Malaria Journal最新文献

{"title":"Monitoring individual rice field flooding dynamics over a large scale to improve mosquito surveillance and control.","authors":"Mauricianot Randriamihaja, Tokiniaina M Randrianjatovo, Michelle V Evans, Felana A Ihantamalala, Vincent Herbreteau, Christophe Révillion, Eric Delaitre, Thibault Catry, Andres Garchitorena","doi":"10.1186/s12936-025-05344-3","DOIUrl":"https://doi.org/10.1186/s12936-025-05344-3","url":null,"abstract":"<p><strong>Background: </strong>Progress in malaria elimination has been hindered by recent changes in mosquito behaviour and increased insecticide resistance in response to traditional vector control measures, such as indoor residual spraying and long-lasting insecticidal nets. There is, therefore, increasing interest in the use of larval source management (LSM) to supplement current insecticide-based interventions. However, LSM implementation requires the characterization of larval habitats at fine spatial and temporal scales to ensure interventions are well-placed and well-timed. Remotely sensed optical imagery captured via drones or satellites offers one way to monitor larval habitats remotely, but its use at large spatio-temporal scales has important limitations.</p><p><strong>Methods: </strong>A method using radar imagery is proposed to monitor flooding dynamics in individual rice fields, a primary larval habitat, over very large geographic areas relevant to national malaria control programmes aiming to implement LSM at scale. This is demonstrated for a 3971 km² malaria-endemic district in Madagascar with over 17,000 rice fields. Rice field mapping on OpenStreetMap was combined with Sentinel-1 satellite imagery (radar, 10 m) from 2016 to 2022 to train a classification model of radar backscatter to identify rice fields with vegetated and open water, resulting in a time-series of weekly flooding dynamics for thousands of rice fields.</p><p><strong>Results: </strong>From these time-series, over a dozen indicators useful for LSM implementation, such as the timing and frequency of flooding seasons, were obtained for each rice field. These monitoring tools were integrated into an interactive GIS dashboard for operational use by vector control programmes, with results available at multiple scales (district, sub-district, rice field) relevant for different phases of LSM intervention (e.g. prioritization of sites, implementation, follow-up).</p><p><strong>Conclusions: </strong>Scale-up of these methods could enable wider implementation of evidence-based LSM interventions and reduce malaria burdens in contexts where irrigated agriculture is a major transmission driver.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"107"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764290","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":"Therapeutic efficacy of artemether-lumefantrine in North-Eastern states of India and prevalence of drug resistance-associated molecular markers.","authors":"Shreelekha Dutta, Sri Krishna, Anup Kumar Vishwakarma, Sweta Mishra, Sushrikanta Khandai, Disphikha Goswami, Soni Kumari, Nazia Ali, Anil Kumar Verma, Kuldeep Singh, Aparup Das, Anup R Anvikar, Praveen Kumar Bharti","doi":"10.1186/s12936-025-05338-1","DOIUrl":"https://doi.org/10.1186/s12936-025-05338-1","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium falciparum is the main cause of malaria in North-Eastern (NE) states of India. Artemether-lumefantrine (AL) was introduced as first-line therapy against uncomplicated P. falciparum cases in 2013 after the emergence of resistance to sulfadoxine-pyrimethamine. The aim of the study was to assess the therapeutic efficacy of AL and status of molecular markers in the circulating parasites.</p><p><strong>Methods: </strong>Therapeutic efficacy of AL was assessed in NE states as per World Health Organization guidelines. Patients with P. falciparum positive peripheral blood smear were enrolled and treated with AL and clinical and parasitological parameters were monitored over a 28-day follow-up period. Furthermore, the pfmdr1, pfdhfr, pfdhps and pfk13 genes were amplified and sequenced for mutation analysis.</p><p><strong>Results: </strong>A total of 231 cases were enrolled and therapeutic efficacy was determined in 215 (93.1%) patients who completed their 28 days' follow-up while 10 patients withdrew and 6 were lost to follow up during study. Overall 99.5% and 98.6% of adequate clinical and parasitological response was observed with and without PCR correction, respectively. Only three cases (1.4%) of late parasitological failure were observed in Mizoram site. One case of recrudescence and two cases of reinfection were detected by msp1 and msp2 genotyping. Mutation analysis showed the 15.8%, 100%, 90.5% mutants in pfmdr1, pfdhfr and pfdhps gene respectively and three non-synonymous mutations were also found in pfk13gene.