Malaria Journal最新文献

{"title":"Occupations at high risk for malaria in Zanzibar: a case-control study, may-august 2023.","authors":"Geofrey Makenga, Sarah Gallalee, Humphrey Mkali, Mwinyi Issa Khamis, Abdulhamid Ramadhan, Mohamed Haji Ali, Wahida S Hassan, Juma Hassan, Stella Makwaruzi, Saidi Mgata, Michael Gulaka, Nicodem James Govella, Fabrizio Molteni, Chonge Kitojo, Erik Reaves, Sarah-Blythe Ballard, Naomi Serbantez, Albert Ikonje, Marguerite Afenu, Sigisbert Mkude, Jennifer L Smith, Safia Mohamed, Shija J Shija, Cara Smith Gueye, Roly Gosling","doi":"10.1186/s12936-025-05517-0","DOIUrl":"https://doi.org/10.1186/s12936-025-05517-0","url":null,"abstract":"<p><strong>Background: </strong>In malaria elimination settings, cases tend to cluster geographically and occur among certain subpopulations. Clustering is often related to specific factors such as occupation or mobility, which increase an individual's risk for malaria infection.</p><p><strong>Methods: </strong>A case-control study was conducted to identify malaria high-risk populations (HRPs) in Zanzibar. Patients presenting with symptoms of malaria at selected facilities were recruited from historically high burden areas in two urban districts (Mjini and Magharibi B) and two rural districts (Kati and Micheweni). Between May and August 2023, the study recruited 197 cases and 557 controls frequency matched by age group and sex. Logistic regression was used to explore associations between risk factors and the epidemiological outcome of local malaria infection, classified as confirmed malaria cases with no travel outside Zanzibar in the prior 3 weeks.</p><p><strong>Results: </strong>In urban districts, night watchmen/police (odds ratio [OR] 5.3, 95% confidence interval [CI]: 2.7-10.6, p < 0.001), construction workers (OR 3.0, 95% CI 1.8-5.0 p = 0.007), and farmers (OR 1.6, 95% CI 1.1-2.2, p = 0.01) were found to have higher odds of malaria infection compared to those not working in those professions. Other high-risk behaviours in urban districts included night-time activities (OR 2.8, 95% CI 1.8-4.3, p < 0.001), meals taken outside (OR 2.0, 95% CI 1.1-3.4, p = 0.01), and recent travel within Zanzibar (OR 3.3, 95% CI 1.5-7.1, p = 0.002). In rural districts, outdoor night-time activities (OR 3.8, 95% CI 1.5-9.9, p = 0.006) and taking meals outside (OR 2.7, 95% CI 1.1-6.6, p = 0.03) were risk factors for malaria; however, no higher risk occupational groups were identified. Overall, there was a trend towards net use being protective against malaria, but this association only reached statistical significance in rural districts (p = 0.015).</p><p><strong>Conclusion: </strong>Tailored interventions targeting specific occupational groups could be an effective strategy to reduce malaria in urban areas in Zanzibar.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"268"},"PeriodicalIF":3.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959829","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":"Concordance of data on key malaria indicators between DHIS2 and source documents, and influencing factors at public primary health facilities in eastern Uganda: a mixed methods study.","authors":"Shivan Nuwasiima, Arthur Mpimbaza, Laban Muteebwa, Elizabeth Nagawa, Emmanuel Arinaitwe, Faizo Kiberu, David Livingstone Ejalu, Jovan Mugerwa, Charles Batte, John Mukisa, Bosco Agaba, David Mukunya, Joan N Kalyango, Moses R Kamya, Joaniter I Nankabirwa","doi":"10.1186/s12936-025-05519-y","DOIUrl":"https://doi.org/10.1186/s12936-025-05519-y","url":null,"abstract":"<p><strong>Background: </strong>Effective malaria surveillance is a key strategy for malaria control in sub-Saharan Africa. In 2012, Uganda rolled out the District Health Information System, version 2 (DHIS2), however, the quality of the DHIS2 malaria surveillance data is questionable. The primary objective of this study was to assess the level of concordance between the DHIS2 and facility source documents on selected malaria data indicators and influencing factors at selected primary health facilities in Mayuge district.</p><p><strong>Methods: </strong>12 public health facilities were enrolled in a parallel convergent mixed-methods study. Data collection included a retrospective review of data on key malaria indicators in DHIS2 weekly reports from 2021 to 2022 and source documents at selected public health facilities. In-depth interviews were conducted with facility heads and records personnel. Data concordance was defined as the agreement between the DHIS2 data and the source documents. Modified Poisson regression with cluster robust standard errors was used to assess factors associated with data concordance on Test Positivity Rates (TPR).