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Molecular identification and anti-malarial drug resistance profile of Plasmodium falciparum from patients attending Kisoro Hospital, southwestern Uganda

January 18, 2022 - 21:17 -- Open Access
Manirakiza G, Kassaza K, Taremwa IM, Bazira J, Byarugaba F
Malar J. 2022 Jan 15;21(1):21

The evolution of malaria infection has necessitated the development of highly sensitive diagnostic assays, as well as the use of dried blood spots (DBS) as a potential source of deoxyribonucleic acid (DNA) yield for polymerase chain reaction (PCR) assays. This study identified the different Plasmodium species in malaria-positive patients, and the anti-malarial drug resistance profile for Plasmodium falciparum using DBS samples collected from patients attending Kisoro Hospital in Kisoro district, Southwestern Uganda.

A Novel Malaria Lateral Flow Assay for Detecting Plasmodium falciparum Lactose Dehydrogenase in Busia, Uganda

January 18, 2022 - 20:58 -- Open Access
Bachman CM, Cate DM, Greenhouse B, et al.
Am J Trop Med Hyg. 2022 Jan 17:tpmd210956

Rapid diagnostic tests (RDTs) for Plasmodium falciparum commonly detect histidine-rich protein 2 (HRP-2), but HRP-2 deletions are increasingly recognized. We evaluated a prototype test detecting parasite lactate dehydrogenase (pLDH) and compared it to commercially available RDTs at a health facility in Uganda, using quantitative polymerase chain reaction as a gold standard.

A quasi-experimental study estimating the impact of long-lasting insecticidal nets with and without piperonyl butoxide on pregnancy outcomes

January 14, 2022 - 23:44 -- Open Access
Michelle E. Roh, Brenda Oundo, Grant Dorsey, Stephen Shiboski, Roly Gosling, M. Maria Glymour, Sarah G. Staedke, Adam Bennett, Hugh Sturrock and Arthur Mpimbaza
Malaria Journal 2022 21:5, 4 January 2022

Long-lasting insecticidal nets (LLINs) are the main vector control tool for pregnant women, but their efficacy may be compromised, in part, due to pyrethroid resistance. In 2017, the Ugandan Ministry of Health embedded a cluster randomized controlled trial into the national LLIN campaign, where a random subset of health subdistricts (HSDs) received LLINs treated with piperonyl butoxide (PBO), a chemical synergist known to partially restore pyrethroid sensitivity. Using data from a small, non-randomly selected subset of HSDs, this secondary analysis used quasi-experimental methods to quantify the overall impact of the LLIN campaign on pregnancy outcomes. In an exploratory analysis, differences between PBO and conventional (non-PBO) LLINs on pregnancy outcomes were assessed.

Efficacy and safety of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria and prevalence of molecular markers associated with artemisinin and partner drug resistance in Uganda

January 12, 2022 - 23:28 -- Open Access
Chris Ebong, Asadu Sserwanga, Adoke Yeka, et al.
Malaria Journal 2021 20:484, 24 December 2021

In Uganda, artemether-lumefantrine (AL) is first-line therapy and dihydroartemisinin-piperaquine (DP) second-line therapy for the treatment of uncomplicated malaria. This study evaluated the efficacy and safety of AL and DP in the management of uncomplicated falciparum malaria and measured the prevalence of molecular markers of resistance in three sentinel sites in Uganda from 2018 to 2019.

Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis

January 7, 2022 - 23:19 -- Open Access
Jane F Namuganga, Jessica Briggs, Joaniter I Nankabirwa, et al.
Malaria Journal 2021 20:475, 20 December 2021

In March 2020, the government of Uganda implemented a strict lockdown policy in response to the COVID-19 pandemic. Interrupted time series analysis (ITSA) was performed to assess whether major changes in outpatient attendance, malaria burden, and case management occurred after the onset of the COVID-19 epidemic in rural Uganda.

Determinants of malaria testing at health facilities: the case of Uganda

December 28, 2021 - 20:58 -- Open Access
Ruth N. Kigozi, JohnBaptist Bwanika, Sam Siduda Gudoi, et al.
Malaria Journal 2021 20:456, 4 December 2021

The World Health Organization (WHO) recommends prompt malaria diagnosis with either microscopy or malaria rapid diagnostic tests (RDTs) and treatment with an effective anti-malarial, as key interventions to control malaria. However, in sub-Saharan Africa, malaria diagnosis is still often influenced by clinical symptoms, with patients and care providers often interpreting all fevers as malaria. The Ministry of Health in Uganda defines suspected malaria cases as those with a fever. A target of conducting testing for at least 75% of those suspected to have malaria was established by the National Malaria Reduction Strategic Plan 2014–2020.

Not Open Access | Piperaquine induced QTc prolongation decreases with repeated monthly dihydroartemisinin-piperaquine dosing in pregnant Ugandan women

December 7, 2021 - 21:33 -- NOT Open Access
Hughes E, Wallender E, Savic RM, et al.
Clin Infect Dis. 2021 Dec 2:ciab965

Intermittent preventive treatment with monthly dihydroartemisinin-piperaquine (DHA-PQ) is highly effective at preventing both malaria during pregnancy and placental malaria. Piperaquine prolongs the corrected QT interval (QTc), and it is possible that repeated monthly dosing could lead to progressive QTc prolongation. Intensive characterization of the relationship between piperaquine concentration and QTc interval throughout pregnancy can inform effective and safe prevention guidelines.

Marked reduction in antibiotic usage following intensive malaria control in a cohort of Ugandan children

December 7, 2021 - 21:30 -- Open Access
Krezanoski PJ, Roh ME, Rek J, Nankabirwa JI, Arinaitwe E, Staedke SG, Nayiga S, Hsiang MS, Smith D, Kamya M, Dorsey G
BMC Med. 2021 Nov 30;19(1):294

Intensive malaria control may have additional benefits beyond reducing the incidence of symptomatic malaria. We compared antibiotic treatment of children before and after the implementation of highly effective malaria control interventions in Tororo, a historically high transmission area of Uganda.

Identifying an optimal dihydroartemisinin-piperaquine dosing regimen for malaria prevention in young Ugandan children

December 1, 2021 - 19:50 -- Open Access
Wallender E, Ali AM, Savic RM, et al.
Nat Commun. 2021 Nov 18;12(1):6714

Intermittent preventive treatment (IPT) with dihydroartemisinin-piperaquine (DP) is highly protective against malaria in children, but is not standard in malaria-endemic countries. Optimal DP dosing regimens will maximize efficacy and reduce toxicity and resistance selection. We analyze piperaquine (PPQ) concentrations (n = 4573), malaria incidence data (n = 326), and P. falciparum drug resistance markers from a trial of children randomized to IPT with DP every 12 weeks (n = 184) or every 4 weeks (n = 96) from 2 to 24 months of age (NCT02163447).

Plasmodium malariae infections as a cause of febrile disease in an area of high Plasmodium falciparum transmission intensity in Eastern Uganda

November 18, 2021 - 13:10 -- Open Access
Daniel Ayo, Bakar Odongo, Joseph Omara, Chiara Andolina, Ole Mulder, Sarah G. Staedke and Teun Bousema
Malaria Journal 2021 20:425, 29 October 2021

Plasmodium falciparum is responsible for the vast majority of (severe) clinical malaria cases in most African settings. Other Plasmodium species often go undiagnosed but may still have clinical consequences.


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