Malaria Journal最新文献

{"title":"Genetic diversity and population structure of Plasmodium falciparum across areas of varied malaria transmission intensities in Uganda.","authors":"Alex Mwesigwa, Stephen Tukwasibwe, Bryan Cummings, Hakiimu Kawalya, Shahiid Kiyaga, Stephen Okoboi, Barbara Castelnuovo, Everd Maniple Bikaitwoha, Joan N Kalyango, Samuel L Nsobya, Charles Karamagi, Pauline Byakika-Kibwika, Joaniter I Nankabirwa","doi":"10.1186/s12936-025-05325-6","DOIUrl":"10.1186/s12936-025-05325-6","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant global health threat, with sub-Saharan Africa (SSA) bearing the highest burden of the disease. Plasmodium falciparum is the predominant species in the region, leading to substantial morbidity and mortality. Despite intensified control efforts over the last two decades, P. falciparum genetic diversity and multiplicity of infections (MOI) continue to pose significant challenges to malaria elimination in the region. This study assessed P. falciparum genetic diversity and population structure in areas with low, medium, and high malaria transmission intensities in Uganda.</p><p><strong>Methods: </strong>A total of 288 P. falciparum-positive samples from children (6 months to 10 years) and adults (≥ 18 years) living in Jinja (low transmission), Kanungu (medium transmission), and Tororo (high transmission) were genotyped using seven neutral microsatellite markers. Genetic diversity was assessed based on the number of alleles (N_a), allelic richness (Ar), and expected heterozygosity (H_e). Population structure was assessed using the fixation index, analysis of molecular variance (AMOVA), and clustering analysis.</p><p><strong>Results: </strong>High P. falciparum genetic diversity was observed across all study sites, with Kanungu exhibiting the highest mean H_e (0.81 ± 0.14), while Jinja and Tororo had lower mean H_e (0.78 ± 0.16). P. falciparum MOI varied significantly, with Tororo showing the highest mean MOI (2.5 ± 0.5) and 70% of samples exhibiting polyclonal infections, compared to Jinja's mean MOI of 1.9 ± 0.3 and 58% polyclonal infections. Significant multilocus linkage disequilibrium (LD) was noted (p < 0.01), ranging from 0.07 in Tororo to 0.14 in Jinja. Parasite population structure showed minimal genetic differentiation (F_ST ranged from 0.011 to 0.021) and a low AMOVA value (0.03), indicating high gene flow.</p><p><strong>Conclusion: </strong>This study demonstrates high P. falciparum genetic diversity and MOI but low population structure, suggesting significant parasite gene flow between study sites. This highlights the need for integrated malaria control strategies across areas with varying malaria transmission intensities in Uganda.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"97"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700555","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":"Identifying gaps in protection from malaria vector biting in rural Cambodia using an entomological assessment and human behaviour observations.","authors":"David J McIver, Elodie A Vajda, Dyna Doum, Nicholas W Daniel, Molly Quan, Diane D Lovin, Joanne M Cunningham, Siv Sovannaroth, Allison Tatarsky, Neil F Lobo","doi":"10.1186/s12936-025-05304-x","DOIUrl":"10.1186/s12936-025-05304-x","url":null,"abstract":"<p><strong>Background: </strong>Forest-exposed populations remain the last significant, and most difficult to access, high-risk populations for malaria in Cambodia. Despite the availability of long-lasting insecticidal nets (LLINs) and/or hammock nets (LLIHNs), continued malaria transmission indicates gaps in protection. This study aimed to identify these gaps among forest-exposed individuals in Plasmodium falciparum hotspots in two provinces in Cambodia, using entomological assessments and human behaviour observations (HBOs).</p><p><strong>Methods: </strong>Anopheles bionomic traits were characterized using Human Landing Catches (HLCs) in a village setting in Mondulkiri province, and in both village and forest settings in Kampong Speu province, Cambodia. Mosquitoes were collected from 17h00 to 07h00 over 540 collection nights. Human behaviour observations (HBOs) focused on monitoring activities near HLC sites and recording the use of LLINs/LLIHNs or Project BITE's bite prevention tools: a volatile pyrethroid spatial repellent (VPSR), topical repellent (TR), and insecticide-treated clothing (ITC). Data on mosquito landing pressure and human behaviours were integrated to generate the HBO-adjusted Human Landing Rate (HBO-adjusted HLR).