</p><p><strong>Results: </strong>Concordance between DHIS2 data and OPD register data for suspected malaria cases was 36.7%, 95% confidence interval [CI] 25.2, 49.9; suspected cases tested was 53.6%, 95% CI; 41.7, 65.05; test positive cases was 55.3%, 95% CI; 43.0, 67.0; and TPR was 56.8%, 95% CI; 43.9, 68.8. The presence of a Health Management Information System (HMIS) personnel at the facility (adjusted prevalence ratio [aPR] 1.41, (95% CI; 1.20, 1.66)), timely reporting (aPR = 1.15, 95% CI; 1.00, 1.31) and stock out of malaria rapid diagnostic tests (RDTs) (aPR = 0.55, 95% CI; 0.35, 0.86) were significantly associated with data concordance. Qualitative data highlighted regular data verification and the perceived value of HMIS data by health workers as facilitators of data concordance, while insufficient training and rapid diagnostic test (RDT) stockouts were identified as barriers.</p><p><strong>Conclusion: </strong>Data concordance between DHIS2 and source documents was below the World Health Organisation (WHO) performance standard of ≥ 80% on key malaria indicators. Presence of data clerks, and timely reporting were identified as the factors that improved data concordance. To improve the quality and timeliness of the DHIS2, having trained data staff at public health facilities is key. Alternatively, electronic primary data capture may help in reducing errors that arise during data capturing and aggregation.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"270"},"PeriodicalIF":3.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959812","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":"Experimental hut resting and entrance behaviour of Anopheles darlingi from Zungarococha, a malaria endemic community in Loreto, Northern Peruvian Amazon.","authors":"Fanny Castro-Llanos, Craig A Stoops, John P Grieco, Karin Escobedo-Vargas, Victor Lopez-Sifuentes, Audrey Lenhart, Frederick M Stell, Ryan T Larson, Nicole L Achee, Gissella M Vásquez","doi":"10.1186/s12936-025-05442-2","DOIUrl":"10.1186/s12936-025-05442-2","url":null,"abstract":"<p><strong>Background: </strong>Anopheles darlingi is a primary malaria vector in the Peruvian Amazon, yet characterization of behavioural traits contributing to human-vector contact is limited. Additionally, studies comparing key behaviours of wild-type to colonized An. darlingi populations are minimal. This study compared resting and entry behaviour between these two types of populations. Specific objectives were to use experimental huts to (1) evaluate and compare indoor resting behaviours of wild-type and colonized An. darlingi populations; (2) quantify An. darlingi house entry rates into interception traps in relation to protected Human Landing collection (HLC).</p><p><strong>Methods: </strong>The study was conducted in Zungarococha village, Loreto, Peru. Prior to hut evaluations, An. darlingi biting activity and population dynamics were evaluated using HLC outside local homes from June 2014 to May 2015. Indoor resting location (window, door, wall, roof) of wild caught and colonized An. darlingi was evaluated in three experimental huts. Controlled indoor releases were performed for 6 days each month from March to August 2015. Wild An. darlingi hourly house-entry rates were quantified using interception traps affixed to an experimental hut and indoor HLC from May to August 2015. Two collectors were positioned inside huts to generate host-seeking cues during evaluations.</p><p><strong>Results: </strong>Anopheles darlingi had a bimodal outdoor biting pattern with two peaks at 1800 h and 2200 h. HLC densities were associated with Amazon River levels measured nearby Iquitos city. Colonized An. darlingi preferred to rest in lower parts of the door (29.8%), roof (12.7%), and window (11.8%) which was similar to wild caught An. darlingi which preferred to rest in low door (32.7%), window (14.0%), and roof (13.0%). Wild An. darlingi entry behaviour peaked from 2200 to 2300 h, this was clearly observed when collection densities increased, varying between 2300 and 2400 h at low collection densities. Capture rates from interception traps were lower compared to indoor HLC rates from adjacent experimental huts and local houses.