Malaria Journal最新文献

{"title":"Overreliance on Plasmodium 18S rRNA gene for malaria molecular diagnosis-inferences from systematic review.","authors":"Nimita Deora, Musabur Rahim Khan, Priyanka Singh, Neelofer Zehra, Shubhankar Sircar, Veena Pande, Prashant K Mallick, Abhinav Sinha","doi":"10.1186/s12936-025-05424-4","DOIUrl":"10.1186/s12936-025-05424-4","url":null,"abstract":"<p><strong>Background: </strong>Molecular diagnosis of malaria through nucleic acid-based amplification test is important to detect low-density, sub-microscopic and residual infections, as well as to prevent importations and re-establishment. Reliance on single/limited molecular targets could be detrimental as evidenced by false-negative PfHRP2-based RDTs, and the same may apply to PCR targets. No systematic exploration of the commonly used PCR targets has yet been documented.</p><p><strong>Methods: </strong>A systematic search was made using a previously generated database through PubMed® and Google Scholar® and supplemented by additional searches. All studies that used PCR for detecting Plasmodium infections were included in this study. Further information was retrieved on molecular targets used and the type of PCR assay used. An independent search was also made to explore the identification/development of newer molecular targets.</p><p><strong>Results: </strong>Almost all studies (93%) used 18S rRNA gene as a molecular target. Nested PCR alone (68%) was the most frequently used assay. Eighty-five percent of the studies that exploited the 18S rRNA gene target and nested PCR used the approach developed in 1993.</p><p><strong>Conclusion: </strong>Overreliance on a solitary molecular target (18S rRNA gene) for many years might be a cause for concern. Research is needed to validate newer multi-copy targets in terms of limit of detection, robust reproducibility, reduced costs, and a possibility of multiplexing.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"239"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A power analysis framework to aid the design of robust semi-field vector control experiments.","authors":"Andrea M Kipingu, Dickson W Lwetoijera, Kija R Ng'habi, Samson S Kiware, Mafalda Viana, Paul C D Johnson","doi":"10.1186/s12936-025-05454-y","DOIUrl":"10.1186/s12936-025-05454-y","url":null,"abstract":"<p><strong>Background: </strong>Semi-field experiments are an efficient way of assessing the impacts of potential new vector control tools (VCTs) before field trials. However, their design is critically important to ensure their results are unbiased and informative. An essential element of the design of semi-field experiments is power analysis, which empowers researchers to ensure that only designs with adequate statistical power are adopted. In this study, a methodology was developed, and its use was demonstrated in a tutorial, to determine the required number of semi-field chambers, sampling frequency and the number of mosquitoes required to achieve sufficient power for evaluating the impact of a single VCT or two in combination.</p><p><strong>Methods: </strong>By analysing data simulated from a generalized linear mixed-effects model, power was estimated for various experimental designs, including short- (24 h) vs. long-term (3 months) experiments and single vs. combined application of interventions (e.g., insecticide-treated nets combined with pyriproxyfen autodissemination).</p><p><strong>Results: </strong>Although power increased with increasing number of chambers, sampling frequency and the number of mosquitoes, the number of chambers and variance between chambers were the dominant factors determining power relative to all other design choices. High variance between chambers decreased power, highlighting the importance of making conditions similar among chambers, by reducing variation if possible and by rotating variables if not. As compared to a single intervention, an additional intervention required an increase in the number of chambers, while short and long experiments were similar in terms of key aspects such as the number of chambers per treatment.