Malaria Journal最新文献

{"title":"Efficacy of attractive targeted sugar bait stations against malaria in Western Province Zambia: epidemiological findings from a two-arm cluster randomized phase III trial.","authors":"Ruth A Ashton, Kochelani Saili, Chama Chishya, Handrinah Banda Yikona, Annie Arnzen, Erica Orange, Chanda Chitoshi, John Chulu, Titus Tobolo, Frank Ndalama, Irene Kyomuhangi, Willy Ngulube, Hawela Moonga, Jacob Chirwa, Laurence Slutsker, Joseph Wagman, Javan Chanda, John Miller, Kafula Silumbe, Busiku Hamainza, Thomas P Eisele, Joshua Yukich, Megan Littrell","doi":"10.1186/s12936-024-05175-8","DOIUrl":"10.1186/s12936-024-05175-8","url":null,"abstract":"<p><strong>Background: </strong>Attractive targeted sugar bait (ATSB) stations containing bait (to attract) and ingestion toxicant (to kill) sugar-foraging mosquitoes are hypothesized to reduce malaria transmission by shortening the lifespan of Anopheles vectors.</p><p><strong>Methods: </strong>A two-arm cluster-randomized controlled trial (cRCT) was conducted in Western Province Zambia. Seventy clusters of 250-350 households were assigned (1:1) by restricted randomization to an intervention arm (ATSB) or control arm (no ATSB) in the context of standard of care vector control (insecticide-treated nets and/or indoor residual spraying). Two ATSB stations (Westham Sarabi, 0.11% dinotefuran w/w) were maintained on exterior walls of eligible household structures for a 7-month deployment period (December-June) during the high malaria transmission season. The primary outcome was clinical malaria incidence among two consecutive seasonal cohorts of children aged 1-14 years, followed-up monthly from January-June in 2022 and 2023. Secondary outcome was Plasmodium falciparum prevalence among individuals aged over six months. Analysis compared clinical malaria incidence and prevalence between arms among the intention-to-treat population.</p><p><strong>Results: </strong>ATSB coverage, assessed by cross-sectional survey, was 98.3% in March-April 2022 and 89.5% in March-April 2023. 4494 children contributed any follow-up time to the cohort, with 2313 incident malaria cases in the intervention arm (1.28 per child per six-month transmission season), and 2449 in the control arm (1.38 per child-season). The incidence rate ratio between the two arms was 0.91 (95% CI 0.72-1.15, p = 0.42). 2536 individuals participated in cross-sectional surveys, with prevalence of P. falciparum 50.7% in the intervention arm and 53.5% in the control arm. The odds ratio between the two arms was 0.89 (95% CI 0.66-1.18, p = 0.42). Secondary covariable-adjusted and subgroup analyses did not substantially alter the findings. No serious adverse events associated with the intervention were reported.</p><p><strong>Conclusions: </strong>Two ATSB stations deployed per eligible structure for two consecutive transmission seasons did not result in a statistically significant reduction in clinical malaria incidence among children aged 1-14 years or in P. falciparum prevalence in rural western Zambia. Further studies are needed to assess the efficacy of ATSB stations in different settings and with different deployment strategies.</p><p><strong>Trial registration: </strong>The trial is registered with Clinicaltrials.gov (NCT04800055).</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"343"},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644468","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":"Declining genetic polymorphism of the C-terminus Merozoite Surface Protein-1 amidst increased Plasmodium knowlesi transmission in Thailand.","authors":"Parsakorn Tapaopong, Sittinont Chainarin, Abdulrohman Mala, Arnuwat Rannarong, Nikom Kangkasikorn, Teera Kusolsuk, Wanlapa Roobsoong, Liwang Cui, Wang Nguitragool, Jetsumon Sattabongkot, Sirasate Bantuchai","doi":"10.1186/s12936-024-05162-z","DOIUrl":"10.1186/s12936-024-05162-z","url":null,"abstract":"<p><strong>Background: </strong>Recent reports from Thailand reveal a substantial surge in Plasmodium knowlesi cases over the past decades, with a more than eightfold increase in incidence by 2023 compared to 2018. This study investigates temporal changes in genetic polymorphism associated with the escalating transmission of P. knowlesi malaria in Thailand over time using the prominent vaccine candidate, pkmsp1 as a marker.</p><p><strong>Methods: </strong>Twenty-five P. knowlesi samples collected in 2018-2023 were sequenced for the 42-kDa region of pkmsp1 and compared with 24 retrieved sequences in 2000-2009, focusing on nucleotide diversity, natural selection, recombination rate, and population differentiation.</p><p><strong>Results: </strong>Seven unique haplotypes were identified in recent samples, compared to 15 in earlier samples. Nucleotide and haplotype diversity were lower in recent samples (π = 0.016, Hd = 0.817) than in earlier samples (π = 0.018, Hd = 0.942). Significantly higher synonymous substitution rates were observed in both sample sets (d_S-d_N = 2.77 and 2.43, p < 0.05), indicating purifying selection and reduced genetic diversity over time. Additionally, 8 out of 17 mutation points were located on predicted B-cell epitopes, suggesting an adaptive response by the parasites to evade immune recognition. Population differentiation analysis using the fixation index (F_st) revealed high genetic differentiation between parasite populations in central and southern Thailand or Malaysia. Conversely, the relatively lower F_st value between southern Thailand and Malaysia suggests a closer genetic relationship, possibly reflecting historical gene flow.