</p><p><strong>Conclusions: </strong>Results from this study provide useful insights into An. darlingi resting and entry behaviour in a malaria endemic area in the Peruvian Amazon and inform on the use of colonized mosquitos in vector behavioural studies. This information is relevant to malaria epidemiology and will be useful to evaluate new tools for malaria control programmes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"267"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883149","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":"Subnational malaria burden in Sindh, Pakistan: over a decade of evidence for tailored strategies.","authors":"Nelofer Baig, Zakir Ali, Muhammad Ahmed, Wafa Zehra Jamal, Saqib Ur Rehman, Zafar Ahmed, Riaz Hussain Rahoojo, Javed Ali Jagirani, Bilal Ahmed Usmani, Zafar Fatmi","doi":"10.1186/s12936-025-05505-4","DOIUrl":"10.1186/s12936-025-05505-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate estimates of malaria burden are crucial for allocating resources and designing effective control strategies. However, global reports often underestimate the burden in low- and middle-income countries, especially beyond the African region. This study addresses this gap by providing a longitudinal time-series analysis of malaria burden and spatio-temporal distribution in Sindh province, Pakistan.</p><p><strong>Methods: </strong>Monthly suspected malaria cases reported from 1088 primary healthcare facilities managed by the PPHI-Sindh across 23 districts of Sindh Province (excluding seven districts of Karachi), Pakistan, were analysed over a 13-year period (2012-2024). Malaria incidence was determined by dividing total malaria cases by each health facility's catchment area population. Population-weighted estimates of malaria cases were calculated to account for variations in population size across districts. Yearly time-trend (with 95% CI), seasonal variation by month (with 95% CI), and a treemap illustrating the distribution of malaria burden across districts in Sindh.</p><p><strong>Results: </strong>An incidence of 92 per 1000 people per annum of suspected malaria cases was reported at primary public healthcare facilities. Pooled estimates of 16.7 million cases occurred during a 13-year period, about 1.28 million cases annually. Marked heterogeneity observed in malaria burden across districts. Malaria positivity rate was 12.3%. Six districts (Khairpur, Sanghar, Naushero Feroze, Badin, Mirpurkhas, and Larkana) carried over 53% burden of malaria in Sindh. A distinct seasonal pattern with peak coinciding with the wet season and post-monsoon period was observed. Since the 2022 floods in Sindh, the malaria incidence has doubled, and it is persisting in the province.</p><p><strong>Conclusions: </strong>The study highlights the substantial malaria burden with wet seasons and post-monsoon peaks in Sindh and identified few high-burden districts. The impact of 2022 flood seems to have persisted to 2024 and onwards, which needs immediate attention. Identification of high-burden districts could help tailor malaria control strategies. Also, the underestimation by global reports emphasizes the need for country-level and subnational analyses for informed decision-making. By addressing these gaps and refining burden estimates, Pakistan can develop more targeted strategies towards malaria control.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"265"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883151","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 Plasmodium falciparum plasmepsin2/3 gene duplication in Africa and Asia: a systematic review and meta-analysis.","authors":"Karol J Marwa, Manase Kilonzi, Rajabu Hussein Mnkugwe, Vito Baraka, Anthony Kapesa, Richard Mwaiswelo, Maria Zinga, Bruno P Mmbando, John P A Lusingu, Erasmus Kamugisha","doi":"10.1186/s12936-025-05423-5","DOIUrl":"10.1186/s12936-025-05423-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Plasmodium falciparum delayed clearance phenotype due to the emergence of partial artemisinin resistance has been documented in Asia and Africa, where it is associated with treatment failure of artemisinin-based combination therapy (ACT). The amplification of the Plasmodium falciparum plasmepsin2/3 gene (pfpm2/3) has been shown to decrease the susceptibility of P. falciparum to piperaquine, leading