Tropical Medicine and Infectious Disease

12 pages, 627 KiB

Open AccessCommentary

Vibrio cholerae Bacteremia: An Enigma in Cholera-Endemic African Countries

by Foster K. Agyei, Birgit Scharf and Samuel Duodu

Trop. Med. Infect. Dis. 2024, 9(5), 103; https://doi.org/10.3390/tropicalmed9050103 - 02 May 2024

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Cholera is highly endemic in many sub-Saharan African countries. The bacterium Vibrio cholerae is responsible for this severe dehydrating diarrheal disease that accounts for over 100,000 deaths each year globally. In recent years, the pathogen has been found to invade intestinal layers and [...] Read more.

Cholera is highly endemic in many sub-Saharan African countries. The bacterium Vibrio cholerae is responsible for this severe dehydrating diarrheal disease that accounts for over 100,000 deaths each year globally. In recent years, the pathogen has been found to invade intestinal layers and translocate into the bloodstream of humans. The non-toxigenic strains of V. cholerae (non-O1/O139), also known as NOVC, which do not cause epidemic or pandemic cases of cholera, are the major culprits of V. cholerae bacteremia. In non-cholera-endemic regions, clinical reports on NOVC infection have been noted over the past few decades, particularly in Europe and America. Although low–middle-income countries are most susceptible to cholera infections because of challenges with access to clean water and inappropriate sanitation issues, just a few cases of V. cholerae bloodstream infections have been reported. The lack of evidence-based research and surveillance of V. cholerae bacteremia in Africa may have significant clinical implications. This commentary summarizes the existing knowledge on the host risk factors, pathogenesis, and diagnostics of NOVC bacteremia. Full article

(This article belongs to the Special Issue Challenges and Solutions in Combating Major Infections in Mid-Income and Low-Income Countries: An Interdisciplinary Perspective)

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14 pages, 744 KiB

Open AccessArticle

Genetic Structure of Introduced Plasmodium vivax Malaria Isolates in Greece, 2015–2019

by Ioanna Spiliopoulou, Danai Pervanidou, Nikolaos Tegos, Maria Tseroni, Agoritsa Baka, Annita Vakali, Chrisovaladou-Niki Kefaloudi, Vasilios Papavasilopoulos, Anastasia Mpimpa and Eleni Patsoula

Trop. Med. Infect. Dis. 2024, 9(5), 102; https://doi.org/10.3390/tropicalmed9050102 - 02 May 2024

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Abstract

Greece has been malaria-free since 1974, after an intense malaria control program. However, as Greece hosts migrant populations from P. vivax malaria-endemic countries, there is a risk of introducing the disease to specific vulnerable and receptive areas of the country. Knowledge of the [...] Read more.

Greece has been malaria-free since 1974, after an intense malaria control program. However, as Greece hosts migrant populations from P. vivax malaria-endemic countries, there is a risk of introducing the disease to specific vulnerable and receptive areas of the country. Knowledge of the genetic diversity of P. vivax populations is essential for understanding the dynamics of malaria disease transmission in a given region. We used nine highly polymorphic markers to genotype 124 P. vivax-infected archived DNA samples from human blood specimens referred to the NMRL from all over Greece throughout 2015–2019. The genotypic variability of the samples studied was noted, as they comprised several unique haplotypes, indicative of the importation of a large number of different P. vivax strains in the country. However, only a few events of local transmission were recorded. Genotyping revealed and confirmed the same clusters as those identified through epidemiological investigation. In only one introduction event was the index case found. No sustained/ongoing malaria transmissions in/between the studied regions or during consecutive years or additional foci of local transmission were observed. Genotyping is an important component in assisting malaria surveillance, as it provides information concerning the patterns of introduction and the effectiveness of implemented malaria control and elimination measures. Full article

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12 pages, 1106 KiB

Open AccessArticle

Community-Based Intervention for Active Detection and Provision of Single-Dose Rifampicin Post-Exposure Prophylaxis to Household Contacts of Leprosy in Bolivia

by Abundio Baptista Mora, Nimer Ortuño-Gutiérrez, Deisy Zurita Paniagua, Carlos Hurtado Solares, Anil Fastenau and Christa Kasang

Trop. Med. Infect. Dis. 2024, 9(5), 101; https://doi.org/10.3390/tropicalmed9050101 - 01 May 2024

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Abstract

Background: To achieve zero leprosy cases in Santa Cruz, Bolivia, we designed a community-based active detection and provision of single-dose rifampicin post-exposure prophylaxis (SDR-PEP) to household contacts with new leprosy patients. Methods: From July to August 2021, we assessed the current knowledge, attitude, [...] Read more.

