Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Steketee R[original query] |
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Surveillance as a core intervention to strengthen malaria control programs in moderate to high transmission settings
Fountain A , Ye Y , Roca-Feltrer A , Rowe AK , Camara A , Fofana A , Candrinho B , Hamainza B , Ndiop M , Steketee R , Thwing J . Am J Trop Med Hyg 2022 108 8-13 New tools are needed for malaria control, and recent improvements in malaria surveillance have opened the possibility of transforming surveillance into a core intervention. Implementing this strategy can be challenging in moderate to high transmission settings. However, there is a wealth of practical experience among national malaria control programs and partners working to improve and use malaria surveillance data to guide programming. Granular and timely data are critical to understanding geographic heterogeneity, appropriately defining and targeting interventions packages, and enabling timely decision-making at the operational level. Resources to be targeted based on surveillance data include vector control, case management commodities, outbreak responses, quality improvement interventions, and human resources, including community health workers, as they contribute to a more refined granularity of the surveillance system. Effectively transforming malaria surveillance into a core intervention will require strong global and national leadership, empowerment of subnational and local leaders, collaboration among development partners, and global coordination. Ensuring that national health systems include community health work can contribute to a successful transformation. It will require a strong supply chain to ensure that all suspected cases can be diagnosed and data reporting tools including appropriate electronic devices to provide timely data. Regular data quality audits, decentralized implementation, supportive supervision, data-informed decision-making processes, and harnessing technology for data analysis and visualization are needed to improve the capacity for data-driven decision-making at all levels. Finally, resources must be available to respond programmatically to these decisions. |
End malaria faster: Taking lifesaving tools beyond "access" to "reach" all people in need
Emerson C , Meline J , Linn A , Wallace J , Kapella BK , Venkatesan M , Steketee R . Glob Health Sci Pract 2022 10 (2) To “reach the unreached” with preventive and curative malaria services, we must know which individuals and communities remain unreached and then bring tailored services from the clinic to the community and home. | To effectively address malaria control and elimination worldwide, we must endeavor to “reach the unreached,” to deliver malaria services from the clinic to the community and home. Reach moves beyond access and requires that we have the data to know who are unreached, where they are located, and how to ensure they receive malaria services. Reach can only be achieved with community health workers that are adequately supported and equipped to diagnose and treat malaria in every person in their communities regardless of age. Reach incorporates equity and responsibility for service delivery more expansively. | eng |
World Malaria Day 2021: Commemorating 15 Years of Contribution by the United States President's Malaria Initiative.
Steketee RW , Choi M , Linn A , Florey L , Murphy M , Panjabi R . Am J Trop Med Hyg 2021 104 (6) 1955-1959 World Malaria Day 2021 coincides with the 15th anniversary of the United States President's Malaria Initiative (PMI) and follows the first anniversary of the declaration of the coronavirus disease (COVID-19) pandemic. From 2006 to the present, the PMI has led to considerable country-managed progress in malaria prevention, care, and treatment in 24 of the highest-burden countries in sub-Saharan Africa and three countries in the Southeast Asia Greater Mekong subregion. Furthermore, it has contributed to a 29% reduction in malaria cases and a 60% reduction in the death rates in sub-Saharan Africa. In this context of progress, substantial heterogeneity persists within and between countries, such that malaria control programs can seek subnational elimination in some populations but others still experience substantial malaria disease and death. During the COVID-19 pandemic, most malaria programs have shown resilience in delivering prevention campaigns, but many experienced important disruptions in their care and treatment of malaria illness. Confronting the COVID-19 pandemic and building on the progress against malaria will require fortitude, including strengthening the quality and ensuring the safety and resiliency of the existing programs, extending services to those currently not reached, and supporting the people and partners closest to those in need. |
Genetic evidence for imported malaria and local transmission in Richard Toll, Senegal.
