Publications by authors named "Jean Louis Ndiaye"

Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months.

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  • In Senegal, a study evaluated the effectiveness of mass drug administration (MDA) as a strategy to reduce malaria incidence, comparing it to the standard seasonal malaria chemoprevention (SMC) methods.
  • The trial was conducted in 60 villages, with one group receiving MDA treatment and the other receiving SMC, both delivered door-to-door.
  • Results showed MDA significantly reduced malaria cases by 55% during the peak transmission season, indicating it may be a more effective intervention than standard care without serious side effects reported.
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  • Despite progress in Senegal, three southeastern regions still face a high burden of malaria, particularly among pregnant women, highlighting a gap in recent studies on this issue.
  • In a 2019 study, 877 pregnant women at 11 health clinics were tested for malaria, revealing a prevalence of 48% among those attending scheduled visits, and a staggering 86% among those showing signs of malaria.
  • The study found that the rapid diagnostic tests (RDT) missed many asymptomatic infections, indicating that more effective prevention methods are needed to address the high prevalence of malaria in pregnant women.
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Background: SMC was adopted in Nigeria in 2014 and by 2021 was being implemented in 18 states, over four months between June and October by 143000 community drug distributors (CDDs) to a target population of 23million children. Further expansion of SMC is planned, extending to 21 states with four or five monthly cycles. In view of this massive scale-up, the National Malaria Elimination Programme undertook qualitative research in five states shortly after the 2021 campaign to understand community attitudes to SMC so that these perspectives inform future planning of SMC delivery in Nigeria.

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Mobile phones are increasingly used in community health programmes, but the use of video job-aids that can be displayed on smart phones has not been widely exploited. We investigated the use of video job-aids to support the delivery of seasonal malaria chemoprevention (SMC) in countries in West and Central Africa. The study was prompted by the need for training tools that could be used in a socially distanced manner during the COVID-19 pandemic.

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Background: Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs.

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  • - Seasonal malaria chemoprevention is implemented in 13 Sahel countries to protect children under 5 from malaria, but drug resistance is a growing concern for its effectiveness.
  • - Community surveys conducted in Burkina Faso, Chad, Guinea, Mali, Nigeria, Niger, and The Gambia analyzed blood samples from children and young adults to detect P. falciparum and identify drug resistance-associated genetic variations.
  • - Results showed a significant decrease in malaria prevalence among children under 5 from 2016 to 2018, with no strong evidence indicating increased drug resistance to amodiaquine or sulfadoxine-pyrimethamine in the sampled populations.
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Background: Seasonal malaria chemoprevention (SMC) has shown high protective efficacy against clinical malaria and severe malaria in a series of clinical trials. We evaluated the effectiveness of SMC treatments against clinical malaria when delivered at scale through national malaria control programmes in 2015 and 2016.

Methods And Findings: Case-control studies were carried out in Mali and The Gambia in 2015, and in Burkina Faso, Chad, Mali, Nigeria, and The Gambia in 2016.

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  • - A systematic literature review and individual patient data (IPD) meta-analysis were conducted to evaluate the effectiveness and tolerability of artemisinin-based versus quinine-based treatments for malaria in pregnant women.
  • - The study searched seven databases and included 19 out of 30 assessed studies, covering 4,968 patient episodes, with outcomes focused on treatment efficacy, parasite clearance, and adverse events.
  • - Findings indicated that quinine monotherapy had a significantly higher risk of treatment failure compared to artemisinin derivatives, particularly artesunate-amodiaquine, which showed a much lower risk of treatment failure.
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Background: Malaria in pregnancy, including asymptomatic infection, has a detrimental impact on foetal development. Individual patient data (IPD) meta-analysis was conducted to compare the association between antimalarial treatments and adverse pregnancy outcomes, including placental malaria, accompanied with the gestational age at diagnosis of uncomplicated falciparum malaria infection.

Methods: A systematic review and one-stage IPD meta-analysis of studies assessing the efficacy of artemisinin-based and quinine-based treatments for patent microscopic uncomplicated falciparum malaria infection (hereinafter uncomplicated falciparum malaria) in pregnancy was conducted.

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The Senegal National Malaria Control Programme (NMCP) introduced home-based malaria management for all ages, with diagnosis by rapid diagnostic test (RDT) and treatment with artemisinin-based combination therapy (ACT) in 2008, expanding to over 2000 villages nationwide by 2014. With prise en charge à domicile (PECADOM), community health workers (CHWs) were available for community members to seek care, but did not actively visit households to find cases. A trial of a proactive model (PECADOM Plus), in which CHWs visited all households in their village weekly during transmission season to identify fever cases and offer case management, in addition to availability during the week for home-based management, found that CHWs detected and treated more cases in intervention villages, while the number of cases detected weekly decreased over the transmission season.

