Malaria JournalPub Date : 2025-02-07DOI: 10.1186/s12936-025-05268-y
Obi Peter Adigwe, Godspower Onavbavba
{"title":"Acceptance and affordability of malaria vaccines: issues relating to hesitancy and willingness to pay amongst Nigerian parents of under-five children.","authors":"Obi Peter Adigwe, Godspower Onavbavba","doi":"10.1186/s12936-025-05268-y","DOIUrl":"10.1186/s12936-025-05268-y","url":null,"abstract":"<p><strong>Background: </strong>With the recent approval of the malaria vaccine by the World Health Organization, it is expected that global acceptance and subsequent uptake of the intervention can help to reduce the burden of the disease in Africa. This study adopted a proactive approach in assessing parents' acceptance of the malaria vaccine, alongside their willingness to pay for the novel public health intervention.</p><p><strong>Methods: </strong>A national cross-sectional survey was undertaken in Nigeria using a questionnaire as the data collection instrument. The study tool was administered to parents of child-bearing age. Descriptive and inferential statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) software version 25.</p><p><strong>Results: </strong>A total of 1413 valid responses were received with male (49.5%) and female (50.5%) participants represented by similar proportions. Close to two-thirds (62.5%) of the participants were between the ages of 31 and 40 years, and 47.4% of the participants were educated up to national diploma level. More than two-thirds (69.6%) of the participants indicated that they were worried about side effects that may be associated with the malaria vaccine. A strong majority (90%) of the participants indicated that the vaccine should be administered at no cost to citizens, while 46.7% of the respondents were willing to pay for the malaria vaccination. Levels of education attained by the respondents influenced their willingness to pay for malaria vaccination. This variable also underpinned participants' reasons for non-acceptance of the vaccine. Those who attained only primary and secondary levels of education were significantly more likely to reject the malaria vaccine because they were against vaccines in general (AOR = 6.63; 95% CI = 1.33 - 39.25; p = 0.021).</p><p><strong>Conclusion: </strong>This study provides critical novel insights which could influence vaccination efforts aimed at reducing the burden of malaria in Nigeria, as well as similar settings.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"36"},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365243","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}
Malaria JournalPub Date : 2025-02-07DOI: 10.1186/s12936-024-05221-5
Cate Namayanja, George Paasi, Jimmy Patrick Alunyo, Denis Amorut, Charles Benard Okalebo, William Okiror, Paul Ongodia, Grace Abongo, Rita Muhindo, Yovani A M Lubaale, Peter Olupot-Olupot
{"title":"Epidemiology, clinical spectrum, and outcomes of severe malaria in Eastern Uganda: a prospective study.","authors":"Cate Namayanja, George Paasi, Jimmy Patrick Alunyo, Denis Amorut, Charles Benard Okalebo, William Okiror, Paul Ongodia, Grace Abongo, Rita Muhindo, Yovani A M Lubaale, Peter Olupot-Olupot","doi":"10.1186/s12936-024-05221-5","DOIUrl":"10.1186/s12936-024-05221-5","url":null,"abstract":"<p><strong>Background: </strong>In sub-Saharan Africa, malaria remains a public health problem despite some reports of declining incidence in the period 2000-2018. Since 2019, there have been some reports of disease epidemics and resurgences in areas that had registered steep declines and unusual clinical presentations. This study aimed to describe the epidemiology, clinical spectrum, and outcomes of severe malaria in children among malaria-endemic Eastern Uganda, a region that has recently experienced disease epidemics.</p><p><strong>Methods: </strong>This prospective study was conducted at Mbale Regional Referral Hospital, Uganda, from 08th May 2019 to August 15, 2023, as part of the Malaria Epidemiological, Pathophysiological and Intervention studies in Highly Endemic Eastern Uganda (EDCTP-TMA2016SF-1514-MEPIE Study). Children aged 60 days to 12 years who at admission tested positive for malaria and fulfilled the clinical World Health Organization criteria for surveillance of severe malaria were enrolled into the study following appropriate informed consent. Data were collected using a customized proforma on social demographic characteristics, clinical presentation, treatment, and outcomes. Laboratory analyses included complete blood counts, lactate, glucose, blood gases, electrolytes, metabolites, and coagulation markers. In addition, urinalysis using dipsticks was done. Data were analysed using STATA V15. The study had ethical and regulatory approval before data collection commenced.