30.

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Watts, Theresa E., John R. Wray, Nicholas H. Ng'andu, and C. C. Draper. "Malaria in an urban and a rural area of Zambia." Transactions of the Royal Society of Tropical Medicine and Hygiene 84, no. 2 (March 1990): 196–200. http://dx.doi.org/10.1016/0035-9203(90)90251-9.

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Lowenthal, Mark N. "Malaria in an urban and a rural area of Zambia." Transactions of the Royal Society of Tropical Medicine and Hygiene 85, no. 1 (January 1991): 137. http://dx.doi.org/10.1016/0035-9203(91)90189-6.

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Nyirenda, Stephen, Mwanasakale Mwanasakale, and Mulele Mulele. "Preventive Strategies for Malaria in Under-Five Children of Poor Resource Communities of Ndola, Zambia." Asian Pacific Journal of Health Sciences 4, no. 3 (September 30, 2017): 112–20. http://dx.doi.org/10.21276/apjhs.2017.4.3.19.

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Chanda, Emmanuel, Alister Kandyata, Javan Chanda, Faustina N. Phiri, Lucy Muzia, and Mulakwa Kamuliwo. "The Efficacy of Vectron 20 WP, Etofenprox, for Indoor Residual Spraying in Areas of High Vector Resistance to Pyrethroids and Organochlorines in Zambia." ISRN Preventive Medicine 2013 (September 5, 2013): 1–6. http://dx.doi.org/10.5402/2013/371934.

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The selection of insecticide resistance in malaria vectors has the potential to compromise any insecticide-based vector control programme. To ensure that the insecticides used for indoor residual spraying and insecticide-treated nets in Zambia remain effective and their choice is evidence based, insecticide resistance surveillance and monitoring are essential. This study assessed and compared the residual efficacy of etofenprox (Vectron 20 WP), an ether pyrethroid, at 0.1 g/m2 with pyrethroids: bifenthrin (Bistar 10 WP) and lambda-cyhalothrin (Icon 10 CS) at 25 mg/m2 for indoor residual spraying. We also assessed the resistance status of etofenprox to local malaria vectors, An. funestus s.s and An. gambiae s.s, using World Health Organization standard protocols. The residual efficacy of Vectron 20 WP on cement, rendered walls of houses lasted for four months with 100% mortality. By the eighth month, the killing effect had reduced to 73.8% compared to 63.3% for bifenthrin and 77.0% for lambda-cyhalothrin. Susceptibility tests using standard World Health Organization assays on An. gambiae s.s showed susceptibility to etofenprox (0.1%) but some resistance was detected to Anopheles funestus s.s. The product is recommended as an ideal insecticide for indoor residual spraying for malaria control in Zambia as part of a resistance management programme in selected areas of the country.

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Ippolito, Matthew M., Jean-Bertin Kabuya, Manuela Hauser, Benjamin Kussin-Shoptaw, Austin Peer, Marco Ruegg, Albert Baschong, Thomas Louis, and William Moss. "4148 Thrombocytopenia and whole blood transfusion in children with severe falciparum malaria." Journal of Clinical and Translational Science 4, s1 (June 2020): 40. http://dx.doi.org/10.1017/cts.2020.153.

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OBJECTIVES/GOALS: Severe malarial anemia due to Plasmodium falciparum is often accompanied by thrombocytopenia. Treatment includes transfusion of whole blood, which contains erythrocytes, platelets, and other blood components. The objective of the study was to assess the effect of whole blood transfusion on survival in children with severe falciparum malaria and to examine the potential interaction of thrombocytopenia with malaria mortality and transfusion response. METHODS/STUDY POPULATION: We analyzed a retrospective cohort of 842 hospitalized children in Zambia with severe malarial anemia (703 transfused, 139 not transfused due to stock-out or other reason). Severe malarial anemia was defined as a positive rapid diagnostic test or blood smear in combination with an admission hemoglobin concentration ≤5 g/dL. RESULTS/ANTICIPATED RESULTS: Mortality was 13% (94/703) in the transfused group and 24% (34/139) in the non-transfused group. Kaplan-Meier survival estimates stratified by transfusion status and thrombocytopenia (150,000/μL threshold) showed increased mortality in children with thrombocytopenia who did not undergo transfusion, with no differences in mortality among the other transfused and non-transfused groups (log-rank test P = 0.0001). Effect modification analysis by Cox proportional hazards regression adjusted for age, sex, hemoglobin concentration, blood group type, and eosinophilia showed a significant interaction between platelet count and transfusion status (P = 0.028). Children with thrombocytopenia who were transfused and died had little or no post-transfusion increase in platelets, in contrast to those who survived. Freshness of transfused whole blood, construed from expiration dates, correlated with greater platelet recovery and improved survival. DISCUSSION/SIGNIFICANCE OF IMPACT: The role of platelets in malaria pathophysiology is complex and incompletely understood; prior studies describe preferential binding of platelets to parasitized erythrocytes and direct parasitocidal activity, whereas others detailed deleterious effects in malaria involving the central nervous system vasculature. These findings point to a potential clinical role for platelet-directed transfusion strategies to improve survival in children with severe falciparum malaria, which should be further assessed in randomized interventional studies.

