Malaria Journal最新文献

{"title":"Acute acalculous cholecystitis and blackwater fever with acute kidney injury in children with malaria: case series and literature review.","authors":"Marco Cugliari, Francesca Piacentini, Sara M M A Montorfani, Obalim Fiddy, Sara Testa","doi":"10.1186/s12936-026-06013-9","DOIUrl":"10.1186/s12936-026-06013-9","url":null,"abstract":"<p><strong>Background: </strong>Acute acalculous cholecystitis (AAC) is an inflammatory gallbladder disease occurring in the absence of gallstones. It typically presents with right upper quadrant (RUQ) pain, fever and gastrointestinal symptoms, and is diagnosed by ultrasound evidence of cholecystitis without gallstones. AAC can have multiple causes, including infections, with malaria only rarely reported.</p><p><strong>Case presentations: </strong>We describe four Ugandan children who developed malaria-associated AAC. They were all referred from other centers and presented at a more advanced stage of disease. Apart from AAC, they also presented blackwater fever (BWF) and severe acute kidney injury (AKI), complications increasingly recognized in malaria. AAC was managed conservatively, while two patients required dialysis for kidney failure. All patients ultimately recovered both gallbladder and renal function.</p><p><strong>Conclusions: </strong>We provide a review of the literature on malaria-associated AAC, which identified 28 previously reported cases, only 7 in children. Most reported patients contracted the infection in malaria-endemic regions but were then managed in high-income countries. The majority were managed conservatively and had favorable outcomes. Including our series, 32 cases (11 pediatric) have now been reported. Our findings suggest that AAC, which can often occur in association with BWF and AKI, is likely underrecognized in malaria-endemic regions. Heightened clinical awareness and early assessment are important, and practical management recommendations are provided.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point of care performance of the improved BIOCREDIT Ag Pf/Pv (pLDH/pLDH) rapid diagnostic test: a cross-sectional study at a health center setting in Ethiopia.","authors":"Eshetu Molla, Eyob Fekadu, Zemed Biyazen, Fikregabrail Aberra Kassa, Melat Gebremedhin Teklewold, Tedros Nigussie, Mihret Ebabu, Mequanint Mande, Muluye Shimeles, Daniel Legese Achalu, Solomon Feleke, Mamud Umer, Derese Bekele Daba, Anneleye Fantahun, Miraf Mesfin, Adamu Bayissa, Sampa Pal, Dagmawi Hailu Yemane, Emily Gerth-Guyette, Stephan Duparc, Gonzalo J Domingo, Endalamaw Gadisa","doi":"10.1186/s12936-026-05994-x","DOIUrl":"10.1186/s12936-026-05994-x","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, co-endemic Plasmodium falciparum and P. vivax require species-specific point-of-care diagnosis and treatment. Following pfhrp2/3 deletions, Ethiopia adopted non-HRP2/3 rapid diagnostic tests (RDTs). This study evaluated the point-of-care diagnostic performance of the improved BIOCREDIT Ag Pf/Pv (pLDH/pLDH) RDT compared to microscopy (comparator), using the 18S rRNA-based qPCR as the reference standard.</p><p><strong>Methods: </strong>This prospective cross-sectional study was nested within an operational feasibility study of radical cure for P. vivax with tafenoquine or primaquine after semi-quantitative G6PD testing in Ethiopia. Conducted from December 2024 to September 2025, it took place at Village 8/9 and Beto Health Centers in Gambella and South Ethiopia regions, respectively. Self-reporting clinical malaria cases (n = 1200) were enrolled, with 846 from Village 8/9 and 354 from Beto. Approximately 150 µL of capillary blood was collected from each participant for point-of-care RDTs (5 µL), thick and thin smear microscopy (7 µL), and dried blood spots (140 µL) for 18S rRNA qPCR. Diagnostic performance was evaluated through sensitivity, specificity, kappa agreement (κ), and case detection comparisons across RDT, qPCR, and microscopy. Associations between parasite density and detectability, as well as the geographic distribution of species, age, and sex, were assessed.</p><p><strong>Results: </strong>Using 18S qPCR, malaria prevalence rate was 40.6% (487/1,200): 63.0% P. falciparum, 29.6% P. vivax, and 7.4% mixed infections. P. falciparum predominated in Gambella (68.5%, 217/317) vis-à-vis South Ethiopia (52.9%, 90/170), whereas P. vivax was more common in South Ethiopia (37.6%, 64/170) vis-à-vis Gambella (25.2%, 80/317). The RDT showed higher sensitivity for qPCR-confirmed Plasmodium infections (89.7%) than routine microscopy (59.8%), with comparable specificities (97.2% versus 96.5%). Species-specific sensitivities were 87.9% for P. falciparum, 86.7% for P. vivax, and 50.0% for mixed infections. Agreement with qPCR was strong for RDT (κ = 0.92) and moderate for microscopy (κ = 0.79). Overall diagnostic accuracy was excellent (AUC ≥ 0.92 for both species). RDT sensitivity declined at low parasite densities but reached 100% at ≥ 5,000 copies/µL for both species.