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CSU 153/2011: AGAINST EUPHORIA

Monday, 25th of April 2011

Those who believe that Africa is within shooting distance of malaria elimination may wish to reconsider their position after reading this article.

One should qualify this Ugandan article in several ways:

1)      Local insurgency in the area under consideration

2)      Hiccoughs with the GF over misappropriation of resources

3)      Autocratic gerontocracy at the national level

Unfortunately, these three factors are not peculiar to Uganda.

Good reading.

BD

Abstract from the American Journal of Tropical Medicine and Hygiene.  Full text available to subscribers

Continuing Intense Malaria Transmission in Northern Uganda

Carla Proietti, Davide D. Pettinato, Bernard N. Kanoi, Edward Ntege, Andrea Crisanti, Eleanor M. Riley, Thomas G. Egwang, Chris Drakeley*, AND Teun Bousema

Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Microtest Matrices, Imperial College London, London, United Kingdom; Med Biotech Laboratories, Kampala, Uganda; Department of Experimental Medicine and Biochemical Science, University of Perugia, Perugia, Italy

Abstract.: Recent reports of reductions in malaria transmission in several African countries have resulted in optimism that malaria can be eliminated in parts of Africa where it is currently endemic. It is not known whether these trends are global or whether they are also present in areas where political instability has hindered effective malaria control. We determined malaria parasite carriage and age-dependent antibody responses to Plasmodium falciparum antigens in cross-sectional surveys in Apac, northern Uganda that was affected by political unrest. Under-five parasite prevalence was 55.8% (115/206) by microscopy and 71.9% (41/57) by polymerase chain reaction. Plasmodium ovale alone, or as a co-infection, was detected in 8.6% (12/139) and Plasmodium malariae in 4.3% (6/139) of the infections. Age seroprevalence curves gave no indication of recent changes in malaria transmission intensity. Malaria control remains a tremendous challenge in areas that have not benefited from large-scale interventions, illustrated here by the district of Apac.

Received September 8, 2010. Accepted for publication December 15, 2010.

We are grateful to the Apac district's inhabitants for their participation to the study; we also thank Martin Ogwal of the Apac District Health Office for sharing details on malaria control programs in the study area.

Financial support: This study was supported by the FIGHTMAL project, receiving funding from the European Community's Seventh Framework Programme [FP7/2007-2013] under grant agreement PIAP-GA-2008-218164.

Authors' addresses: Carla Proietti, Eleanor M. Riley, Chris Drakeley, and Teun Bousema, London School of Hygiene and Tropical Medicine, Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London, UK, E-mails: carla.proietti@lshtm.ac.uk , eleanor.riley@lshtm.ac.uk , chris.drakeley@lshtm.ac.uk , and teun.bousema@lshtm.ac.uk . Davide D. Pettinato and Andrea Crisanti, Imperial College London, Division of Cell and Molecular Biology, London, UK, E-mails: davidepettinato@googlemail.com and crisanti@unipg.it . Bernard N. Kanoi, Edward Ntege, and Thomas G. Egwang, Medical Biotech Laboratories, Kampala, Uganda, E-mails: bnkanoi@gmail.com , edwardsdoc@yahoo.com , and director.mbl@gmail.com .

*Address correspondence to Chris Drakeley, Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK. E-mail: chris.drakeley@lshtm.ac.uk