Reactive case detection of Plasmodium falciparum in western Kenya highlands: effective in identifying additional cases, yet limited effect on transmission

  title={Reactive case detection of Plasmodium falciparum in western Kenya highlands: effective in identifying additional cases, yet limited effect on transmission},
  author={Ebenezer K. Aidoo and Y. Afrane and Maxwell G. Machani and Winnie Chebore and B. Lawson and H. Atieli and S. Kariuki and Ming-chieh Lee and C. Koepfli and Guofa Zhou and A. Githeko and G. Yan},
  journal={Malaria Journal},
BackgroundIdentifying asymptomatic reservoirs of malaria parasites using index cases as entry points into the community is potentially a cost-effective way towards achieving malaria elimination.MethodsWithin 1 year, 1430 confirmed malaria cases were identified in Marani hospital, western Kenya. Fifty cases were followed up, and 108 index case household members and 612 neighbours within a 100 m radius were screened. As controls, samples were collected from 510 individuals matched with index… Expand
9 Citations
Malaria infection prevalence and sensitivity of reactive case detection in zanzibar.
  • L. Stuck, B. Fakih, +11 authors J. Yukich
  • Medicine
  • International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
  • 2020
Malaria prevalence in index households in Zanzibar is much higher than in non-index households, in which prevalence is very low, and low sensitivity of RDTs due to a high prevalence of low-density infections results in an RCD system missing a large proportion of the parasite reservoir. Expand
Genetic Evidence of Focal Plasmodium falciparum Transmission in a Pre-elimination Setting in Southern Province, Zambia
The utility of parasite genetic data in assessing programmatic interventions is highlighted, and similar approaches may be useful to malaria elimination programs seeking to tailor intervention strategies to the underlying transmission epidemiology. Expand
Quantifying Plasmodium falciparum infections clustering within households to inform household-based intervention strategies for malaria control programs: An observational study and meta-analysis from 41 malaria-endemic countries
In areas where malaria transmission is peri-domestic, there are programmatic options for identifying households where residual infections are likely to be found and combining these detection strategies with presumptively treating residents of index households over a sustained time period could contribute to malaria elimination efforts. Expand
Understanding adherence to reactive treatment of asymptomatic malaria infections in The Gambia.
A cluster-randomized trial to evaluate the effect of reactive treatment in The Gambia, all residents in the compound of a diagnosed clinical malaria patient received dihydro-artemisinin-piperaquine and adherence was assessed. Expand
Complexities in Defining the Unit of Intervention for Reactive Community-Based Malaria Treatment in the Gambia
This study demonstrates the appropriateness of using transdisciplinary research for investigating alternative intervention units that are better tailored to reactive treatment approaches for malaria elimination in The Gambia. Expand
Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review
Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process. Expand
Effectiveness of the innovative 1,7-malaria reactive community-based testing and response (1, 7-mRCTR) approach on malaria burden reduction in Southeastern Tanzania
The 1,7-mRCTR approach significantly reduced the malaria burden in the areas of high transmission in rural southern Tanzania and could accelerate malaria control and elimination efforts. Expand
Adding proactive and reactive case detection into the integrated community case management system to optimise diagnosis and treatment of malaria in a high transmission setting of Cameroon: an observational quality improvement study
Most symptomatic cases of malaria remain undetected in the community despite the introduction of CCM of malaria, and iCCM+ can be adopted to diagnose and treat more of these undiagnosed cases especially when targeted to schools, older children and larger households. Expand
A Malaria Transmission Model Predicts Holoendemic, Hyperendemic, and Hypoendemic Transmission Patterns Under Varied Seasonal Vector Dynamics
The model shows that coupling the effect of varying larval habitat availability with the effects of clinical and parasite-suppressing immunity is enough to produce known patterns of malaria transmission. Expand


A method of active case detection to target reservoirs of asymptomatic malaria and gametocyte carriers in a rural area in Southern Province, Zambia
This pilot project showed that active case detection is feasible and can identify reservoirs of asymptomatic infection and a larger sample size, data over multiple low transmission seasons, and in areas with different transmission dynamics are needed to further validate this approach. Expand
Reactive case-detection of malaria in Pailin Province, Western Cambodia: lessons from a year-long evaluation in a pre-elimination setting
RACD is not appropriate, where exposure to malaria occurs away from the community, and there is a high level of treatment-seeking from the private sector, the results suggest. Expand
Reactive Case Detection for Plasmodium vivax Malaria Elimination in Rural Amazonia
High P. vivax diversity was found in farming settlements in the Amazon Basin of Brazil, consistent with complex transmission networks and multiple sources of infection within clusters, potentially complicating malaria elimination efforts. Expand
Efficiency of Household Reactive Case Detection for Malaria in Rural Southern Zambia: Simulations Based on Cross-Sectional Surveys from Two Epidemiological Settings
Testing and treating individuals residing within a defined radius from an index case has the potential to be an effective strategy to identify and treat a large proportion of infected individuals who do not seek medical care, although the efficiency of this strategy is likely to decrease with declining parasite prevalence. Expand
Limitations of malaria reactive case detection in an area of low and unstable transmission on the Myanmar–Thailand border
The results of these simulations indicate that reactive case detection for clinical cases using RDTs has limited ability in halting transmission in regions of low and unstable transmission. Expand
Reactive Case Detection for Malaria Elimination: Real-Life Experience from an Ongoing Program in Swaziland
Future RACD in Swaziland could be made more effective by achieving high coverage amongst individuals located near to index cases and in areas where spraying has not been conducted, which would help to more precisely define the optimal screening radius. Expand
Surveillance of malaria vector population density and biting behaviour in western Kenya
This study suggests that mass distribution of ITNs has had a significant impact on vector densities, species distribution and sporozoite rate, however, shift of biting time poses significant threats to the current malaria vector control strategies which heavily rely on indoor controls. Expand
Changing Patterns of Malaria Epidemiology between 2002 and 2010 in Western Kenya: The Fall and Rise of Malaria
The resurgence in parasite prevalence and malaria vectors has been observed in two out of three sentinel sites in western Kenya despite a high ownership of ITNs, and the likely factors contributing to malaria resurgence include reduced efficacy of ITN, insecticide resistance in mosquitoes and lack of proper use ofITNs. Expand
Spatial clustering of patent and sub-patent malaria infections in northern Namibia: Implications for surveillance and response strategies for elimination
Results suggest that infections missed by RDTs during RACD would allow 50–71% of infections to mosquitoes to occur in this setting, and more sensitive field diagnostics or forms of focal presumptive treatment should be tested as strategies to reduce malaria transmission. Expand
Indoor and outdoor malaria vector surveillance in western Kenya: implications for better understanding of residual transmission
While the majority of malaria transmission occurred indoor, the magnitude of outdoor transmission was considerably high, and additional control tools that complement the existing interventions are required to control residual transmission. Expand