Longitudinal study of urban malaria in a cohort of Ugandan children: description of study site, census and recruitment

Jennifer C Davis, Tamara D Clark, Sarah K Kemble, Nalugwa Talemwa, Denise Njama-Meya, Sarah G Staedke, Grant Dorsey, Jennifer C Davis, Tamara D Clark, Sarah K Kemble, Nalugwa Talemwa, Denise Njama-Meya, Sarah G Staedke, Grant Dorsey

Abstract

Background: Studies of malaria in well-defined cohorts offer important data about the epidemiology of this complex disease, but few have been done in urban African populations. To generate a sampling frame for a longitudinal study of malaria incidence and treatment in Kampala, Uganda, a census, mapping and survey project was conducted.

Methods: All households in a geographically defined area were enumerated and mapped. Probability sampling was used to recruit a representative sample of children and collect baseline descriptive data for future longitudinal studies.

Results: 16,172 residents living in 4931 households in a densely-populated community (18,824 persons/km2) were enumerated. A total of 582 households were approached with at least one child less than 10 years of age in order to recruit 601 children living in 322 households. At enrollment, 19% were parasitaemic, 24% were anaemic, 43% used bednets, and 6% used insecticide-treated nets. Low G6PD activity (OR = 0.33, P = 0.009) and bednet use (OR = 0.64, P = 0.045) were associated with a decreased risk of parasitaemia. Increasing age (OR = 0.62 for each year, P < 0.001) and bednet use (OR = 0.58, P = 0.02) were associated with a decreased risk of anaemia

Conclusion: Detailed surveys of target populations in urban Africa can provide valuable descriptive data and provide a sampling frame for recruitment of representative cohorts for longitudinal studies. Plans to use a multi-disciplinary approach to improve the understanding of the distribution and determinants of malaria incidence and response to therapy in this population are discussed.

Figures

Figure 1
Figure 1
Schematic of census, household recruitment, and enrolment of children into longitudinal study. Reasons that children were excluded before enrolment: 42 (5.6%) did not give informed consent, 28 (3.8%) moving out of Kampala, 27 (3.7%) weight

Figure 2

Map of the Mulago III…

Figure 2

Map of the Mulago III parish study area in Kampala, Uganda.

Figure 2
Map of the Mulago III parish study area in Kampala, Uganda.

Figure 3

Bednet and insecticide-treated net use…

Figure 3

Bednet and insecticide-treated net use by age category in the Mulago III parish…

Figure 3
Bednet and insecticide-treated net use by age category in the Mulago III parish census population. For all pairwise comparisons, P
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References
    1. Snow RW, Craig M, Deichmann U, Marsh K. Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population. Bulletin of the World Health Organization. 1999;77:624–635. - PMC - PubMed
    1. Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis. 2002;2:564–573. doi: 10.1016/S1473-3099(02)00372-9. - DOI - PubMed
    1. Trape JF, Pison G, Spiegel A, Enel C, Rogier C. Combating malaria in Africa. Trends Parasitol. 2002;18:224–230. doi: 10.1016/S1471-4922(02)02249-3. - DOI - PubMed
    1. Breman JG. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg. 2001;64:1–11. - PubMed
    1. Holding PA, Snow RW. Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence. Am J Trop Med Hyg. 2001;64:68–75. - PubMed
Show all 29 references
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Figure 2
Figure 2
Map of the Mulago III parish study area in Kampala, Uganda.
Figure 3
Figure 3
Bednet and insecticide-treated net use by age category in the Mulago III parish census population. For all pairwise comparisons, P