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Clare, Camille A., Lisa Weingrad, and Padmini Murthy. "Impact of HIV/AIDS, Malaria, and HIV/Malarial Coinfection in Pregnant Women in Zambia and Zimbabwe." Ethics in Biology, Engineering and Medicine: An International Journal 5, no. 3 (2014): 193–205. http://dx.doi.org/10.1615/ethicsbiologyengmed.2015012736.

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Chanda, Emmanuel, Victor Munyongwe Mukonka, David Mthembu, Mulakwa Kamuliwo, Sarel Coetzer, and Cecilia Jill Shinondo. "Using a Geographical-Information-System-Based Decision Support to Enhance Malaria Vector Control in Zambia." Journal of Tropical Medicine 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/363520.

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Geographic information systems (GISs) with emerging technologies are being harnessed for studying spatial patterns in vector-borne diseases to reduce transmission. To implement effective vector control, increased knowledge on interactions of epidemiological and entomological malaria transmission determinants in the assessment of impact of interventions is critical. This requires availability of relevant spatial and attribute data to support malaria surveillance, monitoring, and evaluation. Monitoring the impact of vector control through a GIS-based decision support (DSS) has revealed spatial relative change in prevalence of infection and vector susceptibility to insecticides and has enabled measurement of spatial heterogeneity of trend or impact. The revealed trends and interrelationships have allowed the identification of areas with reduced parasitaemia and increased insecticide resistance thus demonstrating the impact of resistance on vector control. The GIS-based DSS provides opportunity for rational policy formulation and cost-effective utilization of limited resources for enhanced malaria vector control.

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Chalwe, Victor, Jean-Pierre Van geertruyden, Doreen Mukwamataba, Joris Menten, John Kamalamba, Modest Mulenga, and Umberto D’Alessandro. "Increased Risk for Severe Malaria in HIV-1–infected Adults, Zambia." Emerging Infectious Diseases 15, no. 5 (May 2009): 749–55. http://dx.doi.org/10.3201/eid1505.081009.

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Kamuliwo, Mulakwa, Karen E. Kirk, Emmanuel Chanda, Maha A. Elbadry, Jailos Lubinda, Thomas A. Weppelmann, Victor M. Mukonka, et al. "Spatial patterns and determinants of malaria infection during pregnancy in Zambia." Transactions of The Royal Society of Tropical Medicine and Hygiene 109, no. 8 (July 9, 2015): 514–21. http://dx.doi.org/10.1093/trstmh/trv049.

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Brennan, Anita G., Godfrey Biemba, Philip E. Thuma, Victor R. Gordeuk, and Warren E. Grupe. "Cabana and Camainza: Malaria-Like Syndromes of Childhood in Rural Zambia." Pediatric Research 45, no. 4, Part 2 of 2 (April 1999): 158A. http://dx.doi.org/10.1203/00006450-199904020-00937.

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Simooya, O. O., R. M. Mwendapole, and B. M. Sikateyo. "Severe falciparum malaria and the acquired immunodeficiency syndrome (AIDS) in Zambia." Annals of Tropical Medicine & Parasitology 85, no. 2 (January 1991): 269–70. http://dx.doi.org/10.1080/00034983.1991.11812556.

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Pylypchuk, Yuriy, and Samuel W. Norton. "Preventing Malaria among Children in Zambia: The Role of Mother's Knowledge." Health Economics 24, no. 11 (August 12, 2014): 1389–402. http://dx.doi.org/10.1002/hec.3093.

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Masaningasup;, Freddie. "Mosquito biting and malaria situation in an urban setting in Zambia." Journal of Public Health and Epidemiology 4, no. 9 (November 30, 2012): 261–69. http://dx.doi.org/10.5897/jphe12.034.