</p><p><strong>Conclusion: </strong>Determining the most efficient experimental design for a semi-field experiment will depend on a balance of design choices and resource constraints. The power analysis framework and tutorial provided here can aid in the robust design of these widely used experiments and ultimately facilitate the development of new vector control tools (VCTs).</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"238"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667928","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":"Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria.","authors":"Kwannan Nantavisai, Srisombat Puttikamonkul, Parnpen Viriyavejakul","doi":"10.1186/s12936-025-05483-7","DOIUrl":"10.1186/s12936-025-05483-7","url":null,"abstract":"<p><strong>Background: </strong>Endocan, a component of endothelial glycocalyx, is a recognized biomarker of endothelial dysfunction in various inflammatory and infectious diseases. Malaria, characterized by marked endothelial activation and microvascular pathology, may involve endocan, but its role remains unclear. This study aimed to assess serum endocan levels in various clinical presentations of malaria and evaluate its correlation with laboratory parameters of disease severity.</p><p><strong>Methods: </strong>Leftover serum samples from 99 participants were categorized into four groups: healthy controls (n = 20), Plasmodium vivax malaria (n = 36), uncomplicated Plasmodium falciparum malaria (n = 30), and severe P. falciparum malaria (n = 13). Serum endocan concentrations were measured via enzyme-linked immunosorbent assay on day 0 (pre-treatment) and day 7 (post-treatment). Correlation analyses examined associations between endocan levels and laboratory parameters, including parasite density, white blood cell count, haemoglobin, and platelet count.</p><p><strong>Results: </strong>All malaria groups showed significantly higher serum endocan levels compared to healthy controls (p < 0.0001). Levels were highest in severe P. falciparum (median 4.67 [IQR 2.85-7.93] ng/ml), followed by uncomplicated P. falciparum (median 3.27 [IQR 2.24-4.33] ng/ml), and P. vivax malaria (median 1.85 [IQR 1.44-3.23] ng/ml). Endocan correlated positively with parasite density in P. vivax (r_s = 0.4632, p = 0.0066) and severe P. falciparum malaria (r_s = 0.6264, p = 0.0251) and negatively with platelet count in P. vivax infections (r_s = - 0.5523, p = 0.001).</p><p><strong>Conclusion: </strong>Serum endocan is elevated in malaria in a severity-dependent manner-highest in severe P. falciparum malaria-and correlates with circulating parasite density and thrombocytopenia, highlighting its potential as a biomarker of endothelial injury in malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"236"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667930","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":"Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision.","authors":"Mathewos Alemu Gebremichael, Tadesse Gebremedhin, Wondwossen Niguse, Girma Mamo, Bezuayehu Alemayehu, Ephrem Negeri, Ibrahim Temam, Haile Zewude, Tamerat Bogale, Endale Sahile, Erkyihun Pawlos","doi":"10.1186/s12936-025-05396-5","DOIUrl":"10.1186/s12936-025-05396-5","url":null,"abstract":"<p><strong>Background: </strong>Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS).</p><p><strong>Methods: </strong>A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings.</p><p><strong>Results: </strong>1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93-38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers.</p><p><strong>Conclusions: </strong>The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"237"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667929","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":"Malaria epidemics and its drivers in Uganda in 2022.","authors":"Maru W Aregawi, Catherine Maiteki, John C Rek, Bosco Agaba, Charles Katureebe, Mansour Ranjbar, Chunzhe Zhang, Samson Kiware, Jimmy Opigo","doi":"10.1186/s12936-025-05351-4","DOIUrl":"10.1186/s12936-025-05351-4","url":null,"abstract":"<p><strong>Background: </strong>In Uganda, malaria is a year-round health threat, with transmission intensity varying across regions. Despite ongoing intensified interventions, an unprecedented malaria resurgence in early 2022 affected several districts, prompting a swift response from the National Malaria Control Division (NMCD). This study aims to assess the scale and underlying causes of the epidemics, quantify the excess cases and deaths, and propose targeted prevention and response strategies.