</p><p><strong>Results: </strong>A total of 1,379 participants were recruited. The median age was 4 years (2 months-12 years). Most children 757/1379 (54.9%) were under 5 years, and 825/1379 (59.8%) were males. The common symptoms were fever 1368 (99.2%), poor appetite 1095 (79.5%), inability to sit upright 1051 (76.2%), vomiting 944 (68.4%) and yellow eyes 833 (60.4%). The common signs included prostration, haemoglobinuria and jaundice. Prolonged hospitalization was found in 284/1339 (21.2%) and was associated with impaired consciousness 116/166 (30.1%), P = 0.003; haemoglobinuria 514/705 (27.1%), P < 0.001 and jaundice 505/690 (26.8%) P < 0.001. The overall mortality was 40/1347 (3.0%). Children who had > 1 severity feature were at a higher risk of mortality.</p><p><strong>Conclusion: </strong>In this prospective study of children with severe malaria in Eastern Uganda, the overall mortality was 3.0% and the more the disease clinical syndromes the higher the risk of death.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"37"},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370760","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}
Malaria JournalPub Date : 2025-02-06DOI: 10.1186/s12936-024-05183-8
Felista Mwingira, Deokary Matiya, Frank Chacky
{"title":"Knowledge and willingness towards malaria vaccines among caregivers in Dar es Salaam, Tanzania.","authors":"Felista Mwingira, Deokary Matiya, Frank Chacky","doi":"10.1186/s12936-024-05183-8","DOIUrl":"10.1186/s12936-024-05183-8","url":null,"abstract":"<p><strong>Background: </strong>Tanzania is a malaria-endemic country that relies solely on anti-malarial drugs and vector control measures, including insecticide-treated bed nets and indoor residual spraying. However, the growing resistance to these interventions threatens their effectiveness, highlighting the need for additional strategies to accelerate malaria eradication efforts. Currently, malaria vaccines have begun to roll out in endemic areas. However, hesitancy emanating from misinformation on vaccine efficacy and safety has been recorded in various parts of the world. In this context, this study investigated the knowledge and willingness of caregivers towards the malaria vaccine.</p><p><strong>Methods: </strong>This is a health facility-based cross-sectional survey conducted from September 2022 to March 2023. In total, 293 caregivers attending Ante-Natal Clinics (ANC) in selected health facilities in Dar es Salaam were recruited. A semi-structured questionnaire was used to collect caregivers' demographic information, knowledge of malaria, knowledge of malaria vaccines and willingness to receive malaria vaccines.</p><p><strong>Results: </strong>The respondents were predominantly women (97.3%) aged 18 to 52 years. Overall, 87.4% had knowledge of malaria disease, while 14% did not know how malaria is transmitted. Most respondents (86.3%) knew about malaria prevention/control methods. However, only 14.7% of the recruited caregivers were aware of the malaria vaccine. Of those exposed to vaccine messages, 67.4% were aware that the vaccine was for children under 5 years of age, while 53.5% knew that the vaccine was for pregnant women. Despite their low exposure, most respondents (92.8%) were willing to receive the malaria vaccine for their children under five years.</p><p><strong>Conclusion: </strong>Malaria knowledge and willingness to vaccinate against malaria was high among Tanzanian caregivers despite the low awareness of malaria vaccines. This suggests the need for targeted information, education and communication strategies (IECs) for communities to curb misconceptions and complement their high willingness to accept the malaria vaccine in Tanzania.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"35"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256053","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}
Malaria JournalPub Date : 2025-02-04DOI: 10.1186/s12936-025-05264-2