References

    1. Snow RW, Craig M, Deichmann U, Marsh K. Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population. Bulletin of the World Health Organization. 1999;77:624–635.
    1. Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis. 2002;2:564–573. doi: 10.1016/S1473-3099(02)00372-9.
    1. Trape JF, Pison G, Spiegel A, Enel C, Rogier C. Combating malaria in Africa. Trends Parasitol. 2002;18:224–230. doi: 10.1016/S1471-4922(02)02249-3.
    1. Breman JG. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg. 2001;64:1–11.
    1. Holding PA, Snow RW. Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence. Am J Trop Med Hyg. 2001;64:68–75.
    1. Trape JF, Rogier C, Konate L, Diagne N, Bouganali H, Canque B, Legros F, Badji A, Ndiaye G, Ndiaye P, et al. The Dielmo project: a longitudinal study of natural malaria infection and the mechanisms of protective immunity in a community living in a holoendemic area of Senegal. Am J Trop Med Hyg. 1994;51:123–137.
    1. Bloland PB, Ruebush TK, McCormick JB, Ayisi J, Boriga DA, Oloo AJ, Beach R, Hawley W, Lal A, Nahlen B, Udhayakumar V, Campbell CC. Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission I. Description of study site, general methodology, and study population. Am J Trop Med Hyg. 1999;60:635–640.
    1. Alonso PL, Sacarlal J, Aponte JJ, Leach A, Macete E, Milman J, Mandomando I, Spiessens B, Guinovart C, Espasa M, Bassat Q, Aide P, Ofori-Anyinam O, Navia MM, Corachan S, Ceuppens M, Dubois MC, Demoitie MA, Dubovsky F, Menendez C, Tornieporth N, Ballou WR, Thompson R, Cohen J. Efficacy of the RTS,S/AS02A vaccine against Plasmodium falciparum infection and disease in young African children: randomised controlled trial. Lancet. 2004;364:1411–1420. doi: 10.1016/S0140-6736(04)17223-1.
    1. D'Alessandro U, Olaleye BO, McGuire W, Langerock P, Bennett S, Aikins MK, Thomson MC, Cham MK, Cham BA, Greenwood BM. Mortality and morbidity from malaria in Gambian children after introduction of an impregnated bednet programme. Lancet. 1995;345:479–483. doi: 10.1016/S0140-6736(95)90582-0.
    1. Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003;68:23–29.
    1. Schellenberg D, Menendez C, Aponte JJ, Kahigwa E, Tanner M, Mshinda H, Alonso P. Intermittent preventive antimalarial treatment for Tanzanian infants: follow-up to age 2 years of a randomised, placebo-controlled trial. Lancet. 2005;365:1481–1483. doi: 10.1016/S0140-6736(05)66418-5.
    1. Division UNP. World Urbanization Prospects: The 2003 Revision. New York , United Nations; 2004.
    1. Tanner M, Harpham T. Action and research in urban health development - progress and prospects. London , Earthscan Publications Ltd.; 1995.
    1. Caldas de Castro M, Yamagata Y, Mtasiwa D, Tanner M, Utzinger J, Keiser J, Singer BH. Integrated urban malaria control: a case study in dar es salaam, Tanzania. Am J Trop Med Hyg. 2004;71:103–117.
    1. Staedke SG, Nottingham EW, Cox J, Kamya MR, Rosenthal PJ, Dorsey G. Short report: proximity to mosquito breeding sites as a risk factor for clinical malaria episodes in an urban cohort of Ugandan children. Am J Trop Med Hyg. 2003;69:244–246.
    1. Thompson R, Begtrup K, Cuamba N, Dgedge M, Mendis C, Gamage-Mendis A, Enosse SM, Barreto J, Sinden RE, Hogh B. The Matola malaria project: a temporal and spatial study of malaria transmission and disease in a suburban area of Maputo, Mozambique. Am J Trop Med Hyg. 1997;57:550–559.
    1. Trape JF, Lefebvre-Zante E, Legros F, Ndiaye G, Bouganali H, Druilhe P, Salem G. Vector density gradients and the epidemiology of urban malaria in Dakar, Senegal. Am J Trop Med Hyg. 1992;47:181–189.
    1. Carter R, Mendis KN, Roberts D. Spatial targeting of interventions against malaria. Bull World Health Organ. 2000;78:1401–1411.
    1. Donnelly MJ, McCall PJ, Lengeler C, Bates I, D'Alessandro U, Barnish G, Konradsen F, Klinkenberg E, Townson H, Trape JF, Hastings IM, Mutero C. Malaria and urbanization in sub-Saharan Africa. Malar J. 2005;4:12. doi: 10.1186/1475-2875-4-12.
    1. Keiser J, Utzinger J, Caldas de Castro M, Smith TA, Tanner M, Singer BH. Urbanization in sub-saharan Africa and implication for malaria control. Am J Trop Med Hyg. 2004;71:118–127.
    1. Dorsey G, Njama D, Kamya MR, Cattamanchi A, Kyabayinze D, Staedke SG, Gasasira A, Rosenthal PJ. Sulfadoxine/pyrimethamine alone or with amodiaquine or artesunate for treatment of uncomplicated malaria: a longitudinal randomised trial. Lancet. 2002;360:2031–2038. doi: 10.1016/S0140-6736(02)12021-6.
    1. Lindsey SW, Egwang T, Kabuye F, Mutambo T, Matwale GK. Community-based environmental management program for malaria control in Kampala and Jinja, Uganda final report. Washington D.C. , United States Agency for International Development; 2004.
    1. Molyneux CS, Mung'Ala-Odera V, Harpham T, Snow RW. Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya. Trop Med Int Health. 1999;4:836–845. doi: 10.1046/j.1365-3156.1999.00489.x.
    1. Robert V, Macintyre K, Keating J, Trape JF, Duchemin JB, Warren M, Beier JC. Malaria transmission in urban sub-Saharan Africa. Am J Trop Med Hyg. 2003;68:169–176.
    1. Holtz TH, Marum LH, Mkandala C, Chizani N, Roberts JM, Macheso A, Parise ME, Kachur SP. Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi. Trop Med Int Health. 2002;7:220–230. doi: 10.1046/j.1365-3156.2002.00846.x.
    1. Uganda Bureau of Statistics (UBOS) and ORC Macro . Uganda Demographic and Health Survey 2000-2001. Calverton , UBOS and ORC Macro; 2001.
    1. Crawley J. Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. Am J Trop Med Hyg. 2004;71:25–34.
    1. Hawley WA, ter Kuile FO, Steketee RS, Nahlen BL, Terlouw DJ, Gimnig JE, Shi YP, Vulule JM, Alaii JA, Hightower AW, Kolczak MS, Kariuki SK, Phillips-Howard PA. Implications of the western Kenya permethrin-treated bed net study for policy, program implementation, and future research. Am J Trop Med Hyg. 2003;68:168–173.
    1. Organization WH. World Malaria Report. Geneva , World Health Organization; 2005.

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