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- Fernando Chaves, Luis, et al.
(författare)
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Spleen rates in children : an old and new surveillance tool for malaria elimination initiatives in island settings
- 2011
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Ingår i: Transactions of the Royal Society of Tropical Medicine and Hygiene. - : Oxford University Press (OUP). - 0035-9203 .- 1878-3503. ; 105:4, s. 226-231
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Tidskriftsartikel (refereegranskat)abstract
- Spleen rates (SR) have been traditionally used to estimate the burden of malaria transmission. Results are presented from 51 surveys, which measured SR and parasite rates (PR) in 29 962 individuals in the archipelago of Vanuatu. Indices for spleen size computed with multivariate statistical tools outperformed the WHO average spleen index and showed that spleen sizes in a population can track shifts in malaria transmission. In general, a positive linear relationship between Plasmodium spp. PR and SR was found for the archipelago. In the context of malaria elimination and for the specific setting of this study we found that spleen examination is a useful tool in post-malaria elimination surveillance. Finally, results highlight the value of measuring spleen sizes to rapidly assess the impact of intervention packages aimed at malaria elimination or control.
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- Kaneko, Akira
(författare)
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A community-directed strategy for sustainable malaria elimination on islands : Short-term MDA integrated with ITNs and robust surveillance
- 2010
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Ingår i: Acta Tropica. - : Elsevier BV. - 0001-706X .- 1873-6254. ; 114:3, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- In the Asia Pacific sites with low and unstable transmission, elimination should be feasible with existing tools. On Aneityum island, Vanuatu both Plasmodium falciparum and Plasmodium vivax malaria were eliminated in 1991 after implementation of a combined intervention package, including mass drug administration (MDA) and insecticide-treated bed nets (ITNs), with high degree of community involvement. Subsequently, community-based surveillance and vector control measures have kept. By reviewing the experiences of the Aneityum project, I intended to examine the roles of community in malaria elimination. To be successful, the program should transfer major intervention components from the external donor-directed initiative to the community-directed approach. Scaling up of community involvement from simple participation to social participation, where communities involve in health planning functions is necessary from malaria control to malaria elimination.
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- Kaneko, Akira, et al.
(författare)
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Characteristic Age Distribution of Plasmodium vivax Infections after Malaria Elimination on Aneityum Island, Vanuatu
- 2014
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Ingår i: Infection and Immunity. - 0019-9567 .- 1098-5522. ; 82:1, s. 243-252
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Tidskriftsartikel (refereegranskat)abstract
- Resurgence is a major concern after malaria elimination. After the initiation of the elimination program on Aneityum Island in 1991, microscopy showed that Plasmodium falciparum disappeared immediately, whereas P. vivax disappeared from 1996 onward, until P. vivax cases were reported in January 2002. By conducting malariometric surveys of the entire population of Aneityum, we investigated the age distribution of individuals with parasites during this epidemic in the context of antimalarial antibody levels and parasite antigen diversity. In July 2002, P. vivax infections were detected by microscopy in 22/759 individuals: 20/298 born after the beginning of the elimination program in 1991, 2/126 born between 1982 and 1991, and none of 335 born before 1982. PCR increased the number of infections detected to 77, distributed among all age groups. Prevalences were 12.1%, 16.7%, and 6.0%, respectively (P<0.001). In November, a similar age pattern was found, but with fewer infections: 6/746 and 39/741 individuals were found to be infected by microscopy and PCR, respectively. The frequencies of antibody responses to P. vivax were significantly higher in individuals born before 1991 than in younger age groups and were similar to those on Malakula Island, an area of endemicity. Remarkably low antigen diversity (h, 0.15) of P. vivax infections was observed on Aneityum compared with the other islands (h, 0.89 to 1.0). A P. vivax resurgence was observed among children and teenagers on Aneityum, an age distribution similar to those before elimination and on islands where P. vivax is endemic, suggesting that in the absence of significant exposure, immunity may persist, limiting infection levels in adults. The limited parasite gene pool on islands may contribute to this protection.
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