Malaria Journal最新文献

{"title":"Larvicidal and adulticidal effects of combined hydroethanolic extracts of clove flower buds and garlic bulbs on Anopheles gambiae.","authors":"Charles O Nwonuma, Temitope E Elleke, Adedapo O Adeogun, Teslim A Lawal, Babasoji P Omoniwa, Anthony B Ojekale","doi":"10.1186/s12936-025-05440-4","DOIUrl":"10.1186/s12936-025-05440-4","url":null,"abstract":"<p><strong>Background: </strong>Insecticides are toxic substances, though not necessarily toxins, intentionally released into the environment to kill or manage insect populations. These chemical toxins pose significant risks to human and animal health due to their direct effects and their impact as environmental pollutants. To mitigate these chemical hazards, the use of phytocompounds with superior larvicidal or mosquitocidal effects, low toxicity levels in mammals, and short-term environmental persistence may be a preferable alternative.</p><p><strong>Methods: </strong>This study aimed to evaluate the larvicidal and adulticidal effects of the combined hydroethanolic extracts of garlic and clove on Anopheles gambiae. The experiment included four treatment groups: garlic, clove, combined extract (garlic + clove), and deltamethrin (standard insecticide). At the end of the 24 h experiment, the knocked-down adult mosquitoes were homogenized and used for biochemical assays.</p><p><strong>Results: </strong>The combined garlic-clove extract significantly increased (p < 0.05) the larval mortality rate compared to the single garlic and clove extracts. Similarly, the combined extracts of garlic-clove significantly increased (p < 0.05) mortality of adult mosquitoes compared to deltamethrin and the individual garlic and clove extract. The garlic-clove combined extracts showed a significant decrease (p < 0.05) in the activity of acetylcholine esterase and Na-k ATPase compared with the deltamethrin group. Furthermore, the docking interaction between AChE and voltage gated ion channel with the GC-MS identified compounds of the extracts showed a higher binding affinity with caryophyllene, estrone, morellinol compared to deltamethrin.</p><p><strong>Conclusions: </strong>The efficacy of the garlic-clove extract as a larvicide and adulticide has been confirmed through biochemical analyses and in silico studies. This lethal effect is likely due to the inhibition of crucial enzymes that facilitate essential processes such as signal transduction and energy production. Moreover, the biocidal properties of these extracts stem from the alteration of vital metabolic pathways, influenced by a range of bioactive compounds found in both garlic and clove.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"249"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of malaria among children aged 6-59 months in Tanzania: a nationwide cross-sectional study.","authors":"Jovinary Adam, Pankras Luoga, Tumaini Nyamhanga, Chijano Makunenge, Meshack Ayubu","doi":"10.1186/s12936-025-05409-3","DOIUrl":"10.1186/s12936-025-05409-3","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a leading cause of morbidity and mortality, especially in children under age 5 years in Tanzania. It is more often recognized as the most serious health problem in the community by women and men in Tanzania. The objective of the study was to determine the prevalence and the determinants of malaria among children aged 6-59 months in Tanzania.</p><p><strong>Methods: </strong>Secondary data analysis was conducted on data from 2022 Tanzanian Demographic and Health Survey and Malaria Indicator Survey. The weighted sample included in this study was 4,923 children aged 6-59 months, who underwent malaria rapid diagnostic test. Data analysis was performed using Stata 18.0 software. The strength of the association was assessed using the adjusted odds ratio (aOR) along with its corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>The prevalence of malaria among children aged 6-59 months was 8% (95% CI 6.2, 9.5). The percentage of children with malaria was highest in Tabora (23%) and below 1% among children in Dodoma, Arusha, Kilimanjaro, Singida, Songwe, and the Zanzibar regions. The study found that children aged 24-59 months (aOR = 1.71, 95% CI 1.33, 2.21), children residing in rural areas (aOR = 6.92, 95% CI 2.19, 8.83), children from lower economic status (aOR = 3.08, 95% CI 1.22-7.83), and children who never slept under an insecticide-treated net (ITN) (aOR = 2.73, 95% CI 1.51-4.91) were significantly associated with malaria among children aged 6-59 months.