Malaria Journal最新文献

{"title":"Two decades of insecticide resistance in Benin: a retrospective analysis of evolution and drivers.","authors":"Steve Zinsou Hougbe, Razaki A Ossé, Roseric Azondékon, Casimir Kpanou, Minassou Juvénal Ahouandjinou, Zul-Kifl Affolabi, Koffi Djigbodi Koumodji, Hermann Sagbohan, Esdras Mahoutin Odjo, Constantin Adoha, Boulais Yovogan, Serge Akpodji, Linda Towakinou, Bruno Akinro, Albert Salako, Filémon Tokponnon, Germain Gil Padonou, Lamine Baba-Moussa, Martin Akogbeto","doi":"10.1186/s12936-025-05403-9","DOIUrl":"10.1186/s12936-025-05403-9","url":null,"abstract":"<p><strong>Background: </strong>Several studies have been conducted in Benin over the past two decades on insecticide resistance in mosquito vectors. These studies, by various authors, lead to diverse and scattered data. The present paper provides a retrospective analysis of these data to assess the current state of insecticide resistance and its evolution over two decades. Phenotypic trends were compared to mechanisms of insecticide resistance, focusing on the pyrethroids target-site mutation at codon 1014 of the voltage-gated sodium channel and the overproduction of detoxification enzymes capable of neutralizing insecticides before reaching their target.</p><p><strong>Methods: </strong>Data were collected from studies between 1996 and 1998 and from 2010 to 2024. For each selected study, the following information were extracted and organized in a Microsoft Excel spreadsheet: study year, adherence to WHO insecticide susceptibility testing protocols, mosquito species tested, study site characteristics, insecticides assessed, data source, and resistance mechanisms identified. Municipalities with data gaps exceeding five consecutive years were excluded.</p><p><strong>Results: </strong>The earliest reported cases of insecticide resistance in Benin date back to 1963, involving organochlorines. Resistance to pyrethroids was first observed in 1999, initially limited in scope. However, from 2010 to 2024, resistance to all pyrethroids spread across all regions of Benin, reaching high levels. In some municipalities, mortality rates in Anopheles gambiae sensu lato (s.l.) populations exposed to permethrin-treated papers fell below 10%. The frequency of the kdr L1014F mutation has mirrored phenotypic resistance trends, increasing from 10% homozygous resistant (kdr/kdr) individuals in 2011 to 90% in 2024 in the municipality of Allada. Detoxification enzymes, such as α-esterase, β-esterase, monooxygenase and glutathione S-transferase showed low, but steadily increasing activity between 2015 and 2024. Resistance to bendiocarb, first reported in 2012, has shown minimal progression, while resistance to pirimiphos methyl has been observed in some municipalities since 2022.</p><p><strong>Conclusion: </strong>First observed with organochlorines around the 1960s, and later with pyrethroids in 1999, insecticide resistance in mosquito vectors has continued to intensify. Over the last 20 years, it has gradually expanded, now affecting all ecological environments in Benin. In this context, the National Malaria Control Programme should prioritize the use of new mosquito nets for future vector control campaigns in Benin.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"156"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094150","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":"Consistency and reproducibility of independent feedings using blood from two consecutive days at varying Plasmodium falciparum gametocyte densities based on both direct membrane feeding assay and direct skin feeding assay.","authors":"Hoseah Miima Akala, John J Aponte, Millicent Anyango Achola, Dennis W Juma, Benjamin H Opot, Risper N Maisiba, Raphael O Okoth, Jackline A Juma, Edwin W Mwakio, Maurine A Mwalo, David O Oullo, David Abuom, Eric C Garges, Fredrick L Eyase, Lucas Otieno Tina, Nathanial K Copeland, Amanda Roth, James Mutunga, Irene Onyango, Jaree Johnson, Bernhards R Ogutu, Peter Sifuna, Jack Hutter, Laina Mercer, Mike Raine, Valerie Moore, Karen Ivinson, Yimin Wu, Ben Andagalu, Christian F Ockenhouse","doi":"10.1186/s12936-025-05360-3","DOIUrl":"10.1186/s12936-025-05360-3","url":null,"abstract":"<p><strong>Background: </strong>New malaria control tools are needed to prevent the transmission of parasites from the host to the mosquito vector and vice versa. The infectiousness of Plasmodium falciparum gametocytes obtained from individuals to laboratory-reared mosquitoes should be quantified to employ easily applicable assays for evaluating transmission-blocking interventions. This study aimed to establish the relationship between parasite transmission from humans to mosquitoes both within a person and across persons by assessing the variation in the proportion of infected mosquitoes with at least one oocyst (oocyst prevalence) in a direct membrane feeding assay (DMFA) and direct skin landing feeding assay (DSFA) performed at two consecutive time points in the same human subject with P. falciparum gametocytaemia.