Background: To achieve zero leprosy cases in Santa Cruz, Bolivia, we designed a community-based active detection and provision of single-dose rifampicin post-exposure prophylaxis (SDR-PEP) to household contacts with new leprosy patients. Methods: From July to August 2021, we assessed the current knowledge, attitude, and practices through structured interviews and focus group discussions with community representatives and health staff. This was followed by sensitization sessions, the training of health staff, and the reinforcement of referral mechanisms. Teams, including health staff and community volunteers, visited all new leprosy patients detected in 2021–2023 and household contacts. Results: Among 115 community representatives, knowledge about leprosy etiology was attributed to non-biological factors (74%); fear accounted for 77%, and access to care was perceived as weak (74%), but the outlook was improved by SDR-PEP (80%). Among the 217 health staff interviewed, the programmatic barriers identified were a lack of referral feedback (67%), limited supplies for diagnosis and prevention, and ineffective training (64%). We visited 70 new patients and 258 household contacts. The median age in household contacts was 25 years old; 49% were women, 98% were eligible for SDR-PEP, and all who were eligible accepted it. Those who were non-eligible included one tuberculosis patient and six newly detected leprosy patients (23‰). Conclusions: A community-based intervention was successful in Santa Cruz, Bolivia. Misbeliefs and a lack of knowledge were identified as barriers. Programmatic components should be reinforced for SDR-PEP extension. Full article

(This article belongs to the Special Issue Community Engagement and Neglected Tropical Diseases (NTDs))

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10 pages, 1764 KiB

Open AccessArticle

Impact of the Stool-Based Xpert Test on Childhood Tuberculosis Diagnosis in Selected States in Nigeria

by Nkiru Nwokoye, Bethrand Odume, Peter Nwadike, Ikechukwu Anaedobe, Zirra Mangoro, Michael Umoren, Chidubem Ogbudebe, Ogoamaka Chukwuogo, Sani Useni, Debby Nongo, Rupert Eneogu, Emeka Elom, Petra De Haas and Mustapha Gidado

Trop. Med. Infect. Dis. 2024, 9(5), 100; https://doi.org/10.3390/tropicalmed9050100 - 01 May 2024

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Abstract

Background: In Nigeria, most children with tuberculosis (TB) present at primary health clinics where there are limited personnel skilled in collecting appropriate respiratory specimens from those who cannot produce sputum. KNCV Nigeria, in collaboration with the National Tuberculosis Control Program, implemented a modified [...] Read more.

Background: In Nigeria, most children with tuberculosis (TB) present at primary health clinics where there are limited personnel skilled in collecting appropriate respiratory specimens from those who cannot produce sputum. KNCV Nigeria, in collaboration with the National Tuberculosis Control Program, implemented a modified simple, one-step (SOS), stool-based Xpert MTB/RIF method for diagnosis of TB in children who cannot expectorate sputum. We evaluated the impact of its implementation on childhood TB diagnosis. Method: A cross-sectional study was conducted across 14 selected states using secondary data of children presumed to have TB. Stool was collected from children presumed to have TB and processed using Xpert. Result: Out of 52,117 presumptive TB cases, 52% were male and 59.7% were under 5 years old. A total of 2440 (5%) cases were diagnosed with TB, and 2307 (95%) were placed on treatment. Annual TB notifications increased significantly after the introduction of the stool-based Xpert test when compared to those in the pre-implementation period. Increasing contributions from stool testing were observed throughout the implementation period, except in 2020 during the COVID-19 era. Overall, stool Xpert testing improved childhood TB notification in the studied states. Interventions aimed at awareness creation, capacity building, and active case finding improved the performance of the test. Full article

(This article belongs to the Section Infectious Diseases)

