Accès ouvert

Targeting malaria in high-risk populations in low endemic regions in northern Namibia: a quasi-experimental controlled trial to reduce malaria in seasonal agricultural workers and cattle herders

Article scientifique 2025 Anglais

Résumé

BACKGROUND: Agricultural worksites are rarely targeted by malaria control programmes, yet may play a role in maintaining local transmission due to workers' high mobility, low intervention coverage and occupational exposures. METHODS: A quasi-experimental controlled intervention study was carried out in farming and cattle herding populations in northern Namibia to evaluate the impact of a targeted malaria intervention package. Eight health facility catchment areas in Zambezi and Ohangwena Regions were randomised to an intervention arm and eligible individuals within worksites in intervention areas received targeted drug administration with artemether-lumefantrine, mop-up indoor residual spraying and long-lasting insecticidal nets, combined with distribution of topical repellent in Zambezi Region. Impact on malaria outcomes and intervention coverage was evaluated over a single transmission season using pre-intervention and post-intervention cross-sectional surveys in a random subset of worksites and community incidence from passively detected cases. Entomological collections and residual efficacy assays on canvas and tarpaulin were conducted. RESULTS: Delivery of a single intervention round was associated with a reduction in the prevalence of malaria (OR 0.24, 95% CI 0.1 to 0.5; risk difference (RD) -6.0%, 95% CI -9.4 to -2.8). Coverage of at least one intervention increased (RD 51.6%, 95% CI 44.4 to 58.2) among the target population in intervention compared with control areas. This effect was largely driven by results in Zambezi Region, which also observed a decline in community incidence (-1.29 cases/1000 person-weeks, 95% CI -2.2 to -0.3). Residual efficacy of pirimiphos-methyl (Actellic) on tarpaulin and canvas was high at 24hours but declined to 44.6% at 4 months. CONCLUSION: transmission in Namibia. TRIAL REGISTRATION NUMBER: NCT04094727.

Citer ce document

Smith, J., Ntuku, H., Rerolle, F., Burke, A., Mwema, T., Turcios, K., Uusiku, P., Haikali, J., Lifasi, M., Smith-Gueye, C., Vajda, É., Jacobson, J., Greenhouse, B., Gosling, R., Bennett, A., Mumbengegwi, D. (2025). Targeting malaria in high-risk populations in low endemic regions in northern Namibia: a quasi-experimental controlled trial to reduce malaria in seasonal agricultural workers and cattle herders. https://doi.org/10.1136/bmjgh-2024-015565

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Voir l'article sur le site de la revue

Auteur(s)

Jennifer L. Smith Henry Ntuku François Rerolle Ashley Burke Tabeth Mwema Keirstinne Turcios Petrina Uusiku Justine Kulla Haikali Michael Lifasi Cara Smith-Gueye Élodie A. Vajda Jerry Owen Jacobson Bryan Greenhouse Roly Gosling Adam Bennett Davis Mumbengegwi

Statistiques

Consultations : 1

Téléchargements : 0