Research Articles (STID)

Permanent URI for this collection

http://hdl.handle.net/11070/707

Browse

Now showing 1 - 20 of 65

The use of some indigenous plants for medicinal and other purposes by local communities in Namibia with emphasis on Oshikoto region: A review
(2011) Cheikhyoussef, Ahmad; Mapaure, Isaac; Shapi, Martin K.
Local communities in Namibia possess an in-depth knowledge of the use of medicinal plants and their environment. Medicinal plants contribute significantly to the intellectual property rights of poor local households in theses local communities. This review gives an overview of the use of indigenous knowledge held by traditional healers, the uses of indigenous plants for medicinal and other purposes, medicinal preparation methods and treated diseases in different parts of Namibia, in particular the Oshikoto region. Factors threatening the existence of the medicinal plants are discussed and the gaps in the indigenous knowledge on the uses of the medicinal plants are also presented. This review strongly recommends the importance of proper and comprehensive documentation of the traditional healing methods in Namibia, which will have a high potential for sustainable development for the medicinal plants in Namibia.
Assessing malaria risk at night-time venues in a low-transmission setting: A time-location sampling study in Zambezi, Namibia
(2011) Jacobson, Jerry O.; Smith, Jennifer L.; Cueto, Carmen; Chisenga, Mukosha; Roberts, Kathryn W.; Hsiang, M.; Gosling, Roly; Mumbengegwi, Davis R.; Bennett, Adam
Background:Identifying efficient and effective strategies to reach and monitor populations at greatest risk of malaria in low-transmission settings is a key challenge for malaria elimination. In Namibia’s Zambezi Region, transmis-sion is ongoing yet its drivers remain poorly understood. A growing literature suggests that night-time social activities may lead to malaria exposure that is beyond the reach of conventional preventive interventions, such as insecticide treated bed nets and indoor residual spraying.Methods:Formative research was conducted with community members in March, 2015 in the catchment areas of six randomly selected health facilities in the western Zambezi Region to identify night-time locations where large numbers of individuals regularly congregate. Using time-location sampling, a survey was conducted between March and May, 2015 at community-identified venues (bars and evening church services) to develop representative esti-mates of the prevalence of parasite infection and risk factors among venue-goers.Results:When compared to a contemporaneous household survey of the general population aged 15 and older (N =1160), venue-goers (N =480) were more likely to have spent the night away from their home recently (17.3% vs. 8.9%, P =0.008), report recent fever (65.2% vs. 36.9%, P < 0.001), and were less likely to have sought care for fever (37.9% vs. 52.1%, P =0.011). Venue-goers had higher, but not significantly different, rates of malaria infection (4.7% vs. 2.8%, P =0.740). Risk factors for malaria infection among venue-goers could not be determined due to the small number of infections identified, however self-reported fever was positively associated with outdoor livelihood activi-ties (adjusted odds ratio [AOR] =1.9, 95% CI 1.0–3.3), not wearing protective measures at the time of the survey (AOR =6.8, 9% CI 1.4–33.6) and having been bothered by mosquitos at the venue (AOR =2.7, 95% CI 1.5–4).Conclusions:Prevention measures and continued surveillance at night-time venues may be a useful complement to existing malaria elimination efforts.
EquiFrame: A framework for analysis of the inclusion of human rights and vulnerable groups in health policies
(2011) Amin, Mutamad; MacLachlan, Malcolm; El Tayeb, Shahla; El Khatim, Amani; Swartz, Leslie; Munthali, Alister; Van Rooy, Gert; McVeigh, Joanne; Eide, Arne H.; Schneider, Marguerite
Ensuring that health policies uphold core concepts of human rights and are inclusive of vulnerable groups are imperative aspects of providing equity in health care, and of realizing the United Nations’ call for Health for All. We outline the process of extensive consultation undertaken across countries and stakeholders culminating in the development of EquiFrame, in conjunction with its associated definitions of core concepts of human rights and vulnerability. EquiFrame is a systematic policy analysis framework that assesses the degree to which 21 core concepts of human rights and 12 vulnerable groups are mentioned and endorsed in health policy documents. We illustrate the scope of the framework by reporting the results of its application to two health policy documents from (Northern) Sudan: the rather generalist Health Policy of (Northern) Sudan, and the more specific National Drug Policy of (Northern) Sudan. We outline some limitations of the framework and highlight issues for consideration in its interpretation. EquiFrame offers a systematic approach to analyzing and facilitating the inclusion of core concepts of human rights and vulnerability in existing or developing health policies and ultimately to promoting greater equity in health care.