</p><p><strong>Conclusions: </strong>This study reports that AL is efficacious against uncomplicated P. falciparum cases in NE states of India. However, prevalence of mutations in molecular marker associated with anti-malarial resistance (pfmdr1, pfdhfr, pfdhps and pfk13) gene indicate possible emergence of drug resistance. This is to underline the fact that the drug is efficacious for now, but rising mutations indicate that continuous monitoring is essential for effective treatment regime.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"106"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764294","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":"Enhancing malaria elimination in high-transmission settings: the synergy of concurrent vector control and chemotherapy.","authors":"Ronald Mulebeke, Adoke Yeka, Jean-Pierre van Geertruyden","doi":"10.1186/s12936-025-05339-0","DOIUrl":"https://doi.org/10.1186/s12936-025-05339-0","url":null,"abstract":"<p><strong>Background: </strong>Malaria elimination, defined as interrupting local transmission and reducing cases to zero, is a critical public health goal. While a dual parasite-vector approach is essential, the path to elimination is complex and marked by both progress and setbacks. Despite renewed commitment and initiatives like the \"High Burden High Impact\" approach, challenges persist, particularly in sub-Saharan Africa. These include shifting epidemiological profiles, weak health systems, drug and insecticide resistance, and emerging global issues. Effective elimination, therefore, requires a multi-pronged approach, scaling-up a package of interventions tailored to transmission intensity, including prompt treatment with ACT, IPTp for pregnant women, vector control measures like IRS and LLINs, and robust community engagement. Ultimately, a combination of contextually appropriate strategies, implemented synergistically, will be crucial to breaking the transmission cycle and achieving sustained malaria elimination. This report aims to review the available evidence on the strategies and deployment of current tools targeting vectors and parasites in resource-limited settings, focusing on sub-Saharan Africa.</p><p><strong>Recent findings: </strong>Combining malaria interventions can create a synergistic effect, where the combined impact is greater than the sum of individual interventions. For example, simulations show benefits from combining MDA and IRS, vaccines and bed nets, or the RTS,S vaccine with perennial malaria chemotherapy. However, synergistic effects are not always guaranteed; some combinations, like LLINs and IRS, may not provide additional benefit. Conversely, combining IRS and MDA, or SMC with seasonal malaria vaccination, has demonstrated increased protective effects. Therefore, successful elimination efforts depend on country-specific factors including malaria burden, political commitment, and health system capacity. However, significant biological and operational challenges remain, which may necessitate contextually appropriate approaches to achieve malaria elimination.</p><p><strong>Conclusion: </strong>Synergistic intervention effects are crucial, but implementation context is paramount. While combining malaria interventions can be highly effective, not all combinations yield equal results. Thus, tailoring strategies to the specific local context and transmission dynamics is essential for maximizing impact. Moreover, successful malaria elimination is heavily reliant robust health systems and understanding the biological and operational challenges. Consequently, adaptable, evidence-based strategies are required to overcome these obstacles and achieve lasting progress toward malaria elimination.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"105"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764288","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":"Evaluation of household coverage with long-lasting insecticidal nets in central Côte d'Ivoire.","authors":"Colette Sih, Serge B Assi, Benoit Talbot, Edouard Dangbenon, Manisha A Kulkarni, Alphonsine A Koffi, Ludovic P Ahoua Alou, Louisa A Messenger, Marius Gonse Zoh, Soromane Camara, Natacha Protopopoff, Raphael N'Guessan, Jackie Cook","doi":"10.1186/s12936-025-05335-4","DOIUrl":"https://doi.org/10.1186/s12936-025-05335-4","url":null,"abstract":"<p><strong>Background: </strong>To reduce malaria burden in Côte d'Ivoire, the Ministry of Health aims for 90% of its population to possess one long-lasting insecticidal net (LLIN) for every two persons by 2025. This study evaluated LLIN coverage two years after a mass distribution in central Côte d'Ivoire.</p><p><strong>Methods: </strong>A census was conducted in 43 villages. Data were collected on household geo-position, composition, number of sleeping units and LLINs owned. LLIN coverage was assessed using: 1/ownership; proportion of household with at least one LLIN; 2/household access; households with sufficient nets for every two persons and for every sleeping unit; and 3/population access; proportion of population with access to LLIN within households and sleeping units.