</p><p><strong>Methods: </strong>District Health Information System (DHIS2) data from 2017 to 2022 were analysed. A 75th percentile threshold from 2017 to 2021 was used to define true malaria epidemics and compare them to the suspected 2022 epidemic. Excess cases, admissions, and deaths were quantified using area under the curve (AUC) calculations. The level of epidemics was compared across districts with Indoor Residual Spraying (IRS) and Integrated Community Case Management (iCCM) interventions. Precipitation data from multiple sources were used to evaluate rainfall patterns and their impact on malaria epidemics.</p><p><strong>Results: </strong>Malaria cases were lowest in 2018 but rose by 31% in 2022 compared to the 2017-2021 3rd quartile. Sixty-four of 146 districts experienced epidemics, with 4 facing persistent epidemics year-round. The 2022 epidemic accounted for 3,379,309 (95% CI 1,553,714, 5,339,709) total excess outpatient malaria cases (confirmed and presumed), 3,018,920 (95% CI 1,321,951, 4,661,201) excess confirmed cases, 149,789 (95% CI 66,029, 235,743) excess inpatient cases. Paradoxically, more epidemics occurred in IRS and iCCM districts. Precipitation patterns were consistent across years and were insignificantly correlated with the 2022 epidemic. Provinces with bimodal rainfall patterns were more prone to epidemics, while unimodal regions had fewer epidemics but higher incidence rates. Rainfall lagged by two months (Lag 2) significantly increased malaria incidence (p < 0.01), with each millimetre of rainfall two months prior associated with 13.4 additional malaria cases.</p><p><strong>Conclusion: </strong>The 2022 malaria epidemic affected 64 districts, with over 3.3 million excess cases and nearly 150,000 excess admissions. Gaps in IRS, iCCM, and intervention coverage, along with minimal rainfall correlation and high vulnerability in bimodal regions, highlight the need for better surveillance, sustainable funding, and tailored responses. While climate was not the main driver, programmatic deficiencies, vector composition shift, reduced efficacy of insecticides, coverage and effectiveness of the interventions likely fueled the epidemic. Strengthening epidemic preparedness, response, and investment will be crucial to preventing future outbreaks and achieving long-term malaria control in Uganda.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"235"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659600","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":"Barriers to effective usage of insecticide-treated mosquito nets (ITNS) among women of reproductive age in Tanzania: a national cross-sectional survey.","authors":"Kelly Taremwa, Ebuka Louis Anyamene, Gideon Ikemdinachi Nwankwo, Miracle Kenile Agbontale, Isaac Isiko","doi":"10.1186/s12936-025-05417-3","DOIUrl":"10.1186/s12936-025-05417-3","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health challenge in Tanzania, with women of reproductive age particularly vulnerable to its effects. Insecticide-treated mosquito nets (ITNs) are a proven vector control strategy; however, their usage remains suboptimal due to various barriers. This study examines the sociodemographic, behavioural, and environmental factors associated with ITN use among women of reproductive age in Tanzania.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from the 2022 Tanzania Demographic and Health Survey (TDHS). A total of 15,254 women aged 15-49 years were included in the study. Survey-weighted logistic regression was employed to determine adjusted odds ratios (AOR) and 95% confidence intervals (CI) for factors associated with ITN usage. All data cleaning and analyses were done using STATA 17 software.