</p><p><strong>Results: </strong>A total of 5,985 Anopheles mosquitoes were collected, with 608 (10%) identified molecularly to species-level. Seventeen Anopheles species were identified, including a likely novel species from the Leucosphyrus Subgroup, which was the predominant species characterized. The HBO-adjusted HLR was found to be greatest during the early evening hours, when people were outdoors awake, followed by when people were sleeping indoors without a net. Relatively few people were observed using, or correctly using, the new bite prevention tools intended for protection in the forest.</p><p><strong>Conclusion: </strong>This study demonstrates the importance of understanding spatial and temporal human exposure to mosquito bites, in the presence of proven vector control tools (LLINs, LLIHNs) and newly introduced bite prevention tools (VPSRs, ITCs, and TRs). To help achieve malaria elimination, human behaviour data on intervention use and behaviour patterns should be evaluated and integrated with entomological data towards identifying and quantifying protection conferred by current interventions, as well as remaining gaps in protection. This information supports the selection of appropriate interventions, which supplement rather than replace existing tools, to target existing gaps in protection.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"96"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700594","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":"Seasonal variation of Microsporidia MB infection in Anopheles gambiae and Anopheles coluzzii in two different geographical localities in Benin.","authors":"Genevieve Tchigossou, Michel Lontsi-Demano, Eric Tossou, Pierre-Marie Sovegnon, Romaric Akoton, Danahe Adanzounon, Camille Dossou, Massioudou Koto, Azarath Ogbon, Marie Gouété, Godfrey Nattoh, Rousseau Djouaka","doi":"10.1186/s12936-025-05247-3","DOIUrl":"10.1186/s12936-025-05247-3","url":null,"abstract":"<p><strong>Background: </strong>Microsporidia MB, a naturally occurring Anopheles symbiont was shown to strongly impair Plasmodium transmission without imposing deleterious fitness effects on larval development, fecundity, adult survival, and adult sex ratio, and for these reasons it is being proposed as a promising tool for malaria control. However, there is a limited knowledge about its ecology, transmission dynamics in the environments with varying abiotic conditions, and whether these could impact on the mode of host transmission. This study aimed to determine the presence and prevalence of Microsporidia MB in rice fields in Benin during both the dry and wet seasons.</p><p><strong>Methods: </strong>Anopheles larvae and adults were collected from rice fields and houses around rice fields in two locations (Koussin-Lélé and Magoumi). The collections took place during both the dry and wet seasons. The larvae and adults were molecularly identified to species level using molecular techniques and they were also screened for the presence of Microsporidia MB using PCR following standard protocols. Moreover, breeding sites were also analysed.</p><p><strong>Results: </strong>The species identification results revealed that Anopheles coluzzii was the main species in Koussin-Lélé, accounting for 100% of the 1718 samples, while Anopheles gambiae sensu stricto (s.s.) was predominant in Magoumi accounting for 98.17% of the 986 samples. In Koussin-Lélé, Microsporidia MB prevalence of 14% (n = 276) was observed, whereas in Magoumi, only two samples (0.3%) were tested positive out of 667 screened in the dry season. During the wet season, the prevalence of Microsporidia MB symbiont was low with rates of 0.7% (5) in Koussin-Lélé and 0.6% (8) in Magoumi. However, the prevalence was relatively moderate in adult field collected mosquitoes with 3.09% (n = 1554) followed by larvae samples with 2.93% (n = 682) and adults emerged from field-collected larvae with 2.67% (n = 1235). Analysis of breeding sites revealed high concentrations of nitrate, nitrite and copper in Magoumi during the dry season, which was associated with a low prevalence of Microsporidia MB symbiont in this area. In the wet season, high concentrations of lead and nitrate were recorded in Koussin-Lélé with high concentration of copper in Magoumi, and both localities showed low prevalence of Microsporidia MB infection.