Malaria Journal最新文献

{"title":"The impact of mass screening and treatment interventions on malaria incidence and prevalence: a retrospective analysis of a malaria elimination programme in eastern Myanmar, and systematic review and meta-analysis.","authors":"Jade D Rae, Angela Devine, Chanapat Patekkham, Aung Myint Thu, Gilles Delmas, Daniel M Parker, Richard J Maude, Jacher Wiladphaingern, Ladda Kajeechiwa, May Myo Thwin, Saw Win Tun, Julie A Simpson, François H Nosten","doi":"10.1186/s12936-025-05392-9","DOIUrl":"10.1186/s12936-025-05392-9","url":null,"abstract":"<p><strong>Background: </strong>Targeted interventions are often needed to accelerate malaria elimination efforts. Mass screening and treatment (MSAT) involves testing all eligible and consenting individuals in an area for malaria and treating all positive individuals simultaneously. However, there are concerns regarding the impact of MSAT. This study evaluates the impact of MSAT on malaria incidence in Karen State, Myanmar, using routine surveillance data, and investigates the impact of MSAT in other settings through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>To investigate the impact of MSAT in Karen State, we retrospectively analysed routine malaria surveillance data collected in 10 villages where MSAT was done in 2018. Pre- and post-MSAT malaria incidences were compared, and a negative binomial mixed-effects model was used to estimate the relative change in monthly incidence for each additional year since MSAT. To investigate the impact of MSAT in other settings, we searched Scopus, Ovid MEDLINE, and Web of Science (end date 11th July 2022) for studies assessing the impact of MSAT interventions on the incidence or prevalence of malaria infections. Studies were summarized, and a random-effects meta-analysis was performed on studies grouped according to study design and the comparator used to assess the impact of MSAT.</p><p><strong>Results: </strong>In the 10 villages in Karen State, there was an overall reduction in P. falciparum incidence following MSAT (Incidence Rate Ratio 0.37; 95% CI: 0.19, 0.73). However, this is likely due to the ongoing impact of early diagnosis and treatment services offered in these communities, as shown by an overall reduction in incidence in the surrounding area. Results from nine studies identified in the systematic review demonstrate the variable impact of MSAT, which is likely influenced by a variety of factors, including intervention coverage and uptake, baseline malaria endemicity, and methods used for MSAT delivery.</p><p><strong>Conclusions: </strong>This retrospective analysis and systemic review highlights the complexities behind the success of targeted interventions for malaria elimination. While these interventions are important drivers for achieving elimination goals, particularly in high-burden settings, it is important that various factors be considered when determining their suitability and how to optimize implementation.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"148"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-economic inequalities in malaria prevalence among under-five children in Ghana between 2016 and 2019: a decomposition analysis.","authors":"Marian Yaa Abrafi Edusei, Olufunke Alaba, Denis Okova, Amarech Obse","doi":"10.1186/s12936-025-05349-y","DOIUrl":"https://doi.org/10.1186/s12936-025-05349-y","url":null,"abstract":"<p><strong>Background: </strong>In a country with limited and unequally distributed resources, and plagued with malaria annually, under-five children are severely affected by this disease in Ghana. While the epidemiological burden of malaria on under-five children is well-documented, the extent and contributors of socio-economic inequalities in malaria prevalence remain under-explored. This study examined the intertemporal socioeconomic status (SES)-related inequalities in malaria prevalence among under-five children in Ghana from 2016 to 2019 and identified the key factors contributing to these disparities.</p><p><strong>Methods: </strong>Data were drawn from the 2016 and 2019 Ghana Malaria Indicator Surveys (GMIS). The study population consisted of under-five children who were tested for malaria in both surveys. Malaria prevalence served as the outcome variable, with the wealth index used as a proxy for socio-economic status. Socio-economic inequalities in malaria prevalence were evaluated using concentration indices and concentration curves. A decomposition analysis was employed to identify the socio-economic factors contributing to the observed inequalities.