</p><p><strong>Conclusions: </strong>The RDT demonstrated strong accuracy for point-of-care, species-specific malaria diagnosis in Ethiopian primary healthcare. Its high sensitivity, particularly for moderate- to high-density infections, supports routine clinical use following Ethiopia's shift to non-HRP2 RDTs.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community perspectives on mass malaria vaccine and drug administration in the Chittagong Hill Tracts, Bangladesh: a qualitative study.","authors":"Md Fojle Rabby, Rupam Tripura, Ibrahim Khalil, Dewan Imtiaj Ahmed, Thomas J Peto, Phaik Yeong Cheah, Md Amir Hossain, A K M Fazlur Rahman, Rasheda Samad, Rumana Rashid, Abdullah Abu Sayeed, Nicholas J White, Nicholas P J Day, Arjen M Dondorp, Lorenz von Seidlein, Bipin Adhikari, Md Abul Faiz","doi":"10.1186/s12936-026-05999-6","DOIUrl":"10.1186/s12936-026-05999-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Malaria remains a major public health burden in Bangladesh, particularly in the Chittagong Hill Tracts (CHT), where indigenous and marginalized populations face persistent transmission risks. The Mass Vaccine and Drug Administration (MVDA) trial is currently being implemented to accelerate malaria elimination. MVDA is socially complex because it involves administering preventive interventions to largely asymptomatic populations in contexts where trust, prior experiences, and sociopolitical factors strongly shape acceptance. Little is known about community perspectives toward such interventions. This study explored local understandings of malaria, health-seeking behaviours, and perceptions of mass vaccine and drug administration in the CHT to inform community engagement and implementation of MVDA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative study collected data using focus group discussions (FGDs), in-depth interviews (IDIs), and key informant interviews (KIIs) in Lama and Alikadam sub-districts of Bandarban among community members with no prior exposure to formal research activities. Participants were purposively selected using a maximum variation sampling approach to capture diverse perspectives across socio-demographic and stakeholder groups. Participants included community members, village leaders, traditional healers, local pharmacists, village health workers, religious leaders, and local government representatives. A total of 105 participants from heterogeneous backgrounds participated in this study between September and October 2024. Data were transcribed, translated, and underwent primarily inductive thematic analysis led by a trained qualitative researcher, a Bengali non-native to the study site. Interpretation was conducted reflexively, considering the researcher's positionality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Malaria was recognized as a recurrent illness, particularly during the rainy season and among traditional farmers. While awareness of malaria symptoms and prevention had increased through non-governmental and government initiatives, health-seeking behaviour remained pluralistic. Communities relied on traditional healers and informal drug sellers before seeking formal care. Village health workers provided malaria diagnosis and treatment but faced challenges of inconsistent services (e.g., irregular supply of health materials). The recent COVID-19 experience seemed to shape vaccine perceptions, with mandates, and adverse event narratives contributing to mistrust. Knowledge of a malaria vaccine was limited, yet participants expressed conditional acceptance, indicating willingness to participate if interventions were perceived as safe, effective, and transparently communicated. MDAs were viewed more positively than mass vaccine administration(s) although adherence, particularly among children and adults was considered a challenge. Trust in institutions and historical political mistrust emerged as ke","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding community and health system acceptability, readiness and perspectives on the introduction of new vector control approaches for malaria control in Papua New Guinea.","authors":"Zebedee Kerry, Rachael Farquhar, Kilon Manuv, Alma Auwun, Petrina Johnson, Paul Daly, Michael Macdonald, Stephen Bell, Maria Ome-Kaius, Stephan Karl, Moses Laman, Leanne J Robinson","doi":"10.1186/s12936-026-05990-1","DOIUrl":"10.1186/s12936-026-05990-1","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major public health challenge in Papua New Guinea (PNG) and accounted for most malaria cases and deaths in the Western Pacific Region in 2023. Despite current national efforts centred on insecticide treated nets (ITNs), there is a pressing need to explore supplementary vector control tools, given the resurgence of malaria in PNG since 2015, partly driven by declining insecticidal efficacy of ITNs. The Newly Adapted Tools and Network Against Mosquito Borne Disease Transmission (NATNAT) project is assessing the feasibility and acceptability of complementary vector control approaches in PNG communities and the health system. These tools include residual spraying, spatial emanators, and larval source management.