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The Garki Project Epidemiology & Control of malaria in the Sudan Savanna of West Africa

The Garki Project Epidemiology & Control of malaria in the Sudan Savanna of West Africa. Publication by L. Molineaux and G. Gramiccia, 1980. Irene kasumba. West African savanna. online google images. Irene kasumba. West African savanna. Online google-images. Irene kasumba.

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The Garki Project Epidemiology & Control of malaria in the Sudan Savanna of West Africa

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  1. The Garki ProjectEpidemiology & Control of malaria in the Sudan Savanna of West Africa Publication by L. Molineaux and G. Gramiccia, 1980 Irene kasumba

  2. West African savanna online google images Irene kasumba

  3. West African savanna Online google-images Irene kasumba

  4. Chapter 3: Control Operations What was done • Insecticide residual spray- propoxur • Most effective (fumigant) • Never used on large scale • Total coverage (total spray coverage) • Spray coverage = # huts completely sprayed among total huts (at spray time). Irene kasumba

  5. Contd: Control operations • MDA, sulfalene + pyrimethamine • Long lasting • Tolerated on empty stomach • Effective against blood stage parasites • Total coverage (all except naïve infants) • High dose – every 2wks wet season or 10wks 2. Low dose – every10wks Irene kasumba

  6. Contd MDA • Residents registered by compound • Active treatment • For residents by name • Parasitemic new borns • Visitors at time of treatment • Effort made to treat absentees (twice) removed if missed >2 or 4x, consecutively • Human coverage = proportion of residents treated at each MDA round Irene kasumba

  7. Garki: treatment areas plus follow up villages A1 C untreated A2 B spray Irene kasumba

  8. Residual spraying: results & issues • Coverage - % huts sprayed among total huts • Varied by village • Varied by spray round • Dose applied • Varied between rounds • true coverage lower (new huts/repairs) 74 – 100% or 84 – 100% Intervention follow up Irene kasumba

  9. MDA coverage High MDA hot dry rainy rainy low MDA cool dry * * * * * * * spray round Irene kasumba

  10. Issues with MDA • Definition: human coverage by MDA round (proportion pple treated/MDA round) • Mobile • No census (# to be treated unknown) • # visitors count not clear • # days/visitors “ • Absentee registration varied, unknown 2. Distribution of registered vs treated nonrandom Irene kasumba

  11. Comparison 1.1 actual distribution vs. binomial distribution Every 10 wks for 9 rounds of MDA high MDA score CLUSTER 6, 8 (A2) % distribution of people by # treatment received - 18 months no. eligible or registered 23 rounds of MDA (6 villages) CLUSTER 5, 7 (A1) good participants Irene kasumba

  12. What was achieved? Malaria knowledge Self treatment Availability of treatment What was not? Why? Random MDA coverage Non randomization Biased results Ineffective control Spray coverage & tally inadequate Control operations: summary Irene kasumba

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