</p><p><strong>Results: </strong>A total of 2323 children in 2016 and 1938 children in 2019 were tested for malaria. Malaria prevalence increased from 8% in 2016 to 10% in 2019. The concentration index for 2019 (Concentration Index = - 0.224; Standard Error = 0.059; p-value = 0.000) was statistically significant and negative, indicating higher malaria prevalence among children from lower socio-economic backgrounds. However, the concentration index for 2016 (Concentration Index = - 0.052; Standard Error = 0.044; p-value = 0.230) was not statistically significant. In 2019, socio-economic status, region, and ethnicity accounted for 59.38%, 23.66%, and 4.46%, respectively, of the observed inequalities in malaria prevalence.</p><p><strong>Conclusion: </strong>The study revealed a persistent pro-poor inequality in malaria prevalence in under-five children in Ghana, underscoring the importance of targeted malaria control interventions. These interventions should prioritize socioeconomically disadvantaged groups to reduce inequalities in malaria prevalence which contributes to the 2030 Sustainable Development Goals of improving health (SDG 3) and reducing inequalities (SDG 10), among others.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"147"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erema po otjindjumba? Highlighting cultural models and knowledge gaps of malaria in rural Namibian pastoralists.","authors":"Sean Prall, Aparicio Lopes","doi":"10.1186/s12936-025-05382-x","DOIUrl":"https://doi.org/10.1186/s12936-025-05382-x","url":null,"abstract":"<p><strong>Background: </strong>As Namibia attempts to eradicate locally transmitted cases of malaria, epidemiological strategies, interventions, and outreach require a sound understanding of indigenous knowledge and practice. Research describing local explanatory models of disease can be of value in these efforts by elucidating how disease is interpreted and treated. To understand how perceptions of malaria infection and treatment may influence health-seeking behaviour, cultural models of the disease were explored in two ethnic groups in rural northwest Namibia.</p><p><strong>Methods: </strong>Mixed-sex focus groups of 4-8 individuals were conducted in the Kunene region of Namibia. All participants were either Himba or Herero and lived between 14 and 57 km of the regional town centre of Opuwo. Discussion prompts were designed to assess knowledge, beliefs, and norms about malaria, including causes, symptoms, treatment, and prevention.</p><p><strong>Results: </strong>Focus groups reported universal difficulty in discrimination between malaria and respiratory infections, the former of which was often only diagnosed at the hospital. Some recognized mosquitoes as the source of malaria, particularly the more formally educated Herero, but all also reported other causes. Notably these causes, including dietary and temperature-based origins, were considered unavoidable. Himba and Herero believed that malaria was infectious person-to-person and incorrectly believed that malaria was most common during the wintertime. Both groups also relied on a number of traditional remedies to alleviate symptoms, which were used as primary treatment, with formal healthcare treatment typically only sought when the illness progressed.</p><p><strong>Conclusions: </strong>These results highlight significant differences between local cultural models and biomedical ones that could be detrimental to malaria eradication efforts. Kunene pastoralists have limited understanding of the causes of malaria, and beliefs about environmental and dietary causes may undermine attempts at prevention. Seeking healthcare solutions to malaria was normative, but secondary to use of at home traditional remedies. These findings indicate public health outreach and information campaigns are needed, particularly in rural groups with less formal education.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"143"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic infarction in a paediatric patient with Plasmodium vivax malaria from Ethiopia: a case report.","authors":"Alemayehu Beharu Tekle, Tamirat T Bekele, Alemu B Solbamo, Molla A Kebede, Melaku T Berhanu, Dereje D Baramo","doi":"10.1186/s12936-025-05386-7","DOIUrl":"https://doi.org/10.1186/s12936-025-05386-7","url":null,"abstract":"<p><strong>Background: </strong>Splenic infarction is an uncommon but serious side effect of Plasmodium vivax malaria, especially in young patients. Prompt diagnosis and effective treatment are essential to avoid serious consequences. Though there are few report of splenic infarction following P. vivax from different endemic country, PubMed and Google-based literature search found that it was the first case report of this type from Ethiopia.