Malaria epidemiology in low-endemicity areas of the northern coast of Ecuador: high prevalence of asymptomatic infections View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-07-26

AUTHORS

Fabián E. Sáenz, Andrea Arévalo-Cortés, Gabriela Valenzuela, Andrés F. Vallejo, Angélica Castellanos, Andrea C. Poveda-Loayza, Juan B. Gutierrez, Alvaro Alvarez, Yi Heng Yan, Yoldy Benavides, Luis Enrique Castro, Myriam Arévalo-Herrera, Sócrates Herrera

ABSTRACT

BackgroundThe recent scale-up in malaria control measures in Latin America has resulted in a significant decrease in the number of reported cases in several countries including Ecuador, where it presented a low malaria incidence in recent years (558 reported cases in 2015) with occasional outbreaks of both Plasmodium falciparum and Plasmodium vivax in the coastal and Amazonian regions. This success in malaria control in recent years has led Ecuador to transition its malaria policy from control to elimination.ResultsThis study evaluated the general knowledge, attitude and practices (KAP) about malaria, as well as its prevalence in four communities of an endemic area in northwest Ecuador. A total of 258 interviews to assess KAP in the community indicated that most people in the study area have a basic knowledge about the disease but did not use to contribute to its control. Six hundred and forty-eight blood samples were collected and analysed by thick blood smear and real-time PCR. In addition, the distribution of the infections was mapped in the study communities. Although, no parasites were found by microscopy, by PCR the total malaria prevalence was 7.5% (6.9% P. vivax and 0.6% P. falciparum), much higher than expected and comparable to that reported in endemic areas of neighbouring countries with higher malaria transmission. Serology using ELISA and immunofluorescence indicated 27% respondents for P. vivax and 22% respondents for P. falciparum.ConclusionsResults suggest that despite a great malaria reduction in Ecuador, transition from control to elimination would demand further improvement in malaria diagnostics, including active case detection to identify and treat parasite asymptomatic carriers, as well as community participation in its elimination. More... »

PAGES

300

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12936-017-1947-0

DOI

http://dx.doi.org/10.1186/s12936-017-1947-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1090897382

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28747199


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31 schema:description BackgroundThe recent scale-up in malaria control measures in Latin America has resulted in a significant decrease in the number of reported cases in several countries including Ecuador, where it presented a low malaria incidence in recent years (558 reported cases in 2015) with occasional outbreaks of both Plasmodium falciparum and Plasmodium vivax in the coastal and Amazonian regions. This success in malaria control in recent years has led Ecuador to transition its malaria policy from control to elimination.ResultsThis study evaluated the general knowledge, attitude and practices (KAP) about malaria, as well as its prevalence in four communities of an endemic area in northwest Ecuador. A total of 258 interviews to assess KAP in the community indicated that most people in the study area have a basic knowledge about the disease but did not use to contribute to its control. Six hundred and forty-eight blood samples were collected and analysed by thick blood smear and real-time PCR. In addition, the distribution of the infections was mapped in the study communities. Although, no parasites were found by microscopy, by PCR the total malaria prevalence was 7.5% (6.9% P. vivax and 0.6% P. falciparum), much higher than expected and comparable to that reported in endemic areas of neighbouring countries with higher malaria transmission. Serology using ELISA and immunofluorescence indicated 27% respondents for P. vivax and 22% respondents for P. falciparum.ConclusionsResults suggest that despite a great malaria reduction in Ecuador, transition from control to elimination would demand further improvement in malaria diagnostics, including active case detection to identify and treat parasite asymptomatic carriers, as well as community participation in its elimination.
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38 America
39 ConclusionsResults
40 ELISA
41 Ecuador
42 KAP
43 Latin America
44 P. falciparum
45 P. vivax
46 PCR
47 Plasmodium falciparum
48 Plasmodium vivax
49 active case detection
50 addition
51 area
52 asymptomatic carriers
53 asymptomatic infection
54 attitudes
55 basic knowledge
56 blood samples
57 blood smears
58 carriers
59 case detection
60 cases
61 coast
62 community
63 community participation
64 control
65 control measures
66 countries
67 decrease
68 detection
69 diagnostics
70 disease
71 distribution
72 elimination
73 endemic areas
74 epidemiology
75 falciparum
76 further improvement
77 general knowledge
78 high malaria transmission
79 high prevalence
80 immunofluorescence
81 improvement
82 incidence
83 infection
84 interviews
85 knowledge
86 low endemicity area
87 low malaria incidence
88 malaria
89 malaria control
90 malaria control measures
91 malaria diagnostics
92 malaria epidemiology
93 malaria incidence
94 malaria policy
95 malaria prevalence
96 malaria reduction
97 malaria transmission
98 measures
99 microscopy
100 most people
101 neighbouring countries
102 northern coast
103 northwest Ecuador
104 number
105 occasional outbreaks
106 outbreak
107 parasites
108 participation
109 people
110 policy
111 practice
112 prevalence
113 real-time PCR
114 recent years
115 reduction
116 region
117 respondents
118 samples
119 serology
120 significant decrease
121 smears
122 study
123 study area
124 study communities
125 success
126 thick blood smears
127 total
128 transition
129 transmission
130 vivax
131 years
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