Journal of Public Health and Epidemiology
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Article Number - 4B1201F62302

Vol.9(1), pp. 9-15 , January 2017
ISSN: 2141-2316

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Full Length Research Paper

A Community-sensor index as a tool for public health surveillance of malaria drug resistance

Barbara Atogho Tiedeu
  • Barbara Atogho Tiedeu
  • Department of Biochemistry, Faculty of Science, and The Biotechnology Centre, University of Yaounde I, Cameroon.
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Mercy Mbacham Tah-Monunde
  • Mercy Mbacham Tah-Monunde
  • Department of Health Economics Policy and Management, Catholic University of Cameroon, Bamenda, Cameroon.
  • Google Scholar
Khan Payne
  • Khan Payne
  • Department of Animal Sciences, University of Dschang, Cameroon.
  • Google Scholar
Wilfred Fon Mbacham
  • Wilfred Fon Mbacham
  • Department of Biochemistry, Faculty of Science, and The Biotechnology Centre, University of Yaounde I, Cameroon.
  • Google Scholar

 Received: 30 September 2016  Accepted: 02 November 2016  Published: 31 January 2017

Copyright © 2017 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0

Infectious diseases like tuberculosis, malaria and the human immunodeficiency virus are both preventable and curable but cause about half of the deaths in the developing world. They affect people in the prime of their productive lives, inflicting a very heavy impact on development, opportunities and livelihood. Poverty is the end result with an enormous toll on the economy of developing nations. As such, the community goes for the cheapest medications that work and therefore can report on the effectiveness of drugs as an effect of many activities upstream that cause parasite unresponsiveness to therapy. The aim of this study was to investigate the relationship between community auto-medication and molecular markers of drug resistance in malaria to detect and provide evidence for when the community feels a drug is not or no longer effective. This would propose a better management policy towards decreasing drug resistance. This would be achieved by promoting proper therapy-seeking habits and thus ensure a higher quality of life and a higher productive capacity of workers. A survey was first carried out in 8 localities to observe various aspects of therapy-seeking behaviour. The knowledge and practice of malaria management and prevention were quite poor, favouring the prevalence of drug resistant parasites.  To establish an index for community-sensing of drug resistance, the prevalence of the mutation of the dhfr gene at position 108 in parasites was used in which Y = -2.5X + 48, where Y = prevalence of mutations (Pm) and X = level of self-prescription. This was confirmed by the extrapolation of the self-prescription of Fansidar (12%) against a value of 18%. This study shows that the therapy-seeking habits of a community can be used to demonstrate the prevalence of mutations to Fansidar and hence possibly to other antimalarial drugs presenting resistance. 
Key words: Therapy-seeking behaviour, auto-medication, community-sensing, molecular markers, surveillance indicators, drug resistance.


AluI, Arthrobacter luteus I; ApoII, Arthrobacter protophormiae II; Bsr I, Bacillus stearothermophilus I; CDC, Centers for Disease Control and Prevention; CTE, Cameroon Tea Estate; dhfr, dihydrofolate reductase gene; DNA, deoxyribonucleic acid; dNTP, deoxynucleotide triphosphate; HaeIII, Haemophilus    aegyptius    III;     HindIII,     Haemophilus influenzae III; HIV, human immunodeficiency syndrome; P. falciparum, Plasmodium falciparum; PCR, polymerase chain reaction; PCR-RFLP, polymerase chain reaction-restriction fragment length polymorphism; Pfcrt, Plasmodium falciparum chloroquine resistance transporter gene; Pm, prevalence of mutations; PR, prevalence of resistance; RDT, rapid diagnostic tests; RFLP, restriction fragment length polymorphism; Taq, Thermophilus aquaticus; UV, ultraviolet; WBC, white blood cell; WHO, World Health Organization.

Azikiwe CCA, Ifezulike CC, Siminialayi IM, Amazu LU, Enye JC, Nwakwunite OE (2012). A comparative laboratory diagnosis of malaria: microscopy versus rapid diagnostic test kits. As. Pac. J. Trop. Biomed. 2(4):307-310.