</p><p><strong>Case presentation: </strong>The patient was an 11-year-old girl, from Wolaita Sodo, Ethiopia, who had a high-grade fever, chills, rigors, headache, vomiting, and abdominal pain in the left upper quadrant. Upon examination, hepatomegaly, splenomegaly, and extreme pallor were found. Laboratory tests revealed acute kidney injury (creatinine 1.63 mg/dL), acute liver injury (AST 323 U/L, ALT 129 U/L), and severe anaemia (haemoglobin 3.4 g/dL, haematocrit 10.2%). A peripheral blood smear showed a trophozoite stage of P. vivax and was negative for Plasmodium falciparum. An abdominal ultrasound revealed hepatosplenomegaly along with a wedge-shaped, multifocal, hypoechoic splenic region that was consistent with an infarction.</p><p><strong>Management and outcome: </strong>The patient had blood transfusions, NSAIDs for pain, and intravenous artesunate as treatment. Primaquine was used in radical therapy. After three days, her abdominal pain had considerably subsided and she became afebrile. Complete symptom relief, normalized abdominal ultrasound findings, and better laboratory results-including normal haemoglobin and liver enzymes-were all observed at the two-month follow-up.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering splenic infarction in paediatric patients with P. vivax malaria presenting with abdominal pain. Early recognition through imaging and laboratory investigations, along with prompt antimalarial therapy, is critical for favourable outcomes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"146"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977796","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":"Integrating local malaria molecular monitoring into regular malaria indicator surveys on Bioko Island: high association between urban communities and low-density infections.","authors":"Thomas C Stabler, Salome Hosch, Elizabeth Nyakarungu, Johanna Nouria Giger, Monserrat Kobe Elonga, Rosalia Nzang Bibang, Victoria Mangue Ndong, Ilda Elobe Mometolo, Alejandro Lopelo Bolopa, Rosa Maria Oko Bedoung, Jose Raso Bijeri, Esperanza Willy Roka, Ana Gertrudis Nguema, Victoria Palacios Ichinda, Salvador Bakale, Cristina Nka Esokolete, Matilde Riloha Rivas, David S Galick, Wonder Philip Phiri, Carlos A Guerra, Guillermo A García, Luca Montemartini, Tobias Schindler, Joana C Silva, Claudia Daubenberger","doi":"10.1186/s12936-025-05374-x","DOIUrl":"https://doi.org/10.1186/s12936-025-05374-x","url":null,"abstract":"<p><strong>Background: </strong>Effective malaria control requires accurate identification of Plasmodium infections to tailor interventions appropriately. Rapid diagnostic tests (RDTs) are crucial tools for this purpose due to their small size and ease-of-use functionality. These tests typically target the Plasmodium falciparum histidine-rich protein 2 (HRP2) antigen. However, some strains of P. falciparum have deletions in the hrp2 and hrp3 genes, which may result in a false negative diagnosis using HRP2-based RDTs. Additionally, RDTs have a detection limit of 100 parasites per microlitre, insufficient for identifying low-density infections that sustain malaria transmission. This study explores integrating molecular monitoring using a novel cartridge-based PCR test, PlasmoPod, using samples from a malaria indicator survey (MIS) on Bioko Island, Equatorial Guinea to enhance detection of low-density infections and inform targeted malaria control strategies.</p><p><strong>Methods: </strong>The study utilized a combination of RDTs and the DiaxxoPCR device for molecular monitoring. The device DiaxxoPCR uses a prefilled cartridge system, termed PlasmoPod for a malaria-based assay that employs a qPCR assay targeting 18S rDNA/rRNA. Samples from the 2023 MIS were extracted from dried blood spots (DBS), qPCR run in duplicate on the PlasmoPod. Epidemiological data from the MIS were merged with molecular data and the association between MIS variables to malaria infection by qPCR, and low-density infections were measured.</p><p><strong>Results: </strong>The integration of molecular monitoring revealed a proportion of low-density infections that circumvented RDTs diagnosis. Notably, individuals in urban communities and those reporting recent fever were more likely to harbour low-density, asymptomatic malaria infections. Findings suggest that urban residents, although less associated to malaria infection than rural residents by both RDT and qPCR, may be serving as a transmission reservoir. The relationship between low-density infections and individuals who recently reported fever may reflect recent anti-malarial treatment or natural clearance, and thus have lingering parasites in their blood.