Malaria Journal最新文献

{"title":"Protocol for a multicentric open-label randomized controlled trial comparing low-dose (0.25 mg/kg) and standard-dose (0.75 mg/kg) primaquine for gametocytocidal efficacy and safety in Plasmodium falciparum malaria.","authors":"Payal Gulati, Richa Singhal, Apoorv Gupta, Anjali, Praveen Kumar Tripathi, Dewesh Kumar, Diamond Prakash Sinha, S P Singh, Khileshwar Singh, Rajendra Kumar Baharia, K N Bhatt, Ashvin H Vasava, Amit Gamit, Manoj B Patki, Waseem A Malla, Lokesh Kori, Deepali Savargaonkar, Nibir Chakma, Daksh Parmar, Lenin Alagesan, Ritika Kashyap, Kuldeep Singh, Anup R Anvikar, Praveen K Bharti, Nitika Nitika","doi":"10.1186/s12936-026-05912-1","DOIUrl":"https://doi.org/10.1186/s12936-026-05912-1","url":null,"abstract":"<p><strong>Introduction: </strong>World Health Organization (WHO) in 2010, recommended 0.75 mg/kg single dose primaquine for killing gametocytes after ruling out glucose-6-phosphate dehydrogenase (G6PD) deficiency. However, considering the practical feasibility of G6PD testing, WHO revised the recommendation in 2012 to 0.25 mg/kg single dose primaquine on day-1. This study aims to investigate the efficacy and safety of single-low dose primaquine (0.25 mg/kg) administered on day-1 to intervention arm compared to standard regimen, high-dose primaquine (0.75 mg/kg) administered on day-2 to control arm.</p><p><strong>Methods and analysis: </strong>This is a hospital based, open-label, multi-centric, randomized-controlled trial being conducted at four different sites in India, with a target sample size of 496 i.e., 124 participants per site. Participants above 18 years of age with uncomplicated P. falciparum malaria and normal glucose-6-phosphate dehydrogenase (G6PD) activity, defined as > 4.0 IU/g Hb using the point-of-care test, weight > 40 kg, haemoglobin > 8 g/dL are treated with ACT and randomized to either control or intervention arm. Efficacy assessment is based on gametocytemia as inferred from examination of stained peripheral blood smears during enrolment and follow-up. In addition, quantitative nucleic acid sequence-based amplification (QT-NASBA) for Pfs25 mRNA, will be used to quantify the gametocytes on day 1, 2/3, 7, and 14. Safety assessment during 14-day follow-up will be based on percentage of participants with more than 25% drop in haemoglobin, haemoglobin drop of 5 g/dl, haemoglobin value less than 8 g/dl, mean of maximum drop in haemoglobin during 28-day follow-up; and frequency of adverse events reported during the follow-up in both the arms. The primary outcome of the study is based on gametocyte density and point prevalence of gametocyte (efficacy) and haemoglobin concentration (safety) from enrolment to day 14 (for efficacy) and day 28 (for safety).</p><p><strong>Ethics and dissemination: </strong>Study has been approved by Institutional Ethics Committee (NIMR/IEC-M/2023/970/v6-Jun/01). The study findings will be disseminated through publications in peer-reviewed journals as well as academic presentations. The findings will support evidence-based recommendations for national malaria control programs in India, potentially advocating for the adoption of the lower dose primaquine regimen.</p><p><strong>Trial registration number: </strong>CTRI/2025/07/091988 (CTRI registration).</p><p><strong>Trial status: </strong>Enrollment started in August, 2025. The trial is going on.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-demographic predictors of insecticide-treated bed net ownership and utilization for protection against malaria by rural community members across five regions of Mainland Tanzania.","authors":"Gervas A Chacha, Misago D Seth, Salehe S Mandai, Daniel A Petro, Daniel P Challe, Angelina J Kisambale, Rule Budodo, Rashid A Madebe, Ruth B Mbwambo, Catherine Bakari, Dativa Pereus, Sijenunu Aaron, Daniel Mbwambo, Abdallah Lusasi, Samuel Lazaro, Celine I Mandara, Deus S Ishengoma","doi":"10.1186/s12936-026-05926-9","DOIUrl":"https://doi.org/10.1186/s12936-026-05926-9","url":null,"abstract":"<p><strong>Background: </strong>Despite decades of control efforts. malaria burden in Tanzania remains high, with marked heterogeneity in transmission intensity across regions. Insecticide-treated bed nets (ITNs) are a core malaria intervention and are distributed through multiple channels in Tanzania to promote equitable access and use, yet disparities in ITNs ownership and use persist. This study evaluated socio-demographic predictors of ITNs ownership and use among rural communities from five regions with varying malaria endemicity.