</p><p><strong>Results: </strong>10,630 households (89.6% response rate) and 46,619 inhabitants were recruited. Household LLIN ownership was 63.8% (95% CI: 58.7-68.8). Household LLIN access was 37.6% (95% CI: 33.2-42.0) based on 1 LLIN per 2 persons and 37.1% (95% CI: 33.0-41.2) based on 1 net per sleeping unit. Population LLIN access based on 1 LLIN per 2 persons and 1 net per sleeping space was 53.3% (95% CI: 48.6-58.1) and 49.4% (95% CI: 45.1-53.6), respectively. Approximately 17% of households with access for every 2 persons did not have access by every sleeping unit and 9.7% of households with access by sleeping unit did not have access for every 2 persons. Households with adequate access by sleeping unit but not for every 2 persons tend to be larger with fewer sleeping units, and have children under 5 years old and female members. The largest households (>7 members) and households with at least one under-five member had the lowest access (20.8 and 27.3%, respectively).</p><p><strong>Conclusion: </strong>LLIN access was low in this area of intense indoor malaria transmission, 2 years after the last mass distribution campaign. Strategies are needed to improve LLINs coverage.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"104"},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743628","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":"High incidence of clinical malaria among asymptomatic Plasmodium falciparum infected children receiving SMC with sulfadoxine-pyrimethamine and amodiaquine (SP + AQ) in Koulikoro, Mali.","authors":"Daouda Sanogo, Mahamoudou Toure, Moussa Keita, Fousseyni Kane, Soumba Keita, Ibrahima Sanogo, Sory Ibrahim Diawara, Cheick Oumar Tangara, Hamady Coulibaly, Bourema Cisse, Sidibé M'Baye Thiam, Mahamadou Diakite, Nafomon Sogoba, Seydou Doumbia","doi":"10.1186/s12936-025-05283-z","DOIUrl":"10.1186/s12936-025-05283-z","url":null,"abstract":"<p><strong>Background: </strong>Seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine (SP + AQ) involves the monthly administration of therapeutic doses to children under five years of age during periods of high risk of malaria in regions where malaria transmission is highly seasonal. Current SMC guidelines recommend administering the same treatment to both non-infected and asymptomatic Plasmodium falciparum-infected children. However, a critical knowledge gap remains the impact asymptomatic infection on the efficacy of SMC in preventing clinical malaria over a four-week period. This study aimed to evaluate the risk of clinical malaria and its association with children's infection status during SMC treatment.</p><p><strong>Methods: </strong>This study was conducted in the Koulikoro health district of Mali and focused on children under 10 years of age. A total of 726 children in 2019 and 1452 children in 2020 were randomly selected and followed throughout the SMC campaigns. The prevalence of asymptomatic P. falciparum infection was assessed in each round using microscopy prior to SMC drug administration. Children were passively monitored over a four-week period to record the incidence of clinical malaria. Data analysis was performed using R-Studio software. The risk of clinical malaria based on infection status was estimated through logistic regression analysis, and a Kaplan-Meier curve was used to compare survival times between infected and uninfected children. Proportions were compared using the Pearson Chi-square test, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The average prevalence of asymptomatic P. falciparum infection was 11.0% across study years. Prevalence was notably higher among children aged 5 to 9 years old in 2019 (p < 0.001) and 2020 (p = 0.016). Asymptomatic infected children had a significantly higher risk of clinical malaria during both transmission seasons: 2019: (RR = 3.05, CI [2.04-4.72]) and 2020 (RR = 1.43, CI [1.04-1.97]). Furthermore, the time to the first malaria episode was significantly shorter among infected children in both years (p < 0.001 for 2019, p = 0.01 for 2020).</p><p><strong>Conclusion: </strong>These findings demonstrate an elevated risk of clinical malaria in asymptomatic infected children during SMC implementation. Screening and treating P. falciparum infections prior to SMC administration could substantially enhance the effectiveness of this strategy in reducing malaria morbidity in endemic areas.