</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of Microsporidia MB symbiont in Benin during the dry season. Further investigations might be necessary, and modelling of the prevalence and characteristics of breeding sites could help predict the presence of this symbiont in other locations and countries.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"95"},"PeriodicalIF":2.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692704","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":"WHO malaria nucleic acid amplification test external quality assessment scheme: results of eleven distributions over 6 years.","authors":"Rebecca M Thomson, Jane A Cunningham, Michelle M Gatton, Sean C Murphy, Maria de la Paz Ade, Xavier C Ding, Sandra Incardona, Eric Legrand, Naomi Lucchi, Didier Menard, Samuel L Nsobya, Agatha C Saez, Jaya Shrivastava, Peter L Chiodini","doi":"10.1186/s12936-025-05282-0","DOIUrl":"10.1186/s12936-025-05282-0","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) recommends parasite-based diagnosis of malaria before treatment. The use of nucleic-acid amplification (NAAT) for detection of Plasmodium spp. has expanded rapidly in recent years, for epidemiological research globally and clinical care in high-resource settings. Data from NAATs are frequently used to inform policy decisions, so quality control is essential to ensure results are reliable and comparable. Therefore, robust quality control, including an external quality assessment (EQA) scheme targeting malaria NAATs, is essential. The WHO Global Malaria Programme and the UK National External Quality Assessment Service (UK NEQAS) have collaborated since 2017 to implement a global malaria NAAT EQA scheme.</p><p><strong>Methods: </strong>Panels of specimens containing five major species of human-infecting Plasmodium at various parasite concentrations and negative samples were created in lyophilized blood (LB) and dried blood spot (DBS) formats. Two distributions per year were sent, containing five LB and five DBS specimens. Samples were validated by expert referee laboratories prior to distribution. Between 37 and 51 laboratories participated in each distribution and submitted results online. Participants were scored based on their laboratory's stated capacity to identify Plasmodium species, and individual laboratory reports were sent which included performance comparison with anonymized peers. Change in performance over time was calculated using a generalized mixed model with a logit link function.</p><p><strong>Results: </strong>Participating laboratories were located in 42 countries. Sample format (DBS or LB) and parasite density were found to significantly affect performance, while referee labs performed better at identifying P. falciparum samples than non-referee labs. Performance of laboratories improved significantly over time, especially for lower density and P. falciparum samples.</p><p><strong>Conclusions: </strong>Results from the first eleven distributions indicate that the EQA scheme has facilitated improved performance of laboratories over time, highlighting the value of implementing such programmes. EQA schemes are critical to safeguarding the reliability of data and diagnoses, especially in situations where NAAT methodologies and protocols are used. In future, funders should make participation in an EQA scheme a requirement for laboratories, and countries can take initiatives to embed such schemes into their own national assessment programmes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"94"},"PeriodicalIF":2.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692706","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":"Retraction Note: Malaria in urban, semi‑urban and rural areas of southern of Gabon: comparison of the Pfmdr 1 and Pfcrt genotypes from symptomatic children.","authors":"Sydney Maghendji-Nzondo, Lady-Charlène Kouna, Gaël Mourembou, Larson Boundenga, Romeo-Karl Imboumy-Limoukou, Pierre-Blaise Matsiegui, Rella Manego-Zoleko, Bertrand Mbatchi, Didier Raoult, Fousseyni Toure-Ndouo, Jean Bernard Lekana-Douki","doi":"10.1186/s12936-025-05334-5","DOIUrl":"10.1186/s12936-025-05334-5","url":null,"abstract":"","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"93"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676990","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":"Acceptance of a malaria vaccine among caregivers of sick children under 5 years of age in Burundi.","authors":"Eric Ntihebuwayo, Manassé Nimpagaritse, Thomas Bizimana, Stany Banzimana, Dieudonné Kabura, Pierre Sinarinzi, Domina Asingizwe","doi":"10.1186/s12936-025-05327-4","DOIUrl":"10.1186/s12936-025-05327-4","url":null,"abstract":"<p><strong>Background: </strong>Malaria poses a significant public health burden globally, particularly in Burundi, where it is the leading cause of mortality and morbidity. To eliminate malaria, the malaria vaccine will be introduced in childhood vaccination. However, the information on malaria vaccine acceptance is limited. Therefore, this study investigates malaria vaccine acceptance and associated factors in Burundi.