</p><p><strong>Conclusion: </strong>The study revealed a malaria prevalence of 8% among children aged 6-59 months in Tanzania, with the highest percentage observed in Tabora. This prevalence was associated with older age, residence in rural areas, lower economic status, and lack of access to insecticide-treated nets (ITNs). These results underscore the need for targeted malaria prevention strategies, particularly in rural areas and among economically disadvantaged populations. Enhancing access to ITNs and promoting their use, along with broader health education initiatives, could significantly reduce malaria incidence in this vulnerable age group.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"248"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Plasmodium falciparum parasites harbouring chloroquine-resistant but not artemisinin-resistant alleles in Busia County, Western Kenya.","authors":"Noah Machuki Onchieku, Nemrod Gesusu, Emmanuelle Caspar, Lewis Karani, Kelvin Thiong'o, Luna Kamau, Daniel Kiboi, Lucas Thiebaut, Laurence Ma, Francis Kimani, Damaris Matoke-Muhia, Didier Ménard","doi":"10.1186/s12936-025-05486-4","DOIUrl":"10.1186/s12936-025-05486-4","url":null,"abstract":"<p><strong>Background: </strong>The recent emergence of Plasmodium falciparum parasites harbouring kelch 13 mutations associated with artemisinin partial resistance (ART-R) in sub-Saharan Africa is a major concern. Regular molecular epidemiological surveys are recommended to monitor the level of mutant parasites associated with drug resistance.</p><p><strong>Objective: </strong>To analyse single nucleotide polymorphisms (SNPs) in P. falciparum genes associated with resistance to antimalarial drugs in blood samples collected from malaria patients prior to treatment in Busia County, Western Kenya, using a highly multiplexed deep amplicon sequencing protocol.</p><p><strong>Methods: </strong>Parasite DNA was extracted from dried blood spots (DBS) collected from patients attending health facilities along the Kenya-Uganda border, in Busia County. A highly multiplexed deep amplicon sequencing protocol was applied to analyze SNPs in genes associated with antimalarial drugs resistance.</p><p><strong>Results: </strong>Out of 118 analysed samples, Pfkelch13 mutations were identified in 6 (5.1%) samples. All the six samples harboured A578S, one of the most frequently detected Pfkelch13 mutations in Africa, which does not confer ART-R. The data also indicated that 11% (13) of the samples had mutant Pfcrt alleles, with 62% harbouring the triple mutant haplotype, CVIET. In contrast, 98% of the samples had dhfr mutations at positions N51I, C59R, or S108N alleles. All the samples carried mutations in the dhps gene with a high prevalence of the single A437G mutation (84%) and a lower frequency of double or triple mutations. Further analysis revealed absence of deletions in the Pfhrp2, with no mutations at Pfmdr1 codons 86 or 1246, both of which are associated with chloroquine resistance.</p><p><strong>Conclusion: </strong>These findings show absence of validated Pfkelch13 markers associated with ART-R in Busia County, Western Kenya. Although chloroquine-sensitive (wild-type) parasites are widely circulating, sulfadoxine-pyrimethamine-sensitive parasites remain rare. Continued large scale genomic surveillance studies are essential to detect emerging resistance and guide malaria treatment strategies in the region.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"247"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753742","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":"Larvicidal and adulticidal effects of Ethiopian medicinal plants against Anopheles gambiae (Diptera: Culicidae).","authors":"Sileshi Tadesse, Solomon Mequanente Abay, Eyasu Makonnen, Abebe Ejigu, Yehenew Asemamaw, Werissaw Haileselassie, Ephrem Engidawork","doi":"10.1186/s12936-025-05443-1","DOIUrl":"10.1186/s12936-025-05443-1","url":null,"abstract":"<p><strong>Background: </strong>The malaria control programmes are facing a challenge due to a rapidly increasing resistance to currently available synthetic insecticides. Medicinal plants offer a promising alternative for mosquito control, addressing environmental and resistance concerns. The study aimed to assess the larvicidal and adulticidal effects of crude extracts and fractions of selected Ethiopian medicinal plants.</p><p><strong>Methods: </strong>Methanol crude extract/fractions of leaves of Croton macrostachyus (Euphorbiaceae) and Dodonaea angustifolia (Sapindaceae), rhizomes of Kniphofia foliosa (Asphodelaceae) and roots of Rumex abyssinicus (Polygonaceae) were tested for their larvicidal and adulticidal activity against late 3rd to early 4th instar larvae and 3 to 5 days adults of Anopheles gambiae, respectively. For both assays, the plants were incubated with the parasites for 48 h at concentrations of 25, 50, 100, 200, and 400 ppm. Percent mean mortality rate was compared using one-way ANOVA, and LC₅₀ and LC₉₀ values were calculated using a generalized linear Probit model.