</p><p><strong>Methods: </strong>A community-based cross-sectional survey covering individuals aged ≥ 6 months was conducted from July to August 2023 in 15 villages across five districts from five regions of Mainland Tanzania (Kagera, Kigoma, Njombe, Ruvuma, and Tanga). Data on demographics, malaria prevention practices, anthropometrics and socio-economic status (SES) were collected using structured questionnaires installed in tablets, run with Open Data Kit (ODK) software. Socio-demographic predictors of ITNs ownership and use were assessed using logistic regression analysis. The results were reported as crude (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (CI) and a p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among the 10,228 enrolled participants, 7939 (77.6%) and 7899 (77.2%) reported owning and using ITNs, respectively. ITNs ownership and use varied significantly across districts (p < 0.001), with the highest rates observed in Nyasa (Ruvuma) and the lowest in Kyerwa (Kagera). Females had higher odds of both ITNs ownership and use than males (aOR = 1.27, 95% CI 1.12-1.45, p < 0.001 for both outcomes). Under-fives were more likely to own (aOR = 1.83, 95%CI 1.56-2.15, p < 0.001) and use ITNs (aOR = 2.26, 95%CI 1.62-3.15, p < 0.001) than adults. Participants from Nyasa (Ruvuma), Ludewa (Njombe), Muheza (Tanga) and Buhigwe (Kigoma) districts exhibited higher odds of ITNs ownership and use compared to those from Kyerwa (Kagera) (p < 0.001). Higher education attainment and household SES were independently associated with increased ITNs ownership and use (p < 0.001).</p><p><strong>Conclusion: </strong>Although ITNs ownership and use were relatively higher across the surveyed communities, coverage remained below the national target of 80% (projected for 2023). Higher ITNs ownership and use were reported among females, under-fives, participants with higher education and those from households with high SES. Disparities by sex, age groups, household SES and education status persist and should be explicitly addressed through ITNs distribution strategies to enable equitable access and use of ITNs across all population groups to expedite progress toward malaria elimination in Tanzania.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAR-macrophage therapy: a novel strategy to overcome antimalarial drug resistance by targeting PfEMP1-mediated adhesion.","authors":"Daiqian Zhu, Weijia Cheng, Yao Zhang, Huiyin Zhu, Zhixin Liu, Haimei Shi, Qingfeng Zhang, Jian Li","doi":"10.1186/s12936-026-05915-y","DOIUrl":"https://doi.org/10.1186/s12936-026-05915-y","url":null,"abstract":"<p><p>Antimalarial drug resistance poses a critical threat to global malaria control efforts. Despite the continuous development of novel antimalarial compounds, the emergence of drug resistance remains inevitable, highlighting the urgent need for paradigm-shifting therapeutic approaches. Here, we propose an innovative chimeric antigen receptor-macrophage (CAR-M) cell therapy that circumvents traditional small-molecule limitations by harnessing the innate phagocytic capacity of macrophages. This strategy exploits the specific adhesive interactions between Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) and host receptors (CD36, ICAM-1/CD54, EPCR/CD201) to enable targeted recognition and elimination of infected erythrocytes. By engineering macrophages with chimeric antigen receptors directed against PfEMP1-binding domains, we establish a cell-based immunotherapy platform that provides sustained anti-parasitic activity independent of conventional drug susceptibility profiles. This approach represents a fundamental departure from chemical-based interventions by providing a potentially resistance-proof therapeutic modality for drug-resistant malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylene blue retains in vitro activity against early ring-stage artemisinin-resistant Plasmodium falciparum.","authors":"Olivia Verdier, Peter Christensen, Chalita Kaewkanya, Pachinee Kobphan, Candy Beau, Aung Pyae Phyo, Mallika Imwong, Kesinee Chotivanich, Nicholas J White, François Nosten, Victor Chaumeau","doi":"10.1186/s12936-026-05928-7","DOIUrl":"https://doi.org/10.1186/s12936-026-05928-7","url":null,"abstract":"<p><p>Artemisinin resistance in Plasmodium falciparum is now well established in three continents and challenges the efficacy of antimalarial drug regimens. This study examined whether methylene blue, an ancient antimalarial drug with a broad spectrum of activity against Plasmodium blood stages, retains its activity against the young rings of artemisinin-resistant parasites. Clinical isolates carrying kelch13 wild type (n = 3), R561H (n = 9), or P441L (n = 10) genotypes were tested with a modified ring survival assay whereby 0- to 3-h post-invasion rings were exposed to a range of methylene blue concentrations. Ring survival was analysed with a Bayesian mixed effects E_max model accounting for variability across isolates and experimental replicates. Methylene blue suppressed ring-stage survival at low nanomolar concentrations with no evidence of kelch13-mediated cross-resistance: the mean 50% inhibitory concentration (IC₅₀) estimates were 23 nM (95% credible interval [CrI]: 15 to 37) for wild type, 27 nM (95% CrI: 21 to 36) for R561H and 14 nM (95% CrI: 10 to 20) for P441L. These findings indicate that methylene blue remains active in vitro against ring-stage artemisinin-resistant parasites.