to treatment failure among patients on dihydroartemisinin-piperaquine. The present systematic meta-analysis summarises the evidence of pfpm2/3 gene amplification in Asia and Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The protocol for the review was registered at the PROSPERO (Reference number: CRD42024599774). Thirty-four studies conducted in Africa and Asia, reporting pfpm2/3 gene amplification among P. falciparum isolates, were identified through the Medline, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, and EMBASE online databases. The potential for publication bias was evaluated by examining asymmetry in funnel plots and using Egger's test. Pooled proportions estimates were calculated using the random effects model, while heterogeneity was assessed through I&lt;sup&gt;2&lt;/sup&gt; statistics. Sub-group analysis was performed based on the year of sample collection and continent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The heterogeneity among the studies included in the meta-analysis was high (I&lt;sup&gt;2&lt;/sup&gt; &gt; 95%, p &lt; 0.01). The funnel plot was asymmetrical, suggesting that publication bias affected the meta-analysis. However, Egger's test and Begg's (adjusted to Kendall's) scores for the pooled proportions of the pfpm2/3 gene confirmed no potential publication bias (p = 0.083 and 0.163, respectively). A total of 34 studies involving 4,005 P. falciparum isolates were included in this review. Of the 34 studies, 18 (53%) were conducted in Asia, and 16 (47%) were conducted in Africa. The samples for these studies were collected from 2009 to 2019. Among these studies, 15 (44%) were performed before 2016. The estimated pooled proportions of pfpm 2/3 gene amplification via the random effects model were 16.0% (95% CI 8.0-26.0%). Subgroup analysis (per continent and year of sample collection) revealed that the pooled proportions estimates of pfpm2/3 gene amplification were greater in Asia (25.0%, 95% CI 9.0-45.0%) than in Africa (8.0%, 95% CI 2.0-15.0%) and lower before 2016 than 2016 to 2020 (11%, 95% CI 3.0-23% and 19%, 95% CI 7.0-36%, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The present review provides up-to-date evidence on the pfpm2/3 gene amplification. A substantial pooled proportion of pfpm2/3 gene amplification was reported, and many of the amplifications were observed in isolates from Asia rather than Africa. This calls for further efforts to monitor/control the emergence and spread of partner drug resistance in the regions to avoid the emergence of total ACT resistance, which will compromi","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"266"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883150","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":"Urban malaria and population mobility in sub-Saharan Africa: systematic review and meta-analysis.","authors":"Hailu Merga, Teshome Degefa, Zewdie Birhanu, Ming-Chieh Lee, Guiyun Yan, Delenasaw Yewhalaw","doi":"10.1186/s12936-025-05508-1","DOIUrl":"10.1186/s12936-025-05508-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria control in African cities faces challenges mainly due to rapid and unplanned urbanization and the spread of the new urban malaria vector, Anopheles stephensi. By 2050, nearly 70% of the world`s population will live in urban areas, a significant increase from the current rate. This systematic review and meta-analysis map the epidemiology of urban malaria in sub-Saharan Africa (SSA). The review included individual participants data from studies conducted in urban settings among all populations to characterize and establish pooled estimates of the prevalence and risk factors, which would help guiding strategies for malaria control and elimination in urban settings.</p><p><strong>Methods: </strong>An exhaustive literature search was done in PubMed, Medline EBSCO, Google Scholar, Science Direct, and Cochrane Library databases. The Joanna Briggs Institute (JBI) guidelines were followed for evidence selection, data extraction, quality assessment and presentation of findings. Peer-reviewed and gray literature published in English since 2000 focusing on urban malaria Epidemiology in SSA was included in the review. Microsoft Excel 2016 spreadsheet and Stata statistical package were used to extract and analyze data, respectively. Potential sources of heterogeneity and publication bias were assessed. A random effects model was employed for the meta- analysis.