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Steury, Elinda Enright. "Mobile Phone Short Message Service to Improve Malaria Pharmacoadherence in Zambia." Journal of Nursing Scholarship 48, no. 4 (May 3, 2016): 354–61. http://dx.doi.org/10.1111/jnu.12216.

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Chizema-Kawesha, Elizabeth, Victor M. Mukonka, Chilandu Mukuka, Simon K. Miti, John M. Miller, Carlos C. Campbell, Richard W. Steketee, and Abdirahman D. Mohamed. "Scaling Up Malaria Control in Zambia: Progress and Impact 2005–2008." American Journal of Tropical Medicine and Hygiene 83, no. 3 (September 1, 2010): 480–88. http://dx.doi.org/10.4269/ajtmh.2010.10-0035.

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Spence-Lewis, I. M. "Scaling Up Malaria Control in Zambia: Progress and Impact 2005–2008." American Journal of Tropical Medicine and Hygiene 84, no. 2 (February 4, 2011): 360. http://dx.doi.org/10.4269/ajtmh.2011.10-0617a.

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Worges, Matt, Michael Celone, Timothy Finn, Zunda Chisha, Anna Winters, Benjamin Winters, Joseph Keating, and Joshua O. Yukich. "Malaria case management in Zambia: A cross-sectional health facility survey." Acta Tropica 195 (July 2019): 83–89. http://dx.doi.org/10.1016/j.actatropica.2019.04.032.

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Shah, Binal N., Philip E. Thuma, N. Scott Reading, Josef T. Prchal, and Victor R. Gordeuk. "Host Genetic Factors in Glucose-6-Phosphate Dehydrogenase and Cytochrome B5 Reductase 3 Affect the Susceptibility of Developing Severe Malarial Anemia." Blood 128, no. 22 (December 2, 2016): 2438. http://dx.doi.org/10.1182/blood.v128.22.2438.2438.

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Abstract Host genetic factors that influence the outcome of Plasmodium falciparum malaria infection are not fully understood. Glucose-6-phosphate dehydrogenase (G6PD), an X-linked gene, encodes the sole enzyme in red blood cells that produces NADPH for protection from reactive oxygen species. G6PD A+ (G6PD c. 376G) is an African specific polymorphism reported to have reduced activity1 but no apparent phenotype; G6PD A- (G6PD c 202A/376G) is a related polymorphism with decreased activity and increased risk for oxidant-induced hemolysis2. Previous investigators have reported that G6PD deficiency provides a protective effect from malaria3. A recent Malaria Genomic Epidemiology Network (MalariaGEN) study with almost 30,000 participants reported that G6PD A- increases the risk for severe malarial anemia4. Cytochrome b5 reductase 3 (CYB5R3) in red blood cells transfers electrons from NADH to cytochrome b5, which in turn converts methemoglobin to hemoglobin. The CYB5R3 T117S variant, an African-specific polymorphism with a prevalence higher than previously described African-specific polymorphisms (allele frequency .23)5, is not associated with methemoglobinemia. We hypothesized that CYB5R3 T117S may protect from severe malarial anemia, possibly by enhanced anti-oxidative potential of erythrocytes through higher NADH levels. We isolated DNA from dried blood spots from 133 children (age < 6 years) who presented to hospital in southern Zambia with clinical malaria. Sixty-seven had severe anemia (hematocrit <15%) and 66 had uncomplicated malaria (hematocrit ≥18%); all had normal coma scores. We determined G6PD A+, G6PD A- and CYB5R3 T117S by Taqman genotyping. We also isolated DNA from plasma samples and genotyped for CYB5R3 T117S. There was 97.7% agreement in the genotyping. The overall prevalence of G6PD A+ was 20.3% and of G6PD A- 12.0%. The gene frequency of CYB5R3 T117S was .31. We examined the association of these genotypes with severe malarial anemia in logistic regression models that adjusted for body weight, duration of febrile illness before presentation, and treatment with traditional herbal medicine or sulfadoxine-pyrimethamine before presentation6. In keeping with the MalariaGEN study, we found that G6PD A- increased the odds of severe malarial anemia (OR 8.2; 95% CI 1.6-42.7l; P=0.013), but we also observed a trend with G6PD A+ (OR 2.1, 95% CI 0.7-6.5; P=0.22). We therefore assessed the additive effect of these polymorphisms and observed a progressive increase in the risk with G6PD A+ and G6PD A- (OR 2.6, 95% CI 1.3-5.3). We added CYB5R3 T117S to this model and found a non-significant trend to a progressive reduction in the risk of severe anemia with heterozygosity and homozygosity for T117S (OR = 0.7, 95% CI 0.3-1.4; P=0.29). In further analysis, we observed an interaction between CYB5R3 T117S and G6PD genotype in the risk for severe anemia (P =0.092). We therefore stratified our analysis according to the presence or absence of G6PD variants. In the absence of G6PD A+ or A-, CYB5R3T117S offered protection against severe anemia (OR 0.3, 95% CI 0.1-0.9, P=0.035) in an additive model. In contrast, in the presence of G6PD A+ or G6PDA-, CYB5R3 T117S mutation tended to increase the odds of severe anemia in malaria (OR 3.1, 95% CI 0.6-15.9, P=0.18). In summary, 1) we confirm the association of G6PD A- with severe malarial anemia in southern Zambian children, 2) we observe an additive increased risk of severe malarial anemia with G6PD A+ and G6PD A-, and 3) we report heterogeneity of the effect of CYB5R3 T117S on the risk of severe anemia according to G6PD A+ and A- status. The observations with CYB5R3 T117S need to be confirmed in a larger cohort and the underlying mechanisms worked out through laboratory and translational research. We conclude that the combined effect of host genetic factors in two different red cell redox regulating enzymes may affect the outcome of P. falciparum infection. ReferencesGomez-Manzo, S. et al. International journal of molecular sciences16, 28657-28668 (2015).Luzzatto, L., Nannelli, C. & Notaro, R. Hematology/oncology clinics of North America30, 373-393 (2016).Ruwende, C. et al. Nature376, 246-249 (1995).Rockett, K. A. et al. Nature genetics46, 1197-1204 (2014).Jenkins, M. M. & Prchal, J. T. Hum Genet99, 248-250 (1997).Thuma, P. E. et al. J Infect Dis203, 211-219 (2011). Disclosures Thuma: Malaria Institute at Macha: Employment.