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of cumulative exposure to media channels for malaria messages on knowledge of malaria prevention among women (15-49 years) in Uganda.","authors":"Charles Natuhamya, Rejoice Uche Obiora, Gideon Ikemdinachi Nwankwo, Delight Mawufemor Agbi, Isaac Isiko, Edson Mwebesa","doi":"10.1186/s12936-026-05927-8","DOIUrl":"https://doi.org/10.1186/s12936-026-05927-8","url":null,"abstract":"<p><strong>Introduction: </strong>Malaria remains a leading global public health concern, disproportionately affecting populations in low-resource settings. Uganda continues to contribute substantially to the global malaria burden, yet exposure to malaria-related health messages remains limited. In recent years, diverse media platforms have been adopted to disseminate prevention messages. This study assessed the influence of cumulative exposure to malaria message media channels on knowledge of malaria prevention and its associated factors among women of reproductive age in Uganda.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the 2018-2019 Uganda Malaria Indicator Survey (UMIS), comprising 7124 women aged 15-49 years selected using a two-stage cluster and stratified sampling design. Knowledge of four prevention methods recommended by World Health Organization (WHO), bed nets, insecticide-treated nets (ITNs), preventive medicine, and indoor residual spraying (IRS) was assessed. Associations between cumulative media exposure and malaria knowledge were examined using t-tests, margins analysis, and mixed-effects negative binomial regression models.</p><p><strong>Results: </strong>Knowledge of malaria prevention was unevenly distributed: 76.5% of women reported awareness of bed nets, compared with only 9.1% for ITNs, 6.2% for preventive medicine, and 4.3% for IRS. Cumulative exposure to media channels was significantly associated with knowledge of ITNs (p < 0.001), preventive medicine (p = 0.002), and IRS (p < 0.001), but not bed nets. Education, age, wealth, residence, and region were significant determinants of exposure to media channels. Women with secondary or higher education were nearly twice as likely to report exposure to multiple channels compared to uneducated women (Incidence Rate Ratio, IRR = 1.86; 95% Confidence Interval, CI 1.59-2.17). Similarly, women aged ≥ 40 years were 69% more likely (IRR = 1.69; 95% CI 1.35-2.11) to report exposure to multiple channels than those under 20 years. In contrast, rural and refugee women reported significantly lower exposure relative to urban residents (IRR = 0.77 and 0.28, respectively).</p><p><strong>Conclusions: </strong>Cumulative multi-channel exposure to malaria prevention messages significantly improves women's knowledge of ITNs, preventive medicine, and IRS. However, structural inequities in education, wealth, and place of residence limit access to diverse channels. Integrated, context-specific, and equity-focused communication strategies are essential to broaden awareness beyond bed nets and to accelerate progress toward malaria control and elimination in Uganda.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasmodium vivax infection in Duffy-negative populations in Sudan: a systematic review and meta-analysis of host-parasite genetic adaptation.","authors":"Mohammed Elfaki, Safaa Ahmed, Musab M Ali Albsheer, Muzamil Mahdi Abdel Hamid","doi":"10.1186/s12936-026-05923-y","DOIUrl":"https://doi.org/10.1186/s12936-026-05923-y","url":null,"abstract":"<p><strong>Background: </strong>Sudan is one of the few African countries reporting increasing Plasmodium vivax infections despite the high prevalence of the Duffy-negative phenotype, historically considered protective against this parasite. Emerging molecular evidence challenges this paradigm. The objective of this systematic review and meta-analysis was to synthesize evidence on the prevalence and geographic distribution of P. vivax infection, Duffy antigen polymorphisms, parasite genetic adaptations, and diagnostic limitations in Sudan.