</p><p><strong>Results: </strong>Croton macrostachyus crude extract exhibited the strongest activity, achieving 100% mortality rate at 400 ppm, with LC₅₀ (69.43 ppm) and LC₉₀ (219.39 ppm) for larvae and LC₅₀ (55.32 ppm) and LC₉₀ (86.77 ppm) for adults. The ethyl acetate fraction of C. macrostachyus was particularly effective, with an LC₅₀ of 38.60 ppm for larvae and 52.72 ppm for adults, superseding all other extracts and fractions. Kniphofia foliosa was the next most potent, though it required slightly higher concentrations.</p><p><strong>Conclusions: </strong>The crude extract and ethyl acetate fractions of C. macrostachyus as well as the rhizome of K. foliosa showed a promising biopesticide activity that could further be developed for malaria vector control.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"246"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subnational introduction of the RTS,S/AS01_E malaria vaccine into routine immunization: experience and lessons from the three pilot countries.","authors":"Rose Jalang'o, Kwame Amponsa-Achiano, Mike Chisema, Keziah Malm, Lydiah Khalayi, Brenda Mhone, Wahjib Mohammed, Franklin Asiedu-Bekoe, Adam Haji, Josephine Njoroge, Boston Zimba, Esther Chirwa, Peter O Tweneboah, Jackson Sillah, Mgaywa G M D Magafu, Cynthia Bergstrom, Tracey Goodman, Jenny Walldorf, Kristen Kelleher, Eliane Pellaux-Furrer, Mary J Hamel, Michael R Adjei, Rafiq N A Okine","doi":"10.1186/s12936-025-05484-6","DOIUrl":"10.1186/s12936-025-05484-6","url":null,"abstract":"<p><strong>Background: </strong>In October 2021, the World Health Organization (WHO) recommended the RTS,S/AS01_E (RTS,S) malaria vaccine for the prevention of Plasmodium falciparum malaria in children living in endemic areas informed by evidence from the subnational pilot introduction and evaluation in Ghana, Kenya, and Malawi as part of the WHO-coordinated Malaria Vaccine Implementation Programme (MVIP). With the global vaccine supply boosted by the pre-qualification of a second malaria vaccine, R21/Matrix-M (R21), in October 2023, many endemic countries (20 as of April 2025) have introduced malaria vaccines into their national childhood immunization and malaria control programmes. More endemic countries are expected to introduce or scale up malaria vaccines in 2025 and beyond. This paper summarizes key operational lessons from the pilot countries to facilitate the introduction and scale-up of malaria vaccination in other countries.</p><p><strong>Methods: </strong>Pilot areas were identified, in part, based on local malaria epidemiology. RTS,S was initially introduced in randomly selected areas, while other areas served as comparators until the four-dose schedule vaccine was scaled up following the WHO recommendation in 2021. In Ghana and Kenya, the vaccine was administered at ages 6, 7, 9, and 24 months (Ghana switched to administer the fourth dose at age 18 months in 2023), and Malawi chose a schedule of 5, 6, 7, and 22 months.</p><p><strong>Results: </strong>Vaccination coverage improved over time, reaching about 80% for the first dose and around 75% for the third dose by 2023 in the initial pilot areas. Implementation challenges included an inadequate understanding of age eligibility among healthcare workers during the early phase of introduction, low fourth dose coverage (with a median coverage of 46% in 2023 across the three countries), and disruptions to service delivery caused by disease outbreaks and other natural disasters. Health stakeholders and caregivers attested to the positive impact of introducing the malaria vaccine, including a reduction in malaria hospitalizations and the strengthening of the National Immunization Programme (NIP) through routine immunization refresher training and supportive supervision.</p><p><strong>Conclusions: </strong>The pilot highlighted lessons for malaria vaccine introduction: (1) clearly outlined roles and responsibilities of key stakeholders including NIP and National Malaria Programme (NMP); (2) appropriate approach to vaccine introduction launch, communication, and demand generation to enhance vaccine uptake; (3) flexibility with dose scheduling to optimize coverage; and (4) updated data collection tools for accurate documentation, and data quality.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"244"},"PeriodicalIF":3.