Background
Methods
Case studies
Setting
Procedures
Laboratory tests
Analysis
Ethical approval
Systematic review
Results
Case study: Chennai
Chennai | Nadiad | |||
---|---|---|---|---|
Index cases N = 18 | RCD N = 868 | Index cases N = 20 | RCD N = 131 | |
Time period | Jan 14–Dec 14 | Jan 14–Jan 15 | Feb 14–Aug 14 | Mar 14–Sep 14 |
Mean age, 95 % CI, years | 32.3, 25.5–39.0 | 31.5, 30.5–32.6 | 27.3, 19.4–35.2 | 37.9, 35.0–40.8a
|
Age <18 years (%) | 3 (16.7) | 171 (19.7) | 7 (35.0) | 16 (12.2)a
|
Female (%) | 5 (27.8) | 526 (60.6)a
| 6 (30.0) | 78 (59.5)a
|
Recruited in rainy season (%) | 10 (55.6) | 472 (54.4) | 9 (45.0) | 60 (45.8) |
Among persons ≥18 years | N = 15 | N = 697 | N = 13 | N = 115 |
Primary school highest level (%) | 8 (53.3) | 230 (33.0) | 6 (46.2) | 46 (40.0) |
Salaried employment (%) | 9 (60.0) | 187 (26.1)a
| 4 (30.8) | 12 (10.4) |
History and symptoms | N = 18 | N = 868 | N = 20 | N = 131 |
Documented fever (%) | 7 (38.9) | 20 (2.3)a
| 11 (55.0) | 7 (5.3)a
|
History of fever in last 48 h (%) | 18 (100) | 121 (13.9)a
| 9 (45.0) | 27 (20.6)a
|
History of or documented fever (%) | 18 (100) | 126 (14.5)a
| 16 (80.0) | 29 (22.1)a
|
History of malaria in last year (%) | 5 (27.8) | 48 (5.5)a
| 2 (10.0) | 3 (2.3) |
Anti-malarials used in last year (%) | 5/5 (100.0) | 31/47 (63.8) | 0/2 (0.0) | 0/3 (0.0) |
Use of netsb (%) | 1 (5.6) | 21 (2.4) | 1 (5.0) | 16 (12.2) |
Use of mosquito repellent (mat/vapour/coil) | 4 (22.2) | 279 (32.1) | 5 (25.0) | 56 (42.8) |
History of travel in last 14 days (%) | 2 (11.1) | 114 (13.1) | 1 (5.0) | 8 (6.1) |
Anaemia (%)c
| 5 (27.8) | 316/866 (36.5) | 14 (70.0) | 87 (66.4) |
Mean haemoglobin, 95 % CI, g/dl | 12.9, 11.7–14.1 | 12.6, 12.4–12.7 | 11.0, 9.8–12.1 | 11.4, 11.1–11.7 |
Laboratory result | N = 18 | N = 868 | N = 20 | N = 131 |
Microscopy: any species (%) | 18 (100) | 4 (0.5) | 20 (100) | 0 |
P. falciparum
| 3 (16.7) | 1 (0.1) | 1 (5.0) | 0 |
P. vivax
| 15 (83.3) | 3 (0.4) | 19 (95.0) | 0 |
Gametocytes P. falciparum (%) | 1 (5.6) | 0 | 1 (5.0) | 0 |
Gametocytes P. vivax (%) | 15 (83.3) | 3 (0.4) | 19 (95.0) | 0 |
Parasites densities 95 % CI, per μl | ||||
P. falciparum
| 843, 34–19,253 (n = 3) | 800 (n = 1) | 3160 (n = 1) | – |
P. vivax
| 1850, 934–3664 (n = 15) | 1754, 517–5950 (n = 3) | 3816, 2280–6388 (n = 19) | – |
Gametocytes P. falciparum
| 40 (n = 1) | – | 520 (n = 1) | – |
Gametocytes P. vivax
| 860, 498–1484 (n = 15) | 395, 160–972 (n = 3) | 1496, 832–2692 (n = 19) | – |
PCR: any species (%) | 17/17 (100.0) | 4 (0.5) | 17 (85.0) | 0/131 (0.0) |
P. falciparum
| 3 (16.7) | 1 (0.1) | 1 (5.0) | 0 |
P. vivax
| 14 (77.8) | 3 (0.4) | 16 (80.0) | 0 |
Case study: Nadiad
Systematic review
Study | Stresman 2010 | Pinchoff 2015 | Littrell 2013 | Sturrock 2013 | Rogawski 2013 | Chennai 2014 | Nadiad 2014 |
---|---|---|---|---|---|---|---|
Country, region | Zambia, Choma and Namwala district | Zambia, Chongwe district | Senegal, Richard Toll District | Swaziland (national data) | Thailand, Bo Rai district | India, Chennai, Tamil Nadu | India, Nadiad, Gujarat |
Time period | Jun–Aug 2009 Dry season | Jun 12–Jun 13 All seasons | High transmission season 2012 | Dec 09–Jun 12 All seasons | July 2011 | Jan 14–Jan 15. All seasons | Mar 14–Sep 14. All seasons |
