Effects of Integrated Vector Management in the Control of Malaria Infection: An Intervention Study in a Malaria Endemic Community in Nigeria.

BACKGROUND/AIM: Malaria is a vector borne disease with high morbidity and mortality in endemic regions. In view to eliminating the disease, integrated vector and environmental hygiene practices have been advocated. There is paucity of studies on the effect of vector control measures on asymptomatic malaria infection which has been observed to be a reflection of malaria transmission. METHODS: Longitudinal community-based intervention study carried out from October to December 2017. Study participants were 477 individuals living in 100 households selected by snow-balling sampling methods. Pre-intervention period included training of all heads of households on vector control methods. During the intervention period, each household received waste bins, two long lasting insecticide bed nets and had wire screen on their doors and windows; every household member was screened for malaria (antigen) using the pf rapid diagnostic test kits. Each household were monitored to ensure they comply with the environmental hygiene practices they were taught. Post-intervention malaria infection was obtained at 8 week being end of the intervention period. RESULTS: Of the 100 households selected, 54.0% were from the lower social class, 45.0% middle class and only 1.0% upper class. Mean age [±] of the heads of the households was 37.1 ± 11.0 (range 16-68) years. There were 477 individuals recruited in the study from the 100 households; 234 (49.0%) females and 243 (51.0%) males; median age was 20.0 (range 1-100) years. Prevalence of malaria infection using mRDT during pre-intervention was 16.8% and an incidence of 1.3% post-intervention. There was 92.0% reduction in asymptomatic malaria infection showing marked reduction in malaria transmission in the study locale. CONCLUSION: Some integrated vector control measures such as use of insecticide-treated net and sanitation were found effective methods for reducing malaria infection and transmission in endemic region.

CONTEXTE/OBJECTIF: Le paludisme est une maladie à transmission vectorielle avec une morbidité et une mortalité élevées dans les régions endémiques. En vue d'éliminer la maladie, des pratiques d'hygiène intégrée des vecteurs et de l'environnement ont été préconisées. Il existe peu d'études sur l'effet des mesures de lutte antivectorielle sur l'infection palustre asymptomatique, qui s'est avérée être le reflet de la transmission du paludisme. MÉTHODES: Étude longitudinale d'intervention communautaire réalisée d'octobre à décembre 2017. Les participants à l'étude étaient 477 personnes vivant dans 100 ménages sélectionnés par des méthodes d'échantillonnage en boule de neige. La période de pré-intervention comprenait la formation de tous les chefs de ménage sur les méthodes de lutte antivectorielle. Au cours de la période d'intervention, chaque ménage a reçu des poubelles, deux moustiquaires à insecticide longue durée et avait des grillages sur leurs portes et fenêtres ; chaque membre du ménage a été dépisté pour le paludisme (antigène) à l'aide des kits de test de diagnostic rapide pf. Chaque ménage a été suivi pour s'assurer qu'il respecte les pratiques d'hygiène environnementale qui lui ont été enseignées. L'infection antipaludique post-intervention a été obtenue à 8 semaines, fin de la période d'intervention. RÉSULTATS: Sur les 100 ménages sélectionnés, 54,0% appartenaient à la classe sociale inférieure, 45,0% à la classe moyenne et seulement 1,0% à la classe supérieure. L'âge moyen [±] des chefs de ménage était de 37,1 ± 11,0 (fourchette de 16 à 68) ans. Il y avait 477 personnes recrutées dans l'étude à partir des 100 ménages ; 234 (49,0 %) femmes et 243 (51,0 %) hommes ; l'âge médian était de 20,0 (intervalle de 1 à 100) ans. La prévalence de l'infection du paludisme à l'aide de mRDT pendant la pré-intervention était de 16,8 % et l'incidence de 1,3 % après l'intervention. Il y avait une réduction de 92,0 % de l'infection asymptomatique du paludisme, montrant une réduction marquée de la transmission du paludisme dans le lieu de l'étude. CONCLUSION: Certaines mesures intégrées de lutte antivectorielle telles que l'utilisation de moustiquaires imprégnées d'insecticide et l'assainissement se sont révélées être des méthodes efficaces pour réduire l'infection et la transmission du paludisme dans les régions endémiques. Mots clés: Endémique, Hygiène Environnementale, Ménages, Intervention, Paludisme, Transmission, Vecteur.

Current State of Malaria Endemicity in Egor South-South Region, Nigeria.

BACKGROUND: BACKGROUND:Existing malaria endemicity classification puts Egor, as holoendemic. Some decades after this classification, there is need to determine the current malaria endemicity of the locale using malariometric indices of asymptomatic malaria parasitaemia and spleen rates. METHODS: Descriptive cross-sectional survey involved apparently healthy school children aged 2-9 years; using a multi-stage stratified cluster sampling technique. Malaria parasite was assessed by blood film microscopy and splenic examination was by bi-manual palpation method. RESULTS: Of the 422 subjects, 126 had an asymptomatic malaria parasitic rate of 29.9%; and was observed more in children aged 5-9 years (30.8%) than in the under-5s; (27.6%). P falciparum was the only malaria parasite specie identified in the study participants. Splenic rate of the study population was 11.0%. CONCLUSION: Malaria endemicity in the study locale is currently mesoendemic as against holoendemic prior to the study. Asymptomatic malaria parasitaemia is commoner in older children than under-5s, contrary to what was observed in previous studies.

High red blood cell folate is associated with an increased risk of death among adults with diabetes, a 15-year follow-up of a national cohort.

BACKGROUND AND AIM: To describe the mortality and fatality of diabetes and assess their relationship with the level of red blood cell (RBC) folate. METHODS AND RESULT: We analyzed the data of 526 adults with diabetes who participated in the National Health and Nutrition Examination Survey (1991-1994) as the baseline examination, and were followed up through December 31, 2006. Estimates of the hazard ratios (HRs) of selected death causes for individuals with different levels of RBC folate were obtained from Cox proportional hazards regression. A total of 295 deaths were recorded by the end of a 15-year follow-up with a mortality rate of 58.48 per 1000 person year (py). Diabetes was listed as a contributing cause for 136 deaths, accounting for 46.1% of the total deaths with a fatality rate 26.96 per 1000 py. Mortality rate for all-cause in the group with upper quartile of RBC folate was almost twice as high as that among the group with lower quartile, 82.75 vs. 44.10 per 1000 py. After adjusting for covariates, including serum concentration of vitamin B12, cotinine, homocysteine and the history of cardio-cerebral vascular diseases assessed at the baseline, the HRs for dying from any causes were 1.00 (reference), 1.82 (95% CI = 1.25-2.66) and 2.10 (1.37-3.20) among diabetic adults with lower, intermediate, and upper quartiles of RBC folate. CONCLUSION: Diabetes was listed as a contributing cause for less than half of the deaths among adults with diabetes after 15+ years of follow-up; high RBC folate concentration was associated with an elevated risk of death among adults with diabetes.