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A cohort study to identify risk factors for Plasmodium falciparum infection in Burkinabe children: implications for other high burden high impact countries

Yaro, Jean Baptiste; Ouedraogo, Alphonse; Ouedraogo, Z. Amidou; Diarra, Amidou; Lankouande, Malik; Agboraw, Efundem; Worrall, Eve; Toe, Kobié Hyacinthe; Sanou, Antoine; Guelbeogo, W. Moussa; Sagnon, N’Fale; Ranson, Hilary; Tiono, Alfred B.; Lindsay, Steven W.; Wilson, Anne L.

A cohort study to identify risk factors for Plasmodium falciparum infection in Burkinabe children: implications for other high burden high impact countries Thumbnail


Authors

Jean Baptiste Yaro

Alphonse Ouedraogo

Z. Amidou Ouedraogo

Amidou Diarra

Malik Lankouande

Efundem Agboraw

Eve Worrall

Kobié Hyacinthe Toe

Antoine Sanou

W. Moussa Guelbeogo

N’Fale Sagnon

Hilary Ranson

Alfred B. Tiono

Anne L. Wilson



Abstract

Background: Progress in controlling malaria has stalled in recent years. Today the malaria burden is increasingly concentrated in a few countries, including Burkina Faso, where malaria is not declining. A cohort study was conducted to identify risk factors for malaria infection in children in southwest Burkina Faso, an area with high insecticide-treated net (ITN) coverage and insecticide-resistant vectors. Methods: Incidence of Plasmodium falciparum infection was measured in 252 children aged 5 to 15 years, using active and passive detection, during the 2017 transmission season, following clearance of infection. Demographic, socio-economic, environmental, and entomological risk factors, including use of ITNs and insecticide resistance were monitored. Results: During the six-month follow-up period, the overall incidence of P. falciparum infection was 2.78 episodes per child (95% CI = 2.66–2.91) by microscopy, and 3.11 (95% CI = 2.95–3.28) by polymerase chain reaction (PCR). The entomological inoculation rate (EIR) was 80.4 infective bites per child over the six-month malaria transmission season. At baseline, 80.6% of children were reported as sleeping under an ITN the previous night, although at the last survey, 23.3% of nets were in poor condition and considered no longer protective. No association was found between the rate of P. falciparum infection and either EIR (incidence rate ratio (IRR): 1.00, 95% CI: 1.00–1.00, p = 0.08) or mortality in WHO tube tests when vectors were exposed to 0.05% deltamethrin (IRR: 1.05, 95% CI: 0.73–1.50, p = 0.79). Travel history (IRR: 1.52, 95% CI: 1.45–1.59, p < 0.001) and higher socio-economic status were associated with an increased risk of P. falciparum infection (IRR: 1.05, 95% CI: 1.00–1.11, p = 0.04). Conclusions: Incidence of P. falciparum infection remains overwhelmingly high in the study area. The study findings suggest that because of the exceptionally high levels of malaria transmission in the study area, malaria elimination cannot be achieved solely by mass deployment of ITNs and additional control measures are needed.

Citation

Yaro, J. B., Ouedraogo, A., Ouedraogo, Z. A., Diarra, A., Lankouande, M., Agboraw, E., …Wilson, A. L. (2020). A cohort study to identify risk factors for Plasmodium falciparum infection in Burkinabe children: implications for other high burden high impact countries. Malaria Journal, 19(1), Article 371. https://doi.org/10.1186/s12936-020-03443-x

Journal Article Type Article
Acceptance Date Oct 7, 2020
Online Publication Date Oct 16, 2020
Publication Date 2020
Deposit Date Oct 28, 2020
Publicly Available Date Mar 29, 2024
Journal Malaria Journal
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Article Number 371
DOI https://doi.org/10.1186/s12936-020-03443-x

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This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.





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