Category Archives: Master’s programme

Treatment of malaria in Arba Minch

Treatment of malaria:

Daka D, Woldeyes D, Golassa L, Alemayehu GS, Zewde Z, Tamiru G, et al. Therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Arba Minch Zuria District, Gamo Zone, Southwest Ethiopia. Malar J. 2024;23(1):282. DOI: 10.1186/s12936-024-05087-7

Abstract

Background: Artemether-lumefantrine (AL) has been the primary anti-malarial drug used to treat uncomplicated Plasmodium falciparum malaria in Ethiopia since 2004. However, there have been recent reports of AL resistance mutations in different African countries, including Ethiopia. This is concerning and requires periodic monitoring of anti-malarial drug resistance. Therefore, the current study aimed to evaluate the therapeutic efficacy of AL in treating uncomplicated P. falciparum malaria in the Arba Minch Zuria District, Gamo Zone, Southwest Ethiopia.

Methods: A single-arm prospective study with a 28-day follow-up period was conducted from July to October 2022. Capillary blood samples were collected for RDT and microscopic examination. The study enrolled monoinfected P. falciparum patients aged ≥ 18 years at Ganta Sira Health Post. Sociodemographic and clinical data were recorded, and a dried blood spot (DBS) was prepared for each participant. Nested polymerase chain reaction (nPCR) genotyping of the msp-1 and msp-2 genes was only performed for recurrent cases to distinguish between recurrence and reinfection. Data entry and analysis were performed using the WHO Excel spreadsheet and SPSS version 26.

Results: A total of 89 patients were enrolled, and 67 adequately completed the 28-day follow-up period. AL showed a 100% clearance rate for fever on day 2 and asexual parasites on day 3. Gametocytes were detected in 13.5% (12/89) of the participants. The gametocyte clearance rate was 58.3% (7/12) until day 7 and 100% (12/12) until day 14. Five participants developed recurrent malaria, three of whom experienced relapse and two of whom experienced reinfection. Based on the Kaplan-Meier survival analysis, the PCR-uncorrected and PCR-corrected cumulative incidence of success were 93.7% (95% CI 85.5-97.3) and 96.2% (95% CI 85.5-98.7), respectively.

Conclusion: AL was efficacious in treating uncomplicated P. falciparum malaria in the study area. However, the detection of recurrent patients highlights the need for continuous efficacy studies in this area.

Keywords: Cure rate; Malaria; Parasite clearance; Recurrence.

Anopheles stephensi is in Arba Minch: A new malaria vector

Malaria is currently spreading fast in Ethiopian towns. The cause is probably a new mosquito.

Massebo F, Ashine T, Negash N, Eligo N, Hailemeskel E, Minda TT, et al. The expansion of an invasive malaria vector: Anopheles stephensi emergence in Arba Minch town in the southern Rift Valley of Ethiopia. Parasitology research. 2024;123(9):333.

DOI: 10.1007/s00436-024-08356-1

Abstract

Urban areas in malaria-endemic countries in East Africa are experiencing a significant increase in malaria cases, with the establishment of an “exotic” urban malaria vector, Anopheles stephensi, increasing the risk of urban malaria. To this end, the present study aimed to investigate the emergence of this species in Arba Minch, Ethiopia. Following the detection of An. stephensi in other parts of Ethiopia, 76 artificial containers (55 discarded tyres, 18 concrete water storage, and three plastic containers) were sampled in 21 locations in Arba Minch town, for immature Anopheles mosquito stages, using the standard dipping technique. Larvae were reared into adults which were morphologically identified at the species level 2-3 days after emergence. Morphological identification results were confirmed by species-specific polymerase chain reaction. Of the examined containers, 67 (88%) had at least one Anopheles larva. Thirty-two of the adults emerged were morphologically identified as An. stephensi, with 26 (81%) confirmed by molecular analysis. This is the first study to report An. stephensi from Arba Minch, one of South Ethiopia’s largest towns, highlighting the need for increased vigilance. The planned and ongoing study in and around Arba Minch will contribute to understanding the bionomics and role of An. stephensi in malaria parasite transmission, helping develop a strategy to address the impending risk of urban malaria in Ethiopia.