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study that involved caregivers of sick children under 5 years old to assess the acceptability of the malaria vaccine. A questionnaire was used to collect data, and SPSS was used to analyse data and identify factors significantly associated with malaria vaccine acceptance.</p><p><strong>Results: </strong>Overall, 405 (90.6%) participants indicated they would accept a malaria vaccine for their children under 5 years. The predictive factors that are significantly associated with the acceptance of the malaria vaccine include the caregivers' knowledge regarding the malaria vaccine (OR = 10.326, P-value = 0.035), the caregivers' employment (OR = 6.088, P-value = 0.02), and previous experience with childhood vaccination (OR = 3.145, P-value = 0.004).</p><p><strong>Conclusion: </strong>This study shows a high proportion of caregivers' willingness to accept the malaria vaccine. Factors including caregivers' employment, prior childhood vaccination experience, and awareness of the malaria vaccine significantly influence acceptance. These findings highlight the need for targeted awareness campaigns to increase awareness, thus, the potential for widespread vaccine adoption. Consequently, building on existing trust in childhood vaccinations, policymakers should prioritize targeted public health interventions that address knowledge gaps and concerns, ultimately contributing to malaria prevention and control efforts.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"90"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670167","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":"Congenital infection with Plasmodium malariae: a rare case of intrauterine transmission in Germany.","authors":"Sarah Goretzki, Nora Bruns, Anna Daniels, Anne Schönecker, Adela Della Marina, Andrea Gangfuß, Bernd Schweiger, Andreas Schönfeld, Oliver Witzke, Jutta Dedy, Jan Dziobaka, Caroline Holtkamp, Peter-Michael Rath, Ursula Felderhoff-Müser, Christian Dohna-Schwake, Hedda-Luise Verhasselt","doi":"10.1186/s12936-025-05331-8","DOIUrl":"10.1186/s12936-025-05331-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains the leading parasitic disease worldwide with a significant global morbidity and mortality burden. Plasmodium malariae, the least prevalent of the five Plasmodium species that cause human malaria, has unique characteristics including prolonged prepatent periods and life-long persistance. In non-endemic countries and particular in neonates with coexisting diseases diagnosis and therapy pose challenges.</p><p><strong>Case presentation: </strong>We report a rare case of severe congenital P. malariae malaria in a 2-month-old female infant born in Germany to a Nigerian mother. The infant presented with fever, hepatosplenomegaly, jaundice, and respiratory distress. Initial workup revealed significant haemolysis, hepatopathy, and thrombocytopenia. Microscopic and PCR confirmed P. malariae. Shortly after the initial presentation, the infant developed clinical signs of cerebral malaria and organ failure, requiring invasive ventilation, anti-seizure medication, and vasoactive support. Following treatment with intravenous artesunate and oral atovaquone/proguanil, the infant showed significant improvement and was discharged after 36 days (22 days of paediatric intensive care) with a multidisciplinary follow-up plan. At six months post-discharge, she demonstrated stable organ function and mild developmental delay.</p><p><strong>Conclusion: </strong>The case highlights the diagnostic and therapeutic complexities of life-threatening congenital P. malariae infections in non-endemic countries. It underlines the importance of clinicians' awareness of maternal travel or migration history and individualized treatment strategies. The increasing global mobility necessitates updated guidelines for congenital malaria management even for less likely P. malariae infections. Prophylactic measures, early recognition, and multidisciplinary management are critical for improving outcomes for such rare but severe presentations and their long-lasting complications. Possible comprehensive neonatal malaria screening in high-risk populations should be considered in the future.