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Published in: Malaria Journal 1/2009

Open Access 01-12-2009 | Research

Evidence of decline of malaria in the general hospital of Libreville, Gabon from 2000 to 2008

Authors: Marielle Karine Bouyou-Akotet, Denise Patricia Mawili-Mboumba, Eric Kendjo, Modeste Mabika-Mamfoumbi, Edgard Brice Ngoungou, Arnaud Dzeing-Ella, Mireille Pemba-Mihindou, Euloge Ibinga, Emmanuel Efame-Eya, Tim Planche, Peter G Kremsner, Maryvonne Kombila, MCRU team

Published in: Malaria Journal | Issue 1/2009

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Abstract

Background

Substantial decline in malaria transmission, morbidity and mortality has been reported in several countries where new malaria control strategies have been implemented. In Gabon, the national malaria policy changed in 2003, according to the WHO recommendations. The trend in malaria morbidity was evaluated among febrile children before and after their implementation in Libreville, the capital city of Gabon.

Methods

From August 2000 to December 2008, febrile paediatric outpatients and inpatients, under 11 years of age, were screened for malaria by microscopic examination at the Malaria Clinical Research Unit (MCRU) located in the largest public hospital in Gabon. Climatic data were also collected.

Results

In total, 28,092 febrile children were examined; those under five years always represented more than 70%. The proportion of malaria-positive slides was 45% in 2000, and declined to 15% in 2008. The median age of children with a positive blood smear increased from 24(15-48) to 41(21-72) months over the study period (p < 0.01). Rainfall patterns had no impact on the decline observed throughout the study period.