</p><p><strong>Conclusion: </strong>The study highlights the limitations of HRP2-based RDTs in detecting low density infections and underscores the potential of molecular tools like PlasmoPod in malaria surveillance. By identifying elusive transmission reservoirs and tracking parasite importation, molecular monitoring can play a crucial role in achieving malaria elimination. The findings advocate for the broader implementation of molecular diagnostics in malaria programs, especially in areas with low transmission, to enhance the detection and targeting of hidden reservoirs of infection.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"145"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017806","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":"Effectiveness of family health education in malaria elimination programmes: a scoping review.","authors":"Misra Helma Firdaus, Sharifa Ezat Wan Puteh, Rosnah Sutan, Mohd Rizal Abdul Manaf","doi":"10.1186/s12936-025-05371-0","DOIUrl":"https://doi.org/10.1186/s12936-025-05371-0","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant global health issue, with vector control strategies likes indoor residual spraying (IRS) and insecticide-treated nets (ITNs) show promise, socio-cultural and structural challenges often hinder their success. Family and community involvement, including individual adherence, household leadership, and participation by community leaders, are crucial in enhancing intervention outcomes. This review evaluates family health education's effectiveness in improving public health impact on malaria elimination programmes.</p><p><strong>Methods: </strong>A systematic review was conducted using Scopus, Web of Science, and PubMed, yielding 1,121 records through a predefined Population, Exposure, Outcome (PEO)-based search strategy. The review focused on studies published between 2019 and 2024 examining malaria elimination programmes and family health education. The Population consisted of families in malaria-endemic regions, particularly rural and urban areas of sub-Saharan Africa and Southeast Asia, including households with young children and pregnant women. The Exposure was participation in malaria elimination programmes, and the Outcome was the effectiveness of family health education in enhancing awareness, knowledge, and public health outcomes. Review articles, editorials, conference papers, and proceedings were excluded. Data extraction adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, and studies were appraised using the Mixed Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>This study examines the effectiveness of malaria health education programmes using a socio-ecological framework, focusing on individual, family, and community-level influences. Twelve studies met the inclusion criteria, exploring interventions likes IRS and ITN across diverse populations. At the individual level, educational programmes significantly enhanced malaria knowledge and prevention behaviours. Within families, health education strengthened decision-making and reinforced preventive measures. At the community level, engagement in malaria-related initiatives improved collective action, though policy barriers limited widespread implementation. The review employed various research designs, underscore the role of multi-stakeholder involvement in ensuring the effectiveness of malaria elimination programmes.</p><p><strong>Conclusion: </strong>This study highlights the important of family structure in malaria elimination emphasizing maternal leadership in decision-making and health-seeking behaviours. Integrating family health education into public health strategies can enhance intervention effectiveness, improve adherence and promote long-term sustainability. Future programmes should leverage maternal influence and community engagement to strengthen malaria elimination programmes' efforts.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"144"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024906","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":"Nurses' knowledge and willingness to recommend malaria vaccination to caregivers of under-5 in Nigeria: a nationwide survey.","authors":"Olumide T Adeleke, Mary A Oboh, Oludamola V Adeleke, Titilope A Awotunde, Dolapo E Ajala, Timothy K Samson, Adepeju O Adegoke","doi":"10.1186/s12936-025-05383-w","DOIUrl":"https://doi.org/10.1186/s12936-025-05383-w","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a major public health problem in Nigeria. This study set out to ascertain Nigerian nurses' knowledge and willingness to recommend malaria vaccination to caregivers of under-5 children.