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732091","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":"Emergence of urban malaria and the associated risk factors: a case-control study in Mutare city, Zimbabwe.","authors":"Sungano Mharakurwa, Natasha Mbwana, Trish Mharakurwa, Thelma Karumbidza, Vuyisile Mathe, Punha Fusire, Andrew Tangwena, Wilson Chauke, Munyaradzi Mukuzunga, Patience Dhliwayo, Shungu Mtero Munyati, Lovemore Gwanzura, Jeffrey A Bailey, William J Moss","doi":"10.1186/s12936-025-05494-4","DOIUrl":"10.1186/s12936-025-05494-4","url":null,"abstract":"<p><strong>Background: </strong>Mutare city of Zimbabwe was considered free of autochthonous malaria, until 2017, when the Ministry of Health and Child Care formally confirmed escalating cases of locally transmitted malaria in the city. The current study examined the risk factors for malaria cases in the city to aid in formulation of targeted intervention packages for helping restore malaria-free status.</p><p><strong>Methods: </strong>The study employed complementary cross-sectional and case-control designs to ascertain the magnitude and risk factors of urban malaria cases presenting at all eight primary health care facilities of Mutare city from 2022 to 2023. Malaria cases were enrolled as confirmed by RDT or microscopy on presenting all-age symptomatic suspected malaria patients. Controls were similarly enrolled as all-age symptomatic suspected malaria patients found negative by both RDT and microscopy. All cases and controls were enrolled as representative of the presenting population with no matching. Data were analysed for descriptive and prevalence statistics, as well as risk factors, using SPSS Faculty version 27.</p><p><strong>Results: </strong>In a multivariate binary logistic model, significant risk factors for malaria cases found in the city included residential locale (RR [95%CI]: 3 [1.1-5.8], p = 0.029, N = 7,222), household proximity to still surface water pools or unprotected wells (16 [3.8-67.5], p < 0.001) and travel history in the past 2 weeks (9 [5.2-14.4], p < 0.001, N = 7,222), modal travel destinations being malaria-endemic adjoining districts within Zimbabwe, as well as areas of neighbouring Mozambique, mainly for trade or work. By far the most predominant risk factor for malaria cases was artisanal mining (RR [95%CI]: 22 [10.7-44.1], p < 0.001), which was 93% dominated by men, and male residents exhibited four-fold higher odds of being malaria cases than females (4 [2.0-6.5]).</p><p><strong>Conclusions: </strong>Significant risk factors for urban malaria were found that were consistent with both autochthonous transmission and imported malaria in Mutare city. Environmental management and the deployment and concomitant promotion of mass ITNs, personal protection and other intervention packages, especially targeting communities exposed to the identified risk factors, would be instrumental towards re-establishing urban malaria elimination from Mutare city.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"245"},"PeriodicalIF":3.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732090","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":"Development and application of an LC-MS/MS method for quantification of fosmidomycin in human and rat plasma.","authors":"Christoph Pfaffendorf, Keanu D Sackmann, Johannes Mischlinger, Jean Claude Dejon-Agobé, Oumou Maïga-Ascofaré, Ebenezer Ahenkan, Ayôla Akim Adegnika, Michael Ramharter, Philipp Uhl, Gert Fricker, Sebastian G Wicha","doi":"10.1186/s12936-025-05489-1","DOIUrl":"10.1186/s12936-025-05489-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria still poses a significant burden on global health, with millions of cases reported annually and rising resistance to current treatments, emphasizing the need for new therapeutic strategies. Fosmidomycin, initially recognized for its antibacterial properties, has emerged as a promising candidate in the fight against malaria.</p><p><strong>Methods: </strong>In this study, a sensitive and robust LC-MS/MS method for quantifying fosmidomycin in human and rat plasma was developed and validated. Plasma samples were prepared using a simple protein precipitation method with 10% trichloroacetic acid (TCA). The assay featured a rapid run time of 5 min, and validation was performed according to the European Medicines Agency's guidelines.</p><p><strong>Results: </strong>The method validation confirmed its selectivity, linearity, accuracy, precision, and stability. Notably, the calibration range was established from 0.25 to 15 mg/L, demonstrating improvements over previous methodologies with lower limits of quantification of 0.5-1.0 mg/L. Using the developed LC-MS/MS method, plasma samples were analysed from a clinical trial conducted in Gabon, as well as from a pharmacokinetic study involving male Wistar rats, revealing viable pharmacokinetic profiles for fosmidomycin.