Natalie Lissenden, John Bradley, Benjamin Menze, Charles Wondji, Constant Edi, Benjamin Koudou, Raphael N'Guessan, Koama Bayili, Abdoulaye Diabaté, Njelembo Mbewe, Basiliana Emidi, Jacklin Mosha, Alphaxard Manjurano, Graham Small, Welbeck Oumbouke, Sarah Jane Moore, Derric Nimmo, Janneke Snetselaar
{"title":"Meta-analysis on the entomological effects of differentially treated ITNs in a multi-site experimental hut study in sub-Saharan Africa.","authors":"Natalie Lissenden, John Bradley, Benjamin Menze, Charles Wondji, Constant Edi, Benjamin Koudou, Raphael N'Guessan, Koama Bayili, Abdoulaye Diabaté, Njelembo Mbewe, Basiliana Emidi, Jacklin Mosha, Alphaxard Manjurano, Graham Small, Welbeck Oumbouke, Sarah Jane Moore, Derric Nimmo, Janneke Snetselaar","doi":"10.1186/s12936-025-05264-2","DOIUrl":"10.1186/s12936-025-05264-2","url":null,"abstract":"<p><strong>Background: </strong>Restricting the placement of active ingredients (AIs) to specific panels on insecticide-treated nets (ITNs) has the potential to reduce the amount of AI required to treat a net. If the restricted placement of the AIs can exploit mosquito behaviour, particularly where they interact with the bed net interface, and not impact the net's effectiveness, then the reduction in AI could result in cost reductions.</p><p><strong>Methods: </strong>Nine individual experimental hut trials were conducted to compare the efficacy of three different partially-treated net relative to fully treated nets; roof-only treated nets, side-only treated nets, and nets with treated roof and pyrethroid-only side panels. These trials were conducted on a range of net products with different AIs, across a range of geographies in Africa (East and West), vector species (Anopheles gambiae, Anopheles coluzzii, Anopheles arabiensis, and Anopheles funestus), hut designs (East and West African style) and hosts (cows and humans). The combined data from these trials were analysed in a meta-analysis, and odds ratios for the effect of the different net designs on mortality and blood-feeding were estimated using mixed effects logistic regression.</p><p><strong>Results: </strong>The results of this meta-analysis demonstrated that fully treated nets provide greater mosquito killing and reduction in blood-feeding effects than any configuration of insecticide treatment restricted to specific panels.</p><p><strong>Conclusions: </strong>This meta-analysis showed that partially-treated net that restrict the insecticide treatment to specific panels of an ITN do not give equivalency or superiority in either mortality or blood-feeding inhibition to fully treated nets. The implications of these findings are discussed.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"34"},"PeriodicalIF":2.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189861","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}
Malaria JournalPub Date : 2025-02-01DOI: 10.1186/s12936-025-05273-1
Lauren Nussbaum, Emma Ortega, E Jennifer Ríos López, Alfonso Simoné Vizcarra, Jhonny J Córdova López, Serafina Calarco, Elena Marbán-Castro, Kevin Tetteh, Sonjelle Shilton, Amy C Morrison, Vanessa Fargnoli, Valerie A Paz-Soldán
{"title":"Voices from the Amazon: exploring implementor and user perceptions of non-invasive malaria diagnostics in Peru.","authors":"Lauren Nussbaum, Emma Ortega, E Jennifer Ríos López, Alfonso Simoné Vizcarra, Jhonny J Córdova López, Serafina Calarco, Elena Marbán-Castro, Kevin Tetteh, Sonjelle Shilton, Amy C Morrison, Vanessa Fargnoli, Valerie A Paz-Soldán","doi":"10.1186/s12936-025-05273-1","DOIUrl":"10.1186/s12936-025-05273-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria burden remains high in some Peruvian regions, especially in the Northeast Amazon rainforest state of Loreto and the tropical coastal state of Tumbes. Novel non-invasive diagnostic tools for malaria are being developed, and formative research in malaria-endemic areas with community members and health professionals who would potentially use these devices is vital for this process. This study aimed to examine the acceptability and feasibility of four new non-invasive malaria diagnostic tools in development in two regions of Peru with significant malaria burden.</p><p><strong>Methods: </strong>The research team conducted focus group discussions and key informant interviews in Spanish to assess acceptability and ascertain questions and concerns regarding the non-invasive diagnostic tools. Focus group discussions included a range of community members (pregnant women, parents), professionals (health, education), and community leaders in Loreto. Vector control authorities and health professionals from Loreto, Tumbes, and Lima participated as key informants.