</p><p><strong>Methods: </strong>This was a cross-sectional study carried out among nurses from all six geopolitical zones of Nigeria. A pretested semi-structured questionnaire was used to collect data on participants' demographics, their knowledge of the RTS S/AS01 and R21 Matrix M malaria vaccines, how they obtain malaria vaccine-related information, and the factors that the nurses consider when recommending any malaria vaccine. Univariate association between each of the demographics characteristics and the key research variables: knowledge of the vaccine and willingness to recommend was used. This was examined using the Chi-Square test and multiple logistic regression.</p><p><strong>Results: </strong>The study found that nearly two out of every three nurses had poor knowledge and perception of the vaccines (p < 0.05). Awareness of the malaria vaccine was the only factor that was found to be associated with their knowledge (p <0.05). The odds of willingness to promote the vaccine were about 21 times higher among nurses with high perceptions of efficacy than their counterparts who have low perceptions.</p><p><strong>Conclusions: </strong>The findings highlight major gaps in Nigerian nursing's knowledge and awareness of malaria vaccinations, as well as their willingness to recommend the vaccine to parents. Addressing these gaps will enable nurses to play a critical role in the successful implementation of malaria immunization campaigns, lowering the illness burden among vulnerable populations.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"142"},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006657","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":"Bringing malaria diagnosis and treatment closer to the people: economic rationale for expanding malaria community case management to all ages in a rural district in Madagascar.","authors":"Walter Ochieng, Julie R Gutman, Catherine Dentinger, Aina Harimanana, Judickaelle Irinantenaina, Hobisoa Léa Razanadranaivo, Oméga Raobela, Aline Mukerabirori, Laurent Kapesa, Andres Garchitorena, Laura Steinhardt","doi":"10.1186/s12936-025-05381-y","DOIUrl":"10.1186/s12936-025-05381-y","url":null,"abstract":"<p><strong>Background: </strong>Expanding malaria community case management (mCCM) to all ages could shift the point-of-care to the community leading to improved healthcare access in underserved populations. This study assesses the economic viability of such an expansion in Farafangana district, Madagascar.</p><p><strong>Methods: </strong>A cluster-randomized trial was conducted across 30 health centres and the 502 community health workers (CHW) in their catchment areas, with the intervention arm implementing the age-expanded mCCM intervention. CHWs across both arms received training, supplies, and supervision to manage malaria. An economic evaluation assessed cost-effectiveness from health sector and societal perspectives, measuring outcomes in disability-adjusted life years (DALYs) averted. The impact of CHW compensation and economic risks were evaluated using sensitivity analyses.</p><p><strong>Results: </strong>Without CHW compensation, annual costs were $794,000, primarily for antimalarials and diagnostic tests. Incremental cost-effectiveness ratios (ICERs) per DALY averted ranged from -$21.86 to $212.42. From a societal perspective, the ICER was -$135.64, and -$243.29 including mortality benefits, meaning the intervention was cost-saving. The programme could avert 99.6 deaths and 3,721.7 DALYs annually, yielding $1,172,283 in net economic benefits. Sensitivity analyses supported these findings.</p><p><strong>Conclusions: </strong>Age-expanded mCCM is highly cost-effective and can enhance malaria treatment access in resource-limited settings.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"141"},"PeriodicalIF":2.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033227","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":"Adherence to anti-malarials among patients diagnosed with malaria in East Africa: a systematic review and meta-analysis.","authors":"Jackline D Nkoma, Susan F Rumisha, Hamisi S Japhari, Emanuel L Peter","doi":"10.1186/s12936-025-05303-y","DOIUrl":"https://doi.org/10.1186/s12936-025-05303-y","url":null,"abstract":"<p><strong>Background: </strong>East Africa continues to bear a significant share of the global malaria burden, despite its commitment to the malaria elimination goal of 2030. Furthermore, reported variations in adherence to anti-malarials hamper the regional effort in malaria elimination. Moreover, the region has no comprehensive and comparable adherence estimates for policymakers to set priorities, target control strategies, and evaluate the effectiveness of interventions. Hence, this systematic review synthesized the regional adherence estimate for East Africa.