Ethnobotanical study of indigenous knowledge on medicinal plant use by traditional healers in Oshikoto region, Namibia
(2011) Cheikhyoussef, Ahmad; Shapi, Martin K.; Matengu, Keneth K.; MuAshekele, Hina
The objective of this study was to establish a regional profile of the indigenous knowledge system (IKS) for medicinal plant use and cultural practices associated with the healing process of these plants by traditional healers in the Oshikoto region, Namibia. An ethnobotanical survey was undertaken to collect information from traditional healers during September and October 2008. Data was collected through the use of questionnaires and personal interviews during field trips in the ten constituencies of the Oshikoto region. A total of 47 respondents were interviewed with most of them aged 66 and above. The traditional healers in Oshikoto region use 61 medicinal plant species that belong to 25 families for the treatment of various diseases and disorders with the highest number of species being used for mental diseases followed by skin infection and external injuries. Trees (28 species) were found to be the most used plants followed by herbs (15 species), shrubs (10 species) and climbers (4 species). The average of the informant consensus factor (FIC) value for all ailment categories was 0.75. High FIC values were obtained for Pergularia daemia, and Tragia okanyua, which were reported to treat weakness and dizziness problems, snake bite, swelling and cardiovascular problems indicating that these species traditionally used to treat these ailments are worth examining for bioactive compounds. The traditional healers in Oshikoto possess rich ethno-pharmacological knowledge. This study allows for identifying many high value medicinal plant species, indicating high potential for economic development through sustainable collection of these medicinal plants.
Core concepts of human rights and inclusion of vulnerable groups in the disability and rehabilitation policies of Malawi, Namibia, Sudan, and South Africa
(2012) Mannan, Hasheem; McVeigh, Joanne; Amin, Mutamad; MacLachlam, Malcolm; Swartz, Leslie; Munthali, Alister; Van Rooy, Gert
In recent decades, there has been a push to incorporate the World Health Organization “Health for All” principles in national, regional, and local health policy documents. However, there is still no methodology guiding the appraisal of such policies with regard to the extent that they address social inclusion. In this article, the authors report on the development of EquiFrame, a novel policy analysis framework that was used to evaluate the disability and rehabilitation policies of Malawi, Namibia, Sudan, and South Africa. The policies were assessed in terms of their commitment to 21 predefined core concepts of human rights and inclusion of 12 vulnerable groups. Substantial variability was identified in the degree to which the core concepts and vulnerable groups were featured in these policy documents. The overall summary rankings for the disability policies of the countries studied were as follows: Namibia–High, Malawi–Low, and Sudan–Low. The rehabilitation policy of South Africa was ranked as Low. The results support the idea that adequate disability and rehabilitation policies remain mostly undefined.
Indigenous knowledge system best practices from Namibia: The case of Oshikundu processing methods
(2012) MuAshekele, Hina; Embashu, Werner; Cheikhyoussef, Ahmad
In recent years there has been increasing recognition by researchers, governments and development agencies That Indigenous Knowledge System (IKS) is one of the sources of knowledge which can be easily understood, accessed and useable to, particularly, people and communities in developing countries. Namibia, as a developing country is no exception in this case. The aim of this study is to present the production processes of oshikundu, a traditional fermented beverage in northern Namibia and to identify the practices that have potential for commercialization. The general IKS best practice protocol of the United Nations Educational Scientific and Cultural Organization and the Netherlands organization for international cooperation (known as Nuffic) will be used to evaluate the production processes that would lend oshikundu for commercialization. The research was carried out in the four “O” northern central regions of Namibia, where the majority of the inhabitants live in rural areas and where they produce and drink oshikundu in the traditional way. The results will be used to draw conclusions, implications and possible applications of how the oshikundu can be processed better and possibly made accessible in modern shops without changing too much its traditional taste.
