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Parasitological Surveys on Malaria in Rural Balombo (Angola) in 2007-2008: Base Line Data for a Malaria Vector Control Project

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Parasitological Surveys on Malaria in Rural Balombo (Angola) in 2007-2008: Base Line Data for a Malaria Vector Control Project International Journal of TROPICAL DISEASE & Health 31(3): 1-12, 2018; Article no.IJTDH.41783 ISSN: 2278–1005, NLM ID: 101632866 Parasitological Surveys on Malaria in Rural Balombo (Angola) in 2007-2008: Base Line Data for a Malaria Vector Control Project Carnevale Pierre1, Dos Santos Maria2, Alcides Moniz Soyto2, Besnard Patrick3, Foumane Vincent4, Fortes Filomeno5, Trari Bouchra6* and Manguin Sylvie7 1Recherches CE II, Immeuble Le Majoral, Portiragnes, France. 2Malaria Control Programme, Sonamet Caixa Postal n° 479, Lobito, Angola. 3Subsea7 Medical Department, Suresnes, France. 4Organisation de Coordination Pour la Lutte Contre Les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon. 5Chief National Malaria Control Programme of Angola, Luanda, Angola. 6Unité de Recherche, Institut Supérieur des Professions Infirmières et Techniques de Santé, Rabat, Maroc / Unité de Recherche pour la Gestion des Zones Humides, Département de Zoologie et Écologie animale, Institut Scientifique, Mohammed V University in Rabat, Morocco. 7Hydro Sciences Montpellier (HSM), Institut de Recherche pour le Développement (IRD), CNRS, Université Montpellier, Montpellier, France. Authors’ contributions This work was carried out in collaboration between all authors. Author CP designed the study, performed the statistical analysis, wrote the protocol and wrote the first draft of the manuscript. Authors DSM, AMS, BP, FV and FF managed the analyses of the study. Author TB finalized the manuscript. Author MS checked data and finalized the text. All authors read and approved the final manuscript. Article Information DOI: 10.9734/IJTDH/2018/41783 Editor(s): (1) Dr. Francis Hombhanje, Centre for Health Research and Diagnostics, Divine Word University, Papua New Guinea. (2) Dr. Kamlesh Kumar Yadav, GBIT Ltd., Jalna, India. (3) Dr. Jorge Paredes Vieyra, Universidad Autonoma De Baja California, Campus Tijuana, Mexico. (4) Dr. William Ebomoyi, Professor, Department of Health Studies, College of Health Sciences, Chicago State University, USA. Reviewers: (1) Arthur V. M. Kwena, Moi University, Kenya. (2) Bamgboye M. Afolabi, National Authority for Remote Sensing and Space Sciences, Egypt. (3) Taratisio Ndwiga, Moi University, Kenya. Complete Peer review History: http://www.sciencedomain.org/review-history/25390 Received 12th April 2018 Accepted 25th June 2018 Original Research Article rd Published 3 July 2018 _____________________________________________________________________________________________________ *Corresponding author: E-mail: [email protected]; Pierre et al.; IJTDH, 31(3): 1-12, 2018; Article no.IJTDH.41783 ABSTRACT Study Design: Balombo area (Angola) f from each other to avoid the possibility of active flights of the mosquitoes and “contamination” of treated or control villages. Methodology: Classical Cross Sectional Surveys (CSS) were symptomless children <15 years. During data analysis this sample was stratified into the 3 conventional age groups: <5 years (often considered as “at risk group"); 2-9 years (often used for classical endemicity index) and <15 years already used in other vector control studies. The 3 classical parasitological indicators: plasmodial prevalence, parasite load, gametocyte prevalence were compared between these 3 age-groups to select the most relevant for further analysis and evaluation of the efficacy of vector control implemented. Blood thick films prepared in the field were colored and microscopically examined at the Malaria Control Program's laboratory of the medical department of the Angolan oil company Sonamet (Lobito). Results: 4625 thick drops were made during the 38 regularly carried out field surveys. Plasmodium falciparum was the predominant species with few mixed P. falciparum + P. malariae infection and a single P. malariae one. The overall Plasmodic index was 42.7%, gametocyte index was 4.4% and high parasite load (> 10.000 par./ml) were noticed in children, even very young, without clinical symptoms. Classical seasonal variations of plasmodic index and some variations according to age group were observed. Gametocytic indices showed relatively stable levels with age group. Conclusion: Statistical analysis showed that “under 15 years” age group could be a relevant indicator to evaluate the efficacy of a vector control programme and it increases the sample size allowing to perceive even small variations induced by vector control. Variability of parasitological index according to age groups, villages, season, confirmed the importance of regularly surveys to know precisely the situation before the implementation of control operations for reliable further evaluation. Missing such base line data induced the failure of a former vector control project in Angola. Keywords: Malaria; Plasmodium; parasite density; plasmodic index; gametocytic index; prevalence. 