Daniels RF , Schaffner SF , Dieye Y , Dieng G , Hainsworth M , Fall FB , Diouf CN , Ndiop M , Cisse M , Gueye AB , Sarr O , Guinot P , Deme AB , Bei AK , Sy M , Thwing J , MacInnis B , Earle D , Guinovart C , Sene D , Hartl DL , Ndiaye D , Steketee RW , Wirth DF , Volkman SK . Malar J 2020 19 (1) 276 BACKGROUND: Malaria elimination efforts can be undermined by imported malaria infections. Imported infections are classified based on travel history. METHODS: A genetic strategy was applied to better understand the contribution of imported infections and to test for local transmission in the very low prevalence region of Richard Toll, Senegal. RESULTS: Genetic relatedness analysis, based upon molecular barcode genotyping data derived from diagnostic material, provided evidence for both imported infections and ongoing local transmission in Richard Toll. Evidence for imported malaria included finding that a large proportion of Richard Toll parasites were genetically related to parasites from Thiès, Senegal, a region of moderate transmission with extensive available genotyping data. Evidence for ongoing local transmission included finding parasites of identical genotype that persisted across multiple transmission seasons as well as enrichment of highly related infections within the households of non-travellers compared to travellers. CONCLUSIONS: These data indicate that, while a large number of infections may have been imported, there remains ongoing local malaria transmission in Richard Toll. These proof-of-concept findings underscore the value of genetic data to identify parasite relatedness and patterns of transmission to inform optimal intervention selection and placement. |
Association between immunoglobulin GM and KM genotypes and placental malaria in HIV-1 negative and positive women in western Kenya.
Iriemenam NC , Pandey JP , Williamson J , Blackstock AJ , Yesupriya A , Namboodiri AM , Rocca KM , van Eijk AM , Ayisi J , Oteino J , Lal RB , Ter Kuile FO , Steketee R , Nahlen B , Slutsker L , Shi YP . PLoS One 2013 8 (1) e53948 Immunoglobulin (Ig) GM and KM allotypes, genetic markers of gamma and kappa chains, are associated with humoral immune responsiveness. Previous studies have shown the relationships between GM6-carrying haplotypes and susceptibility to malaria infection in children and adults; however, the role of the genetic markers in placental malaria (PM) infection and PM with HIV co-infection during pregnancy has not been investigated. We examined the relationship between the gene polymorphisms of Ig GM6 and KM allotypes and the risk of PM infection in pregnant women with known HIV status. DNA samples from 728 pregnant women were genotyped for GM6 and KM alleles using polymerase chain reaction-restriction fragment length polymorphism method. Individual GM6 and KM genotypes and the combined GM6 and KM genotypes were assessed in relation to PM in HIV-1 negative and positive women, respectively. There was no significant effect of individual GM6 and KM genotypes on the risk of PM infection in HIV-1 negative and positive women. However, the combination of homozygosity for GM6(+) and KM3 was associated with decreased risk of PM (adjusted OR, 0.25; 95% CI, 0.08-0.8; P = 0.019) in HIV-1 negative women while in HIV-1 positive women the combination of GM6(+/-) with either KM1-3 or KM1 was associated with increased risk of PM infection (adjusted OR, 2.10; 95% CI, 1.18-3.73; P = 0.011). Hardy-Weinberg Equilibrium (HWE) tests further showed an overall significant positive F(is) (indication of deficit in heterozygotes) for GM6 while there was no deviation for KM genotype frequency from HWE in the same population. These findings suggest that the combination of homozygous GM6(+) and KM3 may protect against PM in HIV-1 negative women while the HIV-1 positive women with heterozygous GM6(+/-) combined with KM1-3 or KM1 may be more susceptible to PM infection. The deficit in heterozygotes for GM6 further suggests that GM6 could be under selection likely by malaria infection. |
New global estimates of malaria deaths
Lynch M , Korenromp E , Eisele T , Newby H , Steketee R , Kachur SP , Nahlen B , Yoon S , MacArthur J , Newman R , Cibulskis R . Lancet 2012 380 (9841) 559 Christopher Murray and colleagues' paper (Feb 4, p 413)1 estimating the number of malaria deaths worldwide, 1980–2010, invites caution in its interpretation. Murray and colleagues estimate that there were 1 238 000 malaria deaths worldwide in 2010, compared with WHO's estimate of 655 000.2 However, wide uncertainty ranges accompany both the Murray and colleagues and WHO estimates, and with one exception—for deaths in people older than 5 years in Africa—these ranges overlap, so the estimates cannot be regarded as significantly different (figure). |
Differential association of gene content polymorphisms of killer cell immunoglobulin-like receptors with placental malaria in HIV- and HIV+ mothers.