</p><p><strong>Methods: </strong>A total of 400 adults without symptoms of malaria residing in Western Kenya were screened for the presence of P. falciparum gametocytes. Individuals who tested positive had DMFAs and DSFAs on two subsequent days of feeding, baseline and final visit, to compare mosquito infection rates between the two feeds.</p><p><strong>Results: </strong>Blood samples from 42 individuals testing positive for gametocytes underwent mosquito infection assays. Survival rates of mosquitoes after feeding at baseline and final visit were 13.2 and 11.6 days for DMFA and 12.1 and 11.4 days for DSFA, respectively. The mean oocyst prevalence on feeding at baseline and final visit was 6.3% and 2.2% for DMFA and 5.2% and 2.3% for DSFA, respectively. A not significantly lower prevalence was not observed on at final visit (- 0.016% for DMFA, p = 0.795) and -0.025% for DSFA, p = 0.711 compared to feeding at baseline. The correlation of oocyst prevalence between feeding baseline and final visit for both was low (0.3 95%CI (0.15, 0.51). Exploratory analysis suggests a lower probability of infection on the second day, with lower oocyst density.</p><p><strong>Conclusions: </strong>These findings have implications for future studies and limit the utility of before-after designs in testing transmission-blocking interventions. The findings show comparable infection rates in both DMFA and DSFA, which allows use of less invasive membrane assays in future studies. Trial registration NCT04666350.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"154"},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086475","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":"Efficacy of artemisinin-based combination therapy (ACT) in people living with HIV (PLHIV) diagnosed with uncomplicated Plasmodium falciparum malaria in Africa: a WWARN systematic review.","authors":"Abena Takyi, Aboubakar Soma, Marianna Przybylska, Eli Harriss, Karen I Barnes, Prabin Dahal, Philippe J Guérin, Kasia Stepniewska, Verena I Carrara","doi":"10.1186/s12936-025-05393-8","DOIUrl":"10.1186/s12936-025-05393-8","url":null,"abstract":"<p><strong>Background: </strong>Africa bears the highest double burden of HIV and malaria worldwide. In 2023, an estimated 25.9 million people were living with HIV (PLHIV), and 246 million malaria cases were diagnosed in Africa. Malaria patients co-infected with HIV are considered at a higher risk of failing malaria treatment, according to the World Health Organization (WHO) guidelines. This systematic literature review aims to assess the treatment outcomes following artemisinin-based combination therapy (ACT) in PLHIV.</p><p><strong>Methods: </strong>The literature search was conducted up to April 2022 in the following databases: MEDLINE, EMBASE, Web of Science, Cochrane Central, WHO Global Index Medicus, Clinicaltrials.gov, and the WorldWide Antimalarial Resistance Network (WWARN) Clinical Trial Library. Studies describing any malaria treatment outcomes or anti-malarial drug exposure in PLHIV treated for uncomplicated Plasmodium falciparum malaria infection were eligible for inclusion.</p><p><strong>Results: </strong>A total of 26 articles describing 19 studies conducted between 2003 and 2017 in six countries were included in this review; it represented 2850 malaria episodes in PLHIV across various transmission settings. The most studied artemisinin-based combination was artemether-lumefantrine (in 16 studies). PLHIV were treated with various antiretroviral therapy (ART) regimens, namely efavirenz (EFV), nevirapine (NVP), atazanavir-ritonavir (ATVr), lopinavir-ritonavir (LPV/r), and/or on prophylaxis with trimethoprim-sulfamethoxazole (TS), or were untreated (in 3 studies). There was no evidence of an increased risk of recrudescence in PLHIV compared to those without HIV. When treated with artemether-lumefantrine, PLHIV receiving LPV/r had a lower risk of malaria recurrence compared to PLHIV on NVP-based or EFV-based ART, or those without HIV. LPV/r increased lumefantrine exposure and EFV-treated patients had a reduced exposure to both artemether and lumefantrine; NVP reduced artemether exposure only.