</p><p><strong>Methods: </strong>This review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO (CRD42025127714). The reports of P. vivax infection in Sudan focusing on host Duffy status and the parasite genetic variability from 2005 to 2025 were identified through systematic searches of PubMed, Web of Science, Scopus, and EMBASE with predefined Boolean search operators. To determine the risk of bias, the Joanna Briggs Institute prevalence study checklist was employed. To obtain a pooled prevalence estimate in Duffy-negative individuals, a random-effects meta-analysis (DerSimonian-Laird estimator) was conducted. Heterogeneity was assessed using Cochran's Q test and the I² statistic, while publication bias was evaluated using funnel plots and Egger's regression test.</p><p><strong>Results: </strong>A total of sixteen studies conducted between 2005 and 2025, including 5,753 participants from various regions of Sudan, were included. P. vivax infection was reported in both Duffy-positive and Duffy-negative individuals. Meta-analysis of five studies reporting host Duffy antigen status showed a pooled prevalence of P. vivax infection of 11.7% (95% CI 7.2-17.3%) among Duffy-negative individuals. The studies showed moderate heterogeneity (I² = 56%). Substantial genetic diversity was observed in the P. vivax Duffy Binding Protein (PvDBP), including multiple haplotypes and both Malagasy-type and Cambodian-type gene duplications. Most studies were assessed as having low to moderate risk of bias, and funnel plot inspection did not suggest substantial publication bias, although interpretation is limited by the small number of studies.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis provide evidence that P. vivax infection occurs among Duffy-negative individuals in Sudan, challenging the long-standing assumption of complete Duffy-mediated protection. The observed parasite genetic diversity highlights adaptive mechanisms that may facilitate infection in Duffy-negative hosts. Strengthening molecular surveillance and integrating host-parasite genomic data into national malaria control programs will be critical to inform malaria elimination strategies and vaccine development in Africa.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous distribution of avian malaria parasites across mosquito species: disproportionate involvement of Culex restuans in the Midwestern United States.","authors":"Arif Ciloglu, Andrew J Mackay, Corrado Cara, Chang-Hyun Kim, Aurora Marguccio, Jiayue Yan, Christopher M Stone","doi":"10.1186/s12936-026-05925-w","DOIUrl":"https://doi.org/10.1186/s12936-026-05925-w","url":null,"abstract":"<p><strong>Background: </strong>Avian malaria parasites and related haemosporidians are diverse and widespread vector-borne parasites that circulate within complex host-vector networks. Despite their ecological importance, their diversity and circulation within mosquito communities remain poorly understood in temperate North America. The Midwestern United States, located along major North American migratory flyways, supports diverse avian habitats and mosquito assemblages, providing an ideal setting to investigate these interactions. Here, we characterized the occurrence, phylogenetic diversity, and mosquito-lineage associations of avian haemosporidians in mosquitoes.</p><p><strong>Methods: </strong>A total of 233 pools comprising 6170 unfed female mosquitoes from seven species were collected from 38 protected natural areas in northern, central, and southern Illinois. Samples were screened for avian haemosporidian DNA by nested PCR targeting the mitochondrial cytochrome b gene. Positive samples were analyzed by multiplex PCR and sequencing to identify parasite lineages and assess potential mixed infections. Phylogenetic relationships were reconstructed, and mosquito-lineage associations were visualized using a bipartite network. Infection rates were estimated using maximum likelihood estimation (MLE) and minimum infection rate (MIR), and factors associated with infection prevalence in pooled samples were evaluated using pooled-binomial regression.</p><p><strong>Results: </strong>Of 233 pools, 44 (18.9%) were positive for avian haemosporidians. Eleven lineages were identified, including nine Plasmodium and two Haemoproteus lineages; one Plasmodium lineage was novel. pTUMIG03 (Plasmodium unalis) was the most frequently detected lineage, whereas pSYAT05 (P. vaughani) showed the broadest mosquito distribution. Culex restuans harbored the highest lineage diversity and infection rate among the mosquito species examined. Mosquito species was a significant predictor of infection prevalence estimated from pooled samples, and Cx. restuans was most strongly associated with avian Plasmodium detection. Additionally, a deer-associated non-avian Plasmodium lineage was incidentally detected in two pools.