</p><p><strong>Conclusions: </strong>These findings confirm the utility of the developed analytical method for supporting the clinical development of fosmidomycin as a potential therapy for malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"243"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718095","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":"How to use learning curves to evaluate the sample size for malaria prediction models developed using machine learning algorithms.","authors":"Sophie G Zaloumis, Megha Rajasekhar, Julie A Simpson","doi":"10.1186/s12936-025-05479-3","DOIUrl":"10.1186/s12936-025-05479-3","url":null,"abstract":"<p><strong>Background: </strong>Machine learning algorithms have been used to predict malaria risk and severity, identify immunity biomarkers for malaria vaccine candidates, and determine molecular biomarkers of antimalarial drug resistance. Developing these prediction models requires large training datasets to ensure prediction accuracy when applied to new individuals in the target population. Learning curves can be used to assess the sample size required for the training dataset by evaluating the predictive performance of a model trained using different dataset sizes. These curves are agnostic to the specific prediction model, but their construction does require existing data. This tutorial demonstrates how to generate and interpret learning curves for malaria prediction models developed using machine learning algorithms.</p><p><strong>Methods: </strong>To illustrate the approach, training dataset sizes were evaluated to inform the design of a \"mock\" prediction modelling study aimed to predict the artemisinin resistance status of Plasmodium falciparum malaria isolates from gene expression data. Data were simulated based on a previously published in vivo parasite gene expression dataset, which contained transcriptomes of 1043 P. falciparum isolates from patients with acute malaria, of which 29% (299/1043) were from slow clearing infections (parasite clearance half-life > 5 h). Learning curves were produced for two machine learning algorithms, sparse Partial Least Squares-Discriminant Analysis plus Support Vector Machines (sPLSDA + SVMs) and random forests. Prediction error was measured using the balanced error rate (average of percentage of slow clearing infections incorrectly predicted as fast and percentage of fast clearing infections predicted as slow).</p><p><strong>Results: </strong>For this mock malaria prediction study, the balanced error rate on a test dataset not used for model training (208 samples) was 50% for sPLSDA + SVMs and 50% for random forests on the smallest training dataset evaluated (20 samples) and 14% for sPLSDA + SVMs and 22% for random forests on the largest training dataset evaluated (835 samples). The shape of the learning curves indicates that increasing the training dataset size beyond 835 samples is unlikely to significantly reduce the balanced error rates further.</p><p><strong>Conclusions: </strong>Learning curves are a simple tool that can be used to determine the minimum sample size required for future prediction modelling studies of different malaria outcomes that use machine learning algorithms for prediction. These curves need to be generated for each specific prediction modelling application.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"242"},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708012","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":"Individual and community-level correlates of optimal doses of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Tanzania: a multilevel analysis of the 2022 national survey.","authors":"Elihuruma Eliufoo Stephano, Tian Yusheng, Thomas Wiswa John, Stephen Mathew Kibusi, Li Yamin, Mtoro J Mtoro","doi":"10.1186/s12936-025-05482-8","DOIUrl":"10.1186/s12936-025-05482-8","url":null,"abstract":"<p><strong>Background: </strong>Malaria during pregnancy remains a significant public health challenge in sub-Saharan Africa, where approximately 32 million pregnant women are at risk. Despite the progress made in the coverage of Intermittent Preventive Treatment of malaria during pregnancy using sulfadoxine-pyrimethamine (IPTp-SP), notable gaps persist in understanding the individual and community-level factors that correlate with optimal dosing adherence. This study aims to assess these correlates in Tanzania using recent Tanzania Demographic and Health Survey (TDHS) data.</p><p><strong>Methods: </strong>This study employed an analytical cross-sectional design, utilizing data from the 2022 TDHS. This study's analysis included 4497 women who had given birth within two years before the survey. The data were analzed using multilevel mixed-effects logistic regression, employing four models to identify factors associated with optimal IPTp-SP dose uptake.