</p><p><strong>Conclusion: </strong>This study highlights a decline in genetic diversity and evidence of purifying selection associated with the recently increased incidence of P. knowlesi malaria in Thailand. The minor genetic differentiation between P. knowlesi populations from southern Thailand and Malaysia suggests a shared recent ancestry of these parasites and underscores the need for coordinated efforts between the two countries for the elimination of P. knowlesi.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"342"},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622841","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":"Perception of caregivers on ITNs utilisation and its effectiveness among children under 5 years of age in Chikwawa district, Malawi.","authors":"Enock Benito, Praveen Suthar, Godfrey Banda, Parthasarthi Ganguly, Wamaka Msopole","doi":"10.1186/s12936-024-05167-8","DOIUrl":"10.1186/s12936-024-05167-8","url":null,"abstract":"<p><strong>Background: </strong>In 2020, Malawi had 6.9 million malaria cases and 2551 deaths, mainly in children under five years of age. The 2017-2022 Malawi malaria control strategic plan promoted the consistent use of insecticide-treated nets through free distribution and mass campaigns. Despite widespread availability of the control strategy plan, Chikwawa District continues to suffer from high malaria burden especially among under five children, due to inconsistent insecticide-treated (ITN) net usage. For this reason, this study aimed at exploring caregivers' perceptions on insecticide-treated net utilisation and also find out about its effectiveness among those who consistently use them.</p><p><strong>Methods: </strong>This study used a sequential exploratory mixed methods design. The data used for quantitative analysis was drawn from the population of under-five children's caregivers within the catchment area of Chikwawa district hospital. The sample size was 96 participants, as determined by Cochran's formula. The data collection lasted from December 2023 to April 2024 and included four in-depth interviews and three focus group discussions to address the objectives qualitatively.</p><p><strong>Results: </strong>The study revealed that 91.67% of households used ITNs, with 87.50% using them daily. The significant factors influencing ITN utilisation included the number of nets, user satisfaction, perceived impact, user habits, acquisition method, and usage frequency (all p values < 0.001). Under-five malaria cases were also significant (p = 0.025). The odds of the perceived net impact influencing utilisation were 4.956 times greater. Non-usage was due to heat, quality concerns, limited access, breathing difficulties, health conditions such as asthma, and misconceptions about net treatment.</p><p><strong>Conclusion: </strong>The study revealed a strong belief in insecticide-treated net efficacy. However, some challenges such as access, durability, and misinformation of insecticide-treated nets were discovered. These challenges affected utilisation of insecticide-treated nets in agreement with some literature reviewed. The insights found in this study will help policymakers in addressing health interventions for the reduction of malaria cases in Malawi.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"341"},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622866","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":"Investigation on chemical composition and insecticidal activity against Anopheles gambiae of essential oil obtained by co-distillation of Cymbopogon citratus and Hyptis suaveolens from Western Burkina Faso.","authors":"Bily Nebié, Constantin M Dabiré, Remy K Bationo, Dieudonné D Soma, Moussa Namountougou, Siaka Sosso, Roger C H Nebié, Roch K Dabiré, Eloi Palé, Pierre Duez","doi":"10.1186/s12936-024-05177-6","DOIUrl":"10.1186/s12936-024-05177-6","url":null,"abstract":"<p><strong>Background: </strong>Essential oils of Cymbopogon citratus and Hyptis suaveolens are known for their insecticidal properties, but remain ineffective against mosquitoes resistant to synthetic insecticides. In order to improve insecticidal properties of these plants, this study aimed to investigate the chemical composition and insecticidal activity against Anopheles gambiae mosquitoes of essential oil obtained by co-distillation of dry leaves of C. citratus and H. suaveolens.</p><p><strong>Methods: </strong>Essential oils were extracted by hydrodistillation from dry leaves of C. citratus and H. suaveolens, separately, then from the mixture of the dry leaves of the two plants in mass ratio 50/50. Each pure essential oil and the mixture obtained either by co-distillation or by combining pure essential oils in volume ratio 50/50 were then analysed by GC/MS. All essential oils and Deltamethrin 0.05% (positive control) were tested on two species of mosquitoes of the genus Anopheles gambiae according to the World Health Organization standard methods.