Conclusion

The decrease of malaria prevalence among febrile children during the last nine years is observed following the introduction of new strategies of malaria cases management, and may announce epidemiological changes. Moreover, preventive measures must be extended to children older than five years.
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Literature
1.
go back to reference References World Health Organization: World malaria report 2008. who/htm/gmp/2008.1 References World Health Organization: World malaria report 2008. who/htm/gmp/2008.1
3.
go back to reference Schellenberg D, Menendez C, Aponte J, Guinovart C, Mshinda H, Tanner M, Alonso P: The changing epidemiology of malaria in Ifakara town, southern Tanzania. Trop Med Int Health. 2004, 9: 68-76. 10.1046/j.1365-3156.2003.01161.x.CrossRefPubMed Schellenberg D, Menendez C, Aponte J, Guinovart C, Mshinda H, Tanner M, Alonso P: The changing epidemiology of malaria in Ifakara town, southern Tanzania. Trop Med Int Health. 2004, 9: 68-76. 10.1046/j.1365-3156.2003.01161.x.CrossRefPubMed
4.
go back to reference Olliaro PL, Delenne H, Cisse M, Badiane M, Olliaro A, Vaillant M, Brasseur P: Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP) at a district health centre in rural Senegal. Malar J. 2008, 7: 234-10.1186/1475-2875-7-234.PubMedCentralCrossRefPubMed Olliaro PL, Delenne H, Cisse M, Badiane M, Olliaro A, Vaillant M, Brasseur P: Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP) at a district health centre in rural Senegal. Malar J. 2008, 7: 234-10.1186/1475-2875-7-234.PubMedCentralCrossRefPubMed
6.
go back to reference Diallo DA, Cousens SN, Cuzin-Ouattara N, Nebié I, Ilboudo-Sanogo E, Esposito F: Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years. Bull World Health Organ. 2004, 82: 85-91.PubMedCentralPubMed Diallo DA, Cousens SN, Cuzin-Ouattara N, Nebié I, Ilboudo-Sanogo E, Esposito F: Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years. Bull World Health Organ. 2004, 82: 85-91.PubMedCentralPubMed
7.
go back to reference Okiro EA, Hay SI, Gikandi PW, Sharif SK, Noor AM, Peshu N, Marsh K, Snow RW: The decline in paediatric malaria admissions on the coast of Kenya. Malar J. 2007, 6: 151-61. 10.1186/1475-2875-6-151.PubMedCentralCrossRefPubMed Okiro EA, Hay SI, Gikandi PW, Sharif SK, Noor AM, Peshu N, Marsh K, Snow RW: The decline in paediatric malaria admissions on the coast of Kenya. Malar J. 2007, 6: 151-61. 10.1186/1475-2875-6-151.PubMedCentralCrossRefPubMed
8.
go back to reference Bhattarai A, Ali AS, Kachur SP, Mårtensson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF, Molteni F, Abdulla S, Montgomery SM, Kaneko A, Björkman A: Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. PLoS Med. 2007, 4: 1784-90. 10.1371/journal.pmed.0040309.CrossRef Bhattarai A, Ali AS, Kachur SP, Mårtensson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF, Molteni F, Abdulla S, Montgomery SM, Kaneko A, Björkman A: Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. PLoS Med. 2007, 4: 1784-90. 10.1371/journal.pmed.0040309.CrossRef
9.
go back to reference Richard-Lenoble D, Kombila M, Chandenier J, Gay F, Billiault X, Nguiri C, Martz M, Boyer F, Bauzou M: Paludisme au Gabon 2. Evaluation des prévalences parasitaires qualitatives et quantitatives sur l'ensemble du pays en milieu scolaire et préscolaire. Bull Soc Pathol Exot Filiales. 1987, 80: 532-42.PubMed Richard-Lenoble D, Kombila M, Chandenier J, Gay F, Billiault X, Nguiri C, Martz M, Boyer F, Bauzou M: Paludisme au Gabon 2. Evaluation des prévalences parasitaires qualitatives et quantitatives sur l'ensemble du pays en milieu scolaire et préscolaire. Bull Soc Pathol Exot Filiales. 1987, 80: 532-42.PubMed
10.
go back to reference Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH: Malaria epidemiology in the province of Moyen Ogoov, Gabon. Trop Med Parasitol. 1995, 46: 77-82.PubMed Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH: Malaria epidemiology in the province of Moyen Ogoov, Gabon. Trop Med Parasitol. 1995, 46: 77-82.PubMed
11.
go back to reference Dzeing-Ella A, Nze Obiang PC, Tchoua R, Planche T, Mboza B, Mbounja M, Muller-Roemer U, Jarvis J, Kendjo E, Ngou-Milama E, Kremsner PG, Krishna S, Kombila M: Severe falciparum malaria in Gabonese children: clinical and laboratory features. Malar J. 2005, 4: 1-7. 10.1186/1475-2875-4-1.PubMedCentralCrossRefPubMed Dzeing-Ella A, Nze Obiang PC, Tchoua R, Planche T, Mboza B, Mbounja M, Muller-Roemer U, Jarvis J, Kendjo E, Ngou-Milama E, Kremsner PG, Krishna S, Kombila M: Severe falciparum malaria in Gabonese children: clinical and laboratory features. Malar J. 2005, 4: 1-7. 10.1186/1475-2875-4-1.PubMedCentralCrossRefPubMed
12.
