Browsing by Author "Verhoeff, F.H."
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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 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.