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Copula geoadditive modelling of anaemia and malaria in young children in Kenya, Malawi, Tanzania and Uganda

November 10, 2020 - 13:46 -- Open Access
Roberts DJ, Zewotir T
J Health Popul Nutr. 2020 Nov 6;39(1):8

Anaemia and malaria are the leading causes of sub-Saharan African childhood morbidity and mortality. This study aimed to explore the complex relationship between anaemia and malaria in young children across the districts or counties of four contiguous sub-Saharan African countries, namely Kenya, Malawi, Tanzania and Uganda, while accounting for the effects of socio-economic, demographic and environmental factors. Geospatial maps were constructed to visualise the relationship between the two responses across the districts of the countries.

NOT Open Access | Changing Prevalence of Potential Mediators of Aminoquinoline, Antifolate, and Artemisinin Resistance Across Uganda

November 7, 2020 - 12:28 -- NOT Open Access
Asua V, Conrad MD, Rosenthal PJ, et al.
J Infect Dis. 2020 Nov 4:jiaa687

In Uganda artemether-lumefantrine is recommended for malaria treatment and sulfadoxine-pyrimethamine (SP) for chemoprevention during pregnancy, but drug resistance may limit efficacies.

NOT Open Access | Assessing Village Health Workers' Ability to Perform and Interpret Rapid Diagnostic Tests for Malaria 4 Years after Initial Training: A Cross-Sectional Study

November 7, 2020 - 12:21 -- NOT Open Access
Miller JS, Mbusa RK, Baguma S, Patel P, Matte M, Ntaro M, Bwambale S, Kenney J, Guiles D, Mulogo EM, Stone GS
Am J Trop Med Hyg. 2020 Nov 2

Village health workers (VHWs) in Bugoye subcounty, Uganda, provide integrated community case management (iCCM) care to children younger than 5 years for malaria, pneumonia, and diarrhea. We assessed the longevity of VHWs' skills in performing and reading malaria rapid diagnostic tests (RDTs) 4 years after initial training, comparing VHWs who had completed initial iCCM training 1 year before the study with VHWs who had completed training 4 years before the study. Both groups received quarterly refresher trainings.

Cost-effectiveness of intermittent preventive treatment with dihydroartemisinin-piperaquine for malaria during pregnancy: an analysis using efficacy results from Uganda and Kenya, and pooled data

November 4, 2020 - 14:38 -- Open Access
Fernandes S, Were V, Gutman J, Dorsey G, Kakuru A, Desai M, Kariuki S, Kamya MR, Ter Kuile FO, Hanson K
Lancet Glob Health. 2020 Oct 30:S2214-109X(20)30369-7

Prevention of malaria infection during pregnancy in HIV-negative women currently relies on the use of long-lasting insecticidal nets together with intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP). Increasing sulfadoxine–pyrimethamine resistance in Africa threatens current prevention of malaria during pregnancy. Thus, a replacement for IPTp-SP is urgently needed, especially for locations with high sulfadoxine–pyrimethamine resistance. Dihydroartemisinin–piperaquine is a promising candidate. We aimed to estimate the cost-effectiveness of intermittent preventive treatment in pregnancy with dihydroartemisinin–piperaquine (IPTp-DP) versus IPTp-SP to prevent clinical malaria infection (and its sequelae) during pregnancy.

Pharmacovigilance of suspected or confirmed therapeutic ineffectiveness of artemisinin-based combination therapy: extent, associated factors, challenges and solutions to reporting

November 4, 2020 - 10:04 -- Open Access
Ronald Kiguba, Helen Byomire Ndagije, Victoria Nambasa, Leonard Manirakiza, Elijah Kirabira, Allan Serwanga, Sten Olsson, Niko Speybroeck and Jackson Mukonzo
Malaria Journal 2020 19:389, 3 November 2020

Therapeutic ineffectiveness of artemisinin-based combination therapy (ACT) increases the risk of malaria-related morbidity and mortality, and raises healthcare costs. Yet, little has been done to promote the pharmacovigilance (PV) of ACT ineffectiveness in sub-Saharan Africa, particularly in Uganda. This study aimed to determine the extent and associated factors of the past 6 months reporting of suspected or confirmed ACT therapeutic ineffectiveness by healthcare professionals (HCPs), and difficulties and potential solutions to the PV of ACT therapeutic ineffectiveness.

