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Zambia

Costing malaria interventions from pilots to elimination programmes

September 15, 2020 - 10:34 -- Open Access
Author(s): 
Katya Galactionova, Mar Velarde, Kafula Silumbe, John Miller, Anthony McDonnell, Ricardo Aguas, Thomas A. Smith and Melissa A. Penny
Reference: 
Malaria Journal 2020 19:332, 14 September 2020

Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of their epidemiological impacts and costs. There is a need to generalize these findings to different epidemiological and health systems contexts.

Comparing prioritization strategies for delivering indoor residual spray (IRS) implementation, using a network approach

September 8, 2020 - 11:52 -- Open Access
Author(s): 
Sadie J. Ryan, Anne C. Martin, Bhavneet Walia, Anna Winters and David A. Larsen
Reference: 
Malaria Journal 2020 19:326, 4 September 2020

Indoor residual spraying (IRS) is an effective method to control malaria-transmitting Anopheles mosquitoes and often complements insecticide-treated mosquito nets, the predominant malaria vector control intervention. With insufficient funds to cover every household, malaria control programs must balance the malaria risk to a particular human community against the financial cost of spraying that community. This study creates a framework for modelling the distance to households for targeting IRS implementation, and applies it to potential risk prioritization strategies in four provinces (Luapula, Muchinga, Eastern, and Northern) in Zambia.

NOT Open Access | CYB5R3(c) (.350C>G) and G6PD A Alleles Modify Severity of Anemia in Malaria and Sickle Cell Disease

July 26, 2020 - 13:26 -- NOT Open Access
Author(s): 
Gordeuk VR, Shah BN, Prchal JT, et al.
Reference: 
Am J Hematol. 2020 Jul 22

Genetic modifiers of anemia in Plasmodium falciparum infection and sickle cell disease (SCD) are not fully known. Both conditions are associated with oxidative stress, hemolysis and anemia. CYB5R3 encodes cytochrome b5 reductase 3, which converts methemoglobin to hemoglobin through oxidation of NADH. CYB5R3c.350C>G , the most frequent recognized African-specific polymorphism, does not have known functional significance, but its high allele frequency (23% in African-Americans) suggests a selection advantage.

Evaluating the impact of programmatic mass drug administration for malaria in Zambia using routine incidence data

July 21, 2020 - 15:47 -- Open Access
Author(s): 
Fraser M, Miller JM, Guinovart C, et al.
Reference: 
J Infect Dis. 2020 Jul 21:jiaa434

In 2016, the Zambian National Malaria Elimination Centre started programmatic mass drug administration (pMDA) campaigns with dihydroartemisinin-piperaquine as a malaria elimination tool in Southern Province. Two rounds were administered, two months apart (coverage 70% and 57% respectively). We evaluated the impact of one year of pMDA on malaria incidence using routine data.

Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model

July 13, 2020 - 16:33 -- Open Access
Author(s): 
Jackson KD, Higgins CR, Laing SK, Mwila C, Kobayashi T, Ippolito MM, Sylvia S, Ozawa S
Reference: 
BMC Public Health. 2020 Jul 9;20(1):1083

Many countries are striving to become malaria-free, but global reduction in case estimates has stagnated in recent years. Substandard and falsified medicines may contribute to this lack of progress. Zambia aims to eliminate their annual burden of 1.2 million pediatric malaria cases and 2500 child deaths due to malaria. We examined the health and economic impact of poor-quality antimalarials in Zambia.

Adherence to Mass Drug Administration with Dihydroartemisinin-Piperaquine and Plasmodium falciparum Clearance in Southern Province, Zambia

July 7, 2020 - 13:05 -- Open Access
Author(s): 
Finn TP, Porter TR, Moonga H, Silumbe K, Daniels RF, Volkman SK, Yukich JO, Keating J, Bennett A, Steketee RW, Miller JM, Eisele TP
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–9

Mass drug administration (MDA) with artemisinin combination therapy is a potentially useful tool for malaria elimination programs, but its success depends partly on drug effectiveness and treatment coverage in the targeted population. As part of a cluster-randomized controlled trial in Southern Province, Zambia evaluating the impact of MDA and household focal MDA (fMDA) with dihydroartemisinin-piperaquine (DHAp), sub-studies were conducted investigating population drug adherence rates and effectiveness of DHAp as administered in clearing Plasmodium falciparum infections following household mass administration.