</p><p><strong>Methods: </strong>Authors searched articles from PubMed, Science Direct, CINHAL, Scopus, and Google Scholar. Two authors independently assessed retrieved studies for eligibility and risk of bias, then the adherence rate was pooled using the random effect model implemented in STATA. Publication bias was assessed using a funnel plot symmetry and the Egger test. Subgroup analysis was performed to explore the effect of the national and types of regimens on the overall estimate. Qualitative analysis was applied to explain factors that influence adherence.</p><p><strong>Results: </strong>A total of 29 studies with 15 927 participants were included. The overall adherence rate was 70.30% (95% CI 61.93-78.67; 29 studies; I² = 99.76%), with the highest level reported in Rwanda (100%, 95% CI 97.28-100.00) and lowest in Tanzania (6.99%, 95% CI 0.2.81-11.17). Furthermore, adherence was high for chloroquine plus sulfadoxine-pyrimethamine (96.27%, 93.87-98.66; one study). Recalling correct instructions and taking the first dose at the health facility had a positive influence on patient adherence.</p><p><strong>Conclusion: </strong>On average, about three-quarters of malaria patients in East Africa adhere to their medications. In light of these findings, further interventional studies are needed to address low adherence to anti-malarials in the region. Moreover, adherence studies with the appropriate method of measurement are still needed to obtain a robust generalizable estimate in East Africa. Trial registration This review was registered at PROSPERO with the registration ID CRD42023410048.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"140"},"PeriodicalIF":2.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024265","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":"A tale of two parasites: a glimpse into the RNA methylome of patient-derived Plasmodium falciparum and Plasmodium vivax isolates.","authors":"Priyanka Roy, Sukriti Gujarati, Pallavi Gupta, Ishaan Gupta, Tanmaya Mahapatra, Dinesh Gupta, Sanjay Kumar Kochar, Dhanpat Kumar Kochar, Ashis Das","doi":"10.1186/s12936-025-05376-9","DOIUrl":"https://doi.org/10.1186/s12936-025-05376-9","url":null,"abstract":"<p><strong>Background: </strong>Understanding the molecular mechanisms of the malarial parasites in hosts is crucial for developing effective treatments. Epitranscriptomic research on pathogens has unveiled the significance of RNA methylation in gene regulation and pathogenesis. This is the first report investigating methylation signatures and alternative splicing events using Nanopore Direct RNA Sequencing to single-base resolution in Plasmodium falciparum and Plasmodium vivax clinical isolates with hepatic dysfunction complications.</p><p><strong>Methods: </strong>Direct RNA Sequencing using Nanopore from clinical isolates of P. falciparum and P. vivax showing hepatic dysfunction manifestation was performed. Subsequently, transcriptome reconstruction using FLAIR and transcript classification using SQANTI3, followed by methylation detection using CHEUI and m6Anet to identify N6-methyladenosine (m6A) and 5-methylcytosine (m5C) methylation signatures, was done. The alternative splicing events from both the datasets were documented.</p><p><strong>Results: </strong>The reference genome of Plasmodium reports > 5000 genes out of which ~ 50% was identified as expressed in the two sequenced isolates, including novel isoforms and intergenic transcripts, highlighting extensive transcriptome diversity. The distinct RNA methylation profiles of m6A and m5C from the expressed transcripts were observed in sense, Natural Antisense Transcripts (NATs) and intergenic categories hinting at species-specific regulatory mechanisms. Dual modification events were observed in a significant number of transcripts in both the parasites. Modified transcripts originating from apicoplast and mitochondrial genomes have also been detected. These modifications are unevenly present in the annotated regions of the mRNA, potentially influencing mRNA export and translation. Several splicing events were observed, with alternative 3' and 5' end splicing predominating in the datasets suggesting differences in translational kinetics and possible protein characteristics in these disease conditions.</p><p><strong>Conclusion: </strong>The data shows the presence of modified sense, NATs and alternatively spliced transcripts. These phenomena together suggest the presence of multiple regulatory layers which decides the post-translational proteome of the parasites in particular disease conditions. Studies like these will help to decipher the post-translational environments of malaria parasites in vivo and elucidate their inherent proteome plasticity, thus allowing the conceptualization of novel strategies for interventions.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"139"},"PeriodicalIF":2.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008400","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}