</p><p><strong>Results: </strong>Of the 2,468 records identified from various databases, 39 articles were selected for systematic review and meta-analysis. The overall pooled prevalence of urban malaria in SSA was 23.01% (95% CI: 19.42, 26.59; I² = 99.8%, p < 0.0001). Substantial heterogeneity was observed (I² = 99.8%), indicating considerable variability in population and methods employed. Among two studies included for analysis, a random effect model showed that odds of malaria infection were higher among study participants who had history of travel (POR = 4.17 (95% CI: 2.33, 7.46, I² = 75.5%, p = 0.002). Similarly, five studies were included in the review and showed that owning livestock in the house was associated with malaria infection in urban settings (POR = 4.1, 95% CI: 1.62, 10.39; I² = 75.3%, p = 0.044).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis showed a high prevalence of urban malaria infection in SSA with high country-wise heterogeneity. While country-level differences contributed to this variability, other important sources of heterogeneity included variations in population included, method employed and population characteristics. The pooled estimate showed that having a travel history and owning livestock in the house were identified as factors associated with urban malaria infection. Therefore, effective urban malaria control requires an integrated and targeted approach that addresses socio-economic, environmental and behavioural drivers.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"264"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873935","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":"Relating household entomological measures to individual malaria risk.","authors":"Max McClure, Emmanuel Arinaitwe, Moses R Kamya, Philip J Rosenthal, Joaniter Nankabirwa, Maxwell Kilama, Alex Musiime, Grant Dorsey, Bryan Greenhouse, Isabel Rodriguez-Barraquer","doi":"10.1186/s12936-025-05504-5","DOIUrl":"10.1186/s12936-025-05504-5","url":null,"abstract":"<p><strong>Background: </strong>The gold standard measure of malaria exposure is the entomological inoculation rate (EIR), or the number of infectious bites an individual receives over a given period. Nevertheless, it is unclear whether EIR measured in the households of individuals reflects heterogeneity in those individuals' infection risk.</p><p><strong>Methods: </strong>To investigate this relationship, this study used data collected from a cohort of 439 children aged 0.5-5 years in 239 households from 2011-2016 in three Ugandan districts: low-EIR Jinja, intermediate-EIR Kanungu and high-EIR Tororo. Participants underwent passive and quarterly active surveillance for clinical malaria, defined as fever with positive thick blood smear. Monthly vector densities and sporozoite rates in participating households were estimated using CDC light traps. The association between spatiotemporally smoothed household log₂-transformed EIR and individual malaria incidence was assessed using Poisson generalized additive mixed effects models.</p><p><strong>Results: </strong>Comparison across sites suggested an increasing relationship between average EIR and malaria incidence. Within-site relationships, however, varied by site, with a positive association in Kanungu (incidence rate ratio [IRR] 1.09, 95% credible interval 1.04-1.14) but none in Jinja (1.02, 0.774-1.26) or Tororo (1.02, 0.986-1.06).</p><p><strong>Conclusions: </strong>These results show the relationship between measured EIR and malaria incidence may depend on site-specific transmission dynamics and be strongest at intermediate EIR, while underscoring the challenges of using household-level measures of exposure.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"261"},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847619","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":"\"We witnessed medicines help our children, then we became proud\": experiences and acceptability of seasonal malaria chemoprevention in Aweil, South Sudan.","authors":"Francis Okot, Maria Suau Sans, Erica Viganò, Abubaker Rom, Denis Mubiru, Kevin Baker, Jamshed Khan, Ahmed Julla","doi":"10.1186/s12936-025-05501-8","DOIUrl":"10.1186/s12936-025-05501-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health concern, particularly in resource-constrained settings and regions affected by ongoing humanitarian crises, such as Northen Bahr el Ghazal in South Sudan. For successful implementation and uptake of malaria interventions, it is important to understand community perceptions in these contexts. Therefore, we present the findings of the qualitative study examining the feasibility of implementing seasonal malaria chemoprevention (SMC) and acceptability of the intervention by the community in this complex setting.