Health promotion: From malaria control to elimination

Here we reflect on the achievement of some of the diverse activities that have brought malaria under control, highlight key challenges and propose specific health promotion interventions required to move South Africa’s malaria programme from control to elimination

Comparación de columna total de ozono OMI-DOAS con mediciones terrestres en Argentina

Total ozone column (TOC) measurements through the Ozone Monitoring Instrument (OMI/NASA EOSAura) are compared with ground-based observations made using Dobson and SAOZ instruments for the period 2004–2019 and 2008–02/2020, respectively. The OMI data were inverted using the Differential Optical Absorption Spectroscopy algorithm (overpass OMI-DOAS). The four ground-based sites used for the analysis are located in subpolar and subtropical latitudes spanning from 34°S to 54°S in the Southern Hemisphere, in the Argentine cities of Buenos Aires (34.58°S, 58.36°W; 25 m a.s.l.), Comodoro Rivadavia (45.86°S, 67.50°W; 46 m a.s.l.), Río Gallegos (51.60°S, 69.30°W; 72 m a.s.l.) and Ushuaia (54.80°S, 68.30°W; 14 m a.s.l.). The linear regression analyzes showed correlation values greater than 0.90 for all sites. The OMI measurements revealed an overestimation of less than 4 % with respect to the Dobson instruments, while the comparison with the SAOZ instrument presented a very low underestimation of less than 1 %.En este trabajo se comparan mediciones de columna total de ozono (CTO) del Ozone Monitoring Instrument (OMI/NASA EOS-Aura), con observaciones terrestres de instrumentos Dobson y SAOZ para el periodo 2004–2019 y 2008–02/2020, respectivamente. Los datos del OMI analizados fueron los invertidos mediante el algoritmo Differential Optical Absorption Spectroscopy (overpass OMI-DOAS). Las 4 estaciones terrestres están ubicadas en latitudes subpolares y subtropicales del Hemisferio Sur, en las ciudades argentinas de Buenos Aires (34,58°S, 58,36°O; 25 m s.n.m.), Comodoro Rivadavia (45,86°S, 67,50°O; 46 m s.n.m.), Río Gallegos (51,60°S, 69,30°O; 72 m s.n.m.) y Ushuaia (54,80°S, 68,30°O; 14 m s.n.m.) cubriendo un rango latitudinal desde los 34°S hasta los 54°S. Los análisis de regresión lineal presentan valores de correlación superior a 0,90. Las mediciones OMI– DOAS muestran una sobrestimación menor al 4 % respecto de los instrumentos Dobson, mientras que la comparación respecto al instrumento SAOZ presenta una muy baja subestimación, menor al 1 %.Fil: Orte, Pablo Facundo. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; Argentina. Ministerio de Defensa. Instituto de Investigaciones Científicas y Técnicas para la Defensa; ArgentinaFil: Luccini, Eduardo Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Excelencia en Productos y Procesos de Córdoba; Argentina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Facultad de Química e Ingeniería-Rosario; ArgentinaFil: Wolfram, Elian Augusto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional; Argentina. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; ArgentinaFil: Nollas, Fernando Martin. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional. Servicio Metereológico Nacional (sede Dorrego).; ArgentinaFil: Pallotta, Juan Vicente. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: D'elia, Raul Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Investigación y Desarrollo Estratégico para la Defensa. Ministerio de Defensa. Unidad de Investigación y Desarrollo Estratégico para la Defensa; ArgentinaFil: Carbajal, G.. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional. Servicio Metereológico Nacional (sede Dorrego).; ArgentinaFil: Mbatha, N.. University of Zululand; SudáfricaFil: Hlongwana, N.. University of Zululand; Sudáfric

Opportunities and obstacles to the elimination of malaria from Peninsular Malaysia: knowledge, attitudes and practices on malaria among aboriginal and rural communities

<p>Abstract</p> <p>Background</p> <p>Despite continuous efforts by the government and private sectors, malaria is still a public health problem in rural Peninsular Malaysia. This study investigated household knowledge, attitude and practices (KAP) regarding malaria in two malaria endemic communities, forest-aboriginal and rural communities, in the Lipis district of Pahang state, Malaysia.</p> <p>Methods</p> <p>A descriptive cross-sectional study with a semi-structured questionnaire was carried out among 100 and 123 households from forest-aboriginal and rural areas, respectively.</p> <p>Results</p> <p>Knowledge about malaria and its transmission is significantly higher among the rural participants than the aborigines (86.2% vs 76%, p < 0.01). However, use of medicinal plants and beliefs in witchcraft and sorcery in treating febrile diseases were significantly higher among the aboriginal population (p < 0.01). There were no significant differences between the two communities in terms of the knowledge about malaria symptoms, attitudes towards its severity and practices in preventive measures against malaria by using mosquito bed nets. However, the knowledge and practice of different preventive measures to combat malaria, such as insecticide and the elimination of breeding areas, was significantly higher among the rural population than the aborigines (p < 0.001).</p> <p>Conclusions</p> <p>Both communities were aware of malaria as a disease, but knowledge, attitudes and practices were inadequate. Providing efficient health education to people residing in malaria endemic areas would improve their understanding about malaria prevention in order to bring about the elimination of malaria from the country.</p

A qualitative study of community perception and acceptance of biological larviciding for malaria mosquito control in rural Burkina Faso