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"102"},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720122","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":"Relationship between unimproved household sanitation facilities and malaria infection among under-five children in Nigeria: insights from Malaria Indicator Survey 2021.","authors":"Olamide A Asifat, Adedeji Adenusi, Tolulope V Adebile, Nicholas Aderinto, Emmanuel Azu, Adverlyn Ivey-Waters, Jing X Kersey","doi":"10.1186/s12936-025-05340-7","DOIUrl":"10.1186/s12936-025-05340-7","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a leading cause of illness and death among children under-five in sub-Saharan Africa, with Nigeria bearing the highest global malaria burden. Despite interventions such as insecticide-treated nets and indoor residual spraying, malaria prevalence remains high. While housing structure and sanitation are recognized as risk factors in other African countries, their relationship with malaria infection among under-five children in Nigeria remains underexplored. This study investigates this association using nationally representative data from the 2021 Nigeria Malaria Indicator Survey (NMIS).</p><p><strong>Methods: </strong>This study analysed data from the 2021 NMIS, including 1833 children aged 5-59 months (weighted sample size: 1,784,805,486) tested for malaria using rapid tests. Data on malaria prevention practices, household characteristics, and children's blood samples were collected. The primary outcome was malaria test results (rapid diagnostic test, RDT), with the type of toilet facility as the main predictor. Covariates included age, sex, wealth index, maternal education, residence type, household construction materials, drinking water sources, type of mosquito nets, and mosquito net usage. Descriptive statistics and logistic regression analyses were conducted to assess associations, reporting adjusted odds ratios (aORs), 95% confidence intervals (CIs), and p-values < 0.05.</p><p><strong>Results: </strong>Children from the poorest (aOR = 3.412, 95% CI: 1.798-6.477, p = 0.0002) and poorer households (aOR = 3.103, 95% CI: 1.714-5.617, p = 0.0002) had significantly higher malaria risk. Rural residence (aOR = 1.898, 95% CI: 1.318-2.734, p = 0.0006) and no maternal education (aOR = 2.003, 95% CI: 1.153-3.480, p = 0.0139) were also associated with increased malaria prevalence. Additionally, unimproved wall materials (aOR = 1.604, 95% CI: 1.061-2.425, p = 0.025) increased malaria risk. However, unimproved sanitation facilities were not significantly associated with malaria risk (p = 0.166).</p><p><strong>Conclusion: </strong>Malaria risk among under-five children in Nigeria is strongly associated with socioeconomic factors, rural residence, and maternal education, but not unimproved sanitation alone. Efforts to reduce malaria prevalence should target broader social determinants through health education and socioeconomic interventions in Nigeria and other endemic regions.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"103"},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730734","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":"False alarm on a malaria \"outbreak\" linked to inconsistencies in malaria diagnostic supply: a call to strengthen supply chain management: Sierra Leone, May-July 2023.","authors":"Timothy N DeVita, Aminata B Kabia, James A M Khobi, Mugagga Malimbo, Samba Kamara, Bridget Magoba, Gebrekrstos N Gebru, Anna H Jammeh, John A Painter, Thomas K Ansumana, Musa Sillah-Kanu, David C Schnabel","doi":"10.1186/s12936-025-05312-x","DOIUrl":"10.1186/s12936-025-05312-x","url":null,"abstract":"<p><strong>Background: </strong>Malaria transmission in Sierra Leone is intense and perennial, accounting for 40% of clinical consultations. Medical workers diagnose suspected malaria cases using rapid diagnostic tests (RDT) and microscopy, with facility-level results reported to the Health Management Information System (HMIS) as monthly aggregates. Commodity stocks are reported to the Logistics Management Information System (LMIS). Partners investigated a striking increase in confirmed malaria during May-July 2023 in Sierra Leone, peaking in June to 46% above the June 2018-2022 mean.</p><p><strong>Methods: </strong>The team first analysed national, district, and facility HMIS/LMIS data for RDT stocks, testing rates, and confirmed cases during January 2018-October 2023. Epidemic thresholds, defined as case counts two standard deviations (σ) above the previous 5 years' monthly mean, were assessed. Then four facilities in two districts were visited to interview staff. Lastly, the team reanalysed LMIS RDT stock data for all facilities in Sierra Leone using R to categorize their stock status by month.</p><p><strong>Results: </strong>National epidemic thresholds were surpassed in May (2.56σ) and June (4.81σ) 2023. Twelve of sixteen districts surpassed epidemic thresholds during May-June. Investigation revealed inconsistent RDT distribution to facilities over time. National RDT distribution spiked in May 2023, when 551,888 RDT test kits were delivered. This was substantially larger than the 2019-2022 mean for May (53,121, 1,000% increase) and all months (126,866, 435% increase). Subsequently in June 2023, 386,343 tests were performed, 36% higher than the June 2018-2022 mean (285,123). Staff at all four visited facilities reported recurrent RDT stockouts. The proportion of facilities in Sierra Leone reporting positive RDT stocks at both the start and end of the month increased from 14% in April to 74% in June. 51% of facilities began May with RDT stockout and received RDTs that month.