Association of house spraying with suppressed levels of drug resistance in Zimbabwe
Abstract Background Public health strategies are needed to curb antimalarial drug resistance. Theoretical argument points to an association between malaria transmission and drug resistance although field evidence remains limited. Field observations, made in Zimbabwe, on the relationship between tran...
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ftdoajarticles:oai:doaj.org/article:f237a6ba80ad48f29034a3580c851c0f 2023-05-15T15:15:29+02:00 Association of house spraying with suppressed levels of drug resistance in Zimbabwe Chandiwana Steven K Chimbadzwa Tawanda Mudyiradima Robert Mutambu Susan L Mharakurwa Sungano Day Karen P 2004-10-01T00:00:00Z https://doi.org/10.1186/1475-2875-3-35 https://doaj.org/article/f237a6ba80ad48f29034a3580c851c0f EN eng BMC http://www.malariajournal.com/content/3/1/35 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-3-35 1475-2875 https://doaj.org/article/f237a6ba80ad48f29034a3580c851c0f Malaria Journal, Vol 3, Iss 1, p 35 (2004) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2004 ftdoajarticles https://doi.org/10.1186/1475-2875-3-35 2022-12-31T01:39:57Z Abstract Background Public health strategies are needed to curb antimalarial drug resistance. Theoretical argument points to an association between malaria transmission and drug resistance although field evidence remains limited. Field observations, made in Zimbabwe, on the relationship between transmission and multigenic drug resistance, typified by chloroquine, are reported here. Methods Periodic assessments of the therapeutic response of uncomplicated falciparum malaria to chloroquine in two selectively sprayed or unsprayed health centre catchments, from 1995 – 2003. Cross-sectional analysis of in vivo chloroquine failure events for five sites in relation to natural endemicity and spraying history. Results During selective house spraying, the chloroquine failure rate for the sprayed catchment decreased, such that, after four years, the odds of chloroquine failure were 4× lower than before start of spraying in the area (OR 0.2, 95% CI 0.07 – 0.75, p = 0.010, n = 100). Chloroquine failure odds for the sprayed area became 4× lower than contemporaneous failure odds for the unsprayed area (OR 0.2 95% CI 0.08 – 0.65, p = 0.003, n = 156), although the likelihood of failure was not significantly different for the two catchments before selective spraying started (OR 0.5, 95% CI 0.21 – 1.32; p = 0.170, n = 88). When spraying ended, in 1999, the drug failure odds for the former sprayed area increased back 4 fold by 2003 (OR 4.2, 95%CI 1.49 – 11.78, p = 0.004, n = 146). High altitude areas with naturally lower transmission exhibited a 6× lower likelihood of drug failure than low-lying areas (OR 0.16 95% CI 0.068 – 0.353, -2 log likelihood change 23.239, p < 0.001, n = 465). Compared to sites under ongoing annual spraying, areas that were last sprayed 3–7 years ago experienced a 4-fold higher probability of chloroquine failure (OR 4.1, 95%CI 1.84 – 9.14, -2 log likelihood change 13.956, p < 0.001). Conclusion Reduced transmission is associated with suppressed levels of resistance to chloroquine and presumably other ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 3 1 35 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Chandiwana Steven K Chimbadzwa Tawanda Mudyiradima Robert Mutambu Susan L Mharakurwa Sungano Day Karen P Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Public health strategies are needed to curb antimalarial drug resistance. Theoretical argument points to an association between malaria transmission and drug resistance although field evidence remains limited. Field observations, made in Zimbabwe, on the relationship between transmission and multigenic drug resistance, typified by chloroquine, are reported here. Methods Periodic assessments of the therapeutic response of uncomplicated falciparum malaria to chloroquine in two selectively sprayed or unsprayed health centre catchments, from 1995 – 2003. Cross-sectional analysis of in vivo chloroquine failure events for five sites in relation to natural endemicity and spraying history. Results During selective house spraying, the chloroquine failure rate for the sprayed catchment decreased, such that, after four years, the odds of chloroquine failure were 4× lower than before start of spraying in the area (OR 0.2, 95% CI 0.07 – 0.75, p = 0.010, n = 100). Chloroquine failure odds for the sprayed area became 4× lower than contemporaneous failure odds for the unsprayed area (OR 0.2 95% CI 0.08 – 0.65, p = 0.003, n = 156), although the likelihood of failure was not significantly different for the two catchments before selective spraying started (OR 0.5, 95% CI 0.21 – 1.32; p = 0.170, n = 88). When spraying ended, in 1999, the drug failure odds for the former sprayed area increased back 4 fold by 2003 (OR 4.2, 95%CI 1.49 – 11.78, p = 0.004, n = 146). High altitude areas with naturally lower transmission exhibited a 6× lower likelihood of drug failure than low-lying areas (OR 0.16 95% CI 0.068 – 0.353, -2 log likelihood change 23.239, p < 0.001, n = 465). Compared to sites under ongoing annual spraying, areas that were last sprayed 3–7 years ago experienced a 4-fold higher probability of chloroquine failure (OR 4.1, 95%CI 1.84 – 9.14, -2 log likelihood change 13.956, p < 0.001). Conclusion Reduced transmission is associated with suppressed levels of resistance to chloroquine and presumably other ... |
format |
Article in Journal/Newspaper |
author |
Chandiwana Steven K Chimbadzwa Tawanda Mudyiradima Robert Mutambu Susan L Mharakurwa Sungano Day Karen P |
author_facet |
Chandiwana Steven K Chimbadzwa Tawanda Mudyiradima Robert Mutambu Susan L Mharakurwa Sungano Day Karen P |
author_sort |
Chandiwana Steven K |
title |
Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
title_short |
Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
title_full |
Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
title_fullStr |
Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
title_full_unstemmed |
Association of house spraying with suppressed levels of drug resistance in Zimbabwe |
title_sort |
association of house spraying with suppressed levels of drug resistance in zimbabwe |
publisher |
BMC |
publishDate |
2004 |
url |
https://doi.org/10.1186/1475-2875-3-35 https://doaj.org/article/f237a6ba80ad48f29034a3580c851c0f |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 3, Iss 1, p 35 (2004) |
op_relation |
http://www.malariajournal.com/content/3/1/35 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-3-35 1475-2875 https://doaj.org/article/f237a6ba80ad48f29034a3580c851c0f |
op_doi |
https://doi.org/10.1186/1475-2875-3-35 |
container_title |
Malaria Journal |
container_volume |
3 |
container_issue |
1 |
container_start_page |
35 |
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1766345851670626304 |