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The Immediate Effects of a Combined Mass Drug Administration and Indoor Residual Spraying Campaign to Accelerate Progress towards Malaria Elimination in Grande-Anse, Haiti

May 18, 2021 - 13:25 -- Open Access
Druetz T, Stresman G, Eisele TP, et al.
J Infect Dis. 2021 May 16:jiab259

Haiti is planning targeted interventions to accelerate progress towards malaria elimination. In the most affected Department (Grande-Anse), a combined mass drug administration (MDA) and indoor residual spraying (IRS) campaign was launched in October 2018. This study assessed the intervention effectiveness in reducing P. falciparum prevalence.

Detecting Malaria Hotspots in Haiti, a Low-Transmission Setting

April 22, 2021 - 08:17 -- Open Access
Dismer AM, Lemoine JF, Baptiste MJ, Mace KE, Impoinvil D, Vanden Eng J, Chang MA
Am J Trop Med Hyg. 2021 Apr 19:tpmd200465

In 2006, Haiti committed to malaria elimination when the transmission was thought to be low, but before robust national parasite prevalence estimates were available. In 2011, the first national population-based survey confirmed the national malaria parasite prevalence was < 1%. In both 2014 and 2015, Haiti reported approximately 17,000 malaria cases identified passively at health facilities. To detect malaria transmission hotspots for targeting interventions, the National Malaria Control Program (NMCP) piloted an enhanced geographic information surveillance system in three departments with relatively high-, medium-, and low-transmission areas.

Rapid Screening for Non-falciparum Malaria in Elimination Settings Using Multiplex Antigen and Antibody Detection: Post Hoc Identification of Plasmodium malariae in an Infant in Haiti

April 7, 2021 - 12:28 -- Open Access
van den Hoogen LL, Herman C, Ashton RA, et al.
Am J Trop Med Hyg. 2021 Apr 5:tpmd201450

Haiti is targeting malaria elimination by 2025. The Grand'Anse department in southwestern Haiti experiences one-third to half of all nationally reported Plasmodium falciparum cases. Although there are historical reports of Plasmodium vivax and Plasmodium malariae, today, non-falciparum infections would remain undetected because of extensive use of falciparum-specific histidine-rich protein 2 (HRP2) rapid diagnostic tests (RDT) at health facilities. A recent case-control study was conducted in Grand'Anse to identify risk factors for P. falciparum infection using HRP2-based RDTs (n = 1,107).

Genetic analysis reveals unique characteristics of Plasmodium falciparum parasite populations in Haiti

October 27, 2020 - 15:49 -- Open Access
Rachel F. Daniels, Stella Chenet, Sarah K. Volkman, et al.
Malaria Journal 2020 19:379, 23 October 2020

With increasing interest in eliminating malaria from the Caribbean region, Haiti is one of the two countries on the island of Hispaniola with continued malaria transmission. While the Haitian population remains at risk for malaria, there are a limited number of cases annually, making conventional epidemiological measures such as case incidence and prevalence of potentially limited value for fine-scale resolution of transmission patterns and trends. In this context, genetic signatures may be useful for the identification and characterization of the Plasmodium falciparum parasite population in order to identify foci of transmission, detect outbreaks, and track parasite movement to potentially inform malaria control and elimination strategies.

Genetic Markers of Adaptation of Plasmodium falciparum to Transmission by American Vectors Identified in the Genomes of Parasites from Haiti and South America

October 22, 2020 - 15:59 -- Open Access
Tagliamonte MS, Yowell CA, Elbadry MA, Boncy J, Raccurt CP, Okech BA, Goss EM, Salemi M, Dame JB
mSphere. 2020 Oct 21;5(5):e00937-20

The malaria parasite, Plasmodium falciparum, was introduced into Hispaniola and other regions of the Americas through the slave trade spanning the 16th through the 19th centuries. During this period, more than 12 million Africans were brought across the Atlantic to the Caribbean and other regions of the Americas. Since malaria is holoendemic in West Africa, a substantial percentage of these individuals carried the parasite.