General practices on indigenous knowledge system technology in selected regions of Namibia
(2012) Shapi, Martin K.; MuAshekele, Hina; Cheikhyoussef, Ahmad
Research into Indigenous Knowledge System Technology (IKST) has been receiving increasing attention from research institutions and Government Ministries in Namibia during the last five years. Indigenous communities in Namibia possess a rich traditional knowledge expressed in many practices in their communities. This study aims to present and identify general indigenous practices that have potentials for development in four regions in Namibia. These regions were Omaheke, Oshikoto, Omusati and the Kavango. These indigenous technologies covered medical, pharmaceutical, indigenous food, tanning, construction and infrastructure technologies and household equipment of the local. This research article also presents Namibia’s best Indigenous Knowledge System Technology practices as compared to United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Netherlands organisation for international cooperation in higher education (Nuffic) protocols. The comparison shows the potentials of these technologies despite their simplicity and poorly developed structures. The local communities need be educated on the importance of these indigenous technologies. The youth should also be encouraged to learn these knowledge systems to preserve them from being lost with the older generation.
Perceived barriers to accessing health services among people with disabilities in rural northern Namibia
(2012) Van Rooy, Gert; Amadhila, Elina; Mufune, Pempelani; Swartz, Leslie; MacLachlan, Malcolm
People living with disabilities (PWD) face unique problems in dealing with con-ventional healthcare facilities. We investigate the experiences of PWD as they access healthcare facilities in rural Namibia. More specifically, we investigate structural–environmental and process barriers to accessing health facilities. The study relied on semi-structured interviews and purposive sampling. The results showed PWD find it difficult to walk to health centers for treatment due to lackof transport, money to pay for treatment and toilet facilities and the distance is too far for people with lower-limb disabilities. There is a need to consider the unique issues affecting access to healthcare for people living with disabilities to achieve equitable access to healthcare services.
Equity and core concepts of human rights in Namibian health policies
(2013) Amadhila, Elina; Van Rooy, Gert; McVeigh, Joanne; Mannan, Hasheem; MacLachlan, Malcolm; Amin, Mutamad
Delivering health services to vulnerable populations is a significant challenge in many countries. Groups vulnerable to social, economic, and environmental challenges may not be considered or may be impacted adversely by the health policies that guide such services.We report on the application of EquiFrame, a novel policy analysis framework, to ten Namibian health policies, representing the top ten health conditions in Namibia identified by the World Health Organization. Health policies were assessed with respect to their commitment to 21 Core Concepts of human rights and their inclusion of 12 Vulnerable Groups. Substantial variation was identified in the extent to which Core Concepts of human rights and Vulnerable Groups are explicitly mentioned and addressed in these health policies. Four health policies received an Overall Summary Ranking of High quality; three policies were scored as having Moderate quality; while three were assessed to be of Low quality. Health service provision that is equitable, universal, and accessible is instigated by policy content of the same. EquiFrame may provide a novel and valuable tool for health policy appraisal, revision, and development.
