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Incidence of Malaria among Mosquito Collectors Conducting Human Landing Catches in Western Kenya
Authors:John E. Gimnig  Edward D. Walker  Peter Otieno  Jackline Kosgei  George Olang  Maurice Ombok  John Williamson  Doris Marwanga  Daisy Abong'o  Meghna Desai  Simon Kariuki  Mary J. Hamel  Neil F. Lobo  John Vulule  M. Nabie Bayoh
Affiliation:Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, Michigan; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Eck Institute for Global Health, Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana
Abstract:The human landing catch (HLC) has long been the gold standard for estimating malaria transmission by mosquitoes, but has come under scrutiny because of ethical concerns of exposing collectors to infectious bites. We estimated the incidence of Plasmodium falciparum malaria infection in a cohort of 152 persons conducting HLCs and compared it with that of 147 non-collectors in western Kenya. Participants were presumptively cleared of malaria with Coartem™ (artemether-lumefantrine) and tested for malaria every 2 weeks for 12 weeks. The HLC collections were conducted four nights per week for six weeks. Collectors were provided chemoprophylaxis with Malarone™ (atovaquone-proguanil) during the six weeks of HLC activities and one week after HLC activities were completed. The incidence of malaria was 96.6% lower in collectors than in non-collectors (hazard ratio = 0.034, P < 0.0001). Therefore, with proper prophylaxis, concern about increased risk of malaria among collectors should not be an impediment to conducting HLC studies.
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