Keywords: Anopheles stephensi; Arba Minch; Entomological surveillance.

 

Arba Minch University: Our collaboration with the Ministry of Health

One of our project aims is to strengthen Ethiopia’s health system. Here is an example of how this is done in malaria control.

Our collaboration with the Ministry of Health began by establishing the Master’s Programme in Medical Entomology and Vector Control in 2014. The first cohort included three health professionals from different districts. One joined the Ethiopian Public Health Institute, while the other two returned to their respective districts to strengthen the health system, particularly in controlling malaria and other vector-borne diseases.

The second cohort was diverse, with 11 members, seven of whom belonged to the public health sector. Three worked at the Ethiopian Public Health Institute, two at the Armauer Hansen Research Institute, one at the regional malaria elimination programme, and the other at the district-level vector control programme.

The third, fourth, fifth, sixth, seventh, and eighth cohorts consisted of 4-5 individuals each, with members from different institutes and organisations working to control and prevent malaria and other vector-borne diseases.

In the third cohort, two of the four members joined the Armauer Hansen Research Institute. The fourth cohort was the largest, with 13 candidates, nine working in the health system at various levels. These candidates are associated with organisations such as the MOH National Malaria Elimination Program, the Ethiopian Public Health Institute, Zone, district malaria, and other vector-borne disease control units.

The fifth cohort had five individuals, with one person from the health sector. After completing their studies, they returned to the district office to work.

The sixth cohort also had five members, including one from the Regional Public Health Laboratory Institute. This institute’s primary objective is to monitor the quality of diagnoses made by other regional institutes. The project work of this cohort was in line with the institute’s aim to evaluate the quality of malaria diagnostics.

The seventh cohort also had five individuals, one from the Regional Public Health Laboratory Institute. Like the sixth cohort member, they also did a project on the challenges of malaria diagnosis.

The eighth cohort had four individuals, two of whom were from the National Institute of Tsetse Control Programme. This institute plays a crucial role in improving animal health in the country. One member of the first cohort and another from the fourth cohort also work at this institute.

Finally, the ninth cohort had four individuals, one from the health sector.

The Norhed-Senuph project provided uninterrupted support to these nine cohorts, producing a skilled workforce that now holds crucial positions in national, regional, zone, and district disease control and prevention programs. These graduates are making remarkable contributions to the nation’s health sector, particularly in controlling malaria and other vector-borne diseases.

Scientific conference for Master’s and PhD students

From November 8 to 10,  we had a scientific conference for masters and PhD students at Hawassa University. Participants were students from the universities in both Hawassa and Arba Minch. Altogether, 28 students presented their research.

The rationale for such an annual event is to have a high-quality conference where students get scientific feedback on their presentations.

The abstracts are found here.

Master’s programme

In 2014, Arba Minch University established the first Master’s programme in Medical Entomology and Vector Control in Ethiopia.

Some recent publications written by these master’s students are:

Yigezu E, Wondale B, Abebe D, Tamiru G, Eligo N, Lindtjørn B, Gadisa E, Tadesse FG, Massebo F. Malaria misdiagnosis in the routine health system in Arba Minch area district in southwest Ethiopia: an implication for malaria control and elimination. Malar J. 2023 Sep 14;22(1):273. doi: 10.1186/s12936-023-04711-2.

Ayele S, Wegayehu T, Eligo N, Tamiru G, Lindtjørn B, Massebo F. Maize pollen diet enhances malaria mosquito longevity and infectivity to Plasmodium parasites in Ethiopia. Sci Rep. 2023 Sep 2;13(1):14490. doi: 10.1038/s41598-023-41826-7.

Ayele T, Wondale B, Tamiru G, Eligo N, Lindtjørn B, Massebo F. Infectivity of symptomatic Plasmodium vivax cases to different generations of wild-caught and laboratory-adapted Anopheles arabiensis using a membrane feeding assay, Ethiopia. Curr Res Parasitol Vector Borne Dis. 2023;4:100137. doi: 10.1016/j.crpvbd.2023.100137.