</p><p><strong>Results: </strong>Participants were initially enthusiastic about all non-invasive diagnostic tools. However, as discussions proceeded, high enthusiasm remained for two devices that were easy to use, acceptable for the communities they were intended for, feasible to carry in remote areas, and did not require new supplies nor generate waste: the skin scan and the skin odour test. The breath and saliva tests were considered less hygienic. They were less acceptable to community members and health professionals due to concerns of disease transmission and other environmental and cultural concerns. Health professionals felt the finger scan test and the skin odour test would help triage community members in endemic sites and would be valuable in remote regions with difficult access to health facilities or laboratories.</p><p><strong>Conclusions: </strong>Novel non-invasive malaria diagnostic tools can be valuable in malaria-endemic settings. As manufacturers evaluate the efficacy and effectiveness of these non-invasive diagnostic tools, international recommendations should be created to ensure their agile integration into national malaria programmes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"32"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074991","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}
Malaria JournalPub Date : 2025-02-01DOI: 10.1186/s12936-025-05277-x
Enock J Kessy, Ally I Olotu
{"title":"Controlled human malaria infection: overview and potential application in the evaluation of transmission-blocking interventions in malaria-endemic areas.","authors":"Enock J Kessy, Ally I Olotu","doi":"10.1186/s12936-025-05277-x","DOIUrl":"10.1186/s12936-025-05277-x","url":null,"abstract":"<p><p>Controlled human malaria infection (CHMI) involves the intentional infection of healthy individuals with malaria parasites, close observation of the volunteers, and clearance of the parasite at a predetermined endpoint. Depending on the need, CHMI can be initiated by either sporozoites or the administration of parasite-infected erythrocytes, with each of the two systems offering different advantages and caveats. Among other uses, CHMI has proven to be a useful tool for the evaluation of new malaria interventions, particularly vaccines and drugs. The majority of CHMI studies have been conducted in Europe, the USA and Australia, with only a handful of studies conducted in malaria-endemic countries. The slow adoption of CHMI in malaria-endemic countries may be attributed to a lack of infrastructure and expertise to conduct studies in malaria-endemic countries and the risk of undue influence and coercion as a result of volunteers' vulnerability due to a lack of education and financial situation. With the need to generate results relevant to the target populations, there has recently been an increase in CHMI studies that are being conducted in malaria-endemic countries. The use of CHMI models for the evaluation of preerythrocytic and blood-stage malaria interventions has been attempted in malaria-endemic countries with great success. There is a need for the adoption of a CHMI model for the evaluation of transmission-blocking interventions in malaria-endemic countries. The establishment of such a model in malaria-endemic countries will facilitate the selection of potential transmission-blocking intervention (TBI) candidates and accelerate their development. Here is an overview of CHMI, key challenges and ethical considerations in adopting CHMI for the evaluation of malaria transmission-blocking interventions in malaria-endemic countries.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"33"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074989","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}
Malaria JournalPub Date : 2025-01-30DOI: 10.1186/s12936-025-05266-0
Michelle V Evans, Felana A Ihantamalala, Mauricianot Randriamihaja, Vincent Herbreteau, Christophe Révillion, Thibault Catry, Eric Delaitre, Matthew H Bonds, Benjamin Roche, Ezra Mitsinjoniala, Fiainamirindra A Ralaivavikoa, Bénédicte Razafinjato, Oméga Raobela, Andres Garchitorena