</p><p><strong>Conclusions: </strong>Limited data on ACT outcomes or drug exposure in PLHIV in Africa remains a reality to date, and the effect of antivirals appears inconsistent in the literature. Considering the heterogeneity in study designs, these review's findings support conducting an individual patient data meta-analysis to explore the impact of antiretroviral therapy on anti-malarial treatment.</p><p><strong>Trial registration: </strong>The protocol for the original search was published on PROSPERO with registration number CRD42018089860.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"153"},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086476","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":"Exploring the prevalence and association between nutritional status and asymptomatic malaria in Rwanda among under-5 children: a cross-sectional analysis.","authors":"Aline Uwimana, Annie Robert, Ayman Ahmed, Hélène Alexiou, Nadine Rujeni, Patrice D Cani, Jean-Paul Coutelier, Léon Mutesa, Amandine Everard","doi":"10.1186/s12936-025-05370-1","DOIUrl":"10.1186/s12936-025-05370-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Undernutrition and severe malaria continue to be major public health concerns worldwide, particularly in African countries. While the association between malaria and malnutrition has been widely studied in various settings, limited research has focused on asymptomatic malaria and its link to nutritional status in Rwanda, leaving a gap in understanding this relationship in the local context. This study aimed to investigate the possible relationship between children's nutritional health and asymptomatic malaria infections. Specifically, the study assessed the prevalence of undernutrition and asymptomatic malaria infection in relation to implemented policies and the link between stunting, wasting, underweight, and asymptomatic malaria infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from three Demographic and Health Surveys (DHS) conducted in Rwanda in 2010, 2014-15, and 2019-20 were used in the study, including children aged 6 to 59 months and confirmed malaria diagnoses via blood smear. The odds ratio of stunting, underweight, and wasting on malaria outcomes were calculated using logistic regression, with and without adjusting for factors such as age, gender, mother's education, wealth index, type of residence, and region within each survey. The present study examined data from three DHSs conducted in Rwanda, which included 10,411 children aged less than five years who were tested for malaria and 11,424 children who had anthropometric measurements. Despite this variation, the available sample size (n = 10,409) remains robust for drawing meaningful conclusions, and potential biases due to missing data in the analysis were taken into account. This study used unadjusted (OR) and adjusted odds ratios (AOR) to evaluate the relationships between stunting, underweight, age, wealth index, and malaria outcomes. All independent variables with a p-value below 0.05 in the unadjusted regression were included and considered significant in the adjusted regression analysis. A p-value &lt; 0.05 was used to determine statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Asymptomatic malaria was found to be present in 1.3% (95% confidence interval (CI) 1.14%-1.59%) of the population (140/10,411). The study also discovered that 38.3% (95% CI 37.42%-39.21%) of the children were stunted (Z-score &lt; - 2.0). Moreover, the results indicate that malaria was more frequent in children with stunting (OR = 1.85, 95% CI = [1.32; 2.59], p &lt; 0.001). Underweight children were also found to have an increased prevalence of malaria (AOR = 1.59, 95% CI [1.14-2.95], p = 0.01). Age was also an important variable correlated with malaria infection since the prevalence of malaria was found to be higher in children over 24 months of age (AOR = 2.72, 95% CI [1.78-4.16], p &lt; 0.001). Children from the richest families were found to be protected from malaria AOR = 0.38 (95% CI [0.24-0.58], p &lt; 0.001) in all 3 DHS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study rev","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"152"},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003535","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":"Perspectives of men and women working in vector control in Africa regarding barriers and opportunities for achieving gender