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16 pages, 2754 KiB

Open AccessArticle

Effectiveness of Using AI-Driven Hotspot Mapping for Active Case Finding of Tuberculosis in Southwestern Nigeria

by Abiola Alege, Sumbul Hashmi, Rupert Eneogu, Vincent Meurrens, Anne-Laure Budts, Michael Pedro, Olugbenga Daniel, Omokhoudu Idogho, Austin Ihesie, Matthys Gerhardus Potgieter, Obioma Chijioke Akaniro, Omosalewa Oyelaran, Mensah Olalekan Charles and Aderonke Agbaje

Trop. Med. Infect. Dis. 2024, 9(5), 99; https://doi.org/10.3390/tropicalmed9050099 - 29 Apr 2024

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Abstract

Background: Nigeria is among the top five countries that have the highest gap between people reported as diagnosed and estimated to have developed tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high [...] Read more.

Background: Nigeria is among the top five countries that have the highest gap between people reported as diagnosed and estimated to have developed tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high risk of TB transmission and targeted active case finding (ACF) interventions. Leveraging community-level data together with granular sociodemographic contextual information can unmask local hotspots that could be otherwise missed. This work evaluated whether this approach helps to reach communities with higher numbers of undiagnosed TB. Methodology: A retrospective analysis of the data generated from an ACF intervention program in four southwestern states in Nigeria was conducted. Wards (the smallest administrative level in Nigeria) were further subdivided into smaller population clusters. ACF sites and their respective TB screening outputs were mapped to these population clusters. This data were then combined with open-source high-resolution contextual data to train a Bayesian inference model. The model predicted TB positivity rates on the community level (population cluster level), and these were visualised on a customised geoportal for use by the local teams to identify communities at high risk of TB transmission and plan ACF interventions. The TB positivity yield (proportion) observed at model-predicted hotspots was compared with the yield obtained at other sites identified based on aggregated notification data. Results: The yield in population clusters that were predicted to have high TB positivity rates by the model was at least 1.75 times higher (p-value < 0.001) than the yield in other locations in all four states. Conclusions: The community-level Bayesian predictive model has the potential to guide ACF implementers to high-TB-positivity areas for finding undiagnosed TB in the communities, thus improving the efficiency of interventions. Full article

(This article belongs to the Special Issue Tuberculosis: Novel Insights and Approaches to Tackle an Ancient Disease)

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13 pages, 1631 KiB

Open AccessArticle

Toxoplasma gondii in a Remote Subsistence Hunting-Based Indigenous Community of the Peruvian Amazon

by María Fernanda Menajovsky, Johan Espunyes, Gabriela Ulloa, Maritza Calderon, Andrea Diestra, Edith Malaga, Carmen Muñoz, Stephanie Montero, Andres G. Lescano, Meddly L. Santolalla, Oscar Cabezón and Pedro Mayor

Trop. Med. Infect. Dis. 2024, 9(5), 98; https://doi.org/10.3390/tropicalmed9050098 - 26 Apr 2024

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Abstract

Toxoplasma gondii is a ubiquitous zoonotic protozoan parasite that infects a wide variety range of warm-blooded animals. This study describes the epidemiological scenario of T. gondii in an indigenous community that relies on subsistence hunting in a well-conserved and isolated area of the [...] Read more.

Toxoplasma gondii is a ubiquitous zoonotic protozoan parasite that infects a wide variety range of warm-blooded animals. This study describes the epidemiological scenario of T. gondii in an indigenous community that relies on subsistence hunting in a well-conserved and isolated area of the Peruvian Amazon. The high seropositivity against T. gondii in humans (83.3% IgG and 6.1% IgM), wild mammals (30.45%, 17 species), peri-domestic rodents (10.0% Rattus sp.), and domestic animals (94.1% dogs and 100% cats) indicates the existence of a sylvatic cycle in the community under study. Individual age was found to be positively associated with IgG detection against T. gondii but not with IgM. It is estimated that each family consumed 5.67 infected animals per year with terrestrial species having higher infective rates than arboreal species. The main risk factors included improper handling and cooking of wild meat, poor hygiene practices, and feeding uncooked offal to domestic animals. This scenario results in a continuous process of infection and reinfection within the indigenous community with cats, dogs, and peri-domestic animals becoming infected through the ingestion of infected raw viscera. Our results emphasize the need to promote safe food handling practices and disposal of waste materials from hunted animals in such communities. Full article