Malaria transmission | Seasonal transmission, Pf6–59m 7.9 % Central province (MIS 2008) | Seasonal transmission, Pf6–59m 0.0 % Lusaka Province (MIS 2012) | Seasonal transmission, Pf6–59m 0.7 % North Region (DHS 2012–2013) | Seasonal transmission, all age groups: 0.07 % (MIS 2010) | Low and seasonal | Low and seasonal | Low and seasonal |
Main species |
P. falciparum
|
P. falciparum
|
P. falciparum
|
P. falciparum
|
P. vivax + P. falciparum
|
P. vivax + P. falciparum
|
P. vivax + P. falciparum
|
Cases | 4 Rural clinics | 1 Clinic | 13 Clinics | Health facilities in Swaziland | 1 Hospital | 1 Urban clinic | 1 Urban clinic |
Trigger and malaria test | Case (RDT) in clinic | Case (RDT and microscopy) in clinic | Case in clinic (test not reported) | Locally acquired cases or imported cases if local ecology is able to support transmission (test not reported) | 1 case in hospital (tests not reported) | Case in clinic (microscopy) | |
Spatial extent | Homestead of index case. Fever was not a criterion | All household members. Fever was not a criterion | Index case compound and 5 neighbouring compounds. Fever was not a criterion | Index case household and neighbouring households within 1-km radius | Neighbours within 1 km of index case, fever was not a criterion | All household members of the index case, persons with a history of fever and a sample of persons without fever in proximal (same apartment block) and distal households (within 0.2 km) | |
Time line response per protocol | Within 2 weeks | Not reported | Within 3 days of case | Not reported | Not reported | Household within 1–7 days, proximal and distal: within 14 days | |
Time line response in reality | No information | No information | No information | 48.6 % screened within 1 week, 87.3 % screened within 14 days. Range 0–90 days | After 2 weeks | Household members: 91.6 % screened within one week. Others: 64.8 % within 2 weeks. Range: 0–32 days | Household members: 84.4 % screened within one week. Others: 93.9 % within 2 weeks. Range: 2–28 days |
No of Index cases | 23 | 426 | 110 | 247 | 1 (Pf and Pv) | 18 (3 Pf, 15 Pv) | 20 (1 Pf, 19 Pv) |
<5 years (%) | Not reported | 185 (43.4 %) | 1 (0.9) | Not reported (mean 25.9 years) | Not reported | 0 (0 %) | 1 (5.0 %) |
Male (%) | Not reported | 228 (53.5 %) | 90 (81.8 %) | 151 (61.1) | Not reported | 13 (72.2 %) | 14 (70.0 %) |
No of contacts screened | 186 | 1621 | 5520 | 3671 | 126 | 868 | 131 |
<5 years (%) | 46 (24.7 %)a
| Not reported | 1021 (18.5 %) | 163 (4.4 %) | Not reported | 44 (5.1 %) | 2 (1.5 %) |
Male (%) | 86 (46.2 %) | Not reported | 2782 (50.4 %) | 2168 (59.1 %) | Not reported | 342 (39.4 %) | 53 (40.5 %) |
Average contacts/case | 8 (range 3–19) | 4 (range 0–13) | 50 (range not reported) | 15 (range 1–157) | 126 | 48 (range 13–74) | 7 (range 2–13) |
Positive among contacts | RDT: 5/185 (2.7 %). PCR: 7/186 (3.4 %) | RDT: 735/1621 (45.3 %) | RDT: 23/5520 (0.4 %) | RDT: 74/3671 (2.0 %) | Microscopy: 1/126 (0.8 %, Pf). PCR: 2/126 (1.6 %, 1 Pf, 1 Pv) | Microscopy and PCR: 4/868 (0.5 %, 3 Pv, 1Pf) | Microscopy and PCR: 0/131 (0.0 %) |
Average number of index cases needed to be traced to find one new caseb
| 5 | 1 | 5 | 3 | Not applicable | 5 | >20 |
Average number of contacts needed to be screened to find a new casec
| 37 | 2 | 240 | 50 | 126 (microscopy in duplicate) 63 (PCR) | 216 | >140 |