Browsing by Author "Mbwambo, Stephen"

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Comparison of cone bioassay estimates at two laboratories with different anopheles mosquitoes for quality assurance of pyrethroid insecticide-treated nets
(NM-AIST, 2022-08) Mbwambo, Stephen
This study explored utility of cone bioassays for pre-delivery quality assurance (QA) of pyrethroid insecticide-treated nets (ITNs) to test the assumption that cone bioassays are consistent across locations, mosquito strains, and laboratories. Double-blinded bioassays were conducted on 20 pyrethroid ITNs of four brands (100 nets, 5 subsamples per net) that had been delivered for mass distribution in Papua New Guinea (PNG) having passed pre-delivery inspections. Cone bioassays were performed on the same net pieces following World Health Organization (WHO) guidelines at the PNG Institute of Medical Research (PNGIMR) using pyrethroid susceptible Anopheles farauti sensu stricto and at Ifakara Health Institute (IHI), Tanzania using pyrethroid susceptible Anopheles gambiae sensu stricto. Results from IHI and PNGIMR were compared using Spearman’s Rank correlation, Bland-Altman (BA) analysis and analysis of agreement. In cone bioassays, 13/20 nets (65%) at IHI and 8/20 (40%) at PNGIMR met WHO bio-efficacy criteria. Results from IHI and PNGIMR correlated on 60-minute knockdown (KD60) (rs= 0.6, p= 0.002, n=20) and 24-hour mortality (M24) (rs=0.9, p<0.0001, n=20) but BA showed systematic bias between the results. The agreement between the results to predict ITN failure was good with kappa=0.79 (0.53-1.00) and 90% accuracy. Based on these study findings, the WHO cone bioassay is a reproducible bioassay for ITNs with >80% M24, and for all ITNs provided inherent stochastic variation and systematic bias are accounted for. The 80% mortality (M24) threshold remains the most reliable indicator of pyrethroid ITN quality using pyrethroid susceptible mosquitoes. In the absence of alternative tests, cone bioassays could be used as part of pre-delivery QA.
Comparison of cone bioassay estimates at two laboratories with different Anopheles mosquitoes for quality assurance of pyrethroid insecticide-treated nets
(Springer Nature., 2022-07-07) Mbwambo, Stephen; Bubun, Nakei; Mbuba, Emmanuel; Moore, Jason; Mbina, Kasiani; Kamande, Dismas; Laman, Moses; Mpolya, Emmanuel; Odufuwa, Olukayode; Freeman, Tim; Karl, Stephan; Moore, Sarah
ckground: Quality assurance (QA) of insecticide-treated nets (ITNs) delivered to malaria-endemic countries is con ducted by measuring physiochemical parameters, but not bioefcacy against malaria mosquitoes. This study explored utility of cone bioassays for pre-delivery QA of pyrethroid ITNs to test the assumption that cone bioassays are consist ent across locations, mosquito strains, and laboratories. Methods: Double-blinded bioassays were conducted on twenty unused pyrethroid ITNs of 4 brands (100 nets, 5 subsamples per net) that had been delivered for mass distribution in Papua New Guinea (PNG) having passed pre delivery inspections. Cone bioassays were performed on the same net pieces following World Health Organization (WHO) guidelines at the PNG Institute of Medical Research (PNGIMR) using pyrethroid susceptible Anopheles farauti sensu stricto (s.s.) and at Ifakara Health Institute (IHI), Tanzania using pyrethroid susceptible Anopheles gambiae s.s. Additionally, WHO tunnel tests were conducted at IHI on ITNs that did not meet cone bioefcacy thresholds. Results from IHI and PNGIMR were compared using Spearman’s Rank correlation, Bland–Altman (BA) analysis and analysis of agreement. Literature review on the use of cone bioassays for unused pyrethroid ITNs testing was conducted. Results: In