Value addition and processed products of three indigenous fruits in Namibia
(2013) Cheikhyoussef, Ahmad; Bille, P.G.; Shikongo-Nambambi, Martha N.;
The objectives of this study were to add value to three popular indigenous fruits found in Namibia namely, Marula (Sclerocarya birrea), Monkey orange (Strychnos cocculoides) and Eembe (Berchemia discolour) into processed food products and to train rural communities on value addition for job creation, income generation and food security. Indigenous fruits are receiving increasing interests from researchers and scholars because of their nutrition and abundance in most African countries. The fruits are important sources of food for rural communities especially at times of food shortage, hunger and other disasters. In addition, they provide enormous health benefits such as antioxidants, vitamins and minerals. They are also known to create jobs and generate income for rural communities. Because of their role in combating food insecurity, nutrition and the problems of seasonality, studies on their value addition were carried out in Namibia. Different types of food products were made from the fruits namely; juice, jam, jelly and muffins (cakes). A pilot study was carried out to determine the levels and preference range of ingredients in the mix to formulate recipes of the products prior to processing and training the community members. The results were subjected to paired preference tests and the best ratio was then used. According to consumer preference test, marula juice was on the lower value (2.3) due to its low pH (3.26). As for jam and jelly; quality, taste and colour were acceptable and preferred. The three products made from monkey orange were all preferred but those from eembe were downgraded (2.31-3.20) due to dark colour and lack of flavour. The microbiological quality of the produced products confirmed their safety characteristics. The products made in this study were shown to be viable, of good quality and good sources of income for rural communities. The fruit flavour from marula and monkey orange can be utilized in the dairy and other soft drink industries for making yoghurts, sour milk, ice cream, juices and jams.
Ethnobotanical knowledge on indigenous fruits in Ohangwena and Oshikoto regions in Northern Namibia
(2013) Cheikhyoussef, Ahmad; Embashu, Werner
Background: Indigenous communities in Namibia possess a rich indigenous knowledge expressed within many practices of these communities. Indigenous wild edible fruits are available along the Namibian 13 regions of which it forms a rich source of vitamins, fibres, minerals and a heterogeneous collection of bioactive compounds referred to as phytochemicals for indigenous people’s diet. The aim of this study was to record the different IKS practices on the indigenous fruit trees in Ohangwena and Oshikoto regions of Namibia. Methods: An ethnobotanical survey was undertaken to collect information from local communities from 23-29 October 2011. Data was collected through the use of questionnaires and personal interviews during field trips in the Ohangwena and Oshikoto regions. A total of 65 respondents were interviewed; 54% women, 38% men and 8% both in group interviews. Results: The majority of the people interviewed were in their thirty’s, with the youngest being 18 years old and the oldest being 98 years old. Forty three plant specimens were collected from the two regions; these specimens belong to 20 genera and 25 species. Regarding to the indigenous knowledge; 87% of the respondents indicated that their knowledge on indigenous fruits was learnt mainly through their parent. Indigenous people’s perception on declining indigenous fruits revealed that 56.3% of the respondents reported that indigenous fruits were declining. Only a 42.2% indicated that the indigenous fruits populations are increasing. Regarding to the management practices to improve the production of these indigenous fruit trees; 38.6% reported that there are some efforts on management practices; on the other hand 61.4% reported there are no management practices on the indigenous fruit trees in their areas. Four species were found to be the most frequently used and mentioned fruits which need to be given high preference in terms of conservation are: Berchemia discolor, Hyphaene petersiana, Sclerocarya birrea and Diospyros mespiliformis. The following diseases and ailments have been reported to be treated by the indigenous fruit trees which include: toothache, diarrhoea, cough, tonsillitis, burns, skin allergy, stomach ache, snake bit, constipation, etc. 28% of the respondents mentioned an ethno veterinary use(s) of these fruits, e.g. the use of the Ziziphus mucronata roots to treat diarrhoea in cattle, the bark of eembe (Berchemia discolor) to treat calf weakness. Conclusions: The local communities in Oshikoto and Ohangwena regions have relatively good knowledge and practices regarding the indigenous fruit. This study enhances our understanding on the indigenous fruit in Namibia and their uses by local communities.