inclusivity.","authors":"Patience Ampuriire, Ramadhani M Bofu, Betwel J Msugupakulya, Winifrida P Mponzi, Damaris Matoke-Muhia, Marceline F Finda, Fredros O Okumu","doi":"10.1186/s12936-025-05394-7","DOIUrl":"https://doi.org/10.1186/s12936-025-05394-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gender-inclusive strategies are crucial for tackling vector-borne diseases in Africa, but most programs still overlook the lived experiences of local practitioners regarding cultural norms, power imbalances, gender stereotypes, and workplace dynamics. This study investigated the gender-related perspectives of men and women working in vector control in Africa and their recommendations for effective gender inclusivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An exploratory mixed-methods study was conducted, starting in Tanzania with 22 in-depth interviews with team leaders, seven focus group discussions with scientists and vector control practitioners and two group discussions with vector control students. This was followed by an online survey of 150 researchers, academics, technicians, students, and vector-control staff from 16 African countries. Data on gender distribution, inclusivity, divergent male-female perspectives, and related experiences, including sexual harassment, were analysed thematically for qualitative responses and descriptively for survey responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study revealed significant gender disparities in staffing and leadership of vector control programmes in Africa, with 70.3% of men and only 40.7% of women having held leadership roles. Men occupied most vector-control roles, except in acadaemia where parity is maintained until master's degree level but biased towards men at PhD levels. Marriage weighed more heavily on women, with 44.1% of female staff remaining unmarried, compared to only 18.7% of men. Most respondents said mixed-gender teams strengthen community engagement, but they differed on effects for creativity, cost and morale, with some insisting that merit alone matters, while others seeing diversity as essential for better results. Women were more likely than men to dismiss the claims that inclusivity is ineffective or disruptive. Challenges to gender inclusivity included cultural norms limiting women's participation in overnight fieldwork, work-family pressures, and scant workplace accommodations. Men recognized the benefits of working with women but noted challenges related to societal expectations and workplace accommodations. Majority of participants (84.1%) reported had never experienced gender-based violence, but women were more likely than men to report sexual harassment. Over half of respondents believed their manager's gender significantly impacted their work environment; and some women preferred female leaders for relatability and support, while others were indifferent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study reveals wide gender gaps in African vector-control staffing and leadership and provides key insights for stakeholders to develop fairer workplace practices. Although the value of inclusivity is broadly recognized, cultural norms, family demands, and social expectations still weigh more heavily on women. These challenges can be addressed by incor","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"151"},"PeriodicalIF":2.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971371","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":"Assessment of the in vitro activity and selectivity of Artemisia afra and Artemisia annua aqueous extracts against artemisinin-resistant Plasmodium falciparum.","authors":"Camille Roesch, Kutub Ashraf, Amélie Vantaux, Adriana A Marin, Steven P Maher, Jean-Francois Franetich, Nimol Kloeung, Sopheakvatey Ke, Hoa Thi My Vo, Dominique Mazier, Benoit Witkowski","doi":"10.1186/s12936-025-05375-w","DOIUrl":"https://doi.org/10.1186/s12936-025-05375-w","url":null,"abstract":"<p><strong>Background: </strong>The recent emergence of artemisinin resistance in Africa is drawing scrutiny toward the use of alternative anti-malarial therapy based on Artemisia annua and Artemisia afra phytotherapies. This study aimed to determine if either A. annua and A. afra extracts are active against artemisinin-resistant Plasmodium falciparum isolates and determine the selectivity of inhibitory phytotherapies.