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Malaria epidemiology in Kobeni department, southeastern Mauritania from 2015 to 2017

Authors
  • Diallo, Sileye Mamadou1, 2, 3
  • Bogreau, Hervé2, 3, 4
  • Papa Mze, Nasserdine2, 3
  • Ould Ahmedou Salem, Mohamed Salem1
  • Ould Khairy, Mohamed Lemine5, 6
  • Parola, Philippe2, 3
  • Basco, Leonardo2, 3
  • Ould Mohamed Salem Boukhary, Ali1, 2
  • 1 Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania , Nouakchott (Mauritania)
  • 2 Aix Marseille Université, IRD, Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Vecteurs – Infections Tropicales et Méditerranéennes (VITROME), Marseille, France , Marseille (France)
  • 3 Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, Marseille, France , Marseille (France)
  • 4 Institut de Recherche Biomédicale des Armées, Marseille, France , Marseille (France)
  • 5 Ministère de la Santé, Programme National de Lutte contre le Paludisme (PNLP), Nouakchott, Mauritania , Nouakchott (Mauritania)
  • 6 Present Address: Direction régionale de l’action sanitaire, Nouakchott sud, Ministère de la santé, Nouakchott, Mauritania , Nouakchott (Mauritania)
Type
Published Article
Journal
Infectious Diseases of Poverty
Publisher
BioMed Central
Publication Date
Feb 12, 2020
Volume
9
Issue
1
Identifiers
DOI: 10.1186/s40249-020-0634-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPlasmodium falciparum malaria is endemic in the southern sahelian zone of Mauritania where intense internal and trans-border human and livestock movement occurs. The risk of importation and spread of drug-resistant parasites need to be regularly assessed in this region. The objective of the study was to assess the recent malaria situation near the Mauritania-Mali border.MethodsBetween February 2015 and December 2017, patients with fever or history of fever during the previous 48 h, presenting at the health centre of Kobeni city, were screened for malaria using a rapid diagnostic test (RDT) and microscopic examination of blood smears. The diagnosis was later confirmed by PCR. Cohen’s kappa statistics was used to estimate the degree of agreement between diagnostic methods. Fisher’s exact test was used to compare proportions. The odds ratio was calculated to measure the association between the use of bed nets and malaria infection.ResultsA total of 2326 febrile patients (mean age, 20.2 years) were screened for malaria. The presence of malaria parasites was detected by RDT and microscopy in 53.0% and 49.3% of febrile patients, respectively, and was confirmed by PCR in 59.7% (45 missing data). Of 1361 PCR-positive samples, 1205 (88.5%) were P. falciparum, 47 (3.5%) P. vivax, and 99 (7.3%) P. falciparum-P. vivax mixed infection. Malaria transmission occurred mostly during and shortly after the rainy season. The annual rainfall was relatively low in 2016 (267 mm) and 2017 (274 mm), compared to 2015 (448 mm), and coincided with a decline in malaria prevalence in 2016–2017. Although 71.8% of febrile patients reported to possess at least one bed net in the household in our questionnaire, its reported use was not protective against malaria infection (odds ratio: 1.1, 95% CI: 0.91–1.32).ConclusionsOur study confirmed that P. falciparum is the dominant species in the sahelian zone and that malaria transmission is seasonal and associated with rainfall in this zone. The application of the current national policy based on rapid and reliable malaria diagnosis, case management with artemisinin-based combination therapy, intermittent preventive treatment for pregnant women, distribution and use of long-lasting insecticide impregnated bed nets, and the planned introduction of seasonal malaria chemoprevention for all children under 6 years old is expected to sustainably reduce malaria transmission in this zone.

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