Malaria Journal最新文献

{"title":"How to use learning curves to evaluate the sample size for malaria prediction models developed using machine learning algorithms.","authors":"Sophie G Zaloumis, Megha Rajasekhar, Julie A Simpson","doi":"10.1186/s12936-025-05479-3","DOIUrl":"https://doi.org/10.1186/s12936-025-05479-3","url":null,"abstract":"<p><strong>Background: </strong>Machine learning algorithms have been used to predict malaria risk and severity, identify immunity biomarkers for malaria vaccine candidates, and determine molecular biomarkers of antimalarial drug resistance. Developing these prediction models requires large training datasets to ensure prediction accuracy when applied to new individuals in the target population. Learning curves can be used to assess the sample size required for the training dataset by evaluating the predictive performance of a model trained using different dataset sizes. These curves are agnostic to the specific prediction model, but their construction does require existing data. This tutorial demonstrates how to generate and interpret learning curves for malaria prediction models developed using machine learning algorithms.</p><p><strong>Methods: </strong>To illustrate the approach, training dataset sizes were evaluated to inform the design of a \"mock\" prediction modelling study aimed to predict the artemisinin resistance status of Plasmodium falciparum malaria isolates from gene expression data. Data were simulated based on a previously published in vivo parasite gene expression dataset, which contained transcriptomes of 1043 P. falciparum isolates from patients with acute malaria, of which 29% (299/1043) were from slow clearing infections (parasite clearance half-life > 5 h). Learning curves were produced for two machine learning algorithms, sparse Partial Least Squares-Discriminant Analysis plus Support Vector Machines (sPLSDA + SVMs) and random forests. Prediction error was measured using the balanced error rate (average of percentage of slow clearing infections incorrectly predicted as fast and percentage of fast clearing infections predicted as slow).</p><p><strong>Results: </strong>For this mock malaria prediction study, the balanced error rate on a test dataset not used for model training (208 samples) was 50% for sPLSDA + SVMs and 50% for random forests on the smallest training dataset evaluated (20 samples) and 14% for sPLSDA + SVMs and 22% for random forests on the largest training dataset evaluated (835 samples). The shape of the learning curves indicates that increasing the training dataset size beyond 835 samples is unlikely to significantly reduce the balanced error rates further.</p><p><strong>Conclusions: </strong>Learning curves are a simple tool that can be used to determine the minimum sample size required for future prediction modelling studies of different malaria outcomes that use machine learning algorithms for prediction. These curves need to be generated for each specific prediction modelling application.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"242"},"PeriodicalIF":2.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708012","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":"Individual and community-level correlates of optimal doses of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Tanzania: a multilevel analysis of the 2022 national survey.","authors":"Elihuruma Eliufoo Stephano, Tian Yusheng, Thomas Wiswa John, Stephen Mathew Kibusi, Li Yamin, Mtoro J Mtoro","doi":"10.1186/s12936-025-05482-8","DOIUrl":"https://doi.org/10.1186/s12936-025-05482-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria during pregnancy remains a significant public health challenge in sub-Saharan Africa, where approximately 32 million pregnant women are at risk. Despite the progress made in the coverage of Intermittent Preventive Treatment of malaria during pregnancy using sulfadoxine-pyrimethamine (IPTp-SP), notable gaps persist in understanding the individual and community-level factors that correlate with optimal dosing adherence. This study aims to assess these correlates in Tanzania using recent Tanzania Demographic and Health Survey (TDHS) data.</p><p><strong>Methods: </strong>This study employed an analytical cross-sectional design, utilizing data from the 2022 TDHS. This study's analysis included 4497 women who had given birth within two years before the survey. The data were analzed using multilevel mixed-effects logistic regression, employing four models to identify factors associated with optimal IPTp-SP dose uptake.</p><p><strong>Results: </strong>The overall uptake of optimal (≥ 3 doses) IPTp-SP was 31.2% (95% CI 29.1-33.3). In the adjusted analysis, individual correlates were women aged 25-34 years (AOR = 1.52, 95% CI 1.21-1.90) and 35-49 years (AOR = 1.47, 95% CI 1.10-1.96) compared to women aged 15-24 years. Women with primary education (AOR = 1.34, 95% CI 1.07-1.68) were more likely to achieve optimal uptake than those with no formal education. Furthermore, women with one child (AOR = 1.65, 95% CI 1.26-2.17) and two children (AOR = 1.37, 95% CI 1.09-1.74) showed higher odds of optimal uptake compared to women with no children. Having more than three antenatal care (ANC) visits (AOR = 1.77, 95% CI 1.47-2.12) increased the likelihood of optimal uptake compared to those with fewer than three visits. Community-level correlates of optimal IPTp-SP uptake included communities with higher ANC visit rates (AOR = 1.49, 95% CI 1.13-1.97), which showed higher odds of optimal uptake than those with low ANC visit rates. Residing in the Northern (AOR = 1.61, 95% CI 1.01-2.59) and Lake zones (AOR = 1.68, 95% CI 1.12-2.53) was also associated with higher odds of optimal uptake compared to women in the Western zone. Conversely, women in Zanzibar (AOR = 0.01, 95% CI 0.01-0.06) had low uptake because IPTp-SP is no longer recommended.