Malaria Journal最新文献

{"title":"Political stability, health system resilience, and macroeconomic shocks as factors associated with malaria control outcomes: a comparative analysis of Ecuador and Venezuela (2000-2023).","authors":"Jose Daniel Sanchez Redroban, Maria Cristina Mideros Mora, Melissa Jaramillo Pérez","doi":"10.1186/s12936-026-05899-9","DOIUrl":"10.1186/s12936-026-05899-9","url":null,"abstract":"<p><strong>Background: </strong>The post-2000 period in South America presents a striking divergence in malaria epidemiology: Ecuador achieved a >99% reduction in malaria incidence approaching elimination, while Venezuela experienced one of the most severe resurgences in modern public health history. We examined the association between governance factors, health policies, intersectoral coordination, and malaria control outcomes by comparing the national experiences of Ecuador and Venezuela.</p><p><strong>Methods: </strong>We conducted a comparative ecological study using epidemiological data from WHO World Malaria Reports and PAHO updates (2000-2023), integrated with political stability indices, health expenditure data, GDP per capita, poverty rates, and crude-oil price series from World Bank and CFR databases. A joinpoint (segmented) regression model was applied to each country's log-transformed malaria incidence time series to identify statistically significant inflection points and estimate annual percentage change (APC) per segment. A multi-dimensional framework assessed governance, health-system capacity, surveillance infrastructure, intersectoral coordination, and community engagement. We also examined systemic fragility through concurrent infectious disease trends (diphtheria, measles, tuberculosis) in Venezuela. Use of AI language models is declared in the Methods.</p><p><strong>Results: </strong>Ecuador reduced cases from 106,641 (2001) to 757 (2023), a 99.3% reduction. The joinpoint model identified two significant inflection points (2008, 2014) delineating three phases of declining trend (APC: <math><mrow><mo>-</mo> <mn>34.2</mn> <mo>%</mo></mrow> </math> , <math><mrow><mo>-</mo> <mn>12.5</mn> <mo>%</mo></mrow> </math> , <math><mrow><mo>-</mo> <mn>1.2</mn> <mo>%</mo></mrow> </math> ). Venezuela experienced a 1,217% increase from 35,500 (2000) to a peak of 527,627 (2018); a single joinpoint at 2014 marked a shift from non-significant endemic transmission (APC: <math><mrow><mo>+</mo> <mn>2.8</mn> <mo>%</mo></mrow> </math> , <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.12</mn></mrow> </math> ) to explosive resurgence (APC: <math><mrow><mo>+</mo> <mn>84.6</mn> <mo>%</mo></mrow> </math> , <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ), temporally coinciding with the global crude-oil price collapse and ensuing fiscal contraction. Post-2018 case declines in Venezuela are accompanied by concurrent surveillance collapse, mass emigration, and reduced care-seeking, suggesting underreporting rather than epidemiological improvement. Pearson correlations with malaria incidence were observed for political stability index ( <math><mrow><mi>r</mi> <mo>=</mo> <mo>-</mo> <mn>0.85</mn></mrow> </math> ), health expenditure (% GDP, <math><mrow><mi>r</mi> <mo>=</mo> <mo>-</mo> <mn>0.78</mn></mrow> </math> ), poverty rate ( <math><mrow><mi>r</mi> <mo>=</mo> <mo>+</mo> <mn>0.82</mn></mrow> </math> ), and crude-oil price ( <math><mrow><mi>r</mi> <","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295782","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":"Molecular surveillance of antimalarial drug resistance markers in the pfcrt, pfmdr1 and pfmrp1 genes of Plasmodium falciparum isolates from southeastern Iran.","authors":"Mohadeseh Jafari, Romina Rezapour, Fahimeh Nemati, Akram Abouie Mehrizi, Sakineh Pirahmadi","doi":"10.1186/s12936-026-06012-w","DOIUrl":"10.1186/s12936-026-06012-w","url":null,"abstract":"<p><strong>Background: </strong>The emergence and spread of Plasmodium falciparum resistance to artemisinin and its partner drugs pose a major challenge to malaria elimination efforts. Continuous monitoring of resistance-associated molecular markers provides valuable insights into the emergence of resistant genotypes and their geographical distribution.</p><p><strong>Methods: </strong>In this study, we investigated mutations linked to antimalarial drug resistance in the pfcrt, pfmdr1, and pfmrp1 genes among 100 P. falciparum isolates collected from southeastern Iran during 2022-2023 and compared the findings with data from the same region a decade earlier. Point mutations were genotyped using PCR-RFLP.