Benguela community/ UNAM wind power demonstration project—Experiences in implementation
(David, 2014) Davidson, Innocent
Abstract: The government of Namibia has committed itself to promote the use of economically viable RE (renewable energy) technologies, as a complement to grid electrification, and to improve energy provision to rural areas. This paper presents the implementation of the Benguela Community-UNAM Wind-Power Demonstration Project, which is a community-run wind-power mini-generation pilot plant in Luderitz, Namibia. Luderitz is located in South-Western Namibia along the Namib Desert. The region experiences abundant south-westerly winds and the coastal weather conditions make it a suitable location for wind energy. This project is an initiative from the community of Luderitz and a first of its kind in Namibia. It demonstrates the application of small-scale wind energy systems in Namibia and contributes to the growing national awareness of RE and use of wind power in the country. Through its activities, the project has created a dialogue between the local authorities, business community, schools and the greater community. The balance of the paper discusses lessons learned; envisaged future development plans; highlights technical, administrative and management activities; as well as potential for replication and barriers encountered during the project implementation including institutional constraints. The solution-methods developed are presented and discussed.
Dominant lactic acid bacteria and their antimicrobial profile from three fermented milk products from northern Namibia
(2014) Heita, Lusia; Cheikhyoussef, Ahmad
The present study focused on the isolation, identification and antimicrobial profile of the dominant lactic acid bacteria from three traditional fermented milk products namely: Omashikwa, Mabisi and Mashini Ghamushikwa from the north-central and north-eastern parts of Namibia. The microbiological and antimicrobial activities of these products fluctuate from one region to another depending on the local indigenous microflora. Omashikwa and Mashini Ghamushikwa fermentation processes involves the addition of Boscia albitrunca root (Omunkuzi) and butter churning. The root contributes to the flavor of the product, increasing the milk fermentation rate and churning. Mabisi is produced by letting the milk to ferment naturally until the water is separated from the whey. The water is then decanted, and the whey is shaken until it is smooth without removal of fat. A total of 180 isolates of Lactic acid bacteria (LAB) were obtained and identified based on their phenotypical characterization. Cell free supernatants (CFS) of the 180 LAB isolates were evaluated for antimicrobial activities against selected food borne pathogens; Escherichia coli ATCC 25,922, Staphylococcus aureus ATCC 25,923, Bacillus cereus ATTC 10,876, Candida famata and Geotrichum klebahnii using the well diffusion assay. Twenty LAB isolates having the highest inhibitory effects were selected for biochemical identification using API 50 kit and these were identified as being; Lactobacillus plantarum (53%), Lactobacillus rhamnosus (29%), Pediococcus pentosaceus (6%), Lactobacillus paracasei ssp. paracasei (6%) and Lactococcus lactic ssp. lactis (6%). Pediococcus pentosaceus showed the highest inhibitory effect on all the indicator strains. This study provides an insight into LAB diversity of unstudied Namibian fermented milk products and reports a potential production of antimicrobial compounds which is significant in the standardization of protective starter cultures which can be used to control fermentation process and shelf life extension of dairy products in Namibia.
A comparative study of medicinal plants used in rural areas of Namibia and Zimbabwe
(2015) Maroyi, A.
Health medicines prepared from wild plants play an important role in the primary healthcare needs of people living in developing countries. A comparative ethnobotanical study was undertaken to document medicinal plants used in rural areas of Namibia and Zimbabwe. In order to document medicinal plants used for primary healthcare in rural areas of Namibia and Zimbabwe, 56 traditional healers were identified using the Participatory Rapid Appraisal approach.
Evaluation of the Antiplasmodial Properties of Namibian Medicinal Plant Species, Moringa ovalifolia
(2017) Du Preez, Iwanette C.; Bussel, Rahl-Jeanne; Mumbengegwi, Davis R.