</p><p><strong>Conclusion: </strong>This study revealed low uptake of optimal doses of IPTp-SP influenced by several individual and community factors. Future malaria prevention in pregnancy requires integrating control programs with reproductive health services, overcoming socio-cultural barriers, and utilizing community engagement to enhance IPTp-SP coverage.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"240"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698978","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":"Self-medication for malaria and associated factors in Kakumiro District, Uganda, August 2023: implications for malaria management and mortality prevention.","authors":"Marie Gorreti Zalwango, Richard Migisha, Bosco B Agaba, Lilian Bulage, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario","doi":"10.1186/s12936-025-05488-2","DOIUrl":"https://doi.org/10.1186/s12936-025-05488-2","url":null,"abstract":"<p><strong>Background: </strong>In August 2022, an epidemiologic investigation into an outbreak of cases of black water fever, a severe and fatal complication of malaria, was conducted in Kakumiro District, Central Uganda. Findings revealed an association between self-medication and the development of severe malaria complications. Factors associated with self-medication for uncomplicated malaria were described for improved malaria management and prevention of malaria related mortality in Uganda.</p><p><strong>Methods: </strong>A community-based cross-sectional survey was conducted in Kakumiro District in August 2023. Using multistage sampling, 592 households were selected. A semi-structured questionnaire was used to interview one participant per household about self-medication for malaria in a family member of any age who suffered from malaria 6 months prior to the interview. Data on demographics, socio-economic factors, health-seeking behaviour, self-medication and antimalarial storage at home were obtained. Modified Poisson regression model was used for multivariate analysis.</p><p><strong>Results: </strong>Of the 592 participants interviewed, 368 (62%; 95% CI 58.2-65.9%) had self-medicated for malaria. Self-medication was significantly associated with household heads aged ≥ 35 years (adjusted prevalence ratio [APR]: 1.77; 95% CI 1.04-3.01); distances ≥ 5 km to the health facility (APR: 3.05; 95% CI 2.09-4.47), and storage of antimalarial drugs at home (APR: 2.21; 95% CI 1.36-3.59). Having malaria episodes ≥ 6 in the household within 6 months was protective (APR: 0.39; 95% CI 0.23-0.65). The major reason for self-medication was antimalarial stockouts at health facilities. Drugs used for self-medication were commonly known to 65% of the respondents and were bought from drug shops (75%). Although, 85% used the recommended drug for malaria treatment, the dose was inappropriate for 66% of the patients and despite the under dose, 85% of the patients recovered without hospitalization.</p><p><strong>Conclusion: </strong>The common occurrence of self-medication for malaria and the high potential for malaria drug resistance and increased malaria mortality due to inappropriate treatment was demonstrated. Adequate antimalarial stock to health facilities, instituting policies prohibiting the sale of incomplete doses by drug shops, social behavioural change campaigns against drug storage in homes and sensitization of communities on the dangers of self-medication and the consumption of inappropriate doses could reduce self-medication practices and its eventual consequences.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"241"},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698979","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":"Overreliance on Plasmodium 18S rRNA gene for malaria molecular diagnosis-inferences from systematic review.","authors":"Nimita Deora, Musabur Rahim Khan, Priyanka Singh, Neelofer Zehra, Shubhankar Sircar, Veena Pande, Prashant K Mallick, Abhinav Sinha","doi":"10.1186/s12936-025-05424-4","DOIUrl":"https://doi.org/10.1186/s12936-025-05424-4","url":null,"abstract":"<p><strong>Background: </strong>Molecular diagnosis of malaria through nucleic acid-based amplification test is important to detect low-density, sub-microscopic and residual infections, as well as to prevent importations and re-establishment. Reliance on single/limited molecular targets could be detrimental as evidenced by false-negative PfHRP2-based RDTs, and the same may apply to PCR targets. No systematic exploration of the commonly used PCR targets has yet been documented.