</p><p><strong>Methods: </strong>Artemisia extracts were tested in vitro to mimic parasites exposure to extracts in population drinking Artemisia sp. teas. Artemisia extracts were tested in Ring Stage Survival Assays (RSA^{0-3 h}) against Cambodian clinical isolates previously genetically and phenotypically characterized as artemisinin resistant or sensitive. Primary human hepatocytes and a human hepatoblastoma cell line (HepG2 cells) were used to assess the cytotoxicity of Artemisia extracts.</p><p><strong>Results: </strong>The study revealed a substantially decreased in vitro activity of A. annua extracts when tested on artemisinin-resistant parasites mutated in the Pfkelch13 gene (RSA₅₀ 0.137-2.56 g.L^-1) compared to artemisinin-sensitive parasites (RSA₅₀ 0.080 g.L^-1). Conversely, the A. afra extracts have a similar activity on the isolates tested whether they are sensitive or resistant to artemisinin (RSA₅₀ 0.537-0.758 g.L^-1) However, the selectivity index for A. afra extracts was much lower than for A. annua extracts (A. afra: 4.628, 4.305 and 6.076 vs A. annua: 387.625, 226.350 and 12.099, respectively for WT, C580Y and R539T).</p><p><strong>Conclusions: </strong>Artemisia annua activity is driven by artemisinin, implicating the same resistance profiles and concerns associated with semisynthetic artemisinin derivatives. Artemisia afra showed artemisinin-independent antiplasmodial activity. However, the molecular basis of this activity is unknown and may not present a sufficient selectivity, thus further characterization of A. afra is essential.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"150"},"PeriodicalIF":2.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991668","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":"Overcoming practical challenges to pilot Sierra Leone's first school-based distribution of piperonyl butoxide-synergist ITNs: findings from a 2023 assessment in Kono district.","authors":"Keith Esch, Fredrick Yamba, Kevin Opondo, Musa Sillah-Kanu, David Schnabel, Prince Owusu, Raymond Sudoi, Malia Skjefte, Wani Lahai, Mohamed G Sheku, Mariama Kabba Jibatteh, Augustine Ngegbe, Jenny Carlson, Temitayo Labor, Djenam Jacob, Charlene Youseff, Elisabeth Tyler, Prince Nallo, Dennis Marke, Stephen Poyer","doi":"10.1186/s12936-025-05369-8","DOIUrl":"https://doi.org/10.1186/s12936-025-05369-8","url":null,"abstract":"<p><strong>Background: </strong>Continuous distribution of insecticide treated nets (ITNs) through schools is increasingly utilized by National Malaria Programmes across sub-Saharan Africa to maintain coverage between three-year mass distribution campaigns. In March 2023, the Sierra Leone National Malaria Control Programme (NMCP) piloted its first school-based distribution (SBD) in Kono district, reaching 88,605 pupils in 531 schools with piperonyl butoxide-synergist (PBO) ITNs. The pilot was assessed to determine changes in household and population ITN access and use, and to identify areas where future widescale SBD campaigns in Sierra Leone can be improved.</p><p><strong>Methods: </strong>This was a mixed methods assessment. A cluster, multi-stage sampled household survey was conducted across 950 households, stratified post-hoc by presence (or not) of children eligible for SBD and powered to determine significant differences in ITN access among 'intervention' households (those with at least one eligible child) and 'control' households (those with no eligible children). Key informant interviews (KIIs) were conducted with 26 SBD stakeholders representing government, donors, third party logistics agencies and implementing partners.</p><p><strong>Results: </strong>One- to two-months post SBD, a significantly higher proportion of households in the intervention group owned at least one ITN (93% versus 69%, p < 0.001) and at least one ITN per two people (42% versus 24%, p < 0.001). Population ITN access was significantly higher in the intervention group than the control group (69% versus 46%, p < 0.001). A higher proportion of the population also reported using an ITN the previous night in the intervention group (71%) than the control group (49%) (p < 0.001). KIIs highlighted resolvable challenges, particularly those related to untimely or insufficient funding, which led to subsequent issues for coordination, storage, transportation, quantification, distribution, training, microplanning and supervision.</p><p><strong>Conclusion: </strong>Sierra Leone's SBD pilot significantly improved key ITN ownership, use and access indicators at the household and population levels in Kono district one- to two-months post-SBD. However, intervention population ITN use, and access were still below the NMCP's 80% target. Gaps should be addressed for SBD scale-up. Research on costing, sustained levels of ITN use and access, and the effect of SBD ITNs on malaria parasitaemia may be considered by the NMCP.