Omosun YO , Blackstock AJ , Gatei W , Hightower A , van Eijk AM , Ayisi J , Otieno J , Lal RB , Steketee R , Nahlen B , Ter Kuile FO , Slutsker L , Shi YP . PLoS One 2012 7 (6) e38617 Pregnant women have abundant natural killer (NK) cells in their placenta, and NK cell function is regulated by polymorphisms of killer cell immunoglobulin-like receptors (KIRs). Previous studies report different roles of NK cells in the immune responses to placental malaria (PM) and human immunodeficiency virus (HIV-1) infections. Given these references, the aim of this study was to determine the association between KIR gene content polymorphism and PM infection in pregnant women of known HIV-1 status. Sixteen genes in the KIR family were analyzed in 688 pregnant Kenyan women. Gene content polymorphisms were assessed in relation to PM in HIV-1 negative and HIV-1 positive women, respectively. Results showed that in HIV-1 negative women, the presence of the individual genes KIR2DL1 and KIR2DL3 increased the odds of having PM, and the KIR2DL2/KIR2DL2 homozygotes were associated with protection from PM. However, the reverse relationship was observed in HIV-1 positive women, where the presence of individual KIR2DL3 was associated with protection from PM, and KIR2DL2/KIR2DL2 homozygotes increased the odds for susceptibility to PM. Further analysis of the HIV-1 positive women stratified by CD4 counts showed that this reverse association between KIR genes and PM remained only in the individuals with high CD4 cell counts but not in those with low CD4 cell counts. Collectively, these results suggest that inhibitory KIR2DL2 and KIR2DL3, which are alleles of the same locus, play a role in the inverse effects on PM and PM/HIV co-infection and the effect of KIR genes on PM in HIV positive women is dependent on high CD4 cell counts. In addition, analysis of linkage disequilibrium (LD) of the PM relevant KIR genes showed strong LD in women without PM regardless of their HIV status while LD was broken in those with PM, indicating possible selection pressure by malaria infection on the KIR genes. |
Targeting of intermittent preventive treatment for malaria
Steketee RW , Slutsker L . Lancet Infect Dis 2012 12 (3) 168-9 Common sense dictates that African children surviving hospital admittance for severe malaria and anaemia likely remain at high risk of malaria reinfection and should be followed up closely in the months after discharge. In The Lancet Infectious Diseases, Kamija Phiri and colleagues1 report a randomised placebo-controlled trial showing that, for such children admitted to hospital and requiring blood transfusion, initial (during hospital stay) and then repeated treatment with artemether–lumefantrine at 1 month and 2 months after discharge provides substantial short-term benefit by lowering the likelihood of death, hospital admittance, and recurrence of severe anaemia compared with placebo (protective efficacy in 1–6 months after discharge was 31%, 95% CI 5–50; p=0·02). | For malaria control, this approach represents a potential new intermittent preventive treatment (IPT) strategy and builds on the use of such strategies in areas of high malaria transmission during pregnancy,2 infancy,3 and in children living in areas of highly seasonal malaria transmission.4 Because malaria treatment programmes include IPT, examination of its basis and the context in which it has value is important, especially because of the substantial reduction in malaria transmission in some African countries. |
Protective efficacy of malaria case management and intermittent preventive treatment for preventing malaria mortality in children: a systematic review for the Lives Saved Tool
Thwing J , Eisele TP , Steketee RW . BMC Public Health 2011 11 Suppl 3 S14 BACKGROUND: The Lives Saved Tool (LiST) model was developed to estimate the impact of the scale-up of child survival interventions on child mortality. New advances in antimalarials have improved their efficacy of treating uncomplicated and severe malaria. Artemisinin-based combination therapies (ACTs) for uncomplicated Plasmodium falciparum malaria and parenteral or rectal artemisinin or quinine for severe malaria syndromes have been shown to be very effective for the treatment of malaria in children. These interventions are now being considered for inclusion in the LiST model. However, for obvious ethical reasons, their protective efficacy (PE) compared to placebo is unknown and their impact on reducing malaria-attributable mortality has not been quantified. METHODS: We performed systematic literature reviews of published studies in P. falciparum endemic settings to determine the protective efficacy (PE) of ACT treatment against