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Nawa, Mukumbuta. "Influence of History, Geography, and Economics on the Elimination of Malaria: A Perspective on Disease Persistence in Rural Areas of Zambia." International Journal of Travel Medicine and Global Health 7, no. 4 (December 15, 2019): 113–17. http://dx.doi.org/10.15171/ijtmgh.2019.24.

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The fight against malaria is currently ongoing in many countries where the disease is still endemic. The overall target is to eliminate malaria in all nations, regardless of their malaria burden, by 2030. Currently, the disease has been eliminated mainly in low-burden and unstable malaria areas globally. However, in high-burden countries, particularly in Africa, the disease is still not eliminated; some countries are even recording increases in incidence. This paper discusses why the disease is currently being eliminated in some countries and not in others using a historical and geo-economic perspective. It identifies gaps in the primary contemporary interventions in high endemic areas, particularly in rural constituencies where incidence of the disease is even higher. The key discussion point is that poor housing and behavioral patterns predispose rural dwellers to more malaria. Other risk factors include agricultural occupations, livestock keeping, and the fact that mosquito vectors in Africa thrive more in rural than urban areas. Combating malaria in rural African areas, therefore, requires radical transformative action to address the unique situations that currently enable the persistence of malaria beyond the contemporary, mainly indoor, and health facility-based interventions. Improving housing structures in rural Africa, which are mainly mud and thatched huts, to at least insect-proof standards is the recommended transformative action. Moreover, behavioral patterns, such as cooking outdoors in the evenings, must be modified to cooking in improvised insect-proof kitchens.

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Green, Cathy, Paula Quigley, Tendayi Kureya, Caroline Barber, Elizabeth Chizema, Haachile Moonga, Ernest Chanda, et al. "Use of rectal artesunate for severe malaria at the community level, Zambia." Bulletin of the World Health Organization 97, no. 12 (September 19, 2019): 810–17. http://dx.doi.org/10.2471/blt.19.231506.

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Ippolito, Matthew M., Julia C. Pringle, Mwiche Siame, Ben Katowa, Ozkan Aydemir, Peter O. Oluoch, Liusheng Huang, et al. "Therapeutic Efficacy of Artemether–Lumefantrine for Uncomplicated Falciparum Malaria in Northern Zambia." American Journal of Tropical Medicine and Hygiene 103, no. 6 (December 2, 2020): 2224–32. http://dx.doi.org/10.4269/ajtmh.20-0852.