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"149"},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064022","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":"The impact of mass screening and treatment interventions on malaria incidence and prevalence: a retrospective analysis of a malaria elimination programme in eastern Myanmar, and systematic review and meta-analysis.","authors":"Jade D Rae, Angela Devine, Chanapat Patekkham, Aung Myint Thu, Gilles Delmas, Daniel M Parker, Richard J Maude, Jacher Wiladphaingern, Ladda Kajeechiwa, May Myo Thwin, Saw Win Tun, Julie A Simpson, François H Nosten","doi":"10.1186/s12936-025-05392-9","DOIUrl":"10.1186/s12936-025-05392-9","url":null,"abstract":"<p><strong>Background: </strong>Targeted interventions are often needed to accelerate malaria elimination efforts. Mass screening and treatment (MSAT) involves testing all eligible and consenting individuals in an area for malaria and treating all positive individuals simultaneously. However, there are concerns regarding the impact of MSAT. This study evaluates the impact of MSAT on malaria incidence in Karen State, Myanmar, using routine surveillance data, and investigates the impact of MSAT in other settings through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>To investigate the impact of MSAT in Karen State, we retrospectively analysed routine malaria surveillance data collected in 10 villages where MSAT was done in 2018. Pre- and post-MSAT malaria incidences were compared, and a negative binomial mixed-effects model was used to estimate the relative change in monthly incidence for each additional year since MSAT. To investigate the impact of MSAT in other settings, we searched Scopus, Ovid MEDLINE, and Web of Science (end date 11th July 2022) for studies assessing the impact of MSAT interventions on the incidence or prevalence of malaria infections. Studies were summarized, and a random-effects meta-analysis was performed on studies grouped according to study design and the comparator used to assess the impact of MSAT.</p><p><strong>Results: </strong>In the 10 villages in Karen State, there was an overall reduction in P. falciparum incidence following MSAT (Incidence Rate Ratio 0.37; 95% CI: 0.19, 0.73). However, this is likely due to the ongoing impact of early diagnosis and treatment services offered in these communities, as shown by an overall reduction in incidence in the surrounding area. Results from nine studies identified in the systematic review demonstrate the variable impact of MSAT, which is likely influenced by a variety of factors, including intervention coverage and uptake, baseline malaria endemicity, and methods used for MSAT delivery.</p><p><strong>Conclusions: </strong>This retrospective analysis and systemic review highlights the complexities behind the success of targeted interventions for malaria elimination. While these interventions are important drivers for achieving elimination goals, particularly in high-burden settings, it is important that various factors be considered when determining their suitability and how to optimize implementation.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"148"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024987","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":"Socio-economic inequalities in malaria prevalence among under-five children in Ghana between 2016 and 2019: a decomposition analysis.","authors":"Marian Yaa Abrafi Edusei, Olufunke Alaba, Denis Okova, Amarech Obse","doi":"10.1186/s12936-025-05349-y","DOIUrl":"https://doi.org/10.1186/s12936-025-05349-y","url":null,"abstract":"<p><strong>Background: </strong>In a country with limited and unequally distributed resources, and plagued with malaria annually, under-five children are severely affected by this disease in Ghana. While the epidemiological burden of malaria on under-five children is well-documented, the extent and contributors of socio-economic inequalities in malaria prevalence remain under-explored. This study examined the intertemporal socioeconomic status (SES)-related inequalities in malaria prevalence among under-five children in Ghana from 2016 to 2019 and identified the key factors contributing to these disparities.