Dataset Information

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

ABSTRACT: The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveillance in the DRC by monitoring malaria across seasons, age groups and in high and low malaria sites. Across seven sites, 242 households and 1591 individuals are participating in the study. Results of the enrollment questionnaire, rapid diagnostic tests and PCR testing of dried blood spots are presented.Overall malaria prevalence in the study cohort is high, 27% by rapid diagnostic test and 31% by polymerase chain reaction, and malaria prevalence is highly varied across very small geographic distances. Malaria prevalence is highest in children aged 6-15. While the majority of households own bed nets, bed net usage is less than 50%.The study cohort will provide an understanding of how malaria persists in populations that have varying environmental exposures, varying community-level malaria, and varying access to malaria control efforts.

SUBMITTER: Mwandagalirwa MK

PROVIDER: S-EPMC5680818 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

Mwandagalirwa Melchior Kashamuka MK Levitz Lauren L Thwai Kyaw L KL Parr Jonathan B JB Goel Varun V Janko Mark M Tshefu Antoinette A Emch Michael M Meshnick Steven R SR Carrel Margaret M

Malaria journal 20171109 1

<h4>Background</h4>The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveilla ...[more]

PMID: 29121931

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Project description:BackgroundLoss of efficacy of diagnostic tests may lead to untreated or mistreated malaria cases, compromising case management and control. There is an increasing reliance on rapid diagnostic tests (RDTs) for malaria diagnosis, with the most widely used of these targeting the Plasmodium falciparum histidine-rich protein 2 (PfHRP2). There are numerous reports of the deletion of this gene in P. falciparum parasites in some populations, rendering them undetectable by PfHRP2 RDTs. The aim of this study was to identify P. falciparum parasites lacking the P. falciparum histidine rich protein 2 and 3 genes (pfhrp2/3) isolated from asymptomatic and symptomatic school-age children in Kinshasa, Democratic Republic of Congo.MethodsThe performance of PfHRP2-based RDTs in comparison to microscopy and PCR was assessed using blood samples collected and spotted on Whatman 903™ filter papers between October and November 2019 from school-age children aged 6-14 years. PCR was then used to identify parasite isolates lacking pfhrp2/3 genes.ResultsAmong asymptomatic malaria carriers (N = 266), 49%, 65%, and 70% were microscopy, PfHRP2_RDT, and pfldh-qPCR positive, respectively. The sensitivity and specificity of RDTs compared to PCR were 80% and 70% while the sensitivity and specificity of RDTs compared to microscopy were 92% and 60%, respectively. Among symptomatic malaria carriers (N = 196), 62%, 67%, and 87% were microscopy, PfHRP2-based RDT, pfldh-qPCR and positive, respectively. The sensitivity and specificity of RDTs compared to PCR were 75% and 88%, whereas the sensitivity and specificity of RDTs compared to microscopy were 93% and 77%, respectively. Of 173 samples with sufficient DNA for PCR amplification of pfhrp2/3, deletions of pfhrp2 and pfhrp3 were identified in 2% and 1%, respectively. Three (4%) of samples harboured deletions of the pfhrp2 gene in asymptomatic parasite carriers and one (1%) isolate lacked the pfhrp3 gene among symptomatic parasite carriers in the RDT positive subgroup. No parasites lacking the pfhrp2/3 genes were found in the RDT negative subgroup.ConclusionPlasmodium falciparum histidine-rich protein 2/3 gene deletions are uncommon in the surveyed population, and do not result in diagnostic failure. The use of rigorous PCR methods to identify pfhrp2/3 gene deletions is encouraged in order to minimize the overestimation of their prevalence.

