edoc

Spatial distribution of Falciparum malaria infections in Zanzibar : implications for focal drug administration strategies targeting asymptomatic parasite carriers

Björkman, Anders and Cook, Jackie and Sturrock, Hugh and Msellem, Mwinyi and Ali, Abdullah and Xu, Weiping and Molteni, Fabrizio and Gosling, Roly and Drakeley, Chris and Mårtensson, Andreas. (2017) Spatial distribution of Falciparum malaria infections in Zanzibar : implications for focal drug administration strategies targeting asymptomatic parasite carriers. Clinical infectious diseases, 64 (9). pp. 1236-1243.

[img]
Preview
PDF - Published Version
Available under License CC BY-NC-ND (Attribution-NonCommercial-NoDerivatives).

1676Kb

Official URL: http://edoc.unibas.ch/54998/

Downloads: Statistics Overview

Abstract

Optimal use of mass/targeted screen-and-treat or mass or focal drug administration as malaria elimination strategies remains unclear. We therefore studied spatial distribution of Plasmodium falciparum infections to compare simulated effects of these strategies on reducing the parasite reservoir in a pre-elimination setting.; P. falciparum rapid diagnostic tests (RDTs) and molecular (polymerase chain reaction [PCR]) and serological (enzyme-linked immunosorbent assay) analyses were performed on finger-prick blood samples from a population-based survey in 3 adjacent communities.; Among 5278 persons screened, 13 (0.2%) were positive by RDT and 123 (2.3%) by PCR. PCR-positive individuals were scattered over the study area, but logistic regression analysis suggested a propensity of these infections to cluster around RDT-positive individuals. The odds ratios for being PCR positive was 7.4 (95% confidence interval, 2.8-19.9) for those living in the household of an RDT-positive individual and 1.64 (1.0-2.8; P = .06) for those living within <300 m, compared with >1000 m. Treating everyone within households of RDT-positive individuals (1% population) would target 13% of those who are PCR positive. Treating all living within a radius of <300 or <1000 m (14% or 58% population) would target 30% or 66% of infections, respectively. Among 4431 serologically screened individuals, 26% were seropositive. Treating everyone within seropositive households (63% population) would target 77% of PCR-positive individuals.; Presumptive malaria treatment seemed justified within RDT-positive households and potentially worth considering within, for example, a radius of <300 m. Serology was not discriminative enough in identifying ongoing infections for improving focal interventions in this setting but may rather be useful to detect larger transmission foci.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Interventions (Lengeler)
UniBasel Contributors:Molteni, Fabrizio
Item Type:Article, refereed
Publisher:Oxford University Press
ISSN:1058-4838
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:25 Oct 2017 10:29
Deposited On:29 May 2017 13:30

Repository Staff Only: item control page