(This article belongs to the Special Issue Community Engagement and Neglected Tropical Diseases (NTDs))

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13 pages, 2122 KiB

Open AccessArticle

SARS-CoV-2 Pandemic in a Small-Sized Municipality in Ceará State, Brazil: Temporal and Spatial Evolution

by Jaliana Holanda Nascimento dos Santos, Carlos Henrique Alencar and Jorg Heukelbach

Trop. Med. Infect. Dis. 2024, 9(5), 97; https://doi.org/10.3390/tropicalmed9050097 - 26 Apr 2024

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Abstract

Data on the temporal and spatial evolution of SARS-CoV-2 and local control measures and their effects on morbidity and mortality patterns in rural Brazil are scarce. We analyzed the data from case notification systems, epidemiological investigation reports, and municipal decrees in Itapajé, a [...] Read more.

Data on the temporal and spatial evolution of SARS-CoV-2 and local control measures and their effects on morbidity and mortality patterns in rural Brazil are scarce. We analyzed the data from case notification systems, epidemiological investigation reports, and municipal decrees in Itapajé, a small municipality in Ceará State in northeast Brazil. For spatial and spatio-temporal analyses, cases and deaths were mapped. There were a total of 3020 cases of COVID-19, recorded between April 2020 and December 2021; 135 (4.5%) died. The cumulative incidence and mortality rates were 5650.3 cases and 252.6 deaths per 100,000 people, respectively. The index case of SARS-CoV-2 in Itapajé was diagnosed in March 2020. The first peak of cases and deaths occurred in May 2020. The second wave peaked in May 2021, with the highest number of deaths in March 2021. According to the spatial analysis, the highest density of cases and deaths occurred in the central urban areas. In these areas, there were also the clusters of highest risk according to the spatio-temporal analyses. The municipal government issued 69 decrees on restriction measures, surveillance, and the maintenance of social isolation as a response to the pandemic. The spread of the SARS-CoV-2 pandemic in Itapajé mirrored the dynamics in large metropolitan regions, going from central neighborhoods of low socio-economic status to the wealthier peripheries. Full article

(This article belongs to the Special Issue COVID-19: Current Situation and Future Trends)

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15 pages, 287 KiB

Open AccessArticle

Prevalence and Determinants of Undernutrition in Schoolchildren in the Kilombero District, South-Eastern Tanzania

by Elihaika G. Minja, Emmanuel C. Mrimi, Winfrida P. Mponzi, Getrud J. Mollel, Christin Lang, Johanna Beckmann, Markus Gerber, Uwe Pühse, Kurt Z. Long, Honorati Masanja, Fredros O. Okumu, Marceline F. Finda and Jürg Utzinger

Trop. Med. Infect. Dis. 2024, 9(5), 96; https://doi.org/10.3390/tropicalmed9050096 - 25 Apr 2024

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Abstract

Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern [...] Read more.

Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6–12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9–12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted. Full article

14 pages, 6073 KiB

Open AccessArticle

Immunological Characteristics of Hepatic Dendritic Cells in Patients and Mouse Model with Liver Echinococcus multilocularis Infection

by Hui Wang, Yinshi Li, Qian Yu, Mingkun Wang, Abidan Ainiwaer, Na Tang, Xuran Zheng, Adilai Duolikun, Bingqing Deng, Jing Li, Yujuan Shen and Chuanshan Zhang

Trop. Med. Infect. Dis. 2024, 9(5), 95; https://doi.org/10.3390/tropicalmed9050095 - 25 Apr 2024

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Abstract

The cestode Echinococcus multilocularis, which mainly dwells in the liver, leads to a serious parasitic liver disease called alveolar echinococcosis (AE). Despite the increased attention drawn to the immunosuppressive microenvironment formed by hepatic AE tissue, the immunological characteristics of hepatic dendritic cells (DCs) [...] Read more.