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Kobayashi, Tamaki, Mufaro Kanyangarara, Natasha M. Laban, Masiliso Phiri, Harry Hamapumbu, Kelly M. Searle, Jennifer C. Stevenson, Philip E. Thuma, and William J. Moss. "Characteristics of Subpatent Malaria in a Pre-Elimination Setting in Southern Zambia." American Journal of Tropical Medicine and Hygiene 100, no. 2 (February 6, 2019): 280–86. http://dx.doi.org/10.4269/ajtmh.18-0399.

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Davis, Ryan G., Aniset Kamanga, Carlos Castillo-Salgado, Nnenna Chime, Sungano Mharakurwa, and Clive Shiff. "Early detection of malaria foci for targeted interventions in endemic southern Zambia." Malaria Journal 10, no. 1 (2011): 260. http://dx.doi.org/10.1186/1475-2875-10-260.

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Gordeuk, Victor R., Mehdi Nouraie, Xiaomei Niu, Jessica Nachel DelBove, and Josef T. Prchal. "Cytochrome B5 Reductase T116S Polymorphism Is Associated with Decreased Risk of Severe Anemia Among Zambian Children with Malaria." Blood 116, no. 21 (November 19, 2010): 4233. http://dx.doi.org/10.1182/blood.v116.21.4233.4233.

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Abstract Abstract 4233 Background. NADH-cytochrome b5 reductase (cytb5r, EC 1.6.2.2) exists in soluble and membrane-bound forms. Both cytb5r isoforms are the product of a single gene locus, DIA1 (or CYB5R3). The known functions of cytb5r include reduction of methemoglobin and cytochrome b5 for the soluble isoenzyme, a fatty acid desaturation complex for the membrane-bound microsomal enzyme, and participation in drug metabolism. Deficiency of cytb5r leads to congenital methemoglobinemia with more than 40 mutations reported to date, the majority being missense mutations associated with mild type I methemoglobinemia. CYBR5T116S is a common genetic polymorphism among African Americans (allele frequency of 23%) that has not yet been detected in other ethnic and racial groups. This polymorphism does not cause methemoglobinemia, but it may be associated with reduced hemolysis in patients with sickle cell disease [Blood (ASH Annual Meeting Abstracts), Nov 2009; 114: 903]. We postulated that this polymorphism may protect from severe anemia in African children with malaria, providing these individuals with a genetic advantage that has likely been the target of positive selection, since severity of anemia is a major risk factor for malaria survival in infants and young children. Methods. Children <6 years of age from the Tonga ethnic group of southern Zambia admitted to hospital with clinical malaria were studied. Sixty-eight had severe malarial anemia (hematocrit<15% and peripheral smear positive for Plasmodium falciparum), 31 had cerebral malaria (Blantyre coma score 0–2, hematocrit >18%, smear positive), and 69 had uncomplicated malaria (hematocrit >18%, smear positive). Children with overlapping severe anemia and cerebral malaria were excluded. Risk factors for severe anemia were determined by pathway analysis and logistic regression. The CYBR5T116S polymorphism was detected by Allele Specific-PCR and its relationship to severe anemia was assessed in the context of the identified risk factors. Results. The allele frequency of CYBR5T116S was 32.8% and the distribution was consistent with Hardy-Weinberg equilibrium. After adjusting for weight-for-age Z score, spleen size, history of treatment with sulfadoxine-pyrimethamine for the current illness, and plasma interleukin-10 concentration, CYBR5T116S was associated with a 3.72-fold reduction in the odds of severe malarial anemia at presentation to hospital (95% CI of 1.32–10.47; P = 0.013). Similarly, in an ANOVA model, the adjusted mean (SE) screening hematocrit was 18.8 (1.0) % in 58 CYBR5 wildtype children compared to 21.9 (0.9) % in 77 children with CYBR5T116S (P = 0.024). Conclusions. CYBR5 T116S is a common polymorphism among African children that may be associated with protection from severe malarial anemia, an important cause of death in this population. We speculate that this polymorphism may be related to a previously reported subpopulation of African Americans with increased cytochrome b5 reductase activity, and that increased anti-oxidant activity may explain the polymorphism's protective effect. Functional studies to investigate this possibility are underway. We submit that a protective effect from severe malaria-induced anemia may be the principal reason for the high prevalence of this African-specific genetic polymorphism. Disclosures: No relevant conflicts of interest to declare.

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Journal articles on the topic 'Malaria – Zambia'

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