go back to reference Richard-Lenoble D, Kombila M, Martz M, Lefèvre B, Chandenier J, Gay F, Billiault X, Thérizol-Ferly M: Evolution de la chloroquino-résistance à Plasmodium falciparum au Gabon entre 1984 et 1987-88 (étude in vivo en milieu scolaire). Ann Soc Belg Med Trop. 1989, 69: 113-9.PubMed Richard-Lenoble D, Kombila M, Martz M, Lefèvre B, Chandenier J, Gay F, Billiault X, Thérizol-Ferly M: Evolution de la chloroquino-résistance à Plasmodium falciparum au Gabon entre 1984 et 1987-88 (étude in vivo en milieu scolaire). Ann Soc Belg Med Trop. 1989, 69: 113-9.PubMed
13.
go back to reference Pradines B, Mabika Mamfoumbi M, Parzy D, Owono Medang M, Lebeau C, Mourou Mbina JR, Doury JC, Kombila M: In vitro susceptibility of Gabonese wild isolates of Plasmodium falciparum to artemether, and comparison with chloroquine, quinine, halofantrine and amodiaquine. Parasitology. 1998, 117: 541-5. 10.1017/S0031182098003400.CrossRefPubMed Pradines B, Mabika Mamfoumbi M, Parzy D, Owono Medang M, Lebeau C, Mourou Mbina JR, Doury JC, Kombila M: In vitro susceptibility of Gabonese wild isolates of Plasmodium falciparum to artemether, and comparison with chloroquine, quinine, halofantrine and amodiaquine. Parasitology. 1998, 117: 541-5. 10.1017/S0031182098003400.CrossRefPubMed
14.
go back to reference Borrmann S, Binder RK, Adegnika AA, Missinou MA, Issifou S, Ramharter M, Wernsdorfer WH, Kremsner PG: Reassessment of the resistance of Plasmodium falciparum to chloroquine in Gabon: implications for the validity of tests in vitro vs. in vivo. Trans R Soc Trop Med Hyg. 2002, 96: 660-3. 10.1016/S0035-9203(02)90345-7.CrossRefPubMed Borrmann S, Binder RK, Adegnika AA, Missinou MA, Issifou S, Ramharter M, Wernsdorfer WH, Kremsner PG: Reassessment of the resistance of Plasmodium falciparum to chloroquine in Gabon: implications for the validity of tests in vitro vs. in vivo. Trans R Soc Trop Med Hyg. 2002, 96: 660-3. 10.1016/S0035-9203(02)90345-7.CrossRefPubMed
15.
go back to reference Ministère de Santé: Rapport de l'atelier national de consensus sur les perspectives thérapeutiques du paludisme. Programme national de lutte contre le paludisme, Gabon. 2003, 13-14. Ministère de Santé: Rapport de l'atelier national de consensus sur les perspectives thérapeutiques du paludisme. Programme national de lutte contre le paludisme, Gabon. 2003, 13-14.
16.
go back to reference Ramharter M, Schuster K, Bouyou-Akotet MK, Adegnika AA, Schmits K, Mombo-Ngoma G, Agnandji ST, Nemeth J, Afène SN, Issifou S, Onnas IN, Kombila M, Kremsner PG: Malaria in Pregnancy Before and After the Implementation of a National IPTp Program in Gabon. Am J Trop Med Hyg. 2007, 77: 418-22.PubMed Ramharter M, Schuster K, Bouyou-Akotet MK, Adegnika AA, Schmits K, Mombo-Ngoma G, Agnandji ST, Nemeth J, Afène SN, Issifou S, Onnas IN, Kombila M, Kremsner PG: Malaria in Pregnancy Before and After the Implementation of a National IPTp Program in Gabon. Am J Trop Med Hyg. 2007, 77: 418-22.PubMed
17.
go back to reference Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG: Comparison of methods for rapid laboratory assessment of children with malaria. Am J Trop Med Hyg. 2001, 65: 599-602.PubMed Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG: Comparison of methods for rapid laboratory assessment of children with malaria. Am J Trop Med Hyg. 2001, 65: 599-602.PubMed
18.
go back to reference Richard-Lenoble D, Kombila M, Chandenier J, Engohan E, Gannier M, Dubourg C: Paludisme au Gabon 1. Etude de 500 enfants fébriles à Libreville. Bull Soc Pathol Exot Filiales. 1986, 79: 284-7.PubMed Richard-Lenoble D, Kombila M, Chandenier J, Engohan E, Gannier M, Dubourg C: Paludisme au Gabon 1. Etude de 500 enfants fébriles à Libreville. Bull Soc Pathol Exot Filiales. 1986, 79: 284-7.PubMed
19.
go back to reference Mawili-Mboumba DP, Bouyou Akotet MK, Ngoungou EB, Kombila M: Evaluation of rapid diagnostic tests for malaria case management in Gabon. Diag Microb Infect Dis. 2009, Mawili-Mboumba DP, Bouyou Akotet MK, Ngoungou EB, Kombila M: Evaluation of rapid diagnostic tests for malaria case management in Gabon. Diag Microb Infect Dis. 2009,
20.
go back to reference Carrara VI, Sirilak S, Thonglairuam J, Rojanawatsirivet C, Proux S, Gilbos V, Brockman A, Ashley EA, McGready R, Krudsood S, Leemingsawat S, Looareesuwan S, Singhasivanon P, White N, Nosten F: Deployment of early diagnosis and mefloquine-artesunate treatment of falciparum malaria in Thailand: the Tak Malaria Initiative. PLoS Med. 2006, e183: 856-64. Carrara VI, Sirilak S, Thonglairuam J, Rojanawatsirivet C, Proux S, Gilbos V, Brockman A, Ashley EA, McGready R, Krudsood S, Leemingsawat S, Looareesuwan S, Singhasivanon P, White N, Nosten F: Deployment of early diagnosis and mefloquine-artesunate treatment of falciparum malaria in Thailand: the Tak Malaria Initiative. PLoS Med. 2006, e183: 856-64.
