Epidemiology: Malaria in Northern Region, Ghana

The Northern Region of Ghana is a remote, sparsely populated savannah area with limited medical and other infrastructure. Malaria is the main reason for seeking health care and for pediatric hospital admissions.

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Epidemiology of malaria

The project aims at assessing the epidemiology of malaria in the region to build a base for subsequent association and intervention studies. Several surveys on the prevalence, incidence, and manifestation of malaria have been conducted in the regional capital Tamale and the surrounding districts. In the Northern Region, malaria is hyperendemic and occurs perennially with only little seasonal variation. In the city of Tamale, children experience approximately three clinical episodes of malaria per year. In the surrounding rural areas, malaria shows pronounced heterogeneity. Chloroquine, first-line antimalarial drug until 2004 and still widely used, suffers a treatment failure rate of >50%. Severe anaemia is the predominant manifestation of severe malaria in this region; cerebral malaria is comparatively rare. The case fatality rate of severe malaria in Tamale is in the range of 11%.

Project Details

Principal Investigator:
Prof. Dr. med. Frank P. Mockenhaupt

Co-workers:
Antje Tomschegg
Bärbel Jakob
Lydia Adjei
Susanne Röwer

Co-operations:
Dr. Rowland Otchwemah, School of Medicine and Health Sciences, Tamale, Ghana
Dr. Sabine Gellert, Tamale Teaching Hospital, Tamale, Ghana
Dr. Stephan Ehrhardt, Dr. Jakob Cramer, Bernhard-Nocht-Institut für Tropenmedizin, Hamburg
Dr. Sylvester Anemana, Dr. Elias Sory, Dr. Andrew Seidu, Ministry of Health, Tamale, Ghana
Dr. Teunis Eggelte, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Amsterdam, Holland
Prof. Klaus Stark, Robert-Koch-Institut, Berlin

Doctoral students:
Andreas Knobloch
Annika Mathieu
Birgit Marsing
Franziska Mylius
Gerrit Weber
Jana Grabenhenrich
Katharina Goltz
Kathrin Hohensee
Martina Kubo
Miriam Markert
Regina Schneiders
Sarah Kayser
Thomas Holstein

Project duration:
2000-2006

Project status:
Abgeschlossen/Auswertung

Funding:
Charité

Papers

Wichmann O, Eggelte TA, Gellert S, Osman ME, Mylius F, Ehrhardt S, Anemana SD, Bienzle U, Mockenhaupt FP. High residual chloroquine blood levels in African children with severe malaria seeking healthcare. Trans R Soc Trop Med Hyg. 2007 Jul;101(7):637-42.

Ehrhardt S, Burchard GD, Mantel C, Cramer JP, Kaiser S, Kubo M, Otchwemah RN, Bienzle U, Mockenhaupt FP. Malaria, anemia, and malnutrition in african children--defining intervention priorities. J Infect Dis. 2006 Jul 1;194(1):108-14. 26.

Röwer S, Bienzle U, Weise A, Lambertz U, Forst T, Otchwemah RN, Pfützner A, Mockenhaupt FP. Short communication: high prevalence of the cytochrome P450 2C8*2 mutation in Northern Ghana. Trop Med Int Health. 2005 Dec;10(12):1271-3.

Ehrhardt S, Mockenhaupt FP, Eggelte TA, Agana-Nsiire P, Stollberg K, Anemana SD, Otchwemah RN, Bienzle U. Chloroquine blood concentrations and molecular markers of chloroquine-resistant Plasmodium falciparum in febrile children in northern Ghana. Trans R Soc Trop Med Hyg. 2003 Nov-Dec;97(6):697-701.

Ehrhardt S, Mockenhaupt FP, Anemana SD, Otchwemah RN, Wichmann D, Cramer JP, Bienzle U, Burchard GD, Brattig NW. High levels of circulating cardiac proteins indicate cardiac impairment in African children with severe Plasmodium falciparum malaria. Microbes Infect. 2005 Aug-Sep;7(11-12):1204-10.

Cramer JP, Nussler AK, Ehrhardt S, Burkhardt J, Otchwemah RN, Zanger P, Dietz E, Gellert S, Bienzle U, Mockenhaupt FP. Age-dependent effect of plasma nitric oxide on parasite density in Ghanaian children with severe malaria.Trop Med Int Health. 2005 Jul;10(7):672-80.

Mockenhaupt FP, Ehrhardt S, Burkhardt J, Bosomtwe SY, Laryea S, Anemana SD, Otchwemah RN, Cramer JP, Dietz E, Gellert S, Bienzle U. Manifestation and outcome of severe malaria in children in northern Ghana. Am J Trop Med Hyg. 2004 Aug;71(2):167-72.

Mockenhaupt FP, Ehrhardt S, Otchwemah R, Eggelte TA, Anemana SD, Stark K, Bienzle U, Kohne E. Limited influence of haemoglobin variants on Plasmodium falciparum msp1 and msp2 alleles in symptomatic malaria. Trans R Soc Trop Med Hyg. 2004 May;98(5):302-10.

Mockenhaupt FP, Ehrhardt S, Eggelte TA, Markert M, Anemana S, Otchwemah R, Bienzle U. Plasmodium falciparum multiplicity correlates with anaemia in symptomatic malaria. Trop Med Int Health. 2003 Oct;8(10):857-9.

Burchard GD, Ehrhardt S, Mockenhaupt FP, Mathieu A, Agana-Nsiire P, Anemana SD, Otchwemah RN, Abel W, Brattig N. Renal dysfunction in children with uncomplicated, Plasmodium falciparum malaria in Tamale, Ghana. Ann Trop Med Parasitol. 2003 Jun;97(4):345-50.