Background and Objective: Malaria is a major cause of morbidity and mortality in Sub-Saharan Africa but it is on the decline in some Southern African countries including Namibia, which is moving towards elimination of the disease. Despite the availability of effective medicines in Namibia, some communities do not accept allopathic medicines, preferring traditional medicines. This study was conducted to determine the phytochemistry and the efficacy of Moringa ovalifolia (M. ovalifolia ) an ethnomedicinal plant, to provide a basis for their integration into mainstream malaria case management. Materials and Methods: Moringa ovalifolia was screened for known classes of antimalarial phytochemicals using thin layer chromatography. In vitro antiplasmodial activity of aqueous and organic extracts from Moringa ovalifolia was measured using parasitaemia post-treatment with plant extracts as well as the IC50 values. Data analysis using two-way ANOVA to determine the significant interactions between plant extracts and plasmodic growth. Results: Phytochemical screening of M. ovalifolia revealed the presence of flavonoids, anthraquinones, coumarin, terpenoids and alkaloids. Against Plasmodium falciparum (P. falciparum) D10, the leaf extracts of M. ovalifolia were the most effective with IC50 values of 14.30 and 20.73 μg mLG1 for the organic and aqueous extracts, respectively. Conclusion: M. ovalifolia extracts exhibited moderate antiplasmodial properties in vitro and have potential as antimalarials. These findings provide a basis for further investigation into their phytochemistry as well as in vivo studies on their safety and efficacy to support their use as an alternative treatment for malaria.
Spatial clustering of patent and sub-patent malaria infections in northern Namibia: Implications for surveillance and response strategies for elimination
(2017) Smith, Jennifer L.; Auala, Joyce R.; Tambo, Munyaradzi; Haindongo, Erastus H.; Katokele, Stark; Uusiku, Petrina; Gosling, Roly; Kleinschmidt, Immo; Mumbengegwi, Davis R.; Sturrock, Hugh J.
Reactive case detection (RACD) around passively detected malaria cases is a strategy to identify and treat hotspots of malaria transmission. This study investigated the unproven assumption on which this approach is based, that in low transmission settings, infections cluster over small scales.
Rondomized anticancer and cytotoxicity activities of Guibourtia Coleosperma and Diospyros Chamaethamnus
(2017) Dushimemaria, Florence; Du Preez, Iwanette C.; Mumbengegwi, Davis R.
Background: Plants have consistently proven to be a reliable and yet not fully explored source of medicines. In light of this, there is a constant demand for new treatment regimens for cancer. Namibia has a rich diversity of plant species of over 4300 with 17 % of them being endemic to Namibia. Plants growing in Namibia’s diverse climatic zones produce many secondary metabolites as part of adaptation to their environment. This article focused on the screening of such phytochemicals and their cytotoxic and anticancer properties in vitro. Two Namibian plants Diospyros chamaethamnus and Guibourtia coleosperma were randomly selected for this purpose. Materials and Methods: The plants were screened for the presence of coumarins, alkaloids, flavonoids, anthraquinones, steroids and terpenoids using thin layer chromatography. Anticancer screening was performed on a panel of three cancer cell lines, while cytotoxicity was determined using a human fibroblast cell line, both using the SRB method. Results: Alkaloids, anthraquinones, flavonoids and steroids were detected in both organic and aqueous extracts of the two plants. The organic plant extracts had a greater anti-proliferative effect on the cancer cell lines than the aqueous extracts; the D. chamaethamnus organic root extract was the most potent with an IC50 of 16.08, 29.12 and 24.67 μg/mL against TK10, UACC62 and MCF7 cells, respectively. Furthermore, cytotoxicity analysis revealed the non-toxic nature of the extracts, except for the organic root extract of D. chamaethamnus that showed significant cytotoxicity (IC50 13.03 μg/mL). Conclusion: D. chamaethamnus is a potential candidate for the development of a plant based cancer treatment. The study showed the value of random screening in drug discovery from plants for pharmacological activity that is unrelated to their ethnomedicinal uses.