</p><p><strong>Results: </strong>Molecular analysis demonstrated a high prevalence (95%) of the pfcrt K76T mutation. In pfmdr1, no mutations were observed at codons 1034, 1042, or 1246; however, the N86Y and Y184F mutations were detected in 3.75% and 51.25% of isolates, respectively. Comparative analysis between the previous (2007-2010) and current (2022-2023) studies revealed a significant increase in the wild-type allele for N86Y and the mutant allele for Y184F. In pfmrp1, mutations at H191Y, S437A, I876V, and F1390I were identified in 68.75%, 85%, 78.75%, and 46.25% of isolates, respectively, while no mutation was observed at K1466R. The predominant pfmdr1 haplotype shifted from wild-type (50%) in the previous study to the single-mutation haplotype N₈₆F₁₈₄S₁₀₃₄N₁₀₄₂D₁₂₄₆ (50%) in the current study. Combined haplotype analysis of all three genes revealed a decrease in one major haplotype T₇₆N₈₆Y₁₈₄S₁₀₄₃N₁₀₄₂D₁₂₄₆Y₁₉₁A₄₃₇V₈₇₆F₁₃₉₀K₁₄₆₆ (from 23.5 to 3.75%) and an increase in haplotype T₇₆N₈₆Y₁₈₄S₁₀₄₃N₁₀₄₂D₁₂₄₆Y₁₉₁A₄₃₇V₈₇₆I₁₃₉₀K₁₄₆₆ (from 7 to 23.75%) over the same period.</p><p><strong>Conclusions: </strong>The persistence of the pfcrt K76T mutant allele despite the withdrawal of Chloroquine from the treatment policy in Iran may be attributable to the co-endemicity of P. vivax in the study area. The increasing prevalence of the N₈₆F₁₈₄S₁₀₃₄N₁₀₄₂D₁₂₄₆ pfmdr1 haplotype is of concern, given its reported association with reduced susceptibility to lumefantrine. Although mutant pfmrp1 alleles were detected at relatively high frequencies, current evidence does not suggest an immediate threat to the efficacy of artemether-lumefantrine in the studied population.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283868","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":"Facility readiness and determinants of malaria test-before-treat implementation in public health facilities in Kaduna and Kano States, Nigeria.","authors":"Uchenna Igbokwe, Zaharaddeen Babandi, Precious Uahomo, Yayo Abdulsalami Manu, Babangida Musa, Sule Danga, Hamza Muhammad, Fatima Mohammed Musa, Zainab Kwaru Muhammad-Idris, Idowu Akanmu, Shukrat Yusuff-Lawal, Osezefe Ehimen, Miftahu Yahaya, Nchelem Ichegbo, Olalekan Ojosipe, Joseph Natsah, Reuben Kaha, Tisan Gugong, Saheed Popoola, Oluwaseun Fadeyi, Eric Aigbogun","doi":"10.1186/s12936-026-05949-2","DOIUrl":"10.1186/s12936-026-05949-2","url":null,"abstract":"<p><strong>Background: </strong>Prompt diagnosis and treatment of malaria remain central to malaria control strategies. The World Health Organization recommends testing suspected malaria cases before treatment using rapid diagnostic tests (RDTs) or microscopy. However, evidence on the readiness of health facilities to implement this policy in high-burden Nigerian states remains limited. This study assessed facility readiness, testing-before-treatment (TBT) coverage, and facility-level determinants of malaria diagnostic readiness among public health facilities in Kaduna and Kano States, Nigeria.</p><p><strong>Methods: </strong>A cross-sectional health facility assessment was conducted across 418 public health facilities in Kaduna and Kano States between August 5 and 28, 2025. A stratified two-stage sampling approach was used, with primary health facilities randomly selected proportionally across all 67 Local Government Areas and all secondary facilities purposively included. Data were collected using a structured Health Facility Assessment questionnaire. Facility readiness was assessed using five indicators: availability of RDTs, availability of microscopy services, trained staff on malaria case management, availability of standard operating procedures, and absence of stock-outs of RDTs or artemisinin-based combination therapy within the previous three months. A composite readiness index (0-5) was constructed and facilities were classified as having full or partial readiness. Associations between facility characteristics and readiness were examined using multivariable logistic regression.