cone bioassays, 13/20 nets (65%) at IHI and 8/20 (40%) at PNGIMR met WHO bioefcacy criteria. All nets met WHO bioefcacy criteria on combined cone/tunnel tests at IHI. Results from IHI and PNGIMR correlated on 60-min knockdown (KD60) (rs=0.6,p=0.002,n=20) and 24-h mortality (M24) (rs=0.9,p<0.0001,n=20) but BA showed systematic bias between the results. Of the 5 nets with discrepant result between IHI and PNGIMR, three had confdence intervals overlapping the 80% mortality threshold, with averages within 1–3% of the threshold. Including these as a pass, the agreement between the results to predict ITN failure was good with kappa=0.79 (0.53–1.00) and 90% accuracy. Conclusions: Based on these study fndings, the WHO cone bioassay is a reproducible bioassay for ITNs with>80% M24, and for all ITNs provided inherent stochastic variation and systematic bias are accounted for. The literature
Cone Bioassays Provide Reproducible Bioefficacy Estimates with Different Anopheline Mosquitoes and Can Be Used for Quality Assurance of Pyrethroid Insecticide Treated Nets
(Research Square, 2022-01-24) Mbwambo, Stephen; Bubun, Nakei; Mbuba, Emmanuel; Moore, Jason; Mbina, Kasiani; Kamande, Dismas; Laman, Moses; Mpolya, Emmanuel; Odufuwa, Olukayode; Freeman, Tim; Karl, Stephan; Moore, Sarah
Background Quality assurance (QA) of insecticide-treated nets (ITNs) delivered to malaria-endemic countries is conducted by measuring physiochemical parameters, but not bioecacy against malaria mosquitoes. The cone bioassay provides a simple evaluation of ITN bioecacy and its conditions and parameters are prescribed by the World Health Organization (WHO). This study explored utility of cone bioassays for pre- delivery QA of pyrethroid ITNs in two test facilities using different mosquito species to test the assumption that cone bioassays are consistent and reproducible across locations, mosquito strains, and laboratories. Methods Double-blinded bioassays were conducted on unused pyrethroid ITNs of 4 brands (5 nets/brand, 5 subsamples/net) that had been delivered for mass distribution in Papua New Guinea (PNG) having passed physiochemical testing of chemical content. Cone bioassays were performed on adjacent net pieces following WHO guidelines at the PNG Institute of Medical Research (PNGIMR) using pyrethroid susceptible Anopheles farauti s.s. and at Ifakara Health Institute (IHI), Tanzania using pyrethroid susceptible Anopheles gambiae s.s. Additionally, WHO tunnel tests was conducted at IHI on ITNs that did not meet cone bioecacy thresholds. Results from IHI and PNGIMR were compared using Spearman’s Rank, Bland Altman and Cohen’s kappa. A literature review on the utility of cone bioassays for unused pyrethroid ITNs testing was also conducted. Results In cone bioassays, 13/20 nets (65%) met WHO bioecacy criteria at IHI and 8/20 (40%) at PNGIMR. All nets met WHO bioecacy criteria on combined cone/tunnel tests. Results from IHI and PNGIMR correlated on 60-minute knockdown (rs=0.6, p=0.002,n=20) and 24-hour mortality (rs=0.9, p<0.0001,n=20) but there was systematic bias between the results measured by Bland Altman. Of the 5 nets with discrepant result between IHI and PNGIMR, three had condence intervals overlapping the 80% mortality threshold, with averages within 1-3% of the threshold. The agreement between the results to predict ITN failure was good with kappa=0.79 (0.53-1.00) and 90% accuracy. Conclusions WHO cone is a reproducible means to measure pyrethroid ITN bioecacy using a combination of knockdown and mortality. In the absence of an alternative tests, cone tests could be used to assess the availability of active ingredients at the surface of ITN (where mosquitoes encounter it) as part of pre-delivery QA.