Basco LK, Ringwald P (2000). Molecular epidemiology of malaria in Yaounde, Cameroon VII. Analysis of recrudescence and re-infection in patients with uncomplicated malaria. Am. J. Trop. Med. Hyg. 63(5):215-221.


Centers for Disease Control and Prevention (CDC) (2015). Insecticide-treated bed nets for malaria prevention. Global Health – Division of Parasitic Diseases and Malaria.


Diourte Y, Djimde A, Doumbo OK, Sagara I, Coulibaly D, Dicko A, Diallo M, Diakite M, Cortesa JF, Plowe CV (2003). Pyrimethamine-Sulfadoxine efficacy and selection for mutations in Plasmodium falciparum Dihydrofolate Reductase and Dihydropteroate Synthase in Mali. Am. J. Trop. Med. Hyg. 60(3):475-478.


Kantele A, Jokiranta TS (2011). Review of cases with the emerging fifth human malaria parasite, Plasmodium knowlesi. Clin. Infect. Dis. 52(11):1356-1362.


Laxminarayan R, Bhutta ZA, Duse A, Jenkins P, O'Brien T, Okeke IN, Pablo-Mendez A, Klugman KP (2006). Drug resistance: risk factors (Drug use in humans). Drug resistance; Disease Control Priorities in Developing Countries (Second Edition), ed. New York: Oxford University Press.


Mackinnon MJ, Hastings IM (1998). The evolution of multi-drug resistance in malaria parasites. Trans. Roy. Soc. Trop. Med. Hyg. 92:188-195.


Mbacham WF (1998). Malaria, an ancient scourge: Myths, mistakes and management. Biodiag. Therapy. 2:4-10.


Mbenda HGN, Awasthi G, Singh PK, Gouado I, Das A (2014). Does malaria epidemiology project Cameroon as 'Africa in Miniature'? J. Biosc. 39:727-738.


Ndo C, Menze-Djantio B, Antonio-Nkondjio C (2011). Awareness, attitudes and prevention of malaria in the cities of Douala and Yaoundé (Cameroon). Parasit. Vect. 4:181-187.


Nosten F, White NJ (2007). Artemisinin-based combination treatment of falciparum malaria. Am. J. Trop. Med. Hyg. 77(6):181-192.


Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, Whitty CJM (2007). Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: Randomized trial. Brit. Med. J. 334:403.


Roll Back Malaria (2013). World Health Organization. Rollback Malaria Partnership Annual Report. Geneva, Switzerland.


Sanz LM, Crespo B, De-Cozar C, Ding XC, Llergo JL, Burrows JN, Garcia-Bustos JF, Gamo F-J (2012). P. falciparum in vitro killing rates allow to discriminate between different antimalarial mode-of-action. PLoS ONE 7(2):e30949.


Talisuna AO, Bloland P, D'Alessandro U (2004). History, dynamics, and public health importance of malaria parasite resistance. Clin. Microbiol. Rev. 17:235-254.


World Health Organization (WHO) (2013). Factsheet on the World Malaria Report 2013.


World Health Organization (WHO) (2015). Guidelines for the Treatment of Malaria. Third Edition. ISBN 978 92 4 154912 7. pp. 1-317.



APA Tiedeu, B. A., Tah-Monunde, M. M., Payne, K., & Mbacham, W. F. (2017). A Community-sensor index as a tool for public health surveillance of malaria drug resistance. Journal of Public Health and Epidemiology, 9(1), 9-15.
Chicago Barbara Atogho Tiedeu,  Mercy Mbacham Tah-Monunde, Khan Payne and Wilfred Fon Mbacham. "A Community-sensor index as a tool for public health surveillance of malaria drug resistance." Journal of Public Health and Epidemiology 9, no. 1 (2017): 9-15.
MLA Barbara Atogho Tiedeu, et al. "A Community-sensor index as a tool for public health surveillance of malaria drug resistance." Journal of Public Health and Epidemiology 9.1 (2017): 9-15.

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