</p><p><strong>Conclusions: </strong>Mosquito populations in Illinois harbor a diverse assemblage of avian haemosporidians, with heterogeneous lineage distributions across mosquito taxa. Culex restuans emerged as the species most strongly associated with avian Plasmodium prevalence, suggesting an important role in local enzootic circulation. These findings expand current knowledge of avian haemosporidian diversity in North American mosquito communities and provide a basis for future studies integrating mosquito surveillance, avian host sampling, and vector competence experiments.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the 2023-armed conflict on routine malaria imapact indicators in Sudan (January 2020-March 2025): a mixed-methods analysis of surveillance data.","authors":"Khlood Fathi Alnaeem, Unnati Rani Saha, Hewida Fathalrhman Ahmed, Christina Mergenthaler","doi":"10.1186/s12936-026-05914-z","DOIUrl":"https://doi.org/10.1186/s12936-026-05914-z","url":null,"abstract":"<p><strong>Background: </strong>Malaria constitutes a major public health burden in Sudan, accounting for most outpatient visits and hospital admissions across approximately 80% of the states. The armed conflict beginning in April 2023 severely disrupted an already fragile health system, affecting the surveillance system infrastructure. No prior studies have assessed the impact of conflict on routine malaria surveillance data reported through District Health Information Software 2 (DHIS2). This study evaluated the effects of conflict on completeness and reporting of malaria impact indicators data across Sudanese states.</p><p><strong>Methods: </strong>A mixed-methods design combined quantitative analysis of quarterly DHIS2 data (January 2020-March 2025) from 17 states with qualitative exploration of surveillance system functionality. Quantitative analysis included descriptive analyses and interrupted time series analysis (ITSA) of three malaria impact indicators: quarterly reported malaria cases (presumed and confirmed) per 100,000 state population, test positivity rate (RDT + microscopy), and quarterly inpatient malaria deaths per 100,000 state population. Data completeness was quantified as the proportion of missing quarterly reports per state. Descriptive analysis graphs illustrate pre- and post-conflict trends and missing data patterns. ITSA was conducted for 11 states with complete post-conflict time series; six states with incomplete data were excluded. Three key informant interviews with national- and state-level malaria programme managers, selected from severe and less severe conflict-affected states, provided contextual insights. Qualitative data were analyzed using a deductive framework approach.</p><p><strong>Results: </strong>Missing DHIS2 reporting increased substantially after April 2023. Inter-state variation was observed: western and southern states (except North Kordofan) experienced persistent data gaps, whereas northern and eastern states maintained relatively continuous reporting despite declining trends. Qualitative findings indicated stronger surveillance functionality in less-affected states by conflict. ITSA showed a statistically significant decline in quarterly reported malaria case rates per 100,000 state population at conflict quarter (p = 0.02), with no significant post-conflict trend change. Key informants identified health facility destruction, workforce shortages, unpaid salaries, and communication breakdowns as major barriers.</p><p><strong>Conclusion: </strong>The conflict coincided with widening disparities in malaria surveillance across states, reflecting underlying inequalities in health system capacity. Strengthening states' surveillance systems is critical in conflict-affected settings. Future research should examine locality-level impacts to better capture subnational variation.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic and behavioral determinants of Plasmodium vivax-specific antibody responses among short-term Myanmar migrants in Thailand.","authors":"Piyarat Sripoorote, Nichakan Inthitanon, Yupaporn Wattanagoon, Pailene S Lim, Liwang Cui, Jetsumon Sattabongkot, Daniel M Parker, Wang Nguitragool, Sadudee Chotirat, Rhea J Longley, Pyae Linn Aung","doi":"10.1186/s12936-026-05921-0","DOIUrl":"https://doi.org/10.1186/s12936-026-05921-0","url":null,"abstract":"<p><strong>Background: </strong>Migrant populations from malaria-endemic countries pose challenges to elimination efforts in low-transmission settings. This study assessed Plasmodium vivax-specific antibody responses and associated sociodemographic and behavioral determinants among short-term Myanmar migrants in Thailand.