</p><p><strong>Methods: </strong>Five monthly cycles of SMC with sulfadoxine-pyrimethamine plus amodiaquine were distributed to children aged 3-59 months in Aweil South county, in Northen Bahr el Gazal. Following the completion of the fifth SMC cycle a qualitative study was conducted to understand perspective on SMC acceptability. Data were collected through key informant interviews with community leaders and other stakeholders at the county and national level and focus group discussions with caregivers of children aged 3-59 months and Boma Health Workers. Data were coded using inductive and deductive approaches.</p><p><strong>Results: </strong>Among the 97 participants, there was high acceptability of SMC. Factors reported that positively influenced acceptability included the perceived effectiveness of SMC in preventing malaria, the door-to-door delivery strategy and the use of trusted Boma Health Workers to deliver SMC. However, challenges reported as affecting feasibility included environmental barriers, inadequate remuneration for Boma Health Workers, and difficulties reaching all eligible children. Stakeholders also expressed a desire for SMC continuation and expansion, emphasizing the positive economic impact.</p><p><strong>Conclusion: </strong>This study provides crucial insights into factors influencing acceptability of SMC in a fragile setting, which can be used to refine community engagement strategies for SMC and generate guidelines for optimizing SMC in similar challenging contexts.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"262"},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855737","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":"Measuring growth, resistance, and recovery after artemisinin treatment of Plasmodium falciparum in a single semi-high-throughput assay.","authors":"Mackenzie A C Sievert, Tarrick Qahash, Puspendra P Singh, Douglas A Shoue, Lisa A Checkley, Katelyn Vendrely Brenneman, Zione Cassady, Sudhir Kumar, Xue Li, François H Nosten, Timothy J C Anderson, Ashley M Vaughan, Jeanne Romero-Severson, Michael T Ferdig","doi":"10.1186/s12936-025-05481-9","DOIUrl":"10.1186/s12936-025-05481-9","url":null,"abstract":"<p><strong>Background: </strong>Artemisinin partial resistance (ART-R) has spread throughout Southeast Asia and mutations in Pfkelch13, the molecular marker of resistance, are widely reported in East Africa. Effective in vitro assays and robust phenotypes are crucial for monitoring populations for the emergence and spread of resistance. The recently developed extended Recovery Ring-stage Survival Assay used a qPCR-based readout to reduce the labour intensiveness for in vitro phenotyping of ART-R and improved correlation with the clinical phenotype of ART-R. Here, the assay is extended and refined to include measurements of parasite growth and recovery after drug exposure. Clinical isolates and progeny from two genetic crosses were used to optimize and validate the reliability of a straight-from-blood, SYBR Green-based qPCR protocol in a 96-well plate format to accurately measure phenotypes with this new Growth, Resistance, and Recovery assay (GRRA).</p><p><strong>Results: </strong>The assay determined growth between 6 and 96 h, resistance at 120 h, and recovery from 120 to 192 h. Growth can be accurately captured by qPCR and is shown by reproduction of previous growth phenotypes from HB3 × Dd2. Resistance measured at 120 h continually shows the most consistent phenotype for ring stage susceptibility. Recovery identifies an additional response to drug in parasites that are determined sensitive by replicative viability at 120 h. Comparison of progeny phenotypes for Growth versus Resistance showed a minor but significant correlation, whereas Growth versus Recovery and Resistance versus Recovery showed no significant correlation. Additionally, dried blood spot (DBS) samples matched replicative viability measured from liquid samples demonstrating Resistance can be easily quantified using either storage method.