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative study to examine community acceptability, readiness and perceptions of current vector control tools such as ITNs and the potential reintroduction of supplementary vector control approaches, like residual spraying. Using in-depth interviews and focus group discussions, data were collected from four villages along the north coast of Madang Province: Megiar, Bulal, Mirap, and Wasab. Transcripts were analyzed thematically using inductive techniques, with collaborative review to refine key themes by study team.</p><p><strong>Results: </strong>The current malaria control practices and contextual factors shaped community perceptions and the prospective acceptability of residual spraying. Community members demonstrated a strong understanding of malaria risk, including seasonal transmission patterns and breeding sites, and reported both traditional and program-implemented vector control approaches used in their village. Engagement for vector control activities was motivated by strong leadership, personal values, and a comprehensive understanding of malaria risk factors. Community support for supplementary vector control measures, alongside a strong desire to address existing gaps in mosquito protection, were key drivers of acceptability. Addressing insecticide safety concerns informed in part by historical DDT spraying campaigns experiences through tailored, context-specific communication strategies will be critical for the successful adoption of residual spraying. Affordability and uptake of new vector control tools into existing programs are essential for sustainable uptake into policy and practice.</p><p><strong>Conclusions: </strong>Findings demonstrate the prospective acceptability of new vector control tools in PNG and underscores the importance of sustained, in-depth community engagement. To ensure effective implementation, policy development must consider community norms and practices, societal attitudes, and resource availability.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic diversity and evolutionary perspectives of Pfcrt in Plasmodium falciparum: insights from Indian and global isolates.","authors":"Geetika Narang, Joseph Hawadak, Jahnvi Jakhan, Vineeta Singh","doi":"10.1186/s12936-026-05974-1","DOIUrl":"10.1186/s12936-026-05974-1","url":null,"abstract":"<p><strong>Background: </strong>Chloroquine resistance in Plasmodium falciparum (Pf) driven by mutations in the Pf chloroquine resistance transporter (Pfcrt) gene continues to pose a challenge to malaria control in endemic regions like India. Understanding the genetic diversity and evolutionary patterns of Pfcrt is important for guiding malaria surveillance and future national drug policy.</p><p><strong>Methods: </strong>This study analysed 979 Indian (exon 2) and 719 global full-length Pfcrt sequences using molecular tools to assess genetic diversity, selection pressure and population structure. Comparative and temporal analyses were conducted across Indian states and global regions to explore evolutionary trends.</p><p><strong>Results: </strong>Indian sequence analysis revealed regional and temporal variations in haplotype diversity with both widespread and region-specific variants. Haplotype networks identified three major haplotypes namely CVIET, SVMNT and CVMNK, with CVIET predominating, particularly in the North-East, while SVMNT and CVMNK showed variable prevalence across regions and time periods. The greatest diversity was recorded between 2010-2019 despite reduced malaria incidence, suggesting ongoing selection pressure. Mizoram exhibited the highest Tajima's D value (D = 3.310, p < 0.01) and Pfcrt sequences from North-East region showed a unique genetic structure reflecting a likely role of selection pressures from the Greater Mekong Subregion. Globally, 65 haplotypes were detected with highest diversity in Cambodia with strong genetic differentiation observed across countries. Distinct genetic clusters and limited haplotype sharing across countries suggest that region-specific evolutionary pressures have shaped Pfcrt diversity. Positive selection at 6 codons and linkage disequilibrium between key SNPs indicate functional adaptation under drug pressure.