21.
go back to reference Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ, White NJ, Sharp BL: Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med. 2005, e330: 1123-34. Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ, White NJ, Sharp BL: Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med. 2005, e330: 1123-34.
22.
go back to reference Nyarango PM, Gebremeskel T, Mebrahtu G, Mufunda J, Abdulmumini U, Ogbamariam A, Kosia A, Gebremichael A, Gunawardena D, Ghebrat Y, Okbaldet Y: A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and the effect of combination of control methods. Malar J. 2004, 5: 33-44. 10.1186/1475-2875-5-33.CrossRef Nyarango PM, Gebremeskel T, Mebrahtu G, Mufunda J, Abdulmumini U, Ogbamariam A, Kosia A, Gebremichael A, Gunawardena D, Ghebrat Y, Okbaldet Y: A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and the effect of combination of control methods. Malar J. 2004, 5: 33-44. 10.1186/1475-2875-5-33.CrossRef
23.
go back to reference Bouyou-Akotet MK, Nzenze-Afène S, Mabika-Mamfoumbi M, Pemba M, Doumbo OK, Kombila M: Evaluation de l'efficacité et de la tolérance de l'Arsucam®, de l'Artequin® et du Coartem® dans le traitement du paludisme non compliqué de l'enfant. Bull Med Owendo. 2006, 11: 70-75. Bouyou-Akotet MK, Nzenze-Afène S, Mabika-Mamfoumbi M, Pemba M, Doumbo OK, Kombila M: Evaluation de l'efficacité et de la tolérance de l'Arsucam®, de l'Artequin® et du Coartem® dans le traitement du paludisme non compliqué de l'enfant. Bull Med Owendo. 2006, 11: 70-75.
24.
go back to reference Bejon P, Warimwe G, Mackintosh CL, Mackinnon MJ, Kinyanjui SM, Musyoki JN, Bull PC, Marsh K: Analysis of immunity to febrile malaria in children that distinguishes immunity from lack of exposure. Infect Immun. 2009, 77: 1917-23. 10.1128/IAI.01358-08.PubMedCentralCrossRefPubMed Bejon P, Warimwe G, Mackintosh CL, Mackinnon MJ, Kinyanjui SM, Musyoki JN, Bull PC, Marsh K: Analysis of immunity to febrile malaria in children that distinguishes immunity from lack of exposure. Infect Immun. 2009, 77: 1917-23. 10.1128/IAI.01358-08.PubMedCentralCrossRefPubMed
25.
go back to reference O'Meara WP, Mwangi TW, Williams TN, McKenzie FE, Snow RW, Marsh K: Relationship between exposure, clinical malaria, and age in an area of changing transmission intensity. Am J Trop Med Hyg. 2008, 79: 185-91.PubMedCentralPubMed O'Meara WP, Mwangi TW, Williams TN, McKenzie FE, Snow RW, Marsh K: Relationship between exposure, clinical malaria, and age in an area of changing transmission intensity. Am J Trop Med Hyg. 2008, 79: 185-91.PubMedCentralPubMed
26.
go back to reference Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ: Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Lancet. 2008, 372: 1545-54. 10.1016/S0140-6736(08)61654-2.PubMedCentralCrossRefPubMed Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ: Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Lancet. 2008, 372: 1545-54. 10.1016/S0140-6736(08)61654-2.PubMedCentralCrossRefPubMed
27.
go back to reference Clarke SE, Brooker S, Njagi JK, Njau E, Estambale B, Muchiri E, Magnussen P: Malaria morbidity among school children living in two areas of contrasting transmission in western Kenya. Am J Trop Med Hyg. 2004, 71: 732-8.PubMed Clarke SE, Brooker S, Njagi JK, Njau E, Estambale B, Muchiri E, Magnussen P: Malaria morbidity among school children living in two areas of contrasting transmission in western Kenya. Am J Trop Med Hyg. 2004, 71: 732-8.PubMed
28.
go back to reference Okiro EA, Al-Taiar A, Reyburn H, Idro R, Berkley JA, Snow RW: Age patterns of severe paediatric malaria and their relationship to Plasmodium falciparum transmission intensity. Malar J. 2009, 8: 4-14. 10.1186/1475-2875-8-4.PubMedCentralCrossRefPubMed Okiro EA, Al-Taiar A, Reyburn H, Idro R, Berkley JA, Snow RW: Age patterns of severe paediatric malaria and their relationship to Plasmodium falciparum transmission intensity. Malar J. 2009, 8: 4-14. 10.1186/1475-2875-8-4.PubMedCentralCrossRefPubMed
Metadata
Title
Evidence of decline of malaria in the general hospital of Libreville, Gabon from 2000 to 2008
Authors
Marielle Karine Bouyou-Akotet
Denise Patricia Mawili-Mboumba
Eric Kendjo
Modeste Mabika-Mamfoumbi
Edgard Brice Ngoungou
Arnaud Dzeing-Ella
Mireille Pemba-Mihindou
Euloge Ibinga
Emmanuel Efame-Eya
Tim Planche
Peter G Kremsner
Maryvonne Kombila
MCRU team
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2009
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-8-300

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