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in March-April 2025 among 300 short-term Myanmar migrants in six malaria high-burden villages of Tha Song Yang District, Tak Province. Sociodemographic and behavioral data were collected via structured questionnaires. Finger-prick dried blood spots were collected to quantify IgG responses to eight P. vivax antigens using a multiplexed Luminex assay. Predicted recent exposure was defined using a previously developed and validated random forest classification algorithm, applying a 95% specificity threshold. Logistic regression models were used to identify factors associated with predicted recent exposure, while linear regression models examined associations with a composite antibody score representing overall seroreactivity across multiple antigens.</p><p><strong>Results: </strong>Among 294 PCR-negative participants, 104 (35.4%) were predicted as recently exposed. In multivariable logistic models, higher odds of predicted recent exposure were observed for age 30-39 years (aOR = 3.11, 95% CI 1.15-8.80), secondary education or above (aOR = 3.28, 95% CI 1.09-10.3), and Karen ethnicity (aOR = 3.68, 95% CI 1.42-10.0). Protective factors included seasonal (aOR = 0.28, 95% CI 0.08-0.95) and temporary work (aOR = 0.26, 95% CI 0.08-0.84), and income > 5,000 THB (aOR = 0.17, 95% CI 0.06-0.45). Exposure was also higher among those living > 15 min from a health facility (aOR = 2.07, 95% CI 1.00-4.43) and with negative malaria attitudes (aOR = 2.02, 95% CI 1.04-4.03). Higher composite antibody levels were observed among males (β = 1.17, 95% CI 0.07-2.28, p = 0.038), older participants (β = 0.12/year, 95% CI 0.08-0.17, p < 0.001), and agricultural workers (β = 2.58, 95% CI 0.01-5.14, p = 0.049). In contrast, higher income (β = - 3.83 per 10,000 THB, 95% CI - 6.28 to - 1.37, p = 0.002), longer stay (β =  - 0.02/day, 95% CI - 0.04 to - 0.00, p = 0.025), and weekly returns to Myanmar (β = - 2.44, 95% CI - 4.14 to - 0.74, p = 0.005) were associated with lower antibody levels.</p><p><strong>Conclusions: </strong>Among PCR-negative short-term migrants, one-third showed evidence of predicted recent P. vivax exposure. Antibody levels varied by demographic, occupational, and mobility-related factors, supporting the use of sero-surveillance to inform border elimination strategies.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of automated loop-mediated isothermal amplification-(LAMP-)based xenomonitoring for Plasmodium spp. in Anopheles mosquitoes.","authors":"Albert Eisenbarth, Ayôla A Adegnika, Stravensky T Boussougou-Sambe, Lynn Glyschewski, Thomas Jacobs, Simone Kann, Andreas Krüger, Ralf M Hagen, Michael Ramharter, Esther Mehmel, Ange G Doumba Ndalembouly, Hagen Frickmann","doi":"10.1186/s12936-026-05917-w","DOIUrl":"10.1186/s12936-026-05917-w","url":null,"abstract":"<p><strong>Background: </strong>Xenomonitoring is an approach of epidemiological infection risk assessment addressing vector-transmitted infections like malaria in hematophagous arthropods. Standardization and automation can facilitate its use even in remote areas. In this study, the suitability of an automated commercial loop-mediated isothermal amplification (LAMP) assay, originally designed for the detection of malaria parasite DNA in human blood, was assessed for its applicability for xenomonitoring purposes.</p><p><strong>Methods: </strong>An automated generic LAMP assay for malaria detection in human blood was applied with Anopheles spp.</p><p><strong>Samples: </strong>The results were compared with commercial generic as well as species-specific real-time PCR.</p><p><strong>Results: </strong>LAMP identified 15/43 (34.9%, 95% CI (20.1%; 50.9%)) mosquitoes artificially exposed to Plasmodium berghei, while this was the case for 22/43 (51.2%, 95% CI (35.5%; 66.7%)) samples applying real-time PCR. Considerably less discrepancy was observed with Anopheles spp. imported to Germany from field studies with 12/172 pools (7.0%, 95% CI (3.7%; 11.9%)) for LAMP and 13/172 pools (7.6%, 95% CI (4.1%; 12.6%)) for real-time PCR. Single testing and typing of DNA isolates indicated an overall infection rate of 1.2% (20/1711) with Plasmodium falciparum, P. malariae and P. ovale. Low rates of invalid results during a field exercise proved the general suitability of the LAMP approach for use at tropical settings.</p><p><strong>Conclusions: </strong>Imperfect sensitivity in case of artificial exposure of mosquitoes to non-human plasmodial species was detected for both compared molecular approaches with slightly lower sensitivity of the LAMP approach. For Anopheles spp. infected with Plasmodium spp. causing human malaria, comparable diagnostic reliability could be shown for both approaches and the LAMP assay was shown to be suitable for application under tropical field conditions.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"25 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}