</p><p><strong>Results: </strong>Several factors were significantly associated with ITN use. Women with primary education had 2.2 times higher odds of ITN use compared to those with no education (AOR: 2.2, 95% CI: 1.23-4.06). Women residing in the Southern zone had nearly three times higher odds of using ITNs (AOR: 2.8, 95% CI: 1.57-5.09), while those in the Lake zone had 1.6 times higher odds (AOR: 1.6, 95% CI: 1.12-2.33) compared to the Western zone. Women in polygamous marriages had lower odds of ITN use (AOR: 0.76, 95% CI: 0.61-0.95) compared to those in monogamous relationships. Perceived ITN effectiveness was a strong predictor, with those in the high-effectiveness category having 2.7 times higher odds of ITN use (AOR: 2.7, 95% CI: 0.94-5.46).</p><p><strong>Conclusion: </strong>ITN usage among women of reproductive age in Tanzania is influenced by education level, geographic location, marital status, and perceived ITN effectiveness. These findings highlight the need for targeted interventions, such as educational campaigns, equitable ITN distribution, and context-appropriate malaria prevention strategies, to improve ITN coverage and reduce the malaria burden.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"234"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659599","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":"Comparative immunological study of Plasmodium knowlesi infections in humans and macaques: insights into cytokine dynamics.","authors":"Mohammad Faruq Abd Rachman Isnadi, Yean Kong Yong, Matthew J Grigg, Symphorosa Sipangkui, Ping-Chin Lee, Nor Afizah Nuin, Angelica Fiona Tan, Paul Molius, Augustine Tuuga, Jum Rafiah Abd Sukor, Giri Rajahram, Sylvia Daim, Tock H Chua","doi":"10.1186/s12936-025-05478-4","DOIUrl":"10.1186/s12936-025-05478-4","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium knowlesi, a simian malaria parasite endemic to Southeast Asia, is transmitted from macaques to humans via mosquitoes and has seen a surge due to human encroachment into macaque habitats. While the primary host, Macaca fascicularis, can regulate P. knowlesi and alleviate disease symptoms, infected humans face a different scenario. A study was conducted in Sabah, Malaysia to compare the effects of parasite genomic DNA (gDNA) and host (both human and macaques) mitochondrial DNA (mtDNA) release on cytokine profiles in humans and macaques infected with P. knowlesi.</p><p><strong>Methods: </strong>Blood samples from 30 Plasmodium knowlesi-infected individuals and 30 healthy controls, along with serum samples from 35 wild macaques, were analysed using PCR and immunological assays. Nested PCR and real-time PCR were performed on macaque blood samples to confirm mono-infection with P. knowlesi. Parasite genomic DNA (gDNA) levels were quantified via qPCR. Additionally, the concentrations of six cytokines-TNF, IFNγ, IL-1β, IL-4, IL-6, and IL-10-were measured in the samples.</p><p><strong>Results: </strong>Parasitaemia levels, determined through microscopy method, exhibited strong correlations with parasite gDNA. Notably, the infected macaques displayed significantly higher parasite gDNA and mtDNA levels compared to humans. Cytokine analysis unveiled IL-10 dominance in humans, positively associated with parasite gDNA, while macaques showed IL-6 dominance unrelated to parasite gDNA. Despite lower parasite gDNA levels, patients exhibited a higher IL-10/TNF ratio, indicative of disease severity.</p><p><strong>Conclusions: </strong>These results suggestively highlight variations in immune responses between two distinct hosts in two different phases of infection: human (acute infection) and macaque (presumed chronic infection) hosts. The correlations and interplay between parasite gDNA, host's mtDNA (both human and macaques) and cytokine levels observed in this study further emphasizing the need for further research to comprehensively understand P. knowlesi pathogenesis.