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"91"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670171","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":"Early evening outdoor biting by malaria-infected Anopheles arabiensis vectors threatens malaria elimination efforts in Zanzibar.","authors":"Bakar Khatib, Juma Mcha, Zamzam Pandu, Makame Haji, Makame Hassan, Huba Ali, Ramla Mrisho, Kali Abdallah, Ali Ali, Khadija Ali, Talib Said, Safia Mohamed, Humphrey Mkali, Said Mgata, Stella Makwaruzi, Michael Gulaka, Geofrey Makenga, Sigsbert Mkude, Victoria Githu, Victor Mero, Naomi Serbantez, Sarah-Blythe Ballard, Adeline Chan, Shija Joseph Shija, Nicodem J Govella","doi":"10.1186/s12936-025-05333-6","DOIUrl":"10.1186/s12936-025-05333-6","url":null,"abstract":"<p><strong>Background: </strong>The Zanzibar Malaria Elimination Programme relies on insecticide-treated nets as the principal vector control method, supplemented by reactive focal indoor residual spraying. Despite the success, local malaria transmission persists, and the underlying reasons for sustained transmission remain unclear, yet critical to optimizing vector control for elimination. Entomological characterization of transmission dynamics was conducted to identify the gaps with existing interventions and opportunities for complementary interventions.</p><p><strong>Methods: </strong>Adult malaria vectors were collected monthly for two consecutive nights at ten sentinel sites (6 Unguja, 4 Pemba) from October 2022 to September 2023. Hourly indoor and outdoor human landing catch method was used for collecting mosquitoes from 18:00 to 06:00 h.</p><p><strong>Results: </strong>Anopheles arabiensis was the predominant malaria vector species across all the sentinel sites, except in the urban district of Unguja, where Anopheles gambiae sensu stricto was predominant. Malaria parasite-infected An. arabiensis bites were distributed disproportionately between indoors (n = 4), 22:00 to 02:00 h, and outdoors (n = 10) earlier in the evenings, 1800 to 2100 h.</p><p><strong>Conclusion: </strong>The outdoor catches of malaria-parasite infected mosquitoes before typical sleeping hours highlight the potential risk of human exposure to outdoor transmission.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"92"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670253","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":"Increasing day three parasitaemia is observed after treatment of patients with artemether-lumefantrine and single dose of primaquine for uncomplicated Plasmodium falciparum malaria in Arbaminch Zuria district, Southwest Ethiopia.","authors":"Bontu Abate, Bokretsion Gidey Brhane, Tsegahun Manyazewal, Hussien Mohammed, Yonas Wuletaw, Moges Kassa, Mesay Hailu, Getachew Tollera, Geremew Tasew, Ashenafi Assefa, Eyasu Makonnen","doi":"10.1186/s12936-025-05337-2","DOIUrl":"10.1186/s12936-025-05337-2","url":null,"abstract":"<p><strong>Background: </strong>Since 2017, the first-line treatment for uncomplicated Plasmodium falciparum infection in Ethiopia has been artemether-lumefantrine (AL), plus a single dose of primaquine (PQ). The World Health Organization (WHO) recommends regular monitoring of the first-line drug efficacy as crucial tool for supporting national treatment policies. This study aimed to assess the efficacy of AL with single dose of PQ for the treatment of uncomplicated P. falciparum malaria.</p><p><strong>Methods: </strong>A prospective single-arm efficacy study was conducted among outpatients at Shecha Health Centre, aged six months and older with confirmed uncomplicated P. falciparum malaria from October 2023 to January 2024. Participants were treated with AL plus single dose of PQ and followed up to 28 days to evaluate clinical and parasitological responses. Kaplan-Meier (KM) survival analysis and per protocol (PP) analysis were used to estimate primary and secondary outcomes. Paired sample t-test was used to compare mean haemoglobin levels across follow-up dates (SPSS v.25). All comparisons were made at 95% confidence interval (CI), with a level of significance at 0.05.