Browsing by Author "Klinkenberg, E."
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Item Cohort trial reveals community impact of insecticide-treated net son malaria metric indices in urban Ghana(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010) Klinkenberg, E.; Onwona-Agyeman, K.A.; McCall, P.J.; Wilson, M.D.; Bates, I.; Verhoeffe, F.H.; Barnish, G.; Donnelly, M.J.The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for amassor community effect, despite ITN use by fewer than 35% of households. Children living within 300m of a household with an ITN had higher haemoglobin concentrations (0.5g/dl higher, P = 0.011) and less anaemia (oddsratio2.21, 95%CI1.08–4.52, P = 0.031atmonth6), than children living more than 300m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings.Item Cohort trial reveals community impact of insecticide-treated nets on malariometric indices in urban Ghana(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2010-07) Klinkenberg, E.; Onwona-Agyeman, K.A.; McCall, P.J.; Wilson, M.D.; Bates, I.; Verhoeff, F.H.; Barnish, G.; Donnelly, M.J.The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for a mass or community effect, despite ITN use by fewer than 35% of households. Children living within 300 m of a household with an ITN had higher haemoglobin concentrations (0.5. g/dl higher, P=0.011) and less anaemia (odds ratio 2.21, 95% CI 1.08-4.52, P=0.031 at month 6), than children living more than 300 m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings. [Registered trial number ISRCTN42261314; http://www.controlled-trials.com/ISRCTN42261314]. © 2010 Royal Society of Tropical Medicine and Hygiene.Item Impact of urban agriculture on malaria vectors in Accra, Ghana(Malaria Journal (7): 151, 2008) Klinkenberg, E.; McCall, P.; Wilson, M.D.; Amerasinghe, F.P.; Donnelly, M.J.To investigate the impact of urban agriculture on malaria transmission risk in urban Accra larval and adult stage mosquito surveys, were performed. Local transmission was implicated as Anopheles spp. were found breeding and infected Anopheles mosquitoes were found resting in houses in the study sites. The predominant Anopheles species was Anopheles gambiae s.s.. The relative proportion of molecular forms within a subset of specimens was 86% S-form and 14% M-form. Anopheles spp. and Culex quinquefasciatus outdoor biting rates were respectively three and four times higher in areas around agricultural sites (UA) than in areas far from agriculture (U). The annual Entomological Inoculation Rate (EIR), the number of infectious bites received per individual per year, was 19.2 and 6.6 in UA and U sites, respectively. Breeding sites were highly transitory in nature, which poses a challenge for larval control in this setting. The data also suggest that the epidemiological importance of urban agricultural areas may be the provision of resting sites for adults rather than an increased number of larval habitats. Host-seeking activity peaked between 2-3 am, indicating that insecticide-treated bednets should be an effective control method.Item Malaria and irrigated crops, Accra, Ghana(Emerging Infectious Diseases, 2005-09) Klinkenberg, E.; McCall, P.J.; Hastings, I.M.; Wilson, M.D.; Amerasinghe, F.P.; Donnelly, M.J.We investigated the prevalence of malaria and associated risk factors in children living in urban Ghana. Malaria prevalence was associated with low hemoglobin concentration, low socioeconomic status, and higher age. Our findings indicate that African urban poor are seriously affected by malaria and that irrigated agriculture may increase this risk.Item Urban malaria and anaemia in children: A cross-sectional survey in two cities of Ghana(Tropical Medicine and International Health, 2006-05) Klinkenberg, E.; McCall, P.J.; Wilson, M.D.; Akoto, A.O.; Amerasinghe, F.P.; Bates, I.; Verhoeff, F.H.; Barnish, G.; Donnelly, M.J.OBJECTIVE: To describe the epidemiology of urban malaria, an emerging problem in sub-Saharan Africa. METHOD: Cross-sectional surveys of communities in Accra and Kumasi, Ghana, determining risk factors for malaria infection and anaemia in children aged 6-60 months. RESULTS: Malaria prevalence rates ranged from 2% to 33% between urban communities. 47.1% of children were anaemic (Hb < 11.0 g/dl). Factors associated with malaria prevalence were low socio-economic status, age and anaemia. The attributable risks of anaemia and severe anaemia (Hb < 8.0 g/dl) caused by malaria were 5% and 23% respectively. CONCLUSIONS: Malaria in urban areas displayed a heterogeneity and complexity that differed from the rural environment, which has important implications for malaria control. Marked intra-city variation indicates the importance of targeting specific areas or districts. The most vulnerable group, the urban poor, should be prioritized when designing control measures. This would require careful assessment of the malaria risk pattern in any city to guide an integrated control program. © 2006 Blackwell Publishing Ltd.