</p><p><strong>Conclusion: </strong>This study highlights the variation in Pfcrt shaped by national drug policies and regional malaria transmission patterns. Continued molecular surveillance is essential to monitor emerging resistant lineages and guide effective malaria treatment strategies. This study highlights the variation in Pfcrt shaped by national drug policies and regional malaria transmission patterns.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Malaria Vaccine Implementation Programme reduced clinical malaria in Kenya, 2020 to 2022 : Impact evaluation with predictive time-series models of routine surveillance data.","authors":"John A Painter, Erika Wallender, Andrew N Hill, Mary Hamel, Rafiq Okine, Eliane Furrer, Rose Jalang'o, Kibor K Keitany, Simon Kariuki, Isabella Nyang'au, Brian Seda, Aaron M Samuels, Nelli Westercamp","doi":"10.1186/s12936-026-05973-2","DOIUrl":"10.1186/s12936-026-05973-2","url":null,"abstract":"<p><strong>Background: </strong>Quantifying the impact of malaria vaccines on outpatient malaria burden in children is of interest to many countries introducing either of the World Health Organization (WHO)-recommended vaccines (RTS,S/AS01 [RTS,S] or R21/Matrix-M [R21]). The cluster randomized implementation of RTS,S by the Kenya Ministry of Health during the Malaria Vaccine Implementation Programme (MVIP) provided a unique opportunity to measure the impact of RTS,S on uncomplicated malaria cases reported through routine malaria case surveillance data in western Kenya.</p><p><strong>Methods: </strong>From 23 implementing and 23 comparison subcounties in western Kenya, monthly numbers of confirmed uncomplicated malaria cases among individuals under 5 years of age (< 5y) and 5 years of age and older (≥ 5y) were extracted from the Kenya Health Management Information System, stored in a DHIS2 instance. Facilities that reported data ≥ 11 months per year from January 2015 through December 2022 (132 implementing, 139 comparison) were included in the analysis. Prevaccination data (January 2015-December 2019) were used to predict counterfactual case counts during the evaluation period (January 2020-December 2022), beginning when the first children vaccinated under MVIP became age-eligible for the third dose. Models of < 5y malaria cases included a covariate for ≥ 5y malaria cases to control for non-RTS,S malaria control measures. The impact was estimated as the difference between predicted and observed cases across implementing and comparison areas.</p><p><strong>Results: </strong>The proportion of vaccine eligible children (RTS,S doses at 6, 7, 9, and 24 months) among all children < 5y was small at the start of MVIP but was estimated to reach 60% by December 2022. During the 3-year evaluation period following dose-3 age-eligibility, < 5y malaria cases were 2.3% lower than predicted in non-implementing facilities and 13.8% lower in implementing facilities, a reduction of 11.6%. The reduction was 5.6% during the first year of follow-up, increasing to 8.2% after two years.</p><p><strong>Conclusion: </strong>This analysis revealed that routine health data, although age-aggregated to both vaccine eligible and noneligible children < 5 years, demonstrated a reduction in malaria cases throughout the evaluation period. A further reduction in cases was observed as more vaccine-eligible children comprised the under 5 population. High quality routine data can be used to monitor vaccine impact on clinical malaria.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We are not sick, so why take medicine?\" Community perspectives on barriers, facilitators, and implementation strategies for IPTsc in Ghana.","authors":"Joseph Sam, Emmanuel Asampong, Harriet Affran Bonful, Dora Dadzie, Mahnaz Vahedi","doi":"10.1186/s12936-026-05997-8","DOIUrl":"10.1186/s12936-026-05997-8","url":null,"abstract":"<p><strong>Background: </strong>Intermittent preventive treatment for school-aged children (IPTsc) is a newly recommended malaria chemoprevention strategy targeting populations that increasingly sustain malaria transmission in sub-Saharan Africa. Ghana recently added IPTsc into its national malaria strategy, yet evidence on community acceptability and implementation strategies in non-trial settings remains limited. This study explored perceived barriers, facilitators, and preferred implementation strategies for IPTsc in a high-transmission district in Ghana.