The cestode Echinococcus multilocularis, which mainly dwells in the liver, leads to a serious parasitic liver disease called alveolar echinococcosis (AE). Despite the increased attention drawn to the immunosuppressive microenvironment formed by hepatic AE tissue, the immunological characteristics of hepatic dendritic cells (DCs) in the AE liver microenvironment have not been fully elucidated. Here, we profiled the immunophenotypic characteristics of hepatic DC subsets in both clinical AE patients and a mouse model. Single-cell RNA sequencing (scRNA-Seq) analysis of four AE patient specimens revealed that greater DC numbers were present within perilesional liver tissues and that the distributions of cDC and pDC subsets in the liver and periphery were different. cDCs highly expressed the costimulatory molecule CD86, the immune checkpoint molecule CD244, LAG3, CTLA4, and the checkpoint ligand CD48, while pDCs expressed these genes at low frequencies. Flow cytometric analysis of hepatic DC subsets in an E. multilocularis infection mouse model demonstrated that the number of cDCs significantly increased after parasite infection, and a tolerogenic phenotype characterized by a decrease in CD40 and CD80 expression levels was observed at an early stage, whereas an activated phenotype characterized by an increase in CD86 expression levels was observed at a late stage. Moreover, the expression profiles of major immune checkpoint molecules (CD244 and LAG3) and ligands (CD48) on hepatic DC subsets in a mouse model exhibited the same pattern as those in AE patients. Notably, the cDC and pDC subsets in the E. multilocularis infection group exhibited higher expression levels of PD-L1 and CD155 than those in the control group, suggesting the potential of these subsets to impair T cell function. These findings may provide valuable information for investigating the role of hepatic DC subsets in the AE microenvironment and guiding DC targeting treatments for AE. Full article

(This article belongs to the Special Issue Echinococcosis: From Parasite–Host Interaction to Rapid Detection)

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13 pages, 4261 KiB

Open AccessArticle

Low Genetic Diversity of Plasmodium vivax Circumsporozoite Surface Protein in Clinical Isolates from Southern Thailand

by Tachin Khulmanee, Thanyapit Thita, Kanyanan Kritsiriwutinan, Usa Boonyuen, Aminoh Saai, Kanjana Inkabjan, Rimi Chakrabarti, Pradipsinh K. Rathod, Srivicha Krudsood, Mathirut Mungthin and Rapatbhorn Patrapuvich

Trop. Med. Infect. Dis. 2024, 9(5), 94; https://doi.org/10.3390/tropicalmed9050094 - 24 Apr 2024

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Abstract

The genetic diversity within the circumsporozoite surface protein (PvCSP) of Plasmodium vivax, the predominant malaria species in Thailand, is primarily observed in the northwestern region along the Thailand–Myanmar border. However, as P. vivax cases shift to southern provinces, particularly Yala Province near [...] Read more.

The genetic diversity within the circumsporozoite surface protein (PvCSP) of Plasmodium vivax, the predominant malaria species in Thailand, is primarily observed in the northwestern region along the Thailand–Myanmar border. However, as P. vivax cases shift to southern provinces, particularly Yala Province near the Thailand–Malaysia border, PvCSP diversity remains understudied. Between 2018 and 2020, 89 P. vivax isolates were collected in Yala Province, a significant malaria hotspot. Employing polymerase chain reaction amplification, restriction fragment length polymorphism (PCR-RFLP), and DNA sequencing, the gene encoding PvCSP (Pvcsp) was analyzed. All Yala P. vivax isolates belonged to the VK210 type, distinct from strains in the western region near the Myanmar border. The central repeat region of Pvcsp revealed two common peptide repeat motifs—GDRADGQPA and GDRAAGQPA—across all southern isolates. Sequence analysis identified two subtypes, with S1 more prevalent (92%) than S2 (8%). This study underscores the limited diversity of VK210 variants of P. vivax populations in southern Thailand. These baseline findings facilitate monitoring for potential new parasite variants, aiding in the future control and management of P. vivax in the region. Full article

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16 pages, 248 KiB

Open AccessArticle

Evaluation of Segmentation, Rotation, and Geographic Delivery Approaches for Deployment of Multiple First-Line Treatment (MFT) to Respond to Antimalarial Drug Resistance in Africa: A Qualitative Study in Seven Sub-Sahara Countries

by Celine Audibert, Adam Aspinall, Andre-Marie Tchouatieu and Pierre Hugo

Trop. Med. Infect. Dis. 2024, 9(5), 93; https://doi.org/10.3390/tropicalmed9050093 - 23 Apr 2024

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Abstract

Background: Several studies recently confirmed the emergence of resistance to antimalarial drugs in sub-Saharan Africa. Multiple first-line treatment (MFT) is one of the measures envisaged to respond to the emergence and spread of this resistance. The aim of this study was to identify [...] Read more.

