title: Incidence of malaria among mosquito collectors conducting human landing catches in western Kenya.
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.
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA. jgimnig@cdc.gov
authors.forename: John E
authors.initials: JE
authors.lastname: Gimnig
authors.forename: Edward D
authors.initials: ED
authors.lastname: Walker
authors.forename: Peter
authors.initials: P
authors.lastname: Otieno
authors.forename: Jackline
authors.initials: J
authors.lastname: Kosgei
authors.forename: George
authors.initials: G
authors.lastname: Olang
authors.forename: Maurice
authors.initials: M
authors.lastname: Ombok
authors.forename: John
authors.initials: J
authors.lastname: Williamson
authors.forename: Doris
authors.initials: D
authors.lastname: Marwanga
authors.forename: Daisy
authors.initials: D
authors.lastname: Abong'o
authors.forename: Meghna
authors.initials: M
authors.lastname: Desai
authors.forename: Simon
authors.initials: S
authors.lastname: Kariuki
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Hamel
authors.forename: Neil F
authors.initials: NF
authors.lastname: Lobo
authors.forename: John
authors.initials: J
authors.lastname: Vulule
authors.forename: M Nabie
authors.initials: MN
authors.lastname: Bayoh
mesh_terms: D000293:Adolescent; D000328:Adult; D053626:Atovaquone / Q000627:therapeutic use; D015331:Cohort Studies; D004338:Drug Combinations; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D002727:Proguanil / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D004338:Drug Combinations; C109496:atovaquone, proguanil drug combination; D002727:Proguanil; D053626:Atovaquone