</p><p><strong>Methods: </strong>A systematic search was made using a previously generated database through PubMed® and Google Scholar® and supplemented by additional searches. All studies that used PCR for detecting Plasmodium infections were included in this study. Further information was retrieved on molecular targets used and the type of PCR assay used. An independent search was also made to explore the identification/development of newer molecular targets.</p><p><strong>Results: </strong>Almost all studies (93%) used 18S rRNA gene as a molecular target. Nested PCR alone (68%) was the most frequently used assay. Eighty-five percent of the studies that exploited the 18S rRNA gene target and nested PCR used the approach developed in 1993.</p><p><strong>Conclusion: </strong>Overreliance on a solitary molecular target (18S rRNA gene) for many years might be a cause for concern. Research is needed to validate newer multi-copy targets in terms of limit of detection, robust reproducibility, reduced costs, and a possibility of multiplexing.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"239"},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690701","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":"A power analysis framework to aid the design of robust semi-field vector control experiments.","authors":"Andrea M Kipingu, Dickson W Lwetoijera, Kija R Ng'habi, Samson S Kiware, Mafalda Viana, Paul C D Johnson","doi":"10.1186/s12936-025-05454-y","DOIUrl":"10.1186/s12936-025-05454-y","url":null,"abstract":"<p><strong>Background: </strong>Semi-field experiments are an efficient way of assessing the impacts of potential new vector control tools (VCTs) before field trials. However, their design is critically important to ensure their results are unbiased and informative. An essential element of the design of semi-field experiments is power analysis, which empowers researchers to ensure that only designs with adequate statistical power are adopted. In this study, a methodology was developed, and its use was demonstrated in a tutorial, to determine the required number of semi-field chambers, sampling frequency and the number of mosquitoes required to achieve sufficient power for evaluating the impact of a single VCT or two in combination.</p><p><strong>Methods: </strong>By analysing data simulated from a generalized linear mixed-effects model, power was estimated for various experimental designs, including short- (24 h) vs. long-term (3 months) experiments and single vs. combined application of interventions (e.g., insecticide-treated nets combined with pyriproxyfen autodissemination).</p><p><strong>Results: </strong>Although power increased with increasing number of chambers, sampling frequency and the number of mosquitoes, the number of chambers and variance between chambers were the dominant factors determining power relative to all other design choices. High variance between chambers decreased power, highlighting the importance of making conditions similar among chambers, by reducing variation if possible and by rotating variables if not. As compared to a single intervention, an additional intervention required an increase in the number of chambers, while short and long experiments were similar in terms of key aspects such as the number of chambers per treatment.</p><p><strong>Conclusion: </strong>Determining the most efficient experimental design for a semi-field experiment will depend on a balance of design choices and resource constraints. The power analysis framework and tutorial provided here can aid in the robust design of these widely used experiments and ultimately facilitate the development of new vector control tools (VCTs).</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"238"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667928","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}

{"title":"Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria.","authors":"Kwannan Nantavisai, Srisombat Puttikamonkul, Parnpen Viriyavejakul","doi":"10.1186/s12936-025-05483-7","DOIUrl":"10.1186/s12936-025-05483-7","url":null,"abstract":"<p><strong>Background: </strong>Endocan, a component of endothelial glycocalyx, is a recognized biomarker of endothelial dysfunction in various inflammatory and infectious diseases. Malaria, characterized by marked endothelial activation and microvascular pathology, may involve endocan, but its role remains unclear. This study aimed to assess serum endocan levels in various clinical presentations of malaria and evaluate its correlation with laboratory parameters of disease severity.</p><p><strong>Methods: </strong>Leftover serum samples from 99 participants were categorized into four groups: healthy controls (n = 20), Plasmodium vivax malaria (n = 36), uncomplicated Plasmodium falciparum malaria (n = 30), and severe P. falciparum malaria (n = 13). Serum endocan concentrations were measured via enzyme-linked immunosorbent assay on day 0 (pre-treatment) and day 7 (post-treatment). Correlation analyses examined associations between endocan levels and laboratory parameters, including parasite density, white blood cell count, haemoglobin, and platelet count.