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Background: Seasonal malaria chemoprevention (SMC) using sulfadoxine-pyrimethamine plus amodiaquine has been introduced in 12 African countries. Additional strategies for safety monitoring are needed to supplement national systems of spontaneous reporting that are known to under represent the incidence of adverse reactions.

Objectives: This study aimed to determine if adverse event (AE) reporting could be improved using a smartphone application provided to village health workers, or by active follow-up using a symptom card provided to caregivers.

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SMC has been introduced widely in the Sahel since its recommendation by WHO in 2012. This study, which provided evidence of feasibility that supported the recommendation, included school-age and pre-school children. School-age children were not included in the 2012 recommendation but bear an increasing proportion of cases.

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Cerebral toxoplasmosis is caused by the protozoan Toxoplasma gondii because of reactivation of latent tissue cysts in the Acquired Immunodeficiency Syndrome (AIDS) patients with severe immunosuppression. The objective of this study was to evaluate the benefit of co-trimoxazole in presumptive and prevention of cerebral toxoplasmosis in Human Immunodeficiency Virus (HIV)/AIDS patients at Bobo-Dioulasso Hospital in Burkina Faso from June 2012 to October 2014. ELISA and ELFA were performed on serum for the quantitative determination of IgG and IgM anti-T.

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In Senegal, antimalarial drugs used in treatment and prevention of malaria are one of the main reasons for the current success in controlling malaria. However, the successful control of malaria is highly dependent on continued effectiveness of these drugs which may be compromised by the spread of drug resistance. Therefore, surveillance of drug resistance in the malaria parasites is essential.

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Seasonal Malaria Chemoprevention (SMC) is recommended for children under 5 in the Sahel and sub-Sahel. The burden in older children may justify extending the age range, as has been done effectively in Senegal. We examine costs of door-to-door SMC delivery to children up to 10 years by community health workers (CHWs).

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In the context of controlling intestinal parasites, accurate diagnosis is essential. Our objective was to evaluate the performance of new diagnostic kits compared to conventional microscopic methods in identifying intestinal parasites. Faeces collected in rural area in Senegal were subjected to several detection techniques.

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Gastrointestinal parasite infections represent one of the biggest public health problems in the world. Therefore, appropriate innovative tools are needed for assessing interventions to control these infections. This study aims to compare the performance of real-time polymerase chain reaction (PCR) assays to microscopic examination for detection of intestinal parasites.

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Background: Anaemia is common in malaria. It is important to quantitate the risk of anaemia and to distinguish factors related to the natural history of disease from potential drug toxicity.

Methods: Individual-patient data analysis based on nine randomized controlled trials of treatments of uncomplicated falciparum malaria from 13 sub-Saharan African countries.

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Introduction: More information is needed about the safety of low-dose primaquine in populations where G6PD deficiency is common.

Methods: Adults with Plasmodium falciparum malaria were randomized to receive 1 of 3 artemisinin combination therapies (ACTs) with or without primaquine (0.25 mg/kg).

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Background: Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ), given each month during the transmission season, is recommended for children living in areas of the Sahel where malaria transmission is highly seasonal. The recommendation for SMC is currently limited to children under five years of age, but, in many areas of seasonal transmission, the burden in older children may justify extending this age limit. This study was done to determine the effectiveness of SMC in Senegalese children up to ten years of age.

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Article Synopsis
  • Artemisinins are at risk of supply disruptions due to climate change, leading to the development of a new synthetic antimalarial combination known as arterolane maleate (AM) with piperaquine phosphate (PQP) for treating uncomplicated malaria.
  • In a clinical trial with 1072 patients, AM-PQP was found to have a high efficacy rate, with 90.48% showing adequate clinical and parasitological response at day 42, comparable to artemether-lumefantrine (A-L) which had a similar success rate.
  • The study concluded that AM-PQP is as effective and safe as A-L in treating uncomplicated P. falciparum malaria, demonstrating quick parasite clearance and minimal
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  • In Senegal, efforts to reduce malaria cases over the past decade have led to a significant decrease in transmission, prompting a study on malaria hotspots in Keur Soce using geographically-weighted regression methods.
  • The research analyzed socio-economic and environmental factors affecting malaria occurrence in small communities, utilizing passive surveillance data and various statistical tools to find relationships between malaria cases and identified predictors.
  • A total of 408 confirmed malaria cases were recorded, with the study demonstrating that household size, housing materials, and proximity to breeding sites significantly impacted malaria incidence, while the models showed that these factors explained about 70% of the malaria occurrence variation.
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