</p><p><strong>Results: </strong>A total of 93 patients with uncomplicated P. falciparum were enrolled and 88 participants completed the study. Based on KM analysis the overall PCR uncorrected cure rate of AL plus single dose of PQ was 96.6% (95% CI 90.4-99.3%). The PCR-corrected cure rate was 100% (95% CI 95.8-100%). Despite high cure rate, accompanied by fast resolution of clinical symptoms, 17% of participants continued to have detectable parasitaemia on day 3. There was a slight decrease in mean haemoglobin on day 28 compared to the baseline. No serious adverse events were reported during the 28-day follow-up period.</p><p><strong>Conclusion: </strong>The study findings reaffirm high efficacy of AL with a single dose of PQ for the treatment of uncomplicated P. falciparum malaria, with acceptable safety profile. These findings support the ongoing use of AL with a single dose of PQ as the primary treatment option for uncomplicated P. falciparum infections in the study area. In the context of the emergence and spread of partial artemisinin-based combination therapy(ACT) resistance in Africa, regular monitoring of the efficacy of current artemisinin-based combinations is recommended for the early detection of emerging drug resistance in the study setting and beyond.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"89"},"PeriodicalIF":2.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657626","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":"Safety, tolerability and immunogenicity of a condensed, multi-dose prime regimen of PfSPZ Vaccine for the prevention of Plasmodium falciparum malaria infection.","authors":"Andrea A Berry, Thomas L Richie, L W Preston Church, Matthew B Laurens, Colleen Boyce, Natasha Kc, Sudhaunshu Joshi, Abra Rachida Koudjra, Lauryn Butler, Mei-Chun Chen, Yonas Abebe, Tooba Murshedkar, Eric R James, Peter F Billingsley, B Kim Lee Sim, Stephen L Hoffman, Kirsten E Lyke","doi":"10.1186/s12936-025-05299-5","DOIUrl":"10.1186/s12936-025-05299-5","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) has called for new malaria vaccines with > 90% efficacy against Plasmodium falciparum infection to expand the anti-disease benefit provided by the RTS,S/AS01 and R21/Matrix M subunit vaccines currently administered to infants and young children in sub-Saharan Africa. Attenuated P. falciparum sporozoites (PfSPZ) are being developed as a traveller's vaccine and to fulfill WHO's call for high-level efficacy in endemic countries to support malaria elimination.</p><p><strong>Methods: </strong>PfSPZ Vaccine, comprised of radiation-attenuated PfSPZ, was compared with normal saline placebo in a randomized, double-blind trial targeting 60 malaria-naive US adults to assess safety, tolerability, immunogenicity, and efficacy against heterologous controlled human malaria infection three and twelve weeks after immunization. Pharmacists provided syringes to blinded clinicians using 3:1 (vaccine:placebo) blocked randomization, for administration by direct venous inoculation on days 1 and 8 (multidose prime) and day 29 (boost), a condensed regimen with superior efficacy. Primary outcomes included adverse events and antibody responses to the P. falciparum circumsporozoite protein (PfCSP).</p><p><strong>Results: </strong>31 participants were screened, randomized and immunized twice (V1, V2) 5-7 days apart, with one withdrawal after an intercurrent adverse event. A vial issue, later traced to the vial manufacturer, halted further immunizations. Solicited local and systemic adverse events recorded for 2 and 7 days after immunizations, respectively, occurred with equal frequency and severity in the 23 vaccinees and 7 controls receiving two immunizations, as did unsolicited adverse events recorded for 28 days and laboratory abnormalities 1 and 5 weeks after V2. Four of 23 vaccinees and one of 7 controls (p = 1.00) developed grade 2 adverse events including subjective fever, headache, malaise, fatigue, rigors, arthralgia and myalgia after V2 but not V1, these symptoms generally resolving within 24 h. Twenty-two of 23 (96%) vaccinees developed IgG (median 99-fold increase over baseline) and IgM (median 1,110-fold increase) antibodies to PfCSP one week after V2. Antibody responses were not associated with reactogenicity.</p><p><strong>Conclusions: </strong>The two-dose priming immunization regimen was safe, well tolerated and highly immunogenic. Larger studies may better define the adverse event profile of condensed regimens of PfSPZ Vaccine in malaria-naive adults.</p><p><strong>Trial registration number: </strong>clinicaltrial.gov NCT05604521.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"88"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648233","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}