</p><p><strong>Results: </strong>All facilities had RDTs and trained staff on malaria case management, and none reported commodity stock-outs during the three-month reference period. Overall, 381 facilities (91.1%) demonstrated full readiness, with a mean readiness score of 4.91 ± 0.29. Microscopy services were available in 23.0% of facilities. Most facilities reported high TBT coverage, with 90.4% reporting ≥ 85% testing coverage. Secondary facilities (aOR = 2.15, 95% CI:1.06-4.36), urban location (aOR = 1.78, 95% CI:1.01-3.12), supportive supervision (aOR = 2.54, 95% CI:1.28-5.02), malaria focal persons (aOR = 2.92, 95% CI:1.63-5.23), and availability of free malaria commodities (aOR = 1.98, 95% CI:1.07-3.68) were significantly associated with full readiness.</p><p><strong>Conclusion: </strong>Public health facilities assessed in Kaduna and Kano States demonstrated high structural readiness for malaria diagnosis. Study limitations include the cross-sectional design, reliance on facility records which may be subject to reporting bias, and the exclusion of private health facilities, limiting generalizability. These findings highlight the need for sustained commodity security, regular supportive supervision, and targeted investments in rural facilities to maintain and strengthen diagnostic readiness.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283852","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":"Archetype-based stratification to inform sub-national tailoring of malaria interventions in Zambia.","authors":"Chilochibi Chiziba, Japhet Chiwaula, Busiku Hamainza, Sampa Chitambala-Otiono, Sheetal Silal","doi":"10.1186/s12936-026-05998-7","DOIUrl":"10.1186/s12936-026-05998-7","url":null,"abstract":"<p><strong>Introduction: </strong>Although Zambia does not rank among the highest contributors to global malaria cases, in 2023, it had approximately eleven million cases. Furthermore, Zambia's malaria incidence distribution is spatially heterogeneous at fine scales such as health facility catchment areas (HFCAs). HFCA-level malaria incidence stratification currently guides implementation and targeting approaches. We aim to enhance the current stratification approach by incorporating archetypical characteristics associated with malaria, including environmental, access, epidemiological, and socioeconomic factors. An archetype-based stratification approach may inform the tailoring of interventions to accelerate progress toward elimination.</p><p><strong>Methods: </strong>We used literature-informed data from 2017 to 2024 from the Zambia Health Information Management System and publicly available datasets. A zero-inflated negative binomial mixed-effects regression model was fitted to identify significant variables associated with malaria heterogeneity at the HFCA level. Significant variables were used to archetype HFCAs using Clustering Large Applications algorithm.</p><p><strong>Results: </strong>Significant variables included: walking travel time to nearest health facility; percentage of malaria attributed to pregnant women; percentage of malaria attributed to children under five (U5); Children U5's bednet (Long-lasting insecticide-treated nets or Insecticide-treated nets) coverage; bednet use rate; elevation; enhanced vegetation index; precipitation; and housing quality. Four new archetypes were derived. Relative to malaria incidence-based stratification, the archetype-based stratification exhibited spatiotemporal stability over time. Across all four new archetypes, elevation, bednet use rate, and housing quality emerged as the top-contributing features. However, all four archetypes exhibited distinct features defining their identity.</p><p><strong>Conclusions: </strong>The study proposes embedding archetypical characteristics in the malaria incidence-based stratification approach to better inform intervention tailoring and prioritisation based on the distinct archetype features associated with malaria at the HFCAs level. Furthermore, the study provides a precursor for simulating potential intervention mixes based on malaria transmission archetypical characteristics, which can provide decision-makers with projected impact of varied investments in HFCAs with similar archetypical features.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277983","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":"Acute acalculous cholecystitis and blackwater fever with acute kidney injury in children with malaria: case series and literature review.","authors":"Marco Cugliari, Francesca Piacentini, Sara M M A Montorfani, Obalim Fiddy, Sara Testa","doi":"10.1186/s12936-026-06013-9","DOIUrl":"10.1186/s12936-026-06013-9","url":null,"abstract":"<p><strong>Background: </strong>Acute acalculous cholecystitis (AAC) is an inflammatory gallbladder disease occurring in the absence of gallstones. It typically presents with right upper quadrant (RUQ) pain, fever and gastrointestinal symptoms, and is diagnosed by ultrasound evidence of cholecystitis without gallstones. AAC can have multiple causes, including infections, with malaria only rarely reported.