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted in four junior high schools in the Hohoe Municipality. Data were collected through five focus group discussions (FGDs), comprising four FGDs with school-aged children and one FGD with caregivers. Additionally, three key informant interviews (KIIs) were conducted with two headteachers and the municipal School Health Education Programme coordinator. Transcripts were analysed using Attride-Stirling's thematic network analysis framework.</p><p><strong>Results: </strong>Perceived barriers included concerns about drug origin, fear of side effects, administering medicines to asymptomatic children, tablet size and taste, and doubts about programme continuity. Facilitators centred on perceived benefits such as reduced malaria episodes, improved school attendance, lower household treatment costs, and community willingness to support IPTsc if adequate sensitisation was provided. Preferred implementation strategies included school-based delivery complemented by community outreach, administration by trained health professionals, clear communication on drug timing and food intake, and early parental involvement.</p><p><strong>Conclusion: </strong>In this setting, perceived acceptability of IPTsc was shaped less by doubts about effectiveness and more by concerns about trust, safety, delivery, and programme continuity. These findings suggest that context-sensitive IPTsc implementation in similar high-transmission settings should prioritise community engagement, involvement of health professionals, and adaptive delivery models that link schools with community health platforms.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258763","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":"Implementing seasonal malaria chemoprevention in conflict-affected settings: experiences from Northern Bahr el Ghazal, South Sudan.","authors":"Abubaker Rom Deng Ayuiel, Francis Okot, Jamshed Khan, Denis Mubiru, Atemthi D Dau, Amanya Jacob, Ezbon W Apary, Simon Peter Katongole, Aweno Norman","doi":"10.1186/s12936-026-05984-z","DOIUrl":"10.1186/s12936-026-05984-z","url":null,"abstract":"<p><strong>Introduction: </strong>South Sudan, a country with a high malaria burden, faces considerable health system challenges due to decades of civil war, which disrupts access to essential services. For three years, the Malaria Consortium has implemented Seasonal Malaria Chemoprevention (SMC) in Aweil South and Aweil West Counties; however, coverage remains below optimal at 79%, falling short of established targets. This study examines the barriers and enablers to accessing and distributing SMC during the 2024 round.</p><p><strong>Methods: </strong>A qualitative study design was used, involving 60 stakeholders involved in implementing SMC. Data were collected through 42 key informant interviews and 18 in-depth interviews with caregivers of eligible children who received all SMC doses or none, as well as those of ineligible children who received SMC. The data were analyzed using deductive thematic analysis.</p><p><strong>Results: </strong>Factors that enabled SMC distribution and access included government support, community trust, efficient logistics, integrated activities, access to vital information, involvement of Boma health workers, supervisor transportation, and organized malaria management. The main challenges included shortages of healthcare workers, drug shortages, geographic and transportation difficulties, caregiver relocation, delayed referrals, and poor communication.</p><p><strong>Conclusion: </strong>These findings underscore the necessity for targeted interventions to address resource constraints, enhance workforce capacity, communication, and logistics infrastructure, thereby ensuring sustainable SMC delivery in conflict-affected areas. Strengthening these areas will be crucial for maximizing the impact of SMC as a malaria prevention strategy in such environments.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258692","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":"From silent infection to symptomatic malaria: host phenomic determinants of Plasmodium falciparum outcomes in Fanteakwa South District, Ghana.","authors":"Enoch Aninagyei, George Abeiku Abbew, Comfort Addo Boatey, Regina Yayra Menu, Ebenezer Tawiah Nyarkotey, Desmond Omane Acheampong","doi":"10.1186/s12936-026-05985-y","DOIUrl":"10.1186/s12936-026-05985-y","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic Plasmodium falciparum infections sustain malaria transmission in endemic areas, yet progression to symptomatic disease varies among individuals. This study examined asymptomatic infection in Fanteakwa South District, Ghana, focusing on how demographic and host phenomic factors influence progression to symptomatic malaria.