{"title":" Increasing the resolution of malaria early warning systems for use by local health actors.","authors":"Michelle V Evans, Felana A Ihantamalala, Mauricianot Randriamihaja, Vincent Herbreteau, Christophe Révillion, Thibault Catry, Eric Delaitre, Matthew H Bonds, Benjamin Roche, Ezra Mitsinjoniala, Fiainamirindra A Ralaivavikoa, Bénédicte Razafinjato, Oméga Raobela, Andres Garchitorena","doi":"10.1186/s12936-025-05266-0","DOIUrl":"10.1186/s12936-025-05266-0","url":null,"abstract":"<p><strong>Background: </strong>The increasing availability of electronic health system data and remotely-sensed environmental variables has led to the emergence of statistical models capable of producing malaria forecasts. Many of these models have been operationalized into malaria early warning systems (MEWSs), which provide predictions of malaria dynamics several months in advance at national and regional levels. However, MEWSs rarely produce predictions at the village-level, the operational scale of community health systems and the first point of contact for the majority of rural populations in malaria-endemic countries.</p><p><strong>Methods: </strong>This study developed a hyper-local MEWS for use within a health-system strengthening intervention in rural Madagascar. It combined bias-corrected, village-level case notification data with remotely sensed environmental variables at spatial scales as fine as a 10 m resolution. A spatio-temporal hierarchical generalized linear regression model was trained on monthly malaria case data from 195 communities from 2017 to 2020 and evaluated via cross-validation. The model was then integrated into an automated workflow with environmental data updated monthly to create a continuously updating MEWS capable of predicting malaria cases up to three months in advance at the village-level. Predictions were transformed into indicators relevant to health system actors by estimating the quantities of medical supplies required at each health clinic and the number of cases remaining untreated at the community level.</p><p><strong>Results: </strong>The statistical model was able to accurately reproduce village-level case data, performing nearly five times as well as a null model during cross-validation. The dynamic environmental variables, particularly those associated with standing water and rice field dynamics, were strongly associated with malaria incidence, allowing the model to accurately predict future incidence rates. The MEWS represented an improvement of over 50% compared to existing stock order quantification methods when applied retrospectively.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of developing an automatic, hyper-local MEWS leveraging remotely-sensed environmental data at fine spatial scales. As health system data become increasingly digitized, this method can be easily applied to other regions and be updated with near real-time health data to further increase performance.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"30"},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066450","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}
Malaria JournalPub Date : 2025-01-30DOI: 10.1186/s12936-025-05251-7
Nora Schmit, Hillary M Topazian, Matteo Pianella, Giovanni D Charles, Peter Winskill, Penelope A Hancock, Ellie Sherrard-Smith, Katharina Hauck, Thomas S Churcher, Azra C Ghani
{"title":"Quantifying the potential value of entomological data collection for programmatic decision-making on malaria control in sub-Saharan African settings.","authors":"Nora Schmit, Hillary M Topazian, Matteo Pianella, Giovanni D Charles, Peter Winskill, Penelope A Hancock, Ellie Sherrard-Smith, Katharina Hauck, Thomas S Churcher, Azra C Ghani","doi":"10.1186/s12936-025-05251-7","DOIUrl":"10.1186/s12936-025-05251-7","url":null,"abstract":"<p><strong>Background: </strong>The availability of many tools for malaria control leads to complex decisions regarding the most cost-effective intervention package based on local epidemiology. Mosquito characteristics influence the impact of vector control, but entomological surveillance is often limited due to a lack of resources in national malaria programmes.</p><p><strong>Methods: </strong>This study quantified the monetary value of information provided by entomological data collection for programmatic decision-making using a mathematical model of Plasmodium falciparum transmission. The 3-year impact and cost of various intervention packages was simulated in different sub-Saharan African settings, including combinations of scaling-up insecticide-treated nets (ITN), switching to next-generation ITNs, and a treatment and prevention package. The DALYs averted and their net monetary benefit were compared at different cost-effectiveness thresholds and the value of resolving uncertainty in entomological model parameters was calculated.