</p><p><strong>Case presentations: </strong>We describe four Ugandan children who developed malaria-associated AAC. They were all referred from other centers and presented at a more advanced stage of disease. Apart from AAC, they also presented blackwater fever (BWF) and severe acute kidney injury (AKI), complications increasingly recognized in malaria. AAC was managed conservatively, while two patients required dialysis for kidney failure. All patients ultimately recovered both gallbladder and renal function.</p><p><strong>Conclusions: </strong>We provide a review of the literature on malaria-associated AAC, which identified 28 previously reported cases, only 7 in children. Most reported patients contracted the infection in malaria-endemic regions but were then managed in high-income countries. The majority were managed conservatively and had favorable outcomes. Including our series, 32 cases (11 pediatric) have now been reported. Our findings suggest that AAC, which can often occur in association with BWF and AKI, is likely underrecognized in malaria-endemic regions. Heightened clinical awareness and early assessment are important, and practical management recommendations are provided.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277859","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":"Point of care performance of the improved BIOCREDIT Ag Pf/Pv (pLDH/pLDH) rapid diagnostic test: a cross-sectional study at a health center setting in Ethiopia.","authors":"Eshetu Molla, Eyob Fekadu, Zemed Biyazen, Fikregabrail Aberra Kassa, Melat Gebremedhin Teklewold, Tedros Nigussie, Mihret Ebabu, Mequanint Mande, Muluye Shimeles, Daniel Legese Achalu, Solomon Feleke, Mamud Umer, Derese Bekele Daba, Anneleye Fantahun, Miraf Mesfin, Adamu Bayissa, Sampa Pal, Dagmawi Hailu Yemane, Emily Gerth-Guyette, Stephan Duparc, Gonzalo J Domingo, Endalamaw Gadisa","doi":"10.1186/s12936-026-05994-x","DOIUrl":"10.1186/s12936-026-05994-x","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, co-endemic Plasmodium falciparum and P. vivax require species-specific point-of-care diagnosis and treatment. Following pfhrp2/3 deletions, Ethiopia adopted non-HRP2/3 rapid diagnostic tests (RDTs). This study evaluated the point-of-care diagnostic performance of the improved BIOCREDIT Ag Pf/Pv (pLDH/pLDH) RDT compared to microscopy (comparator), using the 18S rRNA-based qPCR as the reference standard.</p><p><strong>Methods: </strong>This prospective cross-sectional study was nested within an operational feasibility study of radical cure for P. vivax with tafenoquine or primaquine after semi-quantitative G6PD testing in Ethiopia. Conducted from December 2024 to September 2025, it took place at Village 8/9 and Beto Health Centers in Gambella and South Ethiopia regions, respectively. Self-reporting clinical malaria cases (n = 1200) were enrolled, with 846 from Village 8/9 and 354 from Beto. Approximately 150 µL of capillary blood was collected from each participant for point-of-care RDTs (5 µL), thick and thin smear microscopy (7 µL), and dried blood spots (140 µL) for 18S rRNA qPCR. Diagnostic performance was evaluated through sensitivity, specificity, kappa agreement (κ), and case detection comparisons across RDT, qPCR, and microscopy. Associations between parasite density and detectability, as well as the geographic distribution of species, age, and sex, were assessed.</p><p><strong>Results: </strong>Using 18S qPCR, malaria prevalence rate was 40.6% (487/1,200): 63.0% P. falciparum, 29.6% P. vivax, and 7.4% mixed infections. P. falciparum predominated in Gambella (68.5%, 217/317) vis-à-vis South Ethiopia (52.9%, 90/170), whereas P. vivax was more common in South Ethiopia (37.6%, 64/170) vis-à-vis Gambella (25.2%, 80/317). The RDT showed higher sensitivity for qPCR-confirmed Plasmodium infections (89.7%) than routine microscopy (59.8%), with comparable specificities (97.2% versus 96.5%). Species-specific sensitivities were 87.9% for P. falciparum, 86.7% for P. vivax, and 50.0% for mixed infections. Agreement with qPCR was strong for RDT (κ = 0.92) and moderate for microscopy (κ = 0.79). Overall diagnostic accuracy was excellent (AUC ≥ 0.92 for both species). RDT sensitivity declined at low parasite densities but reached 100% at ≥ 5,000 copies/µL for both species.