Behavioral Sentinel Surveillance Survey in Nigeria

This technical report presents results of the baseline Behavioral Sentinel Surveillance survey by Breakthrough RESEARCH in Nigeria in September and October 2019. From 2019 to 2021, baseline, midline, and endline surveys will assess the effectiveness of Breakthrough ACTION integrated social and behavior change activities for malaria, family planning, and maternal, newborn and child health plus nutrition in Kebbi and Sokoto in comparison to Breakthrough ACTION\u27s exclusively malaria activities in Zamfara state. Malaria activities were initiated in Zamfara in October 2019. This technical report presents detailed baseline results, including comparisons of results for the Breakthrough ACTION integrated and malaria-exclusive program areas. This report also presents findings about contextual factors influencing health behavior and service utilization outcomes, as these results have important and direct implications for Breakthrough ACTION program adaption and expansion

West Africa International Centers of Excellence for Malaria Research: Drug Resistance Patterns to Artemether-Lumefantrine in Senegal, Mali, and The Gambia.

In 2006, artemether-lumefantrine (AL) became the first-line treatment of uncomplicated malaria in Senegal, Mali, and the Gambia. To monitor its efficacy, between August 2011 and November 2014, children with uncomplicated Plasmodium falciparum malaria were treated with AL and followed up for 42 days. A total of 463 subjects were enrolled in three sites (246 in Senegal, 97 in Mali, and 120 in Gambia). No early treatment failure was observed and malaria infection cleared in all patients by day 3. Polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) was 100% in Mali, and the Gambia, and 98.8% in Senegal. However, without PCR adjustment, ACPR was 89.4% overall; 91.5% in Mali, 98.8% in Senegal, and 64.3% in the Gambia (the lower value in the Gambia attributed to poor compliance of the full antimalarial course). However, pfmdr1 mutations were prevalent in Senegal and a decrease in parasite sensitivity to artesunate and lumefantrine (as measured by ex vivo drug assay) was observed at all sites. Recrudescent parasites did not show Kelch 13 (K13) mutations and AL remains highly efficacious in these west African sites