</p><p><strong>Methods: </strong>Data were drawn from the 2016 and 2019 Ghana Malaria Indicator Surveys (GMIS). The study population consisted of under-five children who were tested for malaria in both surveys. Malaria prevalence served as the outcome variable, with the wealth index used as a proxy for socio-economic status. Socio-economic inequalities in malaria prevalence were evaluated using concentration indices and concentration curves. A decomposition analysis was employed to identify the socio-economic factors contributing to the observed inequalities.</p><p><strong>Results: </strong>A total of 2323 children in 2016 and 1938 children in 2019 were tested for malaria. Malaria prevalence increased from 8% in 2016 to 10% in 2019. The concentration index for 2019 (Concentration Index = - 0.224; Standard Error = 0.059; p-value = 0.000) was statistically significant and negative, indicating higher malaria prevalence among children from lower socio-economic backgrounds. However, the concentration index for 2016 (Concentration Index = - 0.052; Standard Error = 0.044; p-value = 0.230) was not statistically significant. In 2019, socio-economic status, region, and ethnicity accounted for 59.38%, 23.66%, and 4.46%, respectively, of the observed inequalities in malaria prevalence.</p><p><strong>Conclusion: </strong>The study revealed a persistent pro-poor inequality in malaria prevalence in under-five children in Ghana, underscoring the importance of targeted malaria control interventions. These interventions should prioritize socioeconomically disadvantaged groups to reduce inequalities in malaria prevalence which contributes to the 2030 Sustainable Development Goals of improving health (SDG 3) and reducing inequalities (SDG 10), among others.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"147"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024626","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":"Erema po otjindjumba? Highlighting cultural models and knowledge gaps of malaria in rural Namibian pastoralists.","authors":"Sean Prall, Aparicio Lopes","doi":"10.1186/s12936-025-05382-x","DOIUrl":"https://doi.org/10.1186/s12936-025-05382-x","url":null,"abstract":"<p><strong>Background: </strong>As Namibia attempts to eradicate locally transmitted cases of malaria, epidemiological strategies, interventions, and outreach require a sound understanding of indigenous knowledge and practice. Research describing local explanatory models of disease can be of value in these efforts by elucidating how disease is interpreted and treated. To understand how perceptions of malaria infection and treatment may influence health-seeking behaviour, cultural models of the disease were explored in two ethnic groups in rural northwest Namibia.</p><p><strong>Methods: </strong>Mixed-sex focus groups of 4-8 individuals were conducted in the Kunene region of Namibia. All participants were either Himba or Herero and lived between 14 and 57 km of the regional town centre of Opuwo. Discussion prompts were designed to assess knowledge, beliefs, and norms about malaria, including causes, symptoms, treatment, and prevention.</p><p><strong>Results: </strong>Focus groups reported universal difficulty in discrimination between malaria and respiratory infections, the former of which was often only diagnosed at the hospital. Some recognized mosquitoes as the source of malaria, particularly the more formally educated Herero, but all also reported other causes. Notably these causes, including dietary and temperature-based origins, were considered unavoidable. Himba and Herero believed that malaria was infectious person-to-person and incorrectly believed that malaria was most common during the wintertime. Both groups also relied on a number of traditional remedies to alleviate symptoms, which were used as primary treatment, with formal healthcare treatment typically only sought when the illness progressed.</p><p><strong>Conclusions: </strong>These results highlight significant differences between local cultural models and biomedical ones that could be detrimental to malaria eradication efforts. Kunene pastoralists have limited understanding of the causes of malaria, and beliefs about environmental and dietary causes may undermine attempts at prevention. Seeking healthcare solutions to malaria was normative, but secondary to use of at home traditional remedies. These findings indicate public health outreach and information campaigns are needed, particularly in rural groups with less formal education.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"143"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031339","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}