</p><p><strong>Conclusions: </strong>The direct-from-blood qPCR-based methodology provides the throughput needed to quickly measure large numbers of parasites for multiple relevant phenotypes. Growth can reveal fitness defects and illuminate relationships between proliferation rates and drug response. Recovery serves as a complementary phenotype to resistance that quantifies the ability of sensitive parasites to tolerate drug exposure. All three phenotypes offer a comprehensive assessment of parasite-drug interaction each with potential independent genetic determinants of main effect and overlapping secondary effects. By adapting the method to include DBS, readouts can be easily extended to ex vivo surveillance applications.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"263"},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the use of Community Health Workers while deploying the Attractive Targeted Sugar Bait (ATSB) for malaria control in Western Province, Zambia.","authors":"Frank Ndalama, David Mulenga, Annie Arnzen, Situmbeko Akalalambili, Titus Tobolo, Chuma Maluma, Chama Chishya, Kochelani Saili, Ruth A Ashton, John Miller, Kafula Silumbe, Javan Chanda, Busiku Hamainza, Megan Littrell, Erica Orange","doi":"10.1186/s12936-025-05503-6","DOIUrl":"10.1186/s12936-025-05503-6","url":null,"abstract":"<p><strong>Background: </strong>Community Health Workers (CHWs) play a crucial role in malaria control efforts, yet their contributions to large-scale field trials remain understudied. This research examined the management of CHWs recruited to support a phase III trial of Attractive Targeted Sugar Baits (ATSBs) in Western Zambia. The study aimed to understand the extent to which CHW involvement in the trial aligned with best practices and challenges faced by CHWs implementing health promotion activities.</p><p><strong>Methods: </strong>A literature review, review of Zambia Ministry of Health Guidelines, and review of WHO guidelines was conducted to identify best practices and common challenges for CHWs contributing to the delivery of malaria interventions. Subsequently ATSB trial documents were reviewed to compare CHW involvement and CHW challenges experienced during the ATSB trial from 2021 to 2023. A comparative analysis was utilized to assess the involvement of CHWs in the ATSB trial against literature review findings, specific to CHW recruitment, training, supervision, incentivization, and community support.</p><p><strong>Results: </strong>Five best practices for CHW delivery of interventions were identified: participatory and gender equitable recruitment and selection; comprehensive training; incentivization for enhanced motivation and performance; high quality supportive supervision; and fostering community support. Five common challenges for involving CHWs in programme delivery were identified: inadequate and poor-quality supervision of CHWs; low compensation and motivation; logistical constraints; workload and multiplicity of roles, and community challenges. The analysis found that ATSB trial practices largely aligned with literature best practices and established guidelines, particularly in training and incentive structures. However, challenges were identified in achieving gender balance (32% female CHWs in year 2), community involvement in CHW selection, and coordination between CHWs and research team members. CHW involvement was a key factor towards successfully implementing the trial protocol.</p><p><strong>Conclusions: </strong>Experiences with CHWs involvement in the ATSB trial in Zambia suggest that some facets of field research readily facilitate adherence to best practices for CHW recruitment and management. Additionally, field research that is adequately funded and characterized by rigorous implementation may avoid some of the common challenges faced by CHWs implementing health promotion activities. Nonetheless, some CHW cadre challenges appear universal to programmatic and research contexts, including an imbalance in gender representation favouring male participation in CHW opportunities. More documentation of research experiences may be needed to understand CHW involvement and experiences in field research outside of randomized controlled trials.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"260"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847618","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}