Understanding the role of serological and clinical data on assessing the dynamic of malaria transmission: a case study of Bagamoyo district, Tanzania
(Pan African Medical Journal, 2022-10-07) Mwamlima, Tunu; Mwakasungula, Solomon; Mkindi, Catherine; Tambwe, Mgeni; Mswata, Sarah; Mbwambo, Stephen; Mboya, Michael; Draper, Simon; Silk, Sarah; Mpina, Maxmillian; Vianney, John-Mary; Olotu, Ally
Introduction: naturally acquired blood-stage malaria antibodies and malaria clinical data have been reported to be useful in monitoring malaria change over time and as a marker of malaria exposure. This study assessed the total immunoglobulin G(IgG) levels to Plasmodium falciparum schizont among infants (5-17 months), estimated malaria incidence using routine health facility-based surveillance data and predicted trend relation between anti-schizont antibodies and malaria incidence in Bagamoyo. Methods: 252 serum samples were used for assessment of total IgG by enzyme-linked immunosorbent assay and results were expressed in arbitrary units (AU). 147/252 samples were collected in 2021 during a blood-stage malaria vaccine trial [ClinicalTrials.gov NCT04318002], and 105/252 were archived samples of malaria vaccine trial conducted in 2012 [ClinicalTrials.gov NCT00866619]. Malaria incidence was calculated from outpatient clinic data of malaria rapid test or blood smear positive results retrieved from District-Health-Information Software-2 (DHIS2) between 2013 and 2020. Cross sectional data from both studies were analysed using STATA version 14. Results: this study demonstrated a decline in total anti-schizont IgG levels from 490.21AU in 2012 to 97.07AU in 2021 which was related to a fall in incidence from 58.25 cases/1000 person-year in 2013 to 14.28 cases/1000 person-year in 2020. We also observed a significant difference in incidence when comparing high and low malaria transmission areas and by gender. However, we did not observe differences when comparing total anti-schizont antibodies by gender and study year. Conclusion: total anti-schizont antibody levels appear to be an important serological marker of exposure for assessing the dynamic of malaria transmission in infants living in malaria-endemic regions.
Understanding the role of serological and clinical data on assessing the dynamic of malaria transmission: a case study of Bagamoyo district, Tanzania
(African Field Epidemiology Network, 2022-10-07) Mwamlima, Tunu; Mwakasungula, Solomon; Mkindi, Catherine; Tambwe, Mgeni; Mswata, Sarah; Mbwambo, Stephen; Mboya, Michael; Draper, Simon; Silk, Sarah; Mpina, Maxmillian; Vianney, John-Mary; Olotu, Ally
Introduction: naturally acquired blood-stage malaria antibodies and malaria clinical data have been reported to be useful in monitoring malaria change over time and as a marker of malaria exposure. This study assessed the totalimmunoglobulin G (IgG) levels to Plasmodium falciparum schizont among infants (5-17 months), estimated malaria incidence using routine health Facility-based surveillance data and predicted trend relation between anti-schizont antibodies and malaria incidence in Bagamoyo. Methods: 252 serum samples were used for assessment of total IgG by enzyme-linked immunosorbent assay and results were expressed in arbitrary units (AU).147/252 samples were collected in 2021 during a blood-stage malaria vaccine trial [ClinicalTrials.gov NCT04318002], and 105/252 were archived samples of malaria vaccine trial conducted in 2012 [ClinicalTrials.gov NCT00866619]. Malaria incidence was calculated from outpatient clinic data of malaria rapid test or blood smear positive results retrieved from District-Health-Information- Software-2 (DHIS2) between 2013 and 2020. Cross-sectional data from both studies were analyzed using STATA version 14. Results: this study demonstrated a decline in total anti-schizont IgG levels from 490.21AU in 2012 to 97.07AU in 2021 which was related to a fall in incidence from 58.25 cases/1000 person-year in 2013 to 14.28 cases/1000 person-year in 2020. We also observed a significant difference in incidence when comparing high and low malaria transmission areas and by gender. However, we did not observe differences when comparing total anti-schizont antibodies by gender and study year. Conclusion: total anti-schizont antibody levels appear to be an important serological marker of exposure for assessing the dynamic of malaria transmission in infants living in malaria-endemic regions.