Establishing a National Molecular Surveillance Program for the Detection of Plasmodium falciparum Markers of Resistance to Antimalarial Drugs in Haiti

October 1, 2020 - 15:38 -- Open Access
Hamre KES, Pierre B, Namuyinga R, Mace K, Rogier EW, Udhayakumar V, Boncy J, Lemoine JF, Chang MA
Am J Trop Med Hyg. 2020 Sep 28

Chloroquine remains the first-line treatment for uncomplicated malaria in Haiti, and until recently, sulfadoxine-pyrimethamine was the second-line treatment. A few studies have reported the presence of molecular markers for resistance in Plasmodium falciparum parasites, and in vivo therapeutic efficacy studies (TESs) have been limited. Recognizing the history of antimalarial resistance around the globe and the challenges of implementing TESs in low-endemic areas, the Ministry of Health established a surveillance program to detect molecular markers of antimalarial resistance in Haiti.

Programmatic options for monitoring malaria in elimination settings: easy access group surveys to investigate Plasmodium falciparum epidemiology in two regions with differing endemicity in Haiti

June 26, 2020 - 15:09 -- Open Access
Druetz T, Stresman G, Ashton RA, van den Hoogen LL, Joseph V, Fayette C, Monestime F, Hamre KE, Chang MA, Lemoine JF, Drakeley C, Eisele TP
BMC Med. 2020 Jun 23; 18(1):141

As in most eliminating countries, malaria transmission is highly focal in Haiti. More granular information, including identifying asymptomatic infections, is needed to inform programmatic efforts, monitor intervention effectiveness, and identify remaining foci. Easy access group (EAG) surveys can supplement routine surveillance with more granular information on malaria in a programmatically tractable way. This study assessed how and which type of venue for EAG surveys can improve understanding malaria epidemiology in two regions with different transmission profiles.

Risk Factors for Malaria Infection and Seropositivity in the Elimination Area of Grand'Anse, Haiti: A Case-Control Study among Febrile Individuals Seeking Treatment at Public Health Facilities

May 29, 2020 - 14:24 -- Open Access
Ashton RA, Joseph V, Eisele TP, et al.
Am J Trop Med Hyg. 2020 May 26.

The island of Hispaniola aims to eliminate malaria by 2025; however, there are limited data to describe epidemiologic risk factors for malaria in this setting. A prospective case–control study was conducted at four health facilities in southwest Haiti, aiming to describe factors influencing the risk of current and past malaria infection. Cases were defined as individuals attending facilities with current or recent fever and positive malaria rapid diagnostic test (RDT), whereas controls were those with current or recent fever and RDT negative.

Combination of Serological, Antigen Detection, and DNA Data for Plasmodium falciparum Provides Robust Geospatial Estimates for Malaria Transmission in Haiti

May 25, 2020 - 07:43 -- Open Access
Oviedo A, Knipes A, Rogier E, et al.
Sci Rep. 2020 May 21; 10(1):8443

Microscopy is the gold standard for malaria epidemiology, but laboratory and point-of-care (POC) tests detecting parasite antigen, DNA, and human antibodies against malaria have expanded this capacity. The island nation of Haiti is endemic for Plasmodium falciparum (Pf) malaria, though at a low national prevalence and heterogenous geospatial distribution. In 2015 and 2016, serosurveys were performed of children (ages 6–7 years) sampled in schools in Saut d’Eau commune (n = 1,230) and Grand Anse department (n = 1,664) of Haiti.

Conventional and High-Sensitivity Malaria Rapid Diagnostic Test Performance in 2 Transmission Settings: Haiti 2017

February 22, 2020 - 17:08 -- Open Access
Rogier E, Hamre KES, Joseph V, Plucinski MM, Presume J, Romilus I, Mondelus G, Elisme T, van den Hoogen L, Lemoine JF, Drakeley C, Ashton RA, Chang MA, Existe A, Boncy J, Stresman G, Druetz T, Eisele TP
The Journal of Infectious Diseases, Volume 221, Issue 5, 1 March 2020, Pages 786–795

Accurate malaria diagnosis is foundational for control and elimination, and Haiti relies on histidine-rich protein 2 (HRP2)–based rapid diagnostic tests (RDTs) identifying Plasmodium falciparum in clinical and community settings. In 2017, 1 household and 2 easy-access group surveys tested all participants (N = 32 506) by conventional and high-sensitivity RDTs. A subset of blood samples (n = 1154) was laboratory tested for HRP2 by bead-based immunoassay and for P. falciparum 18S rDNA by photo-induced electron transfer polymerase chain reaction.


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