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Research: Malaria epidemic outbreaks in the Democratic Republic of Congo, part I: cross-sectional survey in Mweka District

September 10, 2015 - 13:00 -- Bart G.J. Knols
Author(s): 
Célestin N. Nsibu, Dieudonné N. Mumba, Gauthier K. Mesia, Thierry L. Bobanga, Célestin de P. Manianga, Clarisse M. Mbo, Samuel M. Mampunza, Gaston L. Tona
Reference: 
MWJ2015, 6, 11
Article type: 
Research
Abstract: 
 
A series of fever outbreaks has previously been reported in the DR Congo. The occurrence of similar outbreaks in Mweka district presented the opportunity to investigate these occurrences.
 Health facilities and communities were visited. Blood samples for malaria, salmonellosis, Chikungunya, dengue and filovirus testing were obtained both in health facilities and the communities. Capture of mosquitoes and larvae in breeding sites was done and used bednets were collected. An increase in the number of malaria cases beyond the expected number for the study period was observed in the two health districts located in the savannah zone (p<0.05) and in one health centre among sixteen located in the forest zone (p<0.05). In the health facilities and households visited (653 people), 141 persons had fever of which 82.2% was attributed to Plasmodium falciparum malaria. An incidence of 5.87% was recorded in the first half of 2013. Hundred and sixty patients (6.9%) died among 2,304 admitted for severe malaria in the three referral hospitals, 118 of them were children of under five years old. PCR testing of the blood samples obtained during home visits revealed malaria parasites in 63 (73.3%) of the 86 analysed samples. The test was negative for other parasites and bacteria and one dengue virus case was detected. Anopheles gambiae from Mweka were found to be resistant to permethrin using the WHO susceptibility test, with a knock down rate of ≤ 50% and mortality of ≤ 30%. These investigations confirmed epidemic outbreaks in Mweka District caused by malaria with a high mortality rate in children below five years of age.

 
 
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Comments

William Jobin's picture
Submitted by William Jobin on
Although this report is for only one province in the Congo (aka DRC), it highlights the importance of pyrethroid resistance in An. gambiae, which not only cancels the effect of indoor spraying, but also the effectiveness of treated bednets. Improved housing and metallic screens would take care of this problem. And in the humid tropical climate of DRC, bednets are too hot for sleeping anyway.

William Jobin Director of Blue Nile Associates