Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults

The European Journal of Public Health · 10 authors, 11 centres

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TL;DR

The study also found that young adults had lower acceptability for mass drug administration compared to older participants.

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An open cohort of 1428 participants from 168 households across 8 villages in Mali and Senegal was followed with four surveys measuring P. falciparum infection prevalence by qPCR. Prevalence varied geographically, from 11% in Senegal to 60% in Northern Mali during the dry season. The analysis revealed that young adults aged 15 to 24 years had a 5.74 times higher odds of asymptomatic carriage in the dry season compared to children under five. A separate questionnaire assessed mass drug administration (MDA) acceptability, finding a mean score of 3.5 on a scale from -7 to 7, but young adults had a significantly lower acceptability score than older participants. The study identifies young adults as a key reservoir for malaria transmission and highlights their lower engagement with a potential control intervention like MDA.

STUDY TYPE

cohort

SPECIALTY

infectious disease

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AI pipeline

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ORIGINAL PAPER

PMC10596378

Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults

The European Journal of Public Health

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ABSTRACT

Abstract Background Mali and Senegal have made important efforts to control malaria. After a period of decline, the number of cases has remained stable for several years. Asymptomatic carriage acting as a reservoir could explain malaria persistence despite malaria control. Mass drug administration (MDA) is a candidate intervention that could help to accelerate the decreasing of malaria transmission if favourable epidemiologic context and good adherence are met. We aimed to update asymptomatic reservoir description along a Sahelian ecological gradient and study MDA acceptability. Methods We conducted an open cohort in 8 villages in Mali and Senegal including all household members sampled aged >6 months. We measured P. falciparum infections prevalence by qPCR in 4 surveys: 2 in dry season 2021, 1 in rainy season 2021 and 1 in dry season 2022. We measured prospective acceptability of MDA in cohort aged ≥15 years in Senegal by questionnaire. We explored risk factors associated to asymptomatic infections and acceptability score with multilevel logistic and linear models. Results We included 168 households and 1428 participants in at least 1 survey. In preliminary results, prevalence of P. falciparum infections was 11% in dry season 2021 in Senegal, 20% in central Mali and 60% in Northern Mali. Young adults between 15 to 24 years old were more likely to carry asymptomatic infections in dry season compared to children <5 years old (OR = 5.74 [2.99;11.04]). MDA presented a good acceptability with a mean score of 3.5 (score between -7 and 7). Young adults had lower acceptability compared to older participants (β=−1.07 [-1.82,-0.32]). Conclusions Young adults were important asymptomatic carriers in Senegal and Mali but were less likely to accept to participate in MDA. Key messages • Young adults represent a public health challenge that need to be address to reach malaria elimination. • Specific sensibilization could be implement to improve adherence to malaria control interventions.

CITATION EXPORT

E Legendre, A Ndiaye, N M Sougou et al.. Malaria asymptomatic carriage in the Sahelian region: the challenge associated to young adults. The European Journal of Public Health. (2023). https://doi.org/10.1093/eurpub/ckad160.555

AUTHORS

10 · 11 CENTRES

E Legendre, A Ndiaye, N M Sougou, C L’Ollivier, M Mehadji, J Gaudart, E H Ba, V Ridde, I Sagara, J Landier

1 SESSTIM, Aix-Marseille University, Marseille, France
2 ISED, Université Cheikh Anta Diop, Dakar, Senegal
3 ISED, Université Cheikh Anta Diop, Dakar, Senegal
4 URMITE, Aix-Marseille, Marseille, France
5 URMITE, Aix-Marseille, Marseille, France
6 SESSTIM, Aix-Marseille University, Marseille, France
7 IRD, Université Cheikh Anta Diop, Dakar, Senegal
8 CEPED, Paris Cité Université, Paris, France
9 ISED, Université Cheikh Anta Diop, Dakar, Senegal
10 MRTC, Université des Sciences des Techniques et des Technologies de Bamako, Bamako, Mali
11 SESSTIM, Aix-Marseille University, Marseille, France