1. INTRODUCTION treated bed nets, insecticide residual spraying , etc. In Angola, malaria is present all over the country but, for meteorological, ecological, Evaluation of the efficacy of vector control entomological, economic and socio-cultural operations requires a precise knowledge of reasons, epidemic outbreaks occurred the epidemiological situation before their recently and required the implementation of implementation to avoid some of the emergency and long term control measures. problems recently encountered during the large scale inside residual spraying (IRS) The 2016 break out of malaria induced, conducted from December 2005 to March 2006 officially, 3,974,253 cases and 15,994 deaths in the southern area of the country at the reported by health services (while they were initiative and support of President Malaria estimated at 8,000 in 2015 and 5,500 in 2014). Initiative (PMI) [1]. Somandjinga and col [1] Since 2017, there is an outbreak in the stressed their "Vigorous objections to the lack of Huambo region, reaching the towns in the reliable data on mosquitoes and malaria" province of Benguela and emergency before implementation of vector control that measures (space spraying) have been staff from the US Centers for Disease implemented. The National Malaria Control Control (CDC) was supposed to collect in due Program (NMCP) has adopted the WHO time but it wasn’t. It is also interesting to note recommended strategy for the elimination of that the treated area had experienced a drought malaria by combining diagnosis (based on accentuated for 5 years and the author rightly rapid detection tests), case management considers that "Implementation of this large- (based on artemisinin-based therapies (ACTs), scale malaria control effort despite the lack of intermittent presumptive therapies (based on malaria transmission in southern Angola during sulfadoxin-pyrimethamin "SP") during pregnancy, 2005- 2006 was unique and unfortunate. One vector control based on long-lasting insecticide- fault of this project was the rush to spray”. 2 Pierre et al.; IJTDH, 31(3): 1-12, 2018; Article no.IJTDH.41783 The objective of the “Balombo Project” was to 2.2 Protocol of Surveys evaluate the effectiveness of 4 methods of Vector Control (VC): classical Long Lasting A preliminary malaria parasite prevalence Insecticide Treated Nets (LLIN) or Inside cluster sampling survey, conducted in Residual Spraying (IRS) versus the newly November 2006 (rainy season) in Balombo developed Insecticide Treated Plastic Sheeting and seven villages around the town, indicated (ITPS) used alone or simultaneously with LLIN or a general Plasmodium parasite index of 75% after 2 rounds of IRS to increase the long lasting (± 7%) (n = 181) (VF unpublished action. Reliable parasitological base line data are observations). Considering a Plasmodic Index of crucial needs to allow an accurate evaluation of # 50% in the area (with a 95% confidence of the impact of VC implemented. level and the usual margin error of 5%) the size of the sample to be studied could be estimated at 2. METHODOLOGY 384 to get significant data. 2.1 Presentation of the Study Area and Parasitological studies were field performed according to the classical method of cross- Villages sectional surveys (CSS) on randomized samples. For parasitological evaluation of VC the issue of Surveys were conducted in four villages near the choice of the most relevant “age group the town of Balombo (12 ° 21'S, 14 ° 46 'E), indicator” in the targeted epidemiological in the province of Benguela: Capango (12°23’ S; conditions has to be solved and therefore 14°50’ E), Canjala (12°21’ S; 14°44’ E), plasmodial infestations were analyzed in the 3 Candiero (12°22’ S; 14°45’ E) and Libata (12°20’ classical age groups: S; 14°45’ E). - Children <5 years of age (Under 5 of These villages are separated by several “U5”), considered as the “at risk group" kilometers preventing any “contamination” of [2], by WHO and therefore specially mosquitoes going from one to the other one targeted for example with the first large village as it is usually considered that the active scale distribution, and its evaluation, of flight of Anopheles is around one mile. impregnated mosquito nets [3]; - Children 2-9 years of age (“2- 9 y”), According to a census carried out at the formerly and largely used to evaluate the beginning of the surveys, the demographic traditional endemic index [4,5,6]; situations of the four villages were: Capango: 177 inhabitants (60 houses); Canjala: 873 - Children <15 years old (Under 15 or “U inhabitants (401 houses); Candiero: 654 15”), already used to evaluate the inhabitants, (190 houses); Libata: 1344 effectiveness of vector control operations
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