malaria deaths among children with uncomplicated malaria, as well as the PE of effective case management including parenteral quinine against malaria deaths among all hospitalized children. As no randomized placebo-controlled trials of malaria treatment have been conducted, we used multiple data sources to ascertain estimates of PE, including a previously performed Delphi estimate for treatment of uncomplicated malaria. RESULTS: Based on multiple data sources, we estimate the PE of ACT treatment of uncomplicated P. falciparum malaria on reducing malaria mortality in children 1-23 months to be 99% (range: 94-100%), and in children 24-59 months to be 97% (range: 86-99%). We estimate the PE of treatment of severe P. falciparum malaria with effective case management including intravenous quinine on reducing malaria mortality in children 1-59 months to be 82% (range: 63-94%) compared to no treatment. CONCLUSIONS: This systematic review quantifies the PE of ACT used for treating uncomplicated malaria and effective case management including parenteral quinine for treating severe P. falciparum malaria for preventing malaria mortality in children <5. These data will be used in the Lives Saved Tool (LiST) model for estimating the impact of scaling-up these interventions against malaria. However, in order to estimate the reduction in child mortality due to scale-up of these interventions, it is imperative to develop standardized indicators to measure population coverage of these interventions. |
Associations between peripheral Plasmodium falciparum malaria parasitemia, human immunodeficiency virus, and concurrent helminthic infection among pregnant women in Malawi
Thigpen MC , Filler SJ , Kazembe PN , Parise ME , Macheso A , Campbell CH , Newman RD , Steketee RW , Hamel M . Am J Trop Med Hyg 2011 84 (3) 379-85 Approximately 2 billion persons worldwide are infected with schistosomiasis and soil-transmitted helminthes (STH), many in areas where endemic malaria transmission coexists. Few data exist on associations between these infections. Nested within a larger clinical trial, primigravid and secundigravid women provided blood samples for human immunodeficiency virus (HIV) testing and peripheral malaria films and stool and urine for evaluation of STH and Schistosoma spp. during their initial antenatal clinic visit. The most common parasitic infections were malaria (37.6%), S. haematobium (32.3%), and hookworm (14.4%); 14.2% of women were HIV-infected. S. haematobium infection was associated with lower malarial parasite densities (344 versus 557 parasites/muL blood; P < 0.05). In multivariate analysis, HIV and hookworm infection were independently associated with malaria infection (adjusted odds ratio = 1.9 and 95% confidence interval = 1.2-3.0 for HIV; adjusted odds ratio = 1.9 and 95% confidence interval = 1.03-3.5 for hookworm). Concurrent helminthic infection had both positive and negative effects on malaria parasitemia among pregnant women in Malawi. |
Caution is required when using health facility-based data to evaluate the health impact of malaria control efforts in Africa
Rowe AK , Kachur SP , Yoon SS , Lynch M , Slutsker L , Steketee RW . Malar J 2009 8 209 The global health community is interested in the health impact of the billions of dollars invested to fight malaria in Africa. A recent publication used trends in malaria cases and deaths based on health facility records to evaluate the impact of malaria control efforts in Rwanda and Ethiopia. Although the authors demonstrate the use of facility-based data to estimate the impact of malaria control efforts, they also illustrate several pitfalls of such analyses that should be avoided, minimized, or actively acknowledged. A critique of this analysis is presented because many country programmes and donors are interested in evaluating programmatic impact with facility-based data. Key concerns related to: 1) clarifying the objective of the analysis; 2) data validity; 3) data representativeness; 4) the exploration of trends in factors that could influence malaria rates and thus confound the relationship between intervention scale-up and the observed changes in malaria outcomes; 5) the analytic approaches, including small numbers of patient outcomes, selective reporting of results, and choice of statistical and modeling methods; and 6) internal inconsistency on the strength and interpretation of the data. In conclusion, evaluations of malaria burden reduction using facility-based data could be very helpful, but those data should be collected, analysed, and interpreted with care, transparency, and a full recognition of their limitations. |
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