Sex-based differences in clearance of chronic Plasmodium falciparum infection

October 28, 2020 - 10:29 -- Open Access
Briggs J, Teyssier N, Greenhouse B, et al.
Elife. 2020 Oct 27;9:e59872

Multiple studies have reported a male bias in incidence and/or prevalence of malaria infection in males compared to females. To test the hypothesis that sex-based differences in host-parasite interactions affect the epidemiology of malaria, we intensively followed Plasmodium falciparum infections in a cohort in a malaria endemic area of eastern Uganda and estimated both force of infection (FOI) and rate of clearance using amplicon deep-sequencing. We found no evidence of differences in behavioral risk factors, incidence of malaria, or FOI by sex.

Estimating the optimal interval between rounds of indoor residual spraying of insecticide using malaria incidence data from cohort studies

October 28, 2020 - 09:25 -- Open Access
Mugenyi L, Nankabirwa JI, Arinaitwe E, Rek J, Hens N, Kamya M, Dorsey G
PLoS One. 2020 Oct 23;15(10):e0241033

Indoor residual spraying (IRS) reduces vector densities and malaria transmission, however, the most effective spraying intervals for IRS have not been well established. We estimated the optimal timing interval for IRS using a statistical approach.

Age-dependent carriage of alleles and haplotypes of Plasmodium falciparum sera5, eba-175, and csp in a region of intense malaria transmission in Uganda

October 8, 2020 - 15:25 -- Open Access
Constance Agwang, Joseph Erume, Brenda Okech, Joseph Olobo and Thomas G. Egwang
Malaria Journal 2020 19:361, 8 October 2020

The development of malaria vaccines is constrained by genetic polymorphisms exhibited by Plasmodium falciparum antigens. The project the age-dependent distribution of alleles or haplotypes of three P. falciparum malaria vaccine candidates, Circumsporozoite Protein (csp), Erythrocyte Binding Antigen 175 (eba-175) and Serine Repeat Antigen 5 (sera5) in a region of intense malaria transmission in Uganda.

NOT Open Access | Piperaquine exposure is altered by pregnancy, HIV and nutritional status in Ugandan women

October 7, 2020 - 15:38 -- NOT Open Access
Hughes E, Imperial M, Savic RM, et al.
Antimicrob Agents Chemother. 2020 Oct 5:AAC.01013-20

Dihydroartemisinin-piperaquine (DHA-PQ) provides highly effective therapy and chemoprevention for malaria in pregnant African women. PQ concentrations >10.3 ng/mL have been associated with reduced maternal parasitemia, placental malaria and improved birth outcomes. We characterized the population pharmacokinetics (PK) of PQ in a post-hoc analysis of human immunodeficiency virus (HIV)-infected and -uninfected pregnant women receiving DHA-PQ as chemoprevention every 4 or 8 weeks.

NOT Open Access | Associations between malaria preventive regimens and Plasmodium falciparum drug resistance mediating polymorphisms in Ugandan pregnant women

October 7, 2020 - 15:35 -- NOT Open Access
Nayebare P, Asua V, Conrad MD, Kajubi R, Kakuru A, Nankabirwa JI, Muhanguzi D, Dorsey G, Kamya MR, Nsobya S, Rosenthal PJ
Antimicrob Agents Chemother. 2020 Oct 5:AAC.01047-20

Intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine (SP) is recommended for malaria-endemic parts of Africa, but efficacy is compromised by resistance and, in recent trials, dihydroartemisinin-piperaquine (DP) has shown better antimalarial protective efficacy. We utilized blood samples from a recent trial to evaluate selection by IPTp with DP or SP of Plasmodium falciparum genetic polymorphisms that alter susceptibility to these drugs.


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