Peterson, I. | bioRxiv Science

bioRxiv2019

Differential contribution of Anopheles coustani and Anopheles arabiensis to the transmission of Plasmodium falciparum and Plasmodium vivax in two neighboring villages of Madagascar

BackgroundMalaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been recently conducted despite the need for such information to design proper vector control measures. In a region of moderate to intense transmission of both Plasmodium falciparum and Plasmodium vivax, we conducted a combined parasitology and entomology survey in two nearby villages, across a malaria transmission season from December 2016 to April 2017.\n\nMethodology/Principal findingsCommunity-based surveys were conducted in the two close by villages at three time points during a single malaria transmission season. Plasmodium carriage in the human populations was determined by Rapid Diagnostic Tests (RDTs), microscopy and real-time PCR. Anthropophilic mosquitoes were captured by human landing captures and presence of Plasmodium sporozoites was assessed by robust Real Time PCR. Overall human malaria prevalence was 8.0% by RDT, 4.8% by microscopy and 11.9% by PCR, mainly due to P. falciparum detected in 92.2% of the PCR positive samples and Plasmodium vivax (5.7%). No significant differences in Plasmodium human carriage was observed between the 2 villages at any time point. Of the 1553 anopheline mosquitoes tested, 13 were found carrying Plasmodium sporozoites, the majority of them being captured outdoor. The mosquito sporozoite indices were not significantly different between the two villages. However, our entomological analysis revealed that Anopheles coustani was the main vector in one village, being responsible of 25.5 infective bites during the whole survey, whereas it was Anopheles arabiensis in the other village with 15 infective bites. In addition, we found a significant higher number of endophagic An. coustani and An. arabiensis in one village compared to the other.\n\nConclusions/SignificanceDespite similar human malaria prevalence in two close by villages, the entomological survey demonstrated the contribution of two different mosquito species in each village, and importantly the role of a suspected secondary malaria vector, An. coustani, as the main vector in one village. This, along with its higher endophagic rate in that village, highlights the importance of combining parasitology and entomology surveys for better targeting the actual local malaria vector. Such study should contribute to the malaria pre-elimination goal established under the 2018-2022 National Malaria Strategic Plan.\n\nAuthor SummaryMalaria is still a major health concern in many countries in sub-Saharan Africa such as Madagascar. In this study, we determined the contribution of malaria vectors in the transmission of Plasmodium parasites in two nearby villages in an area of moderate to high malaria transmission in Madagascar. We collected, during a single malaria transmission season, parasitological data in the human population and entomological data in the mosquito population, in order to evaluate Plasmodium carriage in these two populations. The results showed that despite similarity in human malaria prevalence and in vector species diversity in each village, the contribution of vectors was different between the two villages. An. arabiensis was the major vector in Ambohitromby while it was An. coustani that played this role in Miarinarivo. Importantly, this study is the first that clearly demonstrates that An. coustani could act as a major local vector in Madagascar. Such study should help deploying adapted malaria vector control and contributing to the malaria pre-elimination goal established under the 2018-2022 National Malaria Strategic Plan.

microbiology↗

bioRxiv2018

Dust or disease? Perceptions of influenza in rural Southern Malawi

BackgroundInfluenza virus infections cause between 291 243 and 645 832 deaths annually, with the highest burden in low-income settings. Research in high-income countries has examined public understanding of influenza, but there is little information on views and behaviours about influenza in low-income countries. We explored communities ideas about the severity, causes, prevention and treatment of influenza in Chikwawa district, Malawi.\n\nMethodsWe conducted 64 in-depth interviews with parents of children aged <5 years, and 7 focus groups with community health workers, parents, and traditional healers. Data were analysed thematically and using a framework matrix to compare views between groups.\n\nResultsRespondents held varied ideas about influenza, and many were uncertain about its causes and treatment. Some parents, traditional healers and health workers thought influenza was not severe because they felt it did not cause death or limit activities, but others disagreed. Many saw influenza as a symptom of other conditions, especially malaria and pneumonia, rather than as a disease of its own. Most mentioned dust as the main cause of influenza and believed influenza could be prevented by cleaning the home thoroughly. Treatment seeking for influenza followed different stages, usually starting with home remedies followed by purchasing drugs from groceries and then visiting a health centre. Seeking a clinician tended to be triggered by severe symptoms like high fever or difficulty breathing, and suspicions of malaria or pneumonia. Community health workers provide health education for communities, but some lacked understanding of influenza.\n\nConclusionOur findings suggest uncertainty about the causes and control of influenza among parents and varied levels of understanding among health providers. Strengthening the capacity of community health workers to provide relevant information about influenza prevention and treatment could address parents interest in further information and support informed health seeking and engagement with future influenza interventions.

pathology↗