</p><p><strong>Conclusions: </strong>The 2023 spike in confirmed malaria was likely related to increased testing following an unusually large distribution of RDTs. Fluctuations in RDT availability impede the ability to recognize true case variations. Sierra Leone and its partners can strengthen supply chain logistics and health commodity stock tracking to ensure a consistent supply of RDTs and improve interpretation of surveillance data.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"100"},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720120","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":"Prevalence of subpatent Plasmodium falciparum infections in regions with varying transmission intensities and implications for malaria elimination in Mainland Tanzania.","authors":"Misago D Seth, Zachary R Popkin-Hall, Rashid A Madebe, Rule Budodo, Catherine Bakari, Beatus M Lyimo, David Giesbrecht, Ramadhani Moshi, Ruth B Mbwambo, Filbert Francis, Dativa Pereus, Doris Mbata, Daniel P Challe, Salehe S Mandai, Gervas A Chacha, Angelina J Kisambale, Daniel Mbwambo, Sijenunu Aaron, Abdallah Lusasi, Samwel Lazaro, Celine I Mandara, Jeffrey A Bailey, Jonathan J Juliano, Julie R Gutman, Deus S Ishengoma","doi":"10.1186/s12936-025-05341-6","DOIUrl":"10.1186/s12936-025-05341-6","url":null,"abstract":"<p><strong>Background: </strong>Subpatent Plasmodium falciparum infections, defined as infections with parasite density below the detection limit of routine malaria diagnostic tests, contribute to infectious reservoirs, sustain transmission, and cause the failure of elimination strategies in target areas. This study assessed the prevalence of subpatent P. falciparum infections and associated risk factors in 14 regions of Mainland Tanzania.</p><p><strong>Methods: </strong>The study used samples randomly selected from RDT-negative dried blood spots (DBS) (n = 2685/10,101) collected in 2021 at 100 health facilities across 10 regions of Mainland Tanzania, and four communities in four additional regions. The regions were selected from four transmission strata; high (five regions), moderate (three regions), low (three regions), and very low (three regions). DNA was extracted by Tween-Chelex method, and the Pf18S rRNA gene was amplified by quantitative polymerase chain reaction (qPCR). Logistic regression analysis was used to assess the associations between age groups, sex, fever status, and transmission strata with subpatent infection status, while linear regression analysis was used to assess the association between these factors and subpatent parasite density.</p><p><strong>Results: </strong>Of the selected samples, 525/2685 (19.6%) were positive by qPCR for P. falciparum, and the positivity rates varied across different regions. Under-fives (aOR: 1.4, 95% CI 1.04-1.88; p < 0.05) from health facilities had higher odds of subpatent infections compared to other groups, while those from community surveys (aOR: 0.33, 95% CI 0.15-0.72; p = 0.005) had lower odds. Participants from very low transmission stratum had significantly lower odds of subpatent infection compared to those from high transmission stratum (aOR = 0.53, 95% CI = 0.37-0.78; p < 0.01). The log-transformed median parasite density (interquartile range) was 6.9 (5.8-8.5) parasites/µL, with significantly higher parasitaemia in the low transmission stratum compared to a very low one (11.4 vs 7.0 parasites/µL, p < 0.001).</p><p><strong>Conclusion: </strong>Even in very low transmission settings, the prevalence of subpatent infections was 13%, and in low transmission settings it was even higher at 29.4%, suggesting a substantial reservoir that is likely to perpetuate transmission but can be missed by routine malaria case management strategies. Thus, control and elimination programmes may benefit from adoption of more sensitive detection methods to ensure that a higher proportion of subpatent infections are detected.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"101"},"PeriodicalIF":2.