</p><p><strong>Results: </strong>Essential oil obtained by co-distillation mainly contained piperitone (40.80%), 1,8-cineole (24.64%), p-menth-4(8)-ene (13.20%), limonene (6.09%) and α-pinene (4.73%). However, the mixture of pure essential oils of these two plants mostly contained geranial (20.74%), neral (16.42%), 1,8-cineole (19.79%), sabinene (6.03%) and β-pinene (3.87%). The essential oil of C. citratus mainly contained geranial (41.49%), neral (32.83%), β-myrcene (13.66%) and geraniol (3.49%) while the major constituents of essential oil of H. suaveolens were 1,8-cineole (39.58%), sabinene (12.06%), β-pinene (7.73%), α-terpinolene (6.72%) and (E)-caryophyllene (7.49%). At the dose of 1%, all essential oils, except that of H. suaveolens, induced about 100% of mortality on the sensitive species of An. gambiae. However, on the resistant species at the same dose, the essential oil obtained by co-distillation induced the highest mortality (53.44%). The essential oils of C. citratus, H. suaveolens and the mixture of the two pure essential oils caused respectively 2.47, 15.28 and 18.33% of mortality. The synthetic insecticide caused 100 and 14.84% of mortality respectively on the sensitive and resistant species of An. gambiae.</p><p><strong>Conclusion: </strong>Essential oil obtained by co-distillation showed good insecticidal efficacy against a resistant species of An. gambiae and might constitute a new solution to fight against mosquitoes resistant to synthetic insecticides.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"339"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622846","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":"Factors associated with severe malaria-related mortality among hospitalized children under five years of age in Eastern Province of Rwanda: a cross-sectional study using hospital records from 2017 to 2021.","authors":"Jean Paul Hategekimana, Clarisse Marie Claudine Simbi, Theoneste Ntakirutimana, Laetitia Nyirazinyoye","doi":"10.1186/s12936-024-05159-8","DOIUrl":"10.1186/s12936-024-05159-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant concern for children under five in malaria-endemic regions. Rwanda's successful efforts in malaria treatment reduced nationwide cases, but high mortality persists in the Eastern and Southern provinces. This study aimed to investigate the clinical features of severe malaria and to identify the death risk factors among under-five children in Eastern province Hospitals.</p><p><strong>Methods: </strong>This cross-sectional study assessed severe malaria-related mortality and associated factors among children aged under five years in hospitals of Eastern Province, Rwanda, from 2017 to 2021. Data were collected from hospital records, and descriptive statistics and logistic regression were used for data analysis.</p><p><strong>Results: </strong>Factors associated with severe malaria-related mortality included coma (aOR: 10, 95% CI: 1.2-82.5, p = 0.03), Vomiting (aOR: 5.2, 95% CI: 1.0-26.0, p = 0.04), four or more days of illness before consultation (aOR: 30.9, 95% CI: 8.7-109.9, p < 0.01). On the other hand, a low parasitaemia level (aOR: 0.01, 95% CI: 0.0-0.1, p < 0.01).</p><p><strong>Conclusion: </strong>In conclusion, coma, vomiting, and healthcare delays increased mortality in children with severe malaria. Prompt treatment, proper assessments, protocol adherence, and caregiver education on early symptom recognition are crucial for improving outcomes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"340"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622845","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 'STRICT' framework for promoting effective malaria control in Ghana.","authors":"Irene G Ampomah, Susan Devine, Genevieve A Ampomah, Theophilus I Emeto","doi":"10.1186/s12936-024-05146-z","DOIUrl":"10.1186/s12936-024-05146-z","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health burden, necessitating evidence-based strategies to reduce prevalence and associated morbidity. This study explores the potential of integrated healthcare, encompassing both modern and traditional herbal medicine (THM), for malaria control in Ghana.</p><p><strong>Methods: </strong>Employing a qualitative approach, semi-structured interviews were conducted with medical doctors, pharmacists, and THM providers. Thematic analysis approach was utilized to inductively analyse interview data and integrate participants' lived experiences and suggestions.</p><p><strong>Results: </strong>Six themes emerged: Standardization of THM practice; Training on THM broadened; Research on THM expanded; Increasing awareness of THM integration hospitals and inclusion of THM in national health insurance scheme; Constant supply of certified herbal medications; and Tax relief provision. These recommendations form the 'STRICT' framework for developing functional health system for promoting an effective malaria control through integrated healthcare in Ghana.