</p><p><strong>Conclusions: </strong>The RDT demonstrated strong accuracy for point-of-care, species-specific malaria diagnosis in Ethiopian primary healthcare. Its high sensitivity, particularly for moderate- to high-density infections, supports routine clinical use following Ethiopia's shift to non-HRP2 RDTs.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272150","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":"Community perspectives on mass malaria vaccine and drug administration in the Chittagong Hill Tracts, Bangladesh: a qualitative study.","authors":"Md Fojle Rabby, Rupam Tripura, Ibrahim Khalil, Dewan Imtiaj Ahmed, Thomas J Peto, Phaik Yeong Cheah, Md Amir Hossain, A K M Fazlur Rahman, Rasheda Samad, Rumana Rashid, Abdullah Abu Sayeed, Nicholas J White, Nicholas P J Day, Arjen M Dondorp, Lorenz von Seidlein, Bipin Adhikari, Md Abul Faiz","doi":"10.1186/s12936-026-05999-6","DOIUrl":"10.1186/s12936-026-05999-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Malaria remains a major public health burden in Bangladesh, particularly in the Chittagong Hill Tracts (CHT), where indigenous and marginalized populations face persistent transmission risks. The Mass Vaccine and Drug Administration (MVDA) trial is currently being implemented to accelerate malaria elimination. MVDA is socially complex because it involves administering preventive interventions to largely asymptomatic populations in contexts where trust, prior experiences, and sociopolitical factors strongly shape acceptance. Little is known about community perspectives toward such interventions. This study explored local understandings of malaria, health-seeking behaviours, and perceptions of mass vaccine and drug administration in the CHT to inform community engagement and implementation of MVDA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative study collected data using focus group discussions (FGDs), in-depth interviews (IDIs), and key informant interviews (KIIs) in Lama and Alikadam sub-districts of Bandarban among community members with no prior exposure to formal research activities. Participants were purposively selected using a maximum variation sampling approach to capture diverse perspectives across socio-demographic and stakeholder groups. Participants included community members, village leaders, traditional healers, local pharmacists, village health workers, religious leaders, and local government representatives. A total of 105 participants from heterogeneous backgrounds participated in this study between September and October 2024. Data were transcribed, translated, and underwent primarily inductive thematic analysis led by a trained qualitative researcher, a Bengali non-native to the study site. Interpretation was conducted reflexively, considering the researcher's positionality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Malaria was recognized as a recurrent illness, particularly during the rainy season and among traditional farmers. While awareness of malaria symptoms and prevention had increased through non-governmental and government initiatives, health-seeking behaviour remained pluralistic. Communities relied on traditional healers and informal drug sellers before seeking formal care. Village health workers provided malaria diagnosis and treatment but faced challenges of inconsistent services (e.g., irregular supply of health materials). The recent COVID-19 experience seemed to shape vaccine perceptions, with mandates, and adverse event narratives contributing to mistrust. Knowledge of a malaria vaccine was limited, yet participants expressed conditional acceptance, indicating willingness to participate if interventions were perceived as safe, effective, and transparently communicated. MDAs were viewed more positively than mass vaccine administration(s) although adherence, particularly among children and adults was considered a challenge. Trust in institutions and historical political mistrust emerged as ke","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265056","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":"Understanding community and health system acceptability, readiness and perspectives on the introduction of new vector control approaches for malaria control in Papua New Guinea.","authors":"Zebedee Kerry, Rachael Farquhar, Kilon