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Mwapasa, V.

Publications and source records attributed to Mwapasa, V..

2 recordsLinked to original sources

Malaria entomological surveillance in Kinshasa Province: A longitudinal study

BackgroundMalaria remains a major public health challenge in the Democratic Republic of Congo. To address the lack of contemporary entomological data, particularly in Kinshasa Province, this four-year study characterized key entomological parameters, including mosquito species composition, abundance, biting behavior, and insecticide resistance. MethodsWe conducted a prospective observational cohort study (2018-2022) in three health areas representing rural, peri-urban, and urban settings in Kinshasa Province. Adult Anopheles mosquitoes were sampled using CDC miniature light traps and pyrethrum spray catches. Insecticide susceptibility of adult females was assessed using WHO tube tests, and a generalized estimating equations model evaluated the effects of year, season, site, sampling location, and collection time on mosquito abundance. ResultsA total of 1,449 Anopheles mosquitoes were collected: 50% in the rural health area of Bu, 49% in peri-urban Kimpoko, and 1% in urban La Voix du Peuple. The species captured were An. gambiae s.l. (85%), An. paludis (11%), and An. funestus (4%). An. gambiae s.l. was significantly more abundant indoors and after 10 PM. The overall entomological inoculation rate (EIR) was 4.6 infective bites per person per year, with An. gambiae s.l. contributing the highest rate. An. paludis showed a localized transmission peak in Impuru during the rainy season (EIR = 8.87). Resistance to DDT and pyrethroids was widespread, with an estimated 0.94 frequency of the kdr L1014F mutation. Bendiocarb and pirimiphos-methyl remained effective. ConclusionsThis study confirms that An. gambiae s.l. remains the predominant malaria vector and plays a central role in transmission in Kinshasa. However, an emerging role of An. paludis in rural settings was observed. These findings underscore the need for vector control strategies tailored to diverse ecological settings. Continued entomological surveillance will be essential to track biting behavior and resistance patterns and ensure that interventions remain effective over time. Author summaryMalaria remains a major health problem in the Democratic Republic of the Congo, but very little recent information is available about the mosquitoes that spread the disease, especially in Kinshasa Province. To help fill this gap, we spent four years studying mosquitoes in rural, peri-urban, and urban communities. We focused on how many mosquitoes were present, which species they were, when and where they bite, and whether they were resistant to the insecticides commonly used in malaria control. We found that most mosquitoes belonged to Anopheles gambiae, the main malaria-transmitting species in Africa. These mosquitoes mostly bit indoors and late at night, when bed nets can offer good protection. However, we also observed mosquitoes biting earlier in the evening and outside, which may reduce the impact of bed nets. Another species, Anopheles paludis, played an important role in malaria transmission in some rural areas, showing that different environments can shape which mosquitoes spread the disease. We also found that many mosquitoes were resistant to widely used insecticides, although some alternative insecticides were still effective. Our findings show why it is important to monitor mosquito behavior and insecticide resistance regularly and to adapt malaria prevention strategies to local conditions.

ecology↗

Impact of efavirenz, ritonavir-boosted lopinavir and nevirapine based antiretroviral regimens on the pharmacokinetics of lumefantrine and safety of artemether-lumefantrine in falciparum-negative HIV-infected Malawian adults stabilized on antiretroviral therapy

There is conflicting evidence of the impact of commonly used antiretroviral therapies (ARTs) on the pharmacokinetics of lumefantrine and safety profile of artemether-lumefantrine. We compared the area under the concentration-time curve (AUC0-14 days) of lumefantrine and safety profile of artemether-lumefantrine in malaria-negative human immunodeficiency virus (HIV) infected adults in two steps. In step 1, a half-dose adult course of artemether-lumefantrine was administered as a safety check in four groups (n = 6/group): (i) antiretroviral-naive, (ii) on nevirapine-based ART, (iii) on efavirenz-based ART and (iv) on ritonavir-boosted lopinavir-based ART. In step 2, a standard-dose adult course of artemether-lumefantrine was administered to a different cohort in three groups (n = 10-15/group): (i) antiretroviral-naive, (ii) on efavirenz-based ART and (iii) on ritonavir-boosted lopinavir-based ART. In step 1, lumefantrines AUC0-14 days was 53% [95% CI: 0.27-0.82] lower in the efavirenz-based ART group than the ART-naive group and was 2.4 [95% CI: 1.58-3.62] and 2.9 [95% CI: 1.75-4.72] times higher in the nevirapine and ritonavir-boosted lopinavir groups, respectively. In step 2, lumefantrines AUC0-14 days was 1.9 [95% CI: 1.26-3.00] times higher in the ritonavir-boosted lopinavir group and not significantly different between the efavirenz-and ART-naive groups (0.99 [95% CI: 0.63-1.57]). Frequent cases of haematological abnormalities (thrombocytopenia and neutropenia) were observed in the nevirapine group in step 1, leading to a recommendation from the data and safety monitoring board not to include a nevirapine group in step 2. Artemether-lumefantrine was well tolerated in the other groups. The therapeutic implications of these findings need to be evaluated among HIV-malaria co-infected adults.

pharmacology and toxicology↗