</p><p><strong>Results: </strong>Across transmission settings and at cost-effectiveness thresholds over US$170 per DALY averted, the most cost-effective intervention package was switching to and scaling up pyrethroid-pyrrole ITNs combined with the treatment and prevention package. The median expected value of perfect information on the entomological indicators was US$0.05 (range 0.02-0.23) and US$0.17 (range 0.09-1.43) per person at risk at thresholds of US$75 and US$1000 per DALY averted, respectively. This represented less than 2% of the net monetary benefit of implementing the most cost-effective intervention package. Value of information estimates at cost-effectiveness thresholds over US$250 were higher than current investments into entomological monitoring by the US President's Malaria Initiative.</p><p><strong>Conclusions: </strong>These results suggest that entomological data collection should not delay implementation of interventions with demonstrated efficacy in most settings, but that sustained investments into and use of entomological surveillance are nevertheless worthwhile and have broad value to national malaria programmes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"31"},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066452","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}
Malaria JournalPub Date : 2025-01-27DOI: 10.1186/s12936-025-05269-x
Angelina J Kisambale, Dativa Pereus, Salehe S Mandai, Beatus M Lyimo, Catherine Bakari, Gervas A Chacha, Ruth B Mbwambo, Ramadhan Moshi, Daniel A Petro, Daniel P Challe, Misago D Seth, Rashid A Madebe, Rule Budodo, Sijenunu Aaron, Daniel Mbwambo, Abdallah Lusasi, Stella Kajange, Samwel Lazaro, Ntuli Kapologwe, Celine I Mandara, Deus S Ishengoma
{"title":"Genetic diversity of Plasmodium falciparum reticulocyte binding protein homologue-5, which is a potential malaria vaccine candidate: baseline data from areas of varying malaria endemicity in Mainland Tanzania.","authors":"Angelina J Kisambale, Dativa Pereus, Salehe S Mandai, Beatus M Lyimo, Catherine Bakari, Gervas A Chacha, Ruth B Mbwambo, Ramadhan Moshi, Daniel A Petro, Daniel P Challe, Misago D Seth, Rashid A Madebe, Rule Budodo, Sijenunu Aaron, Daniel Mbwambo, Abdallah Lusasi, Stella Kajange, Samwel Lazaro, Ntuli Kapologwe, Celine I Mandara, Deus S Ishengoma","doi":"10.1186/s12936-025-05269-x","DOIUrl":"10.1186/s12936-025-05269-x","url":null,"abstract":"<p><strong>Background: </strong>The limited efficacy of the two recently approved malaria vaccines, RTS,S/AS01 and R21/Matrix- M™, highlights the need for alternative vaccine candidate genes. Plasmodium falciparum Reticulocyte Binding Protein Homologue 5 (Pfrh5) is a promising malaria vaccine candidate, given its limited polymorphism, its essential role in parasite survival, a lack of immune selection pressure and higher efficacy against multiple parasites strains. This study evaluated the genetic diversity of Pfrh5 gene among parasites from regions with varying malaria transmission intensities in Mainland Tanzania, to generate baseline data for this potential malaria vaccine candidate.</p><p><strong>Methods: </strong>This study utilized secondary data of 697 whole-genome sequences which were generated by the MalariaGEN Community Network. The samples which were sequenced to generated the data were collected between 2010 and 2015 from five districts within five regions of Mainland Tanzania, with varying endemicities (Morogoro-urban district in Morogoro region, Muheza in Tanga, Kigoma-Ujiji in Kigoma, Muleba in Kagera, and Nachingwea district in Lindi region). Wright's fixation index (F<sub>ST</sub>), Wright's inbreeding coefficient (Fws), Principal component analysis (PCA), nucleotide diversity (π), haplotype network, haplotype diversity (Hd), Tajima's D, and Linkage disequilibrium (LD) were used to assess the diversity of the gene.