</p><p><strong>Conclusion: </strong>It was evident that the 'STRICT' framework can potentially transform healthcare delivery and improve service quality for malaria patients. Policymakers, healthcare providers, and managers can utilize these insights to advocate for and implement integrated healthcare strategies, ultimately enhancing service delivery for all Ghanaians, particularly those suffering from malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"338"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623132","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":"Vector-borne diseases on Borneo island: a scoping review.","authors":"Song-Quan Ong, Ag Shazmeer Ag Safree, Nur Badriah Asmail Ismai","doi":"10.1186/s12936-024-05132-5","DOIUrl":"10.1186/s12936-024-05132-5","url":null,"abstract":"<p><strong>Background: </strong>Borneo, the third largest island in the world, is facing a significant burden of emerging and re-emerging vector-borne diseases due to rapid changes in primary tropical rainforests and urban landscapes. These vector-borne diseases include the endemic epidemic cycles that occur in the more populated and urbanized areas, as well as the possible transmission through enzootic and sylvatic transmission cycles that occur mainly in the overlapping landscapes or among the indigenous population in the forest. The island will be changed significantly in the future due to the increase in human activities, especially mega events such as the relocation of the Indonesian capital to Nusantara in East Kalimantan Borneo, increasing urbanization, agriculture, hydropower projects, ecotourism activities in Sabah, North Borneo, and Sarawak, Central and South Borneo. Therefore, an overview of the current situation of vector-borne diseases is crucial for the next possible epidemic preparedness.</p><p><strong>Methods: </strong>This study conducted the PRISMA-ScR scoping review and formulated a set of research questions to identify current trends in vector-borne diseases in Borneo. These questions aim to identify which diseases have been studied, what geographical areas have been covered by the research, how the One Health approach-encompassing human, animal and environmental factors-is integrated, and what gaps and challenges exist in addressing these diseases.</p><p><strong>Results: </strong>A total of 2241 references were screened for eligibility and 117 articles were selected for review. The majority of the materials focused on mosquitoes and malaria, and the One Health elements focused mainly on humans.</p><p><strong>Conclusions: </strong>This review has identified the most and least studied vector-borne diseases and highlighted some of the gaps in knowledge and research on vector-borne diseases on the island of Borneo. Future studies should particularly focus on other neglected diseases such as Zika, chikungunya, Japanese encephalitis, filariasis and tick-borne diseases. In addition, advanced surveillance systems will be developed to improve early detection and response specifically for remote regions where vector-borne diseases are endemic or emerging.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"337"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623278","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":"Association between RANTES/CCL5 levels with Plasmodium infections and malaria severity: a systematic review.","authors":"Pattamaporn Kwankaew, Aongart Mahittikorn, Wanida Mala, Kwuntida Uthaisar Kotepui, Nsoh Godwin Anabire, Polrat Wilairatana, Manas Kotepui","doi":"10.1186/s12936-024-05152-1","DOIUrl":"10.1186/s12936-024-05152-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria continues to be a significant global health concern, and developing effective therapeutic strategies requires an understanding of the immune response to the disease. This systematic review synthesized the current body of research on the role of regulated on activation, normal T cell expressed and secreted (RANTES)-in the pathogenesis and disease severity of malaria.</p><p><strong>Methods: </strong>A systematic review protocol was registered with PROSPERO under the registration number CRD42024535822. The systematic review was conducted following PRISMA guidelines to identify studies examining RANTES levels in individuals infected with Plasmodium species. Searches were performed across multiple databases, including ProQuest, Journals@Ovid, Embase, Scopus, PubMed, and MEDLINE. Further searches were performed in Google Scholar. Quality assessment was done using the Joanna Briggs Institute (JBI) critical appraisal tools. Alterations in RANTES levels in patients with malaria were synthesized narratively.</p><p><strong>Results: </strong>A comprehensive search of major databases identified 22 studies meeting inclusion criteria, predominantly focusing on Plasmodium falciparum and Plasmodium vivax infections. RANTES levels were found to vary significantly across different severities of malaria, with several studies reporting lower levels in severe cases compared to non-malarial controls. However, inconsistencies were observed in the alterations of RANTES levels between severe and non-severe malaria cases.</p><p><strong>Conclusion: </strong>Taken together, the finding of this systematic review underscore the complex regulation of RANTES in malaria pathophysiology. Future research should focus on longitudinal assessments to elucidate the dynamic role of RANTES throughout the course of malaria and recovery, to potentially inform the design of novel therapeutic strategies.