Manuv, Alma Auwun, Petrina Johnson, Paul Daly, Michael Macdonald, Stephen Bell, Maria Ome-Kaius, Stephan Karl, Moses Laman, Leanne J Robinson","doi":"10.1186/s12936-026-05990-1","DOIUrl":"10.1186/s12936-026-05990-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major public health challenge in Papua New Guinea (PNG) and accounted for most malaria cases and deaths in the Western Pacific Region in 2023. Despite current national efforts centred on insecticide treated nets (ITNs), there is a pressing need to explore supplementary vector control tools, given the resurgence of malaria in PNG since 2015, partly driven by declining insecticidal efficacy of ITNs. The Newly Adapted Tools and Network Against Mosquito Borne Disease Transmission (NATNAT) project is assessing the feasibility and acceptability of complementary vector control approaches in PNG communities and the health system. These tools include residual spraying, spatial emanators, and larval source management.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative study to examine community acceptability, readiness and perceptions of current vector control tools such as ITNs and the potential reintroduction of supplementary vector control approaches, like residual spraying. Using in-depth interviews and focus group discussions, data were collected from four villages along the north coast of Madang Province: Megiar, Bulal, Mirap, and Wasab. Transcripts were analyzed thematically using inductive techniques, with collaborative review to refine key themes by study team.</p><p><strong>Results: </strong>The current malaria control practices and contextual factors shaped community perceptions and the prospective acceptability of residual spraying. Community members demonstrated a strong understanding of malaria risk, including seasonal transmission patterns and breeding sites, and reported both traditional and program-implemented vector control approaches used in their village. Engagement for vector control activities was motivated by strong leadership, personal values, and a comprehensive understanding of malaria risk factors. Community support for supplementary vector control measures, alongside a strong desire to address existing gaps in mosquito protection, were key drivers of acceptability. Addressing insecticide safety concerns informed in part by historical DDT spraying campaigns experiences through tailored, context-specific communication strategies will be critical for the successful adoption of residual spraying. Affordability and uptake of new vector control tools into existing programs are essential for sustainable uptake into policy and practice.</p><p><strong>Conclusions: </strong>Findings demonstrate the prospective acceptability of new vector control tools in PNG and underscores the importance of sustained, in-depth community engagement. To ensure effective implementation, policy development must consider community norms and practices, societal attitudes, and resource availability.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265150","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":"Genetic diversity and evolutionary perspectives of Pfcrt in Plasmodium falciparum: insights from Indian and global isolates.","authors":"Geetika Narang, Joseph Hawadak, Jahnvi Jakhan, Vineeta Singh","doi":"10.1186/s12936-026-05974-1","DOIUrl":"10.1186/s12936-026-05974-1","url":null,"abstract":"<p><strong>Background: </strong>Chloroquine resistance in Plasmodium falciparum (Pf) driven by mutations in the Pf chloroquine resistance transporter (Pfcrt) gene continues to pose a challenge to malaria control in endemic regions like India. Understanding the genetic diversity and evolutionary patterns of Pfcrt is important for guiding malaria surveillance and future national drug policy.</p><p><strong>Methods: </strong>This study analysed 979 Indian (exon 2) and 719 global full-length Pfcrt sequences using molecular tools to assess genetic diversity, selection pressure and population structure. Comparative and temporal analyses were conducted across Indian states and global regions to explore evolutionary trends.