Getting to zero: micro-foci of malaria in the Solomon Islands requires stratified control

Malaria Journal

Tanya L. Russell¹  Thomas R. Burkot¹  Chris Drakeley²  Lynn Grignard²  Nathan Kama³  Alan Apairamo³  Albino Bobogare³ 

[1] Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia;Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK;National Vector Borne Disease Control Programme, Ministry of Health and Medical Services, Honiara, Solomon Islands;

关键词: Plasmodium falciparum;    Plasmodium vivax;    Solomon Islands;    Malaria elimination;    Heterogeneous transmission;   

DOI  :  10.1186/s12936-021-03779-y

来源: Springer

【 摘 要 】

BackgroundThe Solomon Islands has made significant progress in the control of malaria through vector control, access and use of improved diagnostics and therapeutic drugs. As transmission is reduced there is a need to understand variations in transmission risk at the provincial and village levels to stratify control methods.MethodsA cross-sectional survey of malaria in humans was conducted in the Solomon Islands during April 2018. Nineteen villages across 4 provinces were included. The presence of Plasmodium species parasites in blood samples was detected using PCR.ResultsBlood samples were analysed from 1,914 participants. The prevalence of DNA of Plasmodium falciparum was 1.2 % (n = 23) and for Plasmodium vivax was 1.5 % (n = 28). 22 % (n = 5/23) of P. falciparum DNA positive participants were febrile and 17 % of P. vivax DNA positive participants (n = 5/28). The prevalence of both P. falciparum and P. vivax was extremely spatially heterogeneous. For P. falciparum, in particular, only 2 small foci of transmission were identified among 19 villages. Plasmodium falciparum infections were uniformly distributed across age groups. Insecticide-treated bed net use the night prior to the survey was reported by 63 % of participants and significantly differed by province.ConclusionsMalaria transmission across the Solomon Islands has become increasingly fragmented, affecting fewer villages and provinces. The majority of infections were afebrile suggesting the need for strong active case detection with radical cure with primaquine for P. vivax. Village-level stratification of targeted interventions based on passive and active case detection data could support the progress towards a more cost-effective and successful elimination programme.

【 授权许可】

CC BY