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"335"},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622650","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":"Cost of treating severe malaria in children in Africa: a systematic literature review.","authors":"Amani Thomas Mori, Grace Mallange, Melf-Jakob Kühl, Lucy Okell","doi":"10.1186/s12936-024-05173-w","DOIUrl":"10.1186/s12936-024-05173-w","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a major cause of ill health and death in children in Africa. The disease also imposes a severe social and economic burden on households and health systems and is strongly associated with poverty. This study summarizes the most up-to-date cost of treating severe malaria in children in Africa.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, Cinahl, and Web of Science databases. Google and Google Scholar were searched for grey literature followed by scanning of the reference lists of the previous systematic reviews. The search was limited to children < 12 years, malaria-endemic countries in Africa, and the English language. All costs were adjusted to the year 2023.</p><p><strong>Results: </strong>19 studies conducted in 12 countries were identified: 14 reported provider costs, and 11 household costs. Out of the 19 studies found, 11 were published before 2018 while 11 reported data that are currently more than ten years old. Studies varied methodologically and in the scope of resources included to estimate the cost. The provider costs ranged from USD 27 in Uganda to USD 165 per patient in Kenya (median value USD 90), while household costs ranged from USD 13 in Kenya to USD 245 per patient in Gabon (median value USD 50). All identified household malaria treatment costs except one represented catastrophic health expenditure, making out more than 10% of the monthly Gross National Income per capita in the respective countries.</p><p><strong>Conclusion: </strong>Evidence on the cost of treating severe malaria in children in Africa is scarce. However, the few existing studies show that severe malaria in children imposes a significant economic burden on the providers and households. More studies are needed, particularly in high-burden high-impact countries, to inform resource allocation decisions.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"334"},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622836","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":"Examining malaria treatment and prevention spending efficiency in malaria-endemic countries, 2000-2020.","authors":"Angela E Apeagyei, Ian Cogswell, Nishali K Patel, Kevin O'Rourke, Golsum Tsakalos, Joseph L Dieleman","doi":"10.1186/s12936-024-05165-w","DOIUrl":"10.1186/s12936-024-05165-w","url":null,"abstract":"<p><strong>Background: </strong>In 2021, an estimated 750,000 people died from malaria. Despite this significant burden, globally, malaria incidence and mortality rates have substantially dropped over the last 30 years. However, growth in spending on malaria and improved outcomes have recently stagnated. This development has made it more important than ever to understand what constitutes efficient spending on malaria.</p><p><strong>Methods: </strong>Data from various sources, including disaggregated data on malaria spending from the WHO Global Malaria Programme, National Health Accounts, and the Global Burden of Disease 2021 study was used in this study. The National Health Account report is produced at the end of a national accounting exercise that aims to map the flow of financial resources from all perspectives-incl. sources, agencies-in the health sector. Malaria spending estimates for all malaria-endemic countries from 2000 to 2020, with government and donor spending disaggregated into 11 key programme areas were generated in this study. Then, these spending estimates were combined with outcome data and estimated country efficiency using robust non-parametric stochastic frontier analysis and linear regression to examine the types of malaria spending associated with better malaria outcomes.</p><p><strong>Results: </strong>Across malaria-endemic countries, there is wide variation in malaria spending, with spending associated with the malaria burden within the country. Argentina, Paraguay, and Turkmenistan stood out as examples of low spending relative to their respective malaria incident per person at risk rates, while the Philippines, Guatemala, and Sri Lanka stood out as countries with case fatality ratios that were low relative to their malaria spending. Having a greater proportion of malaria spending sourced from donors or on prevention was associated with increases in incidence efficiency, while having a greater proportion of spending on anti-malarial medicines was associated with increases in case fatality efficiency.</p><p><strong>Conclusions: </strong>Prioritization of spending on prevention, anti-malarial medicines, and health systems strengthening can fight incident cases and fatalities simultaneously, especially in resource-scarce, malaria-endemic countries. Furthermore, improving the availability, frequency of collection, and quality of detailed disaggregated spending data is essential to support work that strengthens the evidence base on spending efficiency and work that improves understanding of how spending on malaria could be leveraged to bridge gaps in equity across population groups.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"23 1","pages":"333"},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622843","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}