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"233"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649865","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":"Investing in traditional medicine: leveraging evidence and innovative research to strengthen the fight against malaria in Nigeria.","authors":"Francisca Ogochukwu Onukansi, Collins Chibueze Anokwuru, Stanley Chinedu Eneh, Goodness Ogeyi Odey, Dough Owojoku Onah, Taiwo Sokunbi, David Chinaecherem Innocent, Ugonma Winnie Dozie, Prince Christian Umoke, Temitope Olumuyiwa Ojo, Cosmas Nnadozie Ezejindu","doi":"10.1186/s12936-025-05359-w","DOIUrl":"10.1186/s12936-025-05359-w","url":null,"abstract":"<p><p>Traditional medicine (TM) has been a cornerstone of healthcare across various cultures, especially in Africa, where it has played an integral role in the management of diseases such as malaria. Despite the popularity and historical significance of TM, scientific validation remains a key challenge, hindering its widespread acceptance in modern healthcare systems. This study explores the potential of traditional African medicine, particularly in the context of Nigeria, as a vital resource in the fight against malaria. Drawing on the success of plants like Artemisia annua in the development of modern anti-malarial drugs, the research emphasizes the need for comprehensive investment in TM research. With Nigeria facing the highest malaria burden globally, the research advocates for increased funding, scientific investigations into the efficacy of traditional remedies, and enhanced regulation of herbal medicine. The paper also highlights the growing trust and reliance on herbal remedies in rural areas of Nigeria and the importance of ensuring their safety through pharmacological testing. This study examines these issues through an analysis of existing literature, historical applications, and documented successes of herbal treatments. By integrating traditional medicine into national health systems, Nigeria could unlock new strategies for combating malaria and other infectious diseases, advancing toward sustainable health outcomes.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"232"},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642918","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":"Efficacy of artemether-lumefantrine, artesunate-amodiaquine, dihydroartemisinin-piperaquine and artesunate-pyronaridine for the treatment of uncomplicated Plasmodium falciparum malaria in Mozambique, 2022.","authors":"Abel Nhama, Arlindo Chidimatembue, Lídia Nhamussua, Quique Bassat, Clemente da Silva, Arsénio Nhacolo, Paulo Arnaldo, Crizolgo Salvador, Annette Cassy, Baltazar Candrinho, Mércia Dimene, Eva Carvalho, Abuchahama Saifodine, Flavio Wate, Hélio Mucavele, Yaritbel Torres-Mendoza, Breanna Horton, Mateusz Plucinski, Pau Cistero, Alfredo Mayor, Pedro Aide","doi":"10.1186/s12936-025-05473-9","DOIUrl":"10.1186/s12936-025-05473-9","url":null,"abstract":"<p><strong>Background: </strong>Artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ) are the first-line treatments against malaria in Mozambique. Dihydroartemisinin-piperaquine (DP) has been used in-country for mass drug administration campaigns, and artesunate-pyronaridine (AS-PY) is considered an alternative drug to delay AL resistance in the country. To assess whether AL and AS-AQ remain efficacious and to confirm that DP and AS-PY are potential alternatives for uncomplicated malaria treatment, an in vivo therapeutic efficacy study was conducted in Mozambique at five sentinel sites.</p><p><strong>Methods: </strong>This study was conducted in the districts of Montepuez (AL), Dondo (AL and AS-AQ), Mopeia (AL and AS-PY), Moatize (AL and AS-AQ), and Massinga (AL and DP) following the 2009 World Health Organization (WHO)-recommended protocol. Patients aged 6 months to 11 years with uncomplicated Plasmodium falciparum malaria (1000-200,000 parasites/µl) were enrolled, followed, and assessed for 28 days (AL and AS-AQ) or 42 days (DP and AS-PY). Genotyping for msp1/msp2/poly-α markers and match counting via the WHO/Medicines for Malaria Venture (MMV) 3/3 algorithm were used to differentiate recrudescences from new infections. The primary outcome was polymerase chain reaction corrected efficacy for each drug.</p><p><strong>Results: </strong>In total, 828 participants were enrolled in the four study arms: AL (462), AS-AQ (183), DP (91), and AS-PY (92). Among the recruited participants, 10.2% (85/828) were lost to follow-up or withdrew, and 60 had recurrent malaria infections, 55 of which were considered new infections and five recrudescences. Day 28 corrected AL efficacy was 100% (95% CI 94.3-100) in Massinga, 100% in Dondo, 100% (95% CI 95.5-100) in Moatize, 97.63% (95% CI 94.4-100) in Mopeia, and 98.68% (95% CI 96.2-100) in Montepuez. Day 28 corrected AS-AQ efficacy was 100% in Dondo and 100% (95% CI 95.4-100) in Moatize. For DP, the corrected efficacy on day 42 was 100% (95% CI 94.1-100) in Massinga, and that on day 42 was 97.75% (95% CI 94.7-100) in Mopeia. All drugs were well tolerated, with adverse events reported in less than 2% of the participants.