</p><p><strong>Results: </strong>Indian sequence analysis revealed regional and temporal variations in haplotype diversity with both widespread and region-specific variants. Haplotype networks identified three major haplotypes namely CVIET, SVMNT and CVMNK, with CVIET predominating, particularly in the North-East, while SVMNT and CVMNK showed variable prevalence across regions and time periods. The greatest diversity was recorded between 2010-2019 despite reduced malaria incidence, suggesting ongoing selection pressure. Mizoram exhibited the highest Tajima's D value (D = 3.310, p < 0.01) and Pfcrt sequences from North-East region showed a unique genetic structure reflecting a likely role of selection pressures from the Greater Mekong Subregion. Globally, 65 haplotypes were detected with highest diversity in Cambodia with strong genetic differentiation observed across countries. Distinct genetic clusters and limited haplotype sharing across countries suggest that region-specific evolutionary pressures have shaped Pfcrt diversity. Positive selection at 6 codons and linkage disequilibrium between key SNPs indicate functional adaptation under drug pressure.</p><p><strong>Conclusion: </strong>This study highlights the variation in Pfcrt shaped by national drug policies and regional malaria transmission patterns. Continued molecular surveillance is essential to monitor emerging resistant lineages and guide effective malaria treatment strategies. This study highlights the variation in Pfcrt shaped by national drug policies and regional malaria transmission patterns.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258757","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 Malaria Vaccine Implementation Programme reduced clinical malaria in Kenya, 2020 to 2022 : Impact evaluation with predictive time-series models of routine surveillance data.","authors":"John A Painter, Erika Wallender, Andrew N Hill, Mary Hamel, Rafiq Okine, Eliane Furrer, Rose Jalang'o, Kibor K Keitany, Simon Kariuki, Isabella Nyang'au, Brian Seda, Aaron M Samuels, Nelli Westercamp","doi":"10.1186/s12936-026-05973-2","DOIUrl":"10.1186/s12936-026-05973-2","url":null,"abstract":"<p><strong>Background: </strong>Quantifying the impact of malaria vaccines on outpatient malaria burden in children is of interest to many countries introducing either of the World Health Organization (WHO)-recommended vaccines (RTS,S/AS01 [RTS,S] or R21/Matrix-M [R21]). The cluster randomized implementation of RTS,S by the Kenya Ministry of Health during the Malaria Vaccine Implementation Programme (MVIP) provided a unique opportunity to measure the impact of RTS,S on uncomplicated malaria cases reported through routine malaria case surveillance data in western Kenya.</p><p><strong>Methods: </strong>From 23 implementing and 23 comparison subcounties in western Kenya, monthly numbers of confirmed uncomplicated malaria cases among individuals under 5 years of age (< 5y) and 5 years of age and older (≥ 5y) were extracted from the Kenya Health Management Information System, stored in a DHIS2 instance. Facilities that reported data ≥ 11 months per year from January 2015 through December 2022 (132 implementing, 139 comparison) were included in the analysis. Prevaccination data (January 2015-December 2019) were used to predict counterfactual case counts during the evaluation period (January 2020-December 2022), beginning when the first children vaccinated under MVIP became age-eligible for the third dose. Models of < 5y malaria cases included a covariate for ≥ 5y malaria cases to control for non-RTS,S malaria control measures. The impact was estimated as the difference between predicted and observed cases across implementing and comparison areas.</p><p><strong>Results: </strong>The proportion of vaccine eligible children (RTS,S doses at 6, 7, 9, and 24 months) among all children < 5y was small at the start of MVIP but was estimated to reach 60% by December 2022. During the 3-year evaluation period following dose-3 age-eligibility, < 5y malaria cases were 2.3% lower than predicted in non-implementing facilities and 13.8% lower in implementing facilities, a reduction of 11.6%. The reduction was 5.6% during the first year of follow-up, increasing to 8.2% after two years.</p><p><strong>Conclusion: </strong>This analysis revealed that routine health data, although age-aggregated to both vaccine eligible and noneligible children < 5 years, demonstrated a reduction in malaria cases throughout the evaluation period. A further reduction in cases was observed as more vaccine-eligible children comprised the under 5 population. High quality routine data can be used to monitor vaccine impact on clinical malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258715","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}