Background: Vector and malaria parasite’s rising resistance against pyrethroid-impregnated bed nets and antimalarial drugs highlight the need for additional control measures. Larviciding against malaria vectors is experiencing a renaissance with the availability of environmentally friendly and target species-specific larvicides. In this study,we analyse the perception and acceptability of spraying surface water collections with the biological larvicide Bacillus thuringiensis israelensis in a single health district in Burkina Faso. Methods: A total of 12focus group discussions and 12key informant interviews were performed in 10 rural villages provided with coverage of various larvicide treatments (all breeding sites treated, the most productive breeding sites treated, and untreated control). Results: Respondents’ knowledge about the major risk factors for malaria transmission was generally good. Most interviewees stated they performed personal protective measures against vector mosquitoes including the use of bed nets and sometimes mosquito coils and traditional repellents. The acceptance of larviciding in and around the villages was high and the majority of respondents reported a relief in mosquito nuisance and malarial episodes. There was high interest in the project and demand for future continuation. Conclusion: This study showed that larviciding interventions received positive resonance from the population. People showed a willingness to be involved and financially support the program. The positive environment with high acceptance for larviciding programs would facilitate routine implementation. An essential factor for the future success of such programs would be inclusion in regional or national malaria control guidelines

Reported reasons for not using a mosquito net when one is available: a review of the published literature

Background: A review of the barriers to mosquito net use in malaria-endemic countries has yet to be presented in the published literature despite considerable research interest in this area. This paper partly addresses this gap by reviewing one component of the evidence base; namely, published research pertaining to self-reported reasons for not using a mosquito net among net 'owning' individuals. It was anticipated that the review findings would potentially inform an intervention or range of interventions best suited to promoting greater net use amongst this group. Method. Studies were sought via a search of the Medline database. The key inclusion criteria were: that study participants could be identified as owning a mosquito net or having a mosquito net available for use; that these participants on one or more occasions were identified or self-reported as not using the mosquito net; and that reasons for not using the mosquito net were reported. Studies meeting these criteria were included irrespective of mosquito net type. Results: A total of 22 studies met the inclusion criteria. Discomfort, primarily due to heat, and perceived (low) mosquito density were the most widely identified reason for non-use. Social factors, such as sleeping elsewhere, or not sleeping at all, were also reported across studies as were technical factors related to mosquito net use (i.e. not being able to hang a mosquito net or finding it inconvenient to hang) and the temporary unavailability of a normally available mosquito net (primarily due to someone else using it). However, confidence in the reported findings was substantially undermined by a range of methodological limitations and a dearth of dedicated research investigation. Conclusions: The findings of this review should be considered highly tentative until such time as greater quantities of dedicated, well-designed and reported studies are available in the published literature. The current evidence-base is not sufficient in scope or quality to reliably inform mosquito net promoting interventions or campaigns targeted at individuals who own, but do not (reliably) use, mosquito nets

Surveillance for Malaria Elimination in Swaziland: A National Cross-Sectional Study Using Pooled PCR and Serology

BACKGROUND: To guide malaria elimination efforts in Swaziland and other countries, accurate assessments of transmission are critical. Pooled-PCR has potential to efficiently improve sensitivity to detect infections; serology may clarify temporal and spatial trends in exposure. METHODOLOGY/PRINCIPAL FINDINGS: Using a stratified two-stage cluster, cross-sectional design, subjects were recruited from the malaria endemic region of Swaziland. Blood was collected for rapid diagnostic testing (RDT), pooled PCR, and ELISA detecting antibodies to Plasmodium falciparum surface antigens. Of 4330 participants tested, three were RDT-positive yet false positives by PCR. Pooled PCR led to the identification of one P. falciparum and one P. malariae infection among RDT-negative participants. The P. falciparum-infected participant reported recent travel to Mozambique. Compared to performing individual testing on thousands of samples, PCR pooling reduced labor and consumable costs by 95.5%. Seropositivity was associated with age ≥20 years (11·7% vs 1·9%, P<0.001), recent travel to Mozambique (OR 4.4 [95% CI 1.0-19.0]) and residence in southeast Swaziland (RR 3.78, P<0.001). CONCLUSIONS: The prevalence of malaria infection and recent exposure in Swaziland are extremely low, suggesting elimination is feasible. Future efforts should address imported malaria and target remaining foci of transmission. Pooled PCR and ELISA are valuable surveillance tools for guiding elimination efforts

Malaria training for community health workers in the setting of elimination: a qualitative study from China

Background: Continuous training of health workers is a key intervention to maintain their good performance and keep their vigilance during malaria elimination programmes. However, countries progressing toward malaria elimination have a largely decreased malaria disease burden, less frequent exposure of health workers to malaria patients, and new challenges in the epidemiology of the remaining malaria cases. Moreover, competing health priorities and usually a decline in resources and in political commitment also pose challenges to the elimination programme. As a consequence, the acceptability, sustainability, and impact of malaria training and education programmes face challenges. However, little is known of the perceptions and expectations of malaria training and education programmes of health workers being engaged in countries with malaria elimination programmes. Methods: This qualitative study provides information on perceptions and expectations of health workers of malaria training programmes from China, which aims to malaria elimination by the year 2020. This study was embedded into a larger study on the challenges and lessons learned during the malaria surveillance strategy in China, involving 42 interviews with malaria experts, health staff, laboratory practitioners, and village doctors at the provincial, city, county, township, and village levels from Gansu province (northwestern China) and Jiangsu province (southeastern China). Results: In the context of an increasing number of imported malaria cases in China, the majority of respondents emphasized the necessity and importance of such programmes and complained about a decreasing frequency of training courses. Moreover, they called for innovative strategies to improve the implementation and sustainability of the malaria training programmes until the elimination goal has been achieved. Perceptions and expectations of health workers from different health centres were quite different. Health workers from higher-level facilities were more concerned about technical training aspects, while health workers from periphery of the health system expected to receive more training on field work coordination and on specific public health actions with regard to case detection and focus investigation. Conclusions: There is need to guarantee an ongoing good training of health workers in China on malaria aspects until the year 2020 and probably beyond