Evidence for Reduced Malaria Parasite Population after Application of Population-Level Antimalarial Drug Strategies in Southern Province, Zambia

July 7, 2020 - 12:48 -- Open Access
Author(s): 
Daniels RF, Schaffner SF, Bennett A, Porter TR, Yukich JO, Mulube C, Mambwe B, Mwenda MC, Chishimba S, Bridges DJ, Moonga H, Hamainza B, Chizema Kawesha E, Miller JM, Steketee RW, Wirth DF, Eisele TP, Hartl DL, Volkman SK
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–8

A mass drug administration trial was carried out in Southern Province, Zambia, between 2014 and 2016, in conjunction with a standard of care package that included improved surveillance, increased access to malaria case management, and sustained high levels of vector control coverage. This was preceded by mass test and treatment in the same area from 2011 to 2013. Concordant decreases in malaria prevalence in Southern Province and deaths attributed to malaria in Zambia over this time suggest that these strategies successfully reduced the malaria burden.

Prevalence of Plasmodium falciparum and Non-falciparum Infections by Photo-Induced Electron Transfer-PCR in a Longitudinal Cohort of Individuals Enrolled in a Mass Drug Administration Trial in Southern Province, Zambia

July 7, 2020 - 12:46 -- Open Access
Author(s): 
Chishimba S, Mwenda M, Mambwe B, Mulube C, Chalwe V, Moonga H, Hamainza B, Chizema-Kawesha E, Steketee RW, Domingo G, Fraser M, Kahn M, Pal S, Silumbe K, Conner RO, Bennett A, Porter TR, Eisele TP, Miller JM, Bridges DJ
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–8

Malaria burden in Zambia has significantly declined over the last decade because of improved coverage of several key malaria interventions (e.g., vector control, case management, bed net distributions, and enhanced surveillance/responses). Campaign-based mass drug administration (MDA) and focal MDA (fMDA) were assessed in a trial in Southern Province, Zambia, to identify its utility in elimination efforts.

Treatment Coverage Estimation for Mass Drug Administration for Malaria with Dihydroartemisinin-Piperaquine in Southern Province, Zambia

July 7, 2020 - 12:43 -- Open Access
Author(s): 
Finn TP, Yukich JO, Bennett A, Porter TR, Lungu C, Hamainza B, Chizema Kawesha E, Conner RO, Silumbe K, Steketee RW, Miller JM, Keating J, Eisele TP
Reference: 
Am J Trop Med Hyg. 2020 Jul 2

Mass drug administration (MDA) is currently being considered as an intervention in low-transmission areas to complement existing malaria control and elimination efforts. The effectiveness of any MDA strategy is dependent on achieving high epidemiologic coverage and participant adherence rates. A community-randomized controlled trial was conducted from November 2014 to March 2016 to evaluate the impact of four rounds of MDA or focal MDA (fMDA)-where treatment was given to all eligible household members if anyone in the household had a positive malaria rapid diagnostic test-on malaria outcomes in Southern Province, Zambia (population approximately 300,000).

Recent Travel History and Plasmodium falciparum Malaria Infection in a Region of Heterogenous Transmission in Southern Province, Zambia

July 7, 2020 - 12:41 -- Open Access
Author(s): 
Porter TR, Finn TP, Silumbe K, Chalwe V, Hamainza B, Kooma E, Moonga H, Bennett A, Yukich JO, Steketee RW, Keating J, Miller JM, Eisele TP
Reference: 
Am J Trop Med Hyg. 2020 Jul 2

As Zambia continues to reduce its malaria incidence and target elimination in Southern Province, there is a need to identify factors that can reintroduce parasites and sustain malaria transmission. To examine the relative contributions of types of human mobility on malaria prevalence, this analysis quantifies the proportion of the population having recently traveled during both peak and nonpeak transmission seasons over the course of 2 years and assesses the relationship between short-term travel and malaria infection status.

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