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Sahel, savana, riverine and urban malaria in West Africa: Similar control policies with different outcomes

2011; Elsevier BV; Volume: 121; Issue: 3 Linguagem: Inglês

10.1016/j.actatropica.2011.11.005

1873-6254

Serign J. Ceesay, Kalifa Bojang, Davis Nwakanma, David J. Conway, Ousmane Koïta, Seydou Doumbia, Daouda Ndiaye, Tinzana F. Coulibaly, Mahamadou Diakité, Sékou F. Traorè, Mamadou B. Coulibaly, Jean Louis Ndiaye, Ousmane Sarr, Oumar Gaye, Lassana Konaté, Ngayo Sy, Babacar Faye, Ousmane Faye, Nafomon Sogoba, Musa Jawara, Adama Dao, Belco Poudiougou, Sory Ibrahim Diawara, Joseph Okebe, Lansana Sangaré, Ismaela Abubakar, Aliou Sissako, Ayouba Diarra, Moussa Keïta, Balla Kandeh, Carole A. Long, Rick M. Fairhurst, Manoj T. Duraisingh, Robert T. Perry, Marc A. T. Muskavitch, Clarissa Valim, Sarah K. Volkman, Dyann F. Wirth, Donald J. Krogstad,

Parasites and Host Interactions

The study sites for the West African ICEMR are in three countries (The Gambia, Senegal, Mali) and are located within 750 km of each other. In addition, the National Malaria Control Programmes of these countries have virtually identical policies: (1) Artemisinin Combination Therapies (ACTs) for the treatment of symptomatic Plasmodium falciparum infection, (2) Long-Lasting Insecticide-treated bed Nets (LLINs) to reduce the Entomololgic Inoculation Rate (EIR), and (3) sulfadoxine-pyrimethamine for the Intermittent Preventive Treatment of malaria during pregnancy (IPTp). However, the prevalence of P. falciparum malaria and the status of malaria control vary markedly across the four sites with differences in the duration of the transmission season (from 4-5 to 10-11 months), the intensity of transmission (with EIRs from unmeasurably low to 4-5 per person per month), multiplicity of infection (from a mean of 1.0 to means of 2-5) and the status of malaria control (from areas which have virtually no control to areas that are at the threshold of malaria elimination). The most important priority is the need to obtain comparable data on the population-based prevalence, incidence and transmission of malaria before new candidate interventions or combinations of interventions are introduced for malaria control.