</p><p><strong>Results: </strong>All malaria groups showed significantly higher serum endocan levels compared to healthy controls (p < 0.0001). Levels were highest in severe P. falciparum (median 4.67 [IQR 2.85-7.93] ng/ml), followed by uncomplicated P. falciparum (median 3.27 [IQR 2.24-4.33] ng/ml), and P. vivax malaria (median 1.85 [IQR 1.44-3.23] ng/ml). Endocan correlated positively with parasite density in P. vivax (r_s = 0.4632, p = 0.0066) and severe P. falciparum malaria (r_s = 0.6264, p = 0.0251) and negatively with platelet count in P. vivax infections (r_s = - 0.5523, p = 0.001).</p><p><strong>Conclusion: </strong>Serum endocan is elevated in malaria in a severity-dependent manner-highest in severe P. falciparum malaria-and correlates with circulating parasite density and thrombocytopenia, highlighting its potential as a biomarker of endothelial injury in malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"236"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667930","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}

{"title":"Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision.","authors":"Mathewos Alemu Gebremichael, Tadesse Gebremedhin, Wondwossen Niguse, Girma Mamo, Bezuayehu Alemayehu, Ephrem Negeri, Ibrahim Temam, Haile Zewude, Tamerat Bogale, Endale Sahile, Erkyihun Pawlos","doi":"10.1186/s12936-025-05396-5","DOIUrl":"10.1186/s12936-025-05396-5","url":null,"abstract":"<p><strong>Background: </strong>Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS).</p><p><strong>Methods: </strong>A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings.</p><p><strong>Results: </strong>1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93-38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers.</p><p><strong>Conclusions: </strong>The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"237"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667929","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}

{"title":"Malaria epidemics and its drivers in Uganda in 2022.","authors":"Maru W Aregawi, Catherine Maiteki, John C Rek, Bosco Agaba, Charles Katureebe, Mansour Ranjbar, Chunzhe Zhang, Samson Kiware, Jimmy Opigo","doi":"10.1186/s12936-025-05351-4","DOIUrl":"10.1186/s12936-025-05351-4","url":null,"abstract":"<p><strong>Background: </strong>In Uganda, malaria is a year-round health threat, with transmission intensity varying across regions. Despite ongoing intensified interventions, an unprecedented malaria resurgence in early 2022 affected several districts, prompting a swift response from the National Malaria Control Division (NMCD). This study aims to assess the scale and underlying causes of the epidemics, quantify the excess cases and deaths, and propose targeted prevention and response strategies.</p><p><strong>Methods: </strong>District Health Information System (DHIS2) data from 2017 to 2022 were analysed. A 75th percentile threshold from 2017 to 2021 was used to define true malaria epidemics and compare them to the suspected 2022 epidemic. Excess cases, admissions, and deaths were quantified using area under the curve (AUC) calculations. The level of epidemics was compared across districts with Indoor Residual Spraying (IRS) and Integrated Community Case Management (iCCM) interventions. Precipitation data from multiple sources were used to evaluate rainfall patterns and their impact on malaria epidemics.</p><p><strong>Results: </strong>Malaria cases were lowest in 2018 but rose by 31% in 2022 compared to the 2017-2021 3rd quartile. Sixty-four of 146 districts experienced epidemics, with 4 facing persistent epidemics year-round. The 2022 epidemic accounted for 3,379,309 (95% CI 1,553,714, 5,339,709) total excess outpatient malaria cases (confirmed and presumed), 3,018,920 (95% CI 1,321,951, 4,661,201) excess confirmed cases, 149,789 (95% CI 66,029, 235,743) excess inpatient cases. Paradoxically, more epidemics occurred in IRS and iCCM districts. Precipitation patterns were consistent across years and were insignificantly correlated with the 2022 epidemic. Provinces with bimodal rainfall patterns were more prone to epidemics, while unimodal regions had fewer epidemics but higher incidence rates. Rainfall lagged by two months (Lag 2) significantly increased malaria incidence (p < 0.01), with each millimetre of rainfall two months prior associated with 13.4 additional malaria cases.</p><p><strong>Conclusion: </strong>The 2022 malaria epidemic affected 64 districts, with over 3.3 million excess cases and nearly 150,000 excess admissions. Gaps in IRS, iCCM, and intervention coverage, along with minimal rainfall correlation and high vulnerability in bimodal regions, highlight the need for better surveillance, sustainable funding, and tailored responses. While climate was not the main driver, programmatic deficiencies, vector composition shift, reduced efficacy of insecticides, coverage and effectiveness of the interventions likely fueled the epidemic. Strengthening epidemic preparedness, response, and investment will be crucial to preventing future outbreaks and achieving long-term malaria control in Uganda.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"235"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659600","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}