Background: Several studies recently confirmed the emergence of resistance to antimalarial drugs in sub-Saharan Africa. Multiple first-line treatment (MFT) is one of the measures envisaged to respond to the emergence and spread of this resistance. The aim of this study was to identify the perceived advantages and disadvantages of several MFT deployment strategies and to better understand potential implementation drivers and barriers. Methods: A qualitative survey was conducted in seven sub-Saharan countries amongst key opinion leaders, national decision makers, and end users. A total of 200 individual interviews were conducted and findings were analyzed following a thematic inductive approach. Results: From a policy perspective, the new MFT intervention would require endorsement at the global, national, and regional levels to ensure its inclusion in guidelines. Funding of the MFT intervention could be a bottleneck due to costs associated with additional training of healthcare workers, adaptation of drug delivery mechanisms, and higher costs of drugs. Concerning the MFT deployment strategies, a slight preference for the segmentation strategy was expressed over the rotation and geographic approaches, due to the perception that a segmentation approach is already in place at country level. Conclusions: The findings highlighted the need for a collective approach to MFT deployment through the engagement of stakeholders at all levels of malaria management. Full article

14 pages, 287 KiB

Open AccessArticle

Prevention of Malaria in Pregnant Women and Its Effects on Maternal and Child Health, the Case of Centre Hospitalier de Kingasani II in the Democratic Republic of the Congo

by Japhet Kabalu Tshiongo, Trésor Zola Matuvanga, Patrick Mitashi, Vivi Maketa, Henk D. F. H. Schallig, Petra F. Mens, Hypolite Muhindo Mavoko and Junior Matangila Rika

Trop. Med. Infect. Dis. 2024, 9(5), 92; https://doi.org/10.3390/tropicalmed9050092 - 23 Apr 2024

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Abstract

This study aimed to evaluate scientific evidence of the benefit of the use of insecticide-treated nets (ITNs) and Intermittent preventive treatment (IPT) on the birth weight of newborns and the hemoglobin level of the mother when used to prevent malaria during pregnancy. This [...] Read more.

This study aimed to evaluate scientific evidence of the benefit of the use of insecticide-treated nets (ITNs) and Intermittent preventive treatment (IPT) on the birth weight of newborns and the hemoglobin level of the mother when used to prevent malaria during pregnancy. This cross-sectional analytical study was conducted on 467 hospitalized women in the Maternity Ward of Centre Hospitalier de Kingasani II, in the Democratic Republic of the Congo. Data were collected using a structured questionnaire that was pre-tested during a face-to-face interview. Apart from basic statistics, the chi-square test was used to compare proportions. Multivariate analysis (logistic regression) was used to identify variables significantly associated with the 95% confidence interval (CI). The ITN ownership rate was 81% (95% CI: 77–84) and the ITN use rate was 66% (95% CI: 62–70). Sixty-five percent (95% CI: 60–69) reported having received at least three doses of IPT during pregnancy with sulfadoxine-pyramethemine (IPTp-SP). There was a statistically significant difference in hemoglobin levels between hospitalized women who did not use the ITN (9.4 g/dL IIQ: 8.7–9.9) and those who did (11 g/dL IIQ: 9.8–12.2). The non-use of the ITN was associated with low birth weight (aOR = 3.6; 95% CI: 2.1–6.2; p < 0.001) and anemia in pregnant women (cOR = 2.41; 95% CI: 1.16–5.01; p = 0.018). The use of ITN and taking at least three doses of ITP during pregnancy are associated with good birth weight. The number of doses of IPTp received during antenatal care is associated with the maternal hemoglobin level in the third trimester of pregnancy. Full article

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Trop. Med. Infect. Dis., Volume 9, Issue 5 (May 2024) – 12 articles

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