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720140","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":"Coinfection of COVID-19 and malaria: clinical profiles, interactions, and strategies for effective control.","authors":"Mu-Zi He, Hai-Ting Zhang, Yi Yang, Yi Fang, Mao Zhang, Sheng-Qun Deng, Xun Sun","doi":"10.1186/s12936-025-05315-8","DOIUrl":"10.1186/s12936-025-05315-8","url":null,"abstract":"<p><p>Since SARS-CoV-2 has caused unprecedented changes in the epidemiology of other infectious diseases, investigations on coinfection between SARS-CoV-2 and one of the famous vector-borne diseases, malaria, are crucial for disease control, especially in malaria-endemic areas. The clinical profiles, possible mechanisms for interactions, and representative control measures of COVID-19 and malaria coinfections have recently garnered public attention. The overlap in epidemiology, infection incubation, and clinical symptoms between COVID-19 and malaria coinfections has been thoroughly discussed to provide a detailed diagnostic procedure for coinfections, thereby guiding appropriate clinical interventions. Immunological and genetic evidence has shown that previous malaria exposure may protect the body from the poor prognosis of COVID-19. ACE2 downregulation and TLR-induced pathways play a role in this protective effect, as do CD8 + and CD4 + T-cell activation and coinhibitory receptor upregulation, which help maintain a balance of immune reactions. Finally, multiple control measures for coinfections were discussed, and malaria control efforts were enriched in the context of COVID-19. These efforts included (1) developing vaccinations; (2) evaluating the efficacy of anti-malarial drugs in the SARS-CoV-2 treatment; (3) exploring recent advances in natural products that are potentially useful for coinfection treatment; (4) researching and implementing bioinsecticides for malaria control, such as gene-driven mosquitoes, fungi, and bacterial symbionts; and (5) improving national electronic disease surveillance platforms in malaria-endemic regions. At last, the above findings summarized valuable lessons about malaria and COVID-19 control and expedite further investigations on coinfections with complex clinical presentations.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"99"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710609","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":"Community pharmacists' knowledge and experience regarding malaria management: a cross-sectional study in Hodeida, Yemen.","authors":"Abdulsalam M Halboup, Sabariah Noor Harun, Siti Maisharah Sheikh Ghadzi, Syed Azhar Syed Sulaiman, Doa'a Anwar Ibrahim, Abdullah Ahmed Areqi, Fahmi Y Al-Ashwal","doi":"10.1186/s12936-025-05291-z","DOIUrl":"10.1186/s12936-025-05291-z","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health concern in Yemen, ranking fourth in incidence within the Eastern Mediterranean Region. Community pharmacists play a pivotal role in malaria management and often dispense anti-malarial medications without prescriptions. However, little is known about their knowledge and adherence to the National Policy for Antimalarial Drugs. This study aimed to evaluate pharmacists' knowledge, experience, and perceived barriers regarding malaria management in Hodeidah, Yemen.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between May and August 2023 across 320 community pharmacies in 16 districts of Hodeidah governorate. A validated questionnaire was used to assess pharmacists' knowledge, experience, and perceived barriers to effective malaria management. Descriptive statistics and logistic regression analysed the associations between sociodemographic factors and pharmacists' knowledge and experience.</p><p><strong>Results: </strong>Of the 304 respondents, 10 were excluded due to incomplete data, yielding a valid response rate of 91.9% (294). Most pharmacies were independent (74.8%), and 51.4% were located in Hodeidah city. The majority of the pharmacists were male (92.2%), aged 19-30 years (50.3%), and held a pharmacy diploma (69%). Poor knowledge of malaria management was observed in 76.5% of respondents (mean: 9.96, SD 3.47), with only 34.4% and 43.2% accurately identifying first-line treatments for uncomplicated and complicated malaria, respectively. Additionally, 60.9% were aware of the prevalent malaria species, and 53.1% knew the correct diagnostic methods. However, only 17.0% recognized high-risk groups for complicated malaria, 18.4% identified causes of treatment failure, and 7.8% understood the consequences of malaria during pregnancy. In terms of experience, 76.2% of the participants reported inadequate experience related to anti-malarial medications (mean: 56.71, SD 7.32), with the main barriers being lack of training (78.9%) and insufficient knowledge (73.5%). Multivariable logistic regression revealed that older age (AOR: 6.827, p = 0.020), holding a pharmacy diploma (AOR: 2.555, p = 0.036), and fewer perceived barriers (AOR = 3.830, p < 0.001) were predictors of poor knowledge, whereas practicing in Hodeidah city (AOR = 1.865, p = 0.043) predicted inadequate experience.</p><p><strong>Conclusion: </strong>Community pharmacists in Hodeidah demonstrate significant gaps in knowledge and experience related to malaria management. Urgent educational interventions are needed to enhance pharmacists' competency, ensure effective malaria treatment, and prevent the emergence of drug resistance in Yemen.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"98"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710610","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}