{"title":"Barriers to effective usage of insecticide-treated mosquito nets (ITNS) among women of reproductive age in Tanzania: a national cross-sectional survey.","authors":"Kelly Taremwa, Ebuka Louis Anyamene, Gideon Ikemdinachi Nwankwo, Miracle Kenile Agbontale, Isaac Isiko","doi":"10.1186/s12936-025-05417-3","DOIUrl":"10.1186/s12936-025-05417-3","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health challenge in Tanzania, with women of reproductive age particularly vulnerable to its effects. Insecticide-treated mosquito nets (ITNs) are a proven vector control strategy; however, their usage remains suboptimal due to various barriers. This study examines the sociodemographic, behavioural, and environmental factors associated with ITN use among women of reproductive age in Tanzania.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from the 2022 Tanzania Demographic and Health Survey (TDHS). A total of 15,254 women aged 15-49 years were included in the study. Survey-weighted logistic regression was employed to determine adjusted odds ratios (AOR) and 95% confidence intervals (CI) for factors associated with ITN usage. All data cleaning and analyses were done using STATA 17 software.</p><p><strong>Results: </strong>Several factors were significantly associated with ITN use. Women with primary education had 2.2 times higher odds of ITN use compared to those with no education (AOR: 2.2, 95% CI: 1.23-4.06). Women residing in the Southern zone had nearly three times higher odds of using ITNs (AOR: 2.8, 95% CI: 1.57-5.09), while those in the Lake zone had 1.6 times higher odds (AOR: 1.6, 95% CI: 1.12-2.33) compared to the Western zone. Women in polygamous marriages had lower odds of ITN use (AOR: 0.76, 95% CI: 0.61-0.95) compared to those in monogamous relationships. Perceived ITN effectiveness was a strong predictor, with those in the high-effectiveness category having 2.7 times higher odds of ITN use (AOR: 2.7, 95% CI: 0.94-5.46).</p><p><strong>Conclusion: </strong>ITN usage among women of reproductive age in Tanzania is influenced by education level, geographic location, marital status, and perceived ITN effectiveness. These findings highlight the need for targeted interventions, such as educational campaigns, equitable ITN distribution, and context-appropriate malaria prevention strategies, to improve ITN coverage and reduce the malaria burden.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"234"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659599","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}

{"title":"Comparative immunological study of Plasmodium knowlesi infections in humans and macaques: insights into cytokine dynamics.","authors":"Mohammad Faruq Abd Rachman Isnadi, Yean Kong Yong, Matthew J Grigg, Symphorosa Sipangkui, Ping-Chin Lee, Nor Afizah Nuin, Angelica Fiona Tan, Paul Molius, Augustine Tuuga, Jum Rafiah Abd Sukor, Giri Rajahram, Sylvia Daim, Tock H Chua","doi":"10.1186/s12936-025-05478-4","DOIUrl":"10.1186/s12936-025-05478-4","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium knowlesi, a simian malaria parasite endemic to Southeast Asia, is transmitted from macaques to humans via mosquitoes and has seen a surge due to human encroachment into macaque habitats. While the primary host, Macaca fascicularis, can regulate P. knowlesi and alleviate disease symptoms, infected humans face a different scenario. A study was conducted in Sabah, Malaysia to compare the effects of parasite genomic DNA (gDNA) and host (both human and macaques) mitochondrial DNA (mtDNA) release on cytokine profiles in humans and macaques infected with P. knowlesi.</p><p><strong>Methods: </strong>Blood samples from 30 Plasmodium knowlesi-infected individuals and 30 healthy controls, along with serum samples from 35 wild macaques, were analysed using PCR and immunological assays. Nested PCR and real-time PCR were performed on macaque blood samples to confirm mono-infection with P. knowlesi. Parasite genomic DNA (gDNA) levels were quantified via qPCR. Additionally, the concentrations of six cytokines-TNF, IFNγ, IL-1β, IL-4, IL-6, and IL-10-were measured in the samples.</p><p><strong>Results: </strong>Parasitaemia levels, determined through microscopy method, exhibited strong correlations with parasite gDNA. Notably, the infected macaques displayed significantly higher parasite gDNA and mtDNA levels compared to humans. Cytokine analysis unveiled IL-10 dominance in humans, positively associated with parasite gDNA, while macaques showed IL-6 dominance unrelated to parasite gDNA. Despite lower parasite gDNA levels, patients exhibited a higher IL-10/TNF ratio, indicative of disease severity.</p><p><strong>Conclusions: </strong>These results suggestively highlight variations in immune responses between two distinct hosts in two different phases of infection: human (acute infection) and macaque (presumed chronic infection) hosts. The correlations and interplay between parasite gDNA, host's mtDNA (both human and macaques) and cytokine levels observed in this study further emphasizing the need for further research to comprehensively understand P. knowlesi pathogenesis.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"233"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649865","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}