Medicinal value of Aptosimum albomarginatum (Marloth and Engl.), Albizia anthelmintica (A. Rich Brongn.) and Dicoma schinzii (O. Hoffm.) to a small community living at Gochas, southern Namibia
(2017) Walter, Sunette; Beukes, Mervyn; Mumbengegwi, Davis R.; Bock, Ronnie
Traditional medicine is widely used, but its effectiveness is often questioned. Biofilm-producing bacteria and fungi are important in difficult-to-treat persistent and recurrent infections. The present study investigated the anti-biofilm properties of crude methanolic extracts from three medicinal plants used in Namibia, namely Aptosimum albomarginatum (Marloth and Engl.), Albizia anthelmintica (A. Rich Brongn.) and Dicoma schinzii (O. Hoffm.). Biofilm formation, inhibition and eradication were determined using microtiter plate assay. Extracts were tested against Escherichia coli ATCC 700928, Staphylococcus aureus ATCC 12600, S. aureus U3300, Bacillus subtilis ATCC 13933, Streptococcus mutans ATCC 25175, Streptococcus sanguinis ATCC 10556, Pseudomonas aeruginosa and Candida albicans. All isolates were strong biofilm producers. A. albomarginatum root extract moderately inhibited biofilm formation in S. mutans ATCC 25175 (60.0%), E. coli ATCC 700928 (51.6%) and P. aeruginosa (49.1%). A. anthelmintica twigs caused 58.4% biofilm inhibition in C. albicans and eradicated S. aureus U3300 biofilm by 74.8%. D. schinzii leaf extract inhibited P. aeruginosa biofilm by 67.3%, and in addition broke down S. mutans ATCC 25175 biofilm by 44.2%. These results validate the usefulness of the three plants as traditional medicine in some instances.
Traditional knowledge of wild edible fruits in southern Africa: A comparative use patterns in Namibia and Zimbabwe
(2017) Maroyi, A.; Cheikhyoussef, Ahmad
A large proportion of resource poor rural households in southern African communal areas are dependent on wild edible fruits to meet part of their daily nutritional needs. For many people and ethnic groups, the use of wild edible fruits is a source of cultural identity, reflecting a deep and important body of knowledge about the environment, survival, harvesting, preservation and other forms of management. This study was aimed at at documenting the role of wild edible fruits in the livelihoods of people in Namibia and Zimbabwe.
Malaria risk in young male travelers but local transmission persists: A case–control study in low transmission Namibia
(2017) Smith, Jennifer L.; Auala, Joyce R.; Haindongo, Erastus H.; Uusiku, Petrina; Gosling, Roly; Kleinschmidt, Immo; Mumbengegwi, Davis R.; Sturrock, Hugh J.
Background: A key component of malaria elimination campaigns is the identification and targeting of high risk populations. To characterize high risk populations in north central Namibia, a prospective health facility-based case–control study was conducted from December 2012–July 2014. Cases (n = 107) were all patients presenting to any of the 46 health clinics located in the study districts with a confirmed Plasmodium infection by multi-species rapid diagnostic test (RDT). Population controls (n = 679) for each district were RDT negative individuals residing within a household that was randomly selected from a census listing using a two-stage sampling procedure. Demographic, travel, socio-economic, behavioural, climate and vegetation data were also collected. Spatial patterns of malaria risk were analysed. Multivariate logistic regression was used to identify risk factors for malaria. Results: Malaria risk was observed to cluster along the border with Angola, and travel patterns among cases were comparatively restricted to northern Namibia and Angola. Travel to Angola was associated with excessive risk of malaria in males (OR 43.58 95% CI 2.12–896), but there was no corresponding risk associated with travel by females. This is the first study to reveal that gender can modify the effect of travel on risk of malaria. Amongst non-travellers, male gender was also associated with a higher risk of malaria compared with females (OR 1.95 95% CI 1.25–3.04). Other strong risk factors were sleeping away from the household the previous night, lower socioeconomic status, living in an area with moderate vegetation around their house, experiencing moderate rainfall in the month prior to diagnosis and living <15 km from the Angolan border. Conclusions: These findings highlight the critical need to target malaria interventions to young male travellers, who have a disproportionate risk of malaria in northern Namibia, to coordinate cross-border regional malaria prevention initiatives and to scale up coverage of prevention measures such as indoor residual spraying and long-lasting insecticide nets in high risk areas if malaria elimination is to be realized.

Browse

Browsing Research Articles (STID) by Issue Date

Results Per Page

Sort Options