</p><p><strong>Results: </strong>The overall uptake of optimal (≥ 3 doses) IPTp-SP was 31.2% (95% CI 29.1-33.3). In the adjusted analysis, individual correlates were women aged 25-34 years (AOR = 1.52, 95% CI 1.21-1.90) and 35-49 years (AOR = 1.47, 95% CI 1.10-1.96) compared to women aged 15-24 years. Women with primary education (AOR = 1.34, 95% CI 1.07-1.68) were more likely to achieve optimal uptake than those with no formal education. Furthermore, women with one child (AOR = 1.65, 95% CI 1.26-2.17) and two children (AOR = 1.37, 95% CI 1.09-1.74) showed higher odds of optimal uptake compared to women with no children. Having more than three antenatal care (ANC) visits (AOR = 1.77, 95% CI 1.47-2.12) increased the likelihood of optimal uptake compared to those with fewer than three visits. Community-level correlates of optimal IPTp-SP uptake included communities with higher ANC visit rates (AOR = 1.49, 95% CI 1.13-1.97), which showed higher odds of optimal uptake than those with low ANC visit rates. Residing in the Northern (AOR = 1.61, 95% CI 1.01-2.59) and Lake zones (AOR = 1.68, 95% CI 1.12-2.53) was also associated with higher odds of optimal uptake compared to women in the Western zone. Conversely, women in Zanzibar (AOR = 0.01, 95% CI 0.01-0.06) had low uptake because IPTp-SP is no longer recommended.</p><p><strong>Conclusion: </strong>This study revealed low uptake of optimal doses of IPTp-SP influenced by several individual and community factors. Future malaria prevention in pregnancy requires integrating control programs with reproductive health services, overcoming socio-cultural barriers, and utilizing community engagement to enhance IPTp-SP coverage.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"240"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698978","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":"Self-medication for malaria and associated factors in Kakumiro District, Uganda, August 2023: implications for malaria management and mortality prevention.","authors":"Marie Gorreti Zalwango, Richard Migisha, Bosco B Agaba, Lilian Bulage, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario","doi":"10.1186/s12936-025-05488-2","DOIUrl":"10.1186/s12936-025-05488-2","url":null,"abstract":"<p><strong>Background: </strong>In August 2022, an epidemiologic investigation into an outbreak of cases of black water fever, a severe and fatal complication of malaria, was conducted in Kakumiro District, Central Uganda. Findings revealed an association between self-medication and the development of severe malaria complications. Factors associated with self-medication for uncomplicated malaria were described for improved malaria management and prevention of malaria related mortality in Uganda.</p><p><strong>Methods: </strong>A community-based cross-sectional survey was conducted in Kakumiro District in August 2023. Using multistage sampling, 592 households were selected. A semi-structured questionnaire was used to interview one participant per household about self-medication for malaria in a family member of any age who suffered from malaria 6 months prior to the interview. Data on demographics, socio-economic factors, health-seeking behaviour, self-medication and antimalarial storage at home were obtained. Modified Poisson regression model was used for multivariate analysis.</p><p><strong>Results: </strong>Of the 592 participants interviewed, 368 (62%; 95% CI 58.2-65.9%) had self-medicated for malaria. Self-medication was significantly associated with household heads aged ≥ 35 years (adjusted prevalence ratio [APR]: 1.77; 95% CI 1.04-3.01); distances ≥ 5 km to the health facility (APR: 3.05; 95% CI 2.09-4.47), and storage of antimalarial drugs at home (APR: 2.21; 95% CI 1.36-3.59). Having malaria episodes ≥ 6 in the household within 6 months was protective (APR: 0.39; 95% CI 0.23-0.65). The major reason for self-medication was antimalarial stockouts at health facilities. Drugs used for self-medication were commonly known to 65% of the respondents and were bought from drug shops (75%). Although, 85% used the recommended drug for malaria treatment, the dose was inappropriate for 66% of the patients and despite the under dose, 85% of the patients recovered without hospitalization.</p><p><strong>Conclusion: </strong>The common occurrence of self-medication for malaria and the high potential for malaria drug resistance and increased malaria mortality due to inappropriate treatment was demonstrated. Adequate antimalarial stock to health facilities, instituting policies prohibiting the sale of incomplete doses by drug shops, social behavioural change campaigns against drug storage in homes and sensitization of communities on the dangers of self-medication and the consumption of inappropriate doses could reduce self-medication practices and its eventual consequences.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"241"},"PeriodicalIF":3.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698979","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}