</p><p><strong>Results: </strong>Of the sequences used in this study, 84.5% (n = 589/697) passed quality control and 313 (53.1%) were monoclonal (contained infections from a single strain of P. falciparum) and were used for haplotype diversity and haplotype network analysis. High within-host diversity (Fws < 0.95) was reported in Kigoma-Ujiji (60.7%), Morogoro-urban (53.1%), and Nachingwea (50.8%), while Muleba (53.9%) and Muheza (61.6%) had low within-host diversity (Fws ≥ 0.95). PCA did not show any population structure and the mean F<sub>ST</sub> value was 0.015. Low nucleotide diversity values were observed across the study sites (mean π = 0.00056). A total of 27 haplotypes were observed among the 313 monoclonal samples and under-fives exhibited higher haplotype counts. The Pf3D7 was detected as Hap_1, which occurred in 16/313 (5.1%) monoclonal sequences. Negative Tajima's D values were observed among the parasite populations in all the study sites.</p><p><strong>Conclusion: </strong>Low levels of polymorphism in the pfrh5 gene were observed based on low nucleotide and haplotype diversity, a lack of population structure and negative Tajima's D values. This study provides essential data on the diversity of the Pfrh5 gene indicating that it can be considered in the development of the next generation malaria vaccines. Robust and intensive studies of this and other candidate genes are crucial to support the prioritization of the Pfrh5 gene for potential inclusion in a broadly cross-protective malaria vaccine.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"29"},"PeriodicalIF":2.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059714","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}
Malaria JournalPub Date : 2025-01-25DOI: 10.1186/s12936-025-05245-5
Ellen Leah Ferriss, Yakou Dieye, Moustapha Cissé, Gnagna Dieng Sow, Jean Louis Lankia, Damien Diedhiou, Abiboulaye Sall, Tamba Souane, Tidiane Thiam, Doudou Sene, Elhadji Doucouré, Ibrahima Diallo, Adam Bennett, Caterina Guinovart
{"title":"Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis.","authors":"Ellen Leah Ferriss, Yakou Dieye, Moustapha Cissé, Gnagna Dieng Sow, Jean Louis Lankia, Damien Diedhiou, Abiboulaye Sall, Tamba Souane, Tidiane Thiam, Doudou Sene, Elhadji Doucouré, Ibrahima Diallo, Adam Bennett, Caterina Guinovart","doi":"10.1186/s12936-025-05245-5","DOIUrl":"10.1186/s12936-025-05245-5","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization conditionally recommends reactive drug administration to reduce malaria transmission in settings approaching elimination. However, few studies have evaluated the impact of reactive focal drug administration (rFDA) in sub-Saharan Africa, and none have evaluated it under programmatic conditions. In 2016, Senegal's national malaria control programme introduced rFDA, the presumptive treatment of compound members of a person with confirmed malaria, and reactive mass focal drug administration (rMFDA), an expanded effort including neighbouring compounds during an outbreak, in 10 low transmission districts in the north of the country. This evaluation sought to measure the impact of rFDA and rMFDA on malaria incidence.</p><p><strong>Methods: </strong>An interrupted time series analysis was conducted with routine surveillance data on health post-level monthly confirmed malaria case counts from the District Health Information Software (DHIS2). The study evaluated the change in incidence following rFDA and rMFDA rollout (level change), which ranged from August 2016 to November 2019, and monthly thereafter (trend change), using an adjusted negative binomial regression model with data from January 2015 through January 2020. The model was used to estimate the number of cases averted via a counterfactual simulation.</p><p><strong>Results: </strong>No incidence rate reductions were estimated immediately following rollout (level change: incidence rate ratio (IRR) = 1.00, 95% credible interval (CI) = 0.76, 1.33). However, rFDA and rMFDA were associated with a 4% monthly decline in incidence relative to the baseline trend (trend change: IRR = 0.96, 95% CI = 0.95, 0.98). Over the study period, RFDA and rMFDA were estimated to avert 2,070 (95% CI = 577, 4,367) of 4,108 (95% CI = 2,620, 6,425) malaria cases.</p><p><strong>Conclusions: </strong>RFDA and rMFDA were associated with reduced malaria incidence in northern Senegal, supporting their use in malaria control in very low transmission areas. However, additional strategies are likely needed to achieve elimination in this setting.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"27"},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039534","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}