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Trop. Med. Infect. Dis., Volume 2, Issue 1 (March 2017) – 4 articles

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Perspective
Assessing the Risk Factors Associated with Malaria in the Highlands of Ethiopia: What Do We Need to Know?
Trop. Med. Infect. Dis. 2017, 2(1), 4; https://doi.org/10.3390/tropicalmed2010004 - 01 Mar 2017
Cited by 11 | Viewed by 2678
Abstract
Malaria has been Ethiopia’s predominant communicable disease for decades. Following the catastrophic malaria outbreak in 2003–2004, the Federal Ministry of Health (FMoH) took drastic public health actions to lower the burden of malaria. The FMoH achieved significant declines in malaria mortality and incidence, [...] Read more.
Malaria has been Ethiopia’s predominant communicable disease for decades. Following the catastrophic malaria outbreak in 2003–2004, the Federal Ministry of Health (FMoH) took drastic public health actions to lower the burden of malaria. The FMoH achieved significant declines in malaria mortality and incidence, and recently declared its objective to achieve malaria elimination in low malaria transmission areas of Ethiopia by 2020. However, while the overall malaria prevalence has decreased, unpredictable outbreaks increasingly occur irregularly in regions previously considered “malaria-free”. Such outbreaks have disastrous consequences on populations of these regions as they have no immunity against malaria. The Amhara Region accounts for 31% of Ethiopia’s malaria burden and is targeted for malaria elimination by the FMoH. Amhara’s epidemiological surveillance system faces many challenges to detect in a timely manner the unpredictable and irregular malaria outbreaks that occur in areas of otherwise low transmission. Despite the evidence of a shift in malaria transmission patterns, Amhara’s malaria control interventions remain constrained to areas that are historically known to have stable malaria transmission. This paper discusses the influence of temperature and precipitation variability, entomological parameters, and human population mobility on malaria transmission patterns across the Amhara Region, and in particular, in areas of unstable transmission. We argue that malaria epidemiological surveillance systems can be improved by accounting for population movements in addition to environmental and entomological factors. However, to date, no study has statistically analyzed the interplay of population dynamics on environmental and entomological drivers of malaria transmission. Full article
Article
Distribution and Risk of Mycolactone-Producing Mycobacteria Transmission within Buruli Ulcer Endemic Communities in Côte d’Ivoire
Trop. Med. Infect. Dis. 2017, 2(1), 3; https://doi.org/10.3390/tropicalmed2010003 - 26 Feb 2017
Cited by 2 | Viewed by 2428
Abstract
In Buruli ulcer (BU) endemic communities, most mycolactone-producing mycobacteria (MPM), including Mycobacterium ulcerans, the causative agent, are present in water bodies used by inhabitants; yet, their mode of transmission is still unclear. This study aimed to assess the distribution of MPM strains, [...] Read more.
In Buruli ulcer (BU) endemic communities, most mycolactone-producing mycobacteria (MPM), including Mycobacterium ulcerans, the causative agent, are present in water bodies used by inhabitants; yet, their mode of transmission is still unclear. This study aimed to assess the distribution of MPM strains, both from human suspected cases and aquatic environments, for identifying possible transmission modes within two BU endemic districts, Daloa and Tiassalé (Taabo), in Côte d’Ivoire. Collected samples were processed using conventional polymerase chain reaction and screened for the presence of non-tuberculous mycobacteria (NTM) and MPMs using 16S rRNA, IS2404 and enoyl reductase (ER) primers. MPM-positive samples were further discriminated using variable number tandem repeat (VNTR) typing and sequencing. 16S rRNA and IS2404 sequences confirmed that 94% of the clinical samples contained MPMs. For environmental samples, 53% were contaminated with NTMs, of which 17% contained MPMs particularly M. ulcerans, suggesting that water-related activities could predispose inhabitants to BU transmission. MPM discrimination by VNTR at four M. ulcerans Agy99 loci identified genotype C, previously reported in Côte d’Ivoire as the most dominant profile. Phylogenetic clustering on the basis of genetic diversity in the MIRU 1 locus showed two main M. ulcerans lineages in Côte d’Ivoire. Full article
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Article
The Epidemiology of Malaria in Kutubu, Southern Highlands Province, Papua New Guinea, before and during a Private Sector Initiative for Malaria Control
Trop. Med. Infect. Dis. 2017, 2(1), 2; https://doi.org/10.3390/tropicalmed2010002 - 10 Feb 2017
Cited by 1 | Viewed by 2479
Abstract
Papua New Guinea (PNG) has a significant malaria burden, is resource constrained, and has isolated populations with limited access to health services. Home-based management is a key element of the national program that supports strategies of early detection, diagnosis and treatment. We describe [...] Read more.
Papua New Guinea (PNG) has a significant malaria burden, is resource constrained, and has isolated populations with limited access to health services. Home-based management is a key element of the national program that supports strategies of early detection, diagnosis and treatment. We describe the epidemiology of malaria near Lake Kutubu in the Southern Highlands Province through reported data on suspected and confirmed malaria in patients accessing public health facilities or using a novel, incentivised, social marketing approach for malaria treatment at the village level. Monthly case data reported by nine health facilities and 14 village-based providers, known as Marasin Stoa Kipas (MSK), were extracted from outpatient registers and MSK malaria case forms. Descriptive statistics of diagnostic use, monthly incidence, test positivity rate and species distribution were estimated. Summary statistics of service delivery demonstrate patient access and diagnostic coverage in program areas. From May 2005 to September 2013, 15,726 individuals were tested with either rapid diagnostic test and/or microscopy at health facilities, and 42% had a positive result for malaria (n = 6604); of these 67.1% (n = 4431) were positive for P. falciparum (alone or mixed) and 32.9% were positive for non-P. falciparum species (alone or mixed). From October 2007 to September 2013, 9687 individuals were tested with either RDT and/or microscopy at MSK sites and 44.2% (n = 4283) tested positive for malaria; of these, 65.3% (n = 2796) were positive for P. falciparum, while 34.7% (n = 1487) were positive for non-P. falciparum species. Up to April 2010 there was an intermittent and upward trend in the reported incidence of all species of confirmed malaria, reaching 50 per 1000 population per month for both sites combined, followed by a steady decline to four per 1000 population per month in 2013, with P. vivax the most common infection. This study is the most recent longitudinal overview of malaria in the Southern Highlands since 2003. It outlines patient access to a community-based model of care. The analysis shows changes in health facility versus MSK use, a strongly decreasing trend in incidence of confirmed malaria from 2010 to 2013, and a shift from predominantly P. falciparum to P. vivax infection. Full article
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Review
A Transdisciplinary Approach to Managing Emerging and Resurging Mosquito-Borne Diseases in the Western Pacific Region
Trop. Med. Infect. Dis. 2017, 2(1), 1; https://doi.org/10.3390/tropicalmed2010001 - 06 Jan 2017
Cited by 6 | Viewed by 3123
Abstract
Mosquitoes transmit a number of harmful diseases that have an impact on local communities and visitors, and many pose a threat to neighboring countries. As federal monitoring budgets shrink across the world, the increasing importance of citizen scientists in monitoring and identifying invasive [...] Read more.
Mosquitoes transmit a number of harmful diseases that have an impact on local communities and visitors, and many pose a threat to neighboring countries. As federal monitoring budgets shrink across the world, the increasing importance of citizen scientists in monitoring and identifying invasive species, as well as acting to prevent these diseases, are discussed. Examples of past mosquito management programs are provided, and future directions are discussed with an emphasis on the Western Pacific Region. Full article
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