Project description:BackgroundDengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts.MethodsIn 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N'Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats, which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA barcoding of the specimens to validate identifications.ResultsThe most rural commune (Mont Ngafula) had the highest pupal index (number of Aedes spp. pupae per 100 inspected houses) at 246 (20) pupae/100 houses, and Breteau index (BI; number of containers positive for immature stages of Aedes spp. per 100 households) at 82.2 (19.5) positive containers/100 houses for the rainy (and dry) season, respectively. The BI was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N'Djili in the rainy (and dry) season, respectively. The house index (number of houses positive for at least one container with immature stages of Aedes spp. per 100 inspected houses) was, on average, across all communes, 27.5% (7.6%); and the container index (number of containers positive for immature stages of Aedes spp. per 100 inspected containers) was 15.0% (10.0%) for the rainy (and dry) season, respectively. The vast majority of Aedes-positive containers were found outside the houses [adjusted odds ratio 27.4 (95% confidence interval 14.9-50.1)]. During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season.ConclusionsIn both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key types of containers for Aedes larvae, which are mainly located in outdoor spaces, for larval habitat destruction or reduction.

Project description:BackgroundIn the Democratic Republic of Congo, the penal code prohibits the provision of abortion. In practice, however, it is widely accepted that the procedure can be performed to save the life of a pregnant woman. Although abortion is highly restricted, anecdotal evidence indicates that women often resort to clandestine abortions, many of which are unsafe. However, to date, there are no official statistics or reliable data to support this assertion.ObjectivesOur study provides the first estimates of the incidence of abortion and unintended pregnancy in Kinshasa.MethodsWe applied the Abortion Incidence Complications Method (AICM) to estimate the incidence of abortion and unintended pregnancy. We used data from a Health Facilities Survey and a Prospective Morbidity Survey to determine the annual number of women treated for abortion complications at health facilities. We also employed data from a Health Professionals Survey to calculate a multiplier representing the number of abortions for every induced abortion complication treated in a health facility.ResultsIn 2016, an estimated 37,865 women obtained treatment for induced abortion complications in health facilities in Kinshasa. For every woman treated in a facility, almost four times as many abortions occurred. In total, an estimated 146,713 abortions were performed, yielding an abortion rate of 56 per 1,000 women aged 15-49. Furthermore, more than 343,000 unintended pregnancies occurred, resulting in an unintended pregnancy rate of 147 per 1,000 women aged 15-49.ConclusionsIncreasing contraceptive uptake can reduce the number of women who experience unintended pregnancies, and as a consequence, result in fewer women obtaining unsafe abortions, suffering abortion complications, and dying needlessly from unsafe abortion. Increasing access to safe abortion and improving post-abortion care are other measures that can be implemented to reduce unsafe abortion and/or its negative consequences, including maternal mortality.

Project description:Rabies is a preventable fatal disease that causes about 61,000 human deaths annually around the world, mostly in developing countries. In Africa, several studies have shown that vaccination of pets is effective in controlling the disease. An annual vaccination coverage of 70% is recommended by the World Health Organization as a control threshold. The effective control of rabies requires vaccination coverage of owned dogs. Identification of the factors determining dog owners' choice to vaccinate is necessary for evidence-based policy-making. However, for the Democratic Republic of Congo (DRC), the limited data on rabies vaccination coverage makes it difficult for its control and formulation of appropriate policies. A cross-sectional study was conducted in Kinshasa (Lemba commune) with dog-owning households and owned dogs as study populations. The association between dog vaccination and independent factors (household socio-demographics characteristics, dog characteristics, knowledge of rabies and location of veterinary offices/clinics) was performed with Epi-info 7. The Odds Ratio (OR) and p-value < 0.05 were used to determine levels of significance. A total of 166 households owning dogs and 218 owned dogs were investigated. 47% of the dogs had been vaccinated within one year preceding the survey which is higher than the critical coverage (25 to 40%) necessary to interrupt rabies transmission but below the 70% threshold recommended by WHO for control. The determinants of vaccination included socio-economic level of the household (OR = 2.9, p<0.05), formal education level of the dog owner (OR = 4, p<0.05), type of residence (OR = 4.6, p<0.05), knowledge of rabies disease (OR = 8.0, p<0.05), knowledge of location of veterinary offices/clinics (OR = 3.4, p<0.05), dog gender (OR = 1.6, p<0.05) and dog breed (OR = 2.1, p<0.05). This study shows that the vaccination coverage in this area can easily reach the WHO threshold if supplemented by mass vaccination campaigns.

Dataset Information

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

Publications

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

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