</p><p><strong>Conclusion: </strong>AL and AS-AQ remain effective, as their efficacy remained above the 90% WHO-recommended cut-off. DP and AS-PY also showed therapeutic efficacy above the WHO-acceptable cut-off and could be used as first-line treatments when needed. All four artemisinin-based combinations were well tolerated, with minimal safety concerns.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov: NCT05343312.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"231"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637401","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":"Physical and insecticidal durability of PermaNet^® 3.0 and Olyset^® plus piperonyl butoxide-synergist insecticide-treated nets in Sierra Leone: results of durability monitoring from 2020 to 2023.","authors":"Raymond Kiprop Sudoi, Keith Esch, Frederick Yamba, Laurent Iyikirenga, Charlene Youssef, Prince Nallo, Isabel Swamidoss, Carla Mapp, Dennis Marke, Samuel Juana Smith, Ronald Carshon-Marsh, Musa Sillah-Kanu, Dave Schnabel, Jacky Raharinjatovo, Jenny Carlson, Rebecca Levine, Evelyne Alyko, Ramlat Jose, Tony Hughes, Djenam Jacob, Yemane Yihdego, Kevin Opondo, Stephen Poyer","doi":"10.1186/s12936-025-05421-7","DOIUrl":"10.1186/s12936-025-05421-7","url":null,"abstract":"<p><strong>Background: </strong>The performance of two piperonyl butoxide (PBO-synergist) insecticide-treated net (ITN) brands, PermaNet^® 3.0 and Olyset^® Plus, were evaluated under field conditions in two neighboring districts in Sierra Leone over 36 months to estimate median ITN survival, understand insecticidal efficacy, and identify factors influencing ITN durability. This assessment can help guide future PBO-synergist ITN procurement and replacement strategies.</p><p><strong>Methods: </strong>This prospective study tracked 370 households and 652 campaign-distributed ITNs from 2020, followed annually for 36 months. Districts were purposefully selected based on shared characteristics. Household surveys were conducted, and 30 ITNs per round were tested for bioefficacy and chemical residue. Key indicators included ITN survival, 24-h mosquito mortality, and chemical content reduction compared to manufacturer targets doses. Cox proportional hazard models identified factors influencing ITN survival.</p><p><strong>Results: </strong>Median useful life was 3.0 (95% CI 2.7-3.5) years for PermaNet^® 3.0 ITNs in Bo and 2.2 (95% CI 2.0-2.4) years for Olyset^® Plus ITNs in Moyamba. PermaNet^® 3.0 ITNs displayed 13% 24-h mortality against pyrethroid-resistant mosquitoes on roof panels, with a 46% reduction in PBO content 34 months post-distribution. Olyset^® Plus ITNs had 3% f24-hour mortality against pyrethroid-resistant mosquitoes, with a 77% reduction in PBO content. Several factors were associated with improved ITN survival, including cohort ITNs from Bo (adjusted hazard ratio [aHR] = 0.33, p < 0.001), households without children under five (CU5) (aHR = 0.64, p = 0.003), highest socio-economic status tertile (aHR = 0.63, p = 0.016), exposure to social and behaviour change (SBC) messages combined with positive net attitudes (aHR = 0.63, p = 0.008), lack of food storage in sleeping spaces (aHR = 0.56, p = 0.006), exclusive adult use of ITNs (aHR = 0.72, p = 0.048), net folding when not in use (aHR = 0.67, p = 0.015), and drying nets outside (aHR = 0.44, p = 0.008).</p><p><strong>Conclusion: </strong>ITNs in Bo outperformed those in Moyamba in both physical and insecticidal performance. However, ITN survival is highly context specific, and further investigation into field performance of new ITN types is necessary across diverse epidemiological settings.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":"24 1","pages":"230"},"PeriodicalIF":2.4,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626684","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}