</p><p><strong>Methods: </strong>This study employed a prospective cohort design nested within a cross-sectional survey. Participants of all ages were recruited from four communities using stratified random sampling and screened for malaria using mRDT and PCR. ABO blood group, Rhesus D factor, and haemoglobin phenotype were determined. Individuals with asymptomatic P. falciparum infection were followed weekly for 28 days with repeat mRDT, microscopy, and temperature measurements. Statistical analyses evaluated associations between demographic, phenomic, and infection outcomes.</p><p><strong>Results: </strong>Among 353 participants, females constituted 59.8%, and adults aged 18-65 years were the largest age group (42.5%). Blood group O (55.8%), HbAA (85.3%), and Rhesus D positivity (91.8%) predominated. PCR detected more P. falciparum infections (52.1%) than mRDT (42.8%), indicating a substantial burden of submicroscopic asymptomatic malaria. PCR positivity varied across communities and was highest among children (61.9%) and adolescents (68.6%). During follow-up, 131 participants (37.1%) converted to mRDT and microscopy positivity, with 43.5% converting in the first week. Early conversion was most frequent among children (54.5%, p < 0.001), followed by adolescents, while adults and older adults showed fewer early conversions. Individuals with blood groups A and AB progressed earlier, whereas blood group O showed delayed conversion. All conversions occurred among HbAA individuals, with no progression among HbAS carriers. The Rhesus D factor had no significant effect, while gender differences emerged later, with higher conversion among males in Week 3 (p = 0.015).</p><p><strong>Conclusion: </strong>Progression from asymptomatic to symptomatic P. falciparum infection is strongly shaped by age and host erythrocyte phenomic traits. Blood groups A and AB and the HbAA phenotype favour early conversion, whereas blood group O and HbAS delay or prevent progression. These findings underscore the importance of molecular surveillance and phenome-informed risk stratification for targeted malaria control in endemic communities.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252236","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 asymptomatic malaria and its associated factors in the Al Zuhrah district, Al-Hodeidah Government, Yemen, 2022.","authors":"Mohammed Ahamed Hajjam, Mohammed Abdullah Al Amad, Samar Saeed Nasher","doi":"10.1186/s12936-026-05993-y","DOIUrl":"10.1186/s12936-026-05993-y","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic malaria represents a significant health issue, especially in endemic regions where asymptomatic individuals serve as reservoirs. In Yemen, the Al-Hodeidah governorate is the primary endemic area. This study aims to determine the prevalence of asymptomatic malaria and its associated factors in Al-Zuhra District, Al-Hodeidah Governorate.</p><p><strong>Methods: </strong>A cross-sectional community-based study was conducted using a multistage sampling method with probability proportional to size to select villages and households. In each household, one eligible member who had not experienced malaria symptoms and had consented to participate was randomly selected. Data were collected using a semi-structured questionnaire, and blood samples were tested for malaria using a Rapid Diagnostic Test. Logistic regression was used to calculate crude and adjusted prevalence odds ratios (APOR) with 95% confidence intervals (CI). A P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 422 participants were enrolled, with a mean age of 35.7 ± 11 years; 47% were male, and 62% were from a family with more than five members. The overall prevalence of asymptomatic malaria was 5%, with Plasmodium falciparum accounting for 95% of infections. Being educated was protective against infection (APOR = 0.35; 95% CI 0.13-0.97; p = 0.043). Absence of window screens (APOR = 9.56; 95% CI 2.15-42.51; p = 0.003), and living near stagnant water (APOR = 4.93; 95% CI 1.50-16.23; p = 0.009) were significantly associated with asymptomatic malaria.</p><p><strong>Conclusion: </strong>Asymptomatic malaria remains present in Al-Zuhra District, with Plasmodium falciparum accounting for the majority of infections. Environmental and household factors, particularly absence of window screening and proximity to stagnant water were strongly associated with infection, while education showed a protective effect. These findings highlight the importance of strengthening household-level vector control measures, improving environmental management, and enhancing community awareness to reduce asymptomatic malaria transmission in the area.</p>","PeriodicalId":18317,"journal":{"name":"Malaria Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239720","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}