Malaria Journal最新文献

Background: Extreme rainfall caused severe flooding in Kidal, northern Mali, in 2024, raising concerns about the outbreak of malaria associated with climate change. The objective of this study was to describe this epidemic and the response implemented by national and regional authorities.

Methods: A historical cohort study was conducted in the Kidal region, covering the entire population. Weekly malaria case data recorded by the national health system between May 2024 and February 2025 were analyzed in conjunction with precipitation data from the Tropical Rainfall Measuring Mission (TRMM, spatial resolution: 0.25°). The interventions included seasonal malaria chemoprevention (SMC), extended to children under 15 years of age, and deployment of mobile health teams in remote areas. The effect of these interventions on malaria cases per 1000 person-weeks was estimated using Generalized Additive models (GAM) applied to interrupted time series, taking rainfall into account. In addition, the spatial distribution of the population at risk was estimated using WorldPop population data.

Results: Rainfall began in week 25 and continued for 15 weeks. The malaria epidemic began in week 30, peaked in week 39 with 1,014 cases, and lasted for 28 weeks, with 1.688 (95% CI 1.687-1.690) cases per 1000 person-weeks. Incidence was highest among children under five. The interventions implemented, using extended SMC and mobile health teams, led respectively to a significant reduction in morbidity (respective Standardized Incidence Ratios (SIRs) of 0.50; 95% CI 0.33-0.75 and SIRs = 0.48; 95% CI 0.28-0.82).

Conclusion: Malaria outbreaks associated with flooding are becoming increasingly frequent in the context of extreme weather conditions. These situations pose a major challenge for malaria control programs and highlight the need to strengthen surveillance systems. The implementation of weather-based preparedness strategies is essential, including expanding preventive treatment coverage (SMC), deploying mobile health teams, and pre-positioning essential inputs.

Falciparum malaria and Vivax malaria are notorious for the development of multiple complications, including acute kidney injury, acute liver injury, severe hemolysis, bone marrow suppression, severe acidosis, hypoglycemia and CNS complications. We hereby present two cases of rare complications associated with Malaria, which were managed in a resource-constrained setting in Eastern Africa. Two individuals working in the malaria endemic region of South Sudan were detected with Mixed Plasmodium falciparum-Plasmodium vivax when they reported to the hospital with acute febrile illness for two days. They were noted to have palpable hepatosplenomegaly. Both patients suffered spontaneous rupture of the spleen, leading to gross hemoperitoneum and hemodynamic instability. They were taken up for an emergency explorative laparotomy as a life-saving measure. Of the two patients, one survived following timely surgical intervention and supportive care, whereas the other succumbed despite emergency management.

Background: Maternal malaria and its sequelae, including maternal mortality and neonatal infection, represent a growing public health crisis in Sub-Saharan Africa, often exacerbated by underlying socioeconomic factors. The study seeks to assess the associations between maternal socioeconomic indicators, maternal malaria, and neonatal peripheral parasitaemia in a Nigerian hospital.

Methods: A cross-sectional analysis of 85 mother-infant pairs was conducted at a hospital in Osogbo, Osun state, Nigeria. Well-structured questionnaires were used to collect maternal demographics, socioeconomic indicators, and preventive practices. Mother, cord blood, and neonatal peripheral blood samples were collected for parasitemia through microscopy. Descriptive statistics, Fisher exact and chi-square tests were used for categorical variables, and univariate logistic regression for continuous predictors.

Results: The prevalence of neonatal peripheral parasitemia was 8.2% (7/85). Maternal parasitemia strongly predicted neonatal infection. All positive neonates were born to mothers with positive microscopy (7/19), whereas no neonates from parasitemia negative mothers were infected (p < 0.001). No statistically significant associations were found between neonatal parasitemia and maternal education (p = 0.912), occupation (p = 0.183), insecticide treated net use (p = 0.413), or intermittent preventive therapy uptake (p = 1.000).

Conclusions: The present study revealed maternal parasitemia as a primary risk factor for neonatal malaria. While socioeconomic factors showed no significant association in this small cohort, these preliminary findings highlighted the need for larger studies with refined socioeconomic measures to fully elucidate these relationships. This highlights the critical need for strengthening antenatal malaria screening, ensuring timely treatment of maternal infection, and enhancing community-based malaria education to reduce vertical transmission in high-burden regions like Osun State, Nigeria.

Background: Malaria is a major public health problem in Ethiopia, and long-lasting insecticide-treated nets (LLINs) are one of the primary preventive strategies used to control it. Gondar Zuria District, Central Gondar Zone's highest malaria-reporting district, reached 100% LLIN coverage in 2023. However, malaria cases remain high, suggesting gaps in LLIN utilization. Therefore, this study aimed to assess LLIN usage and determinants in Gondar Zuria District.

Methods: Community-based mixed-methods study was conducted from February 1 to 28, 2025 among 700 participants selected through multistage sampling. Quantitative data was collected via interviewer-administered questionnaires and entered into EpiData version 4.6.0.2 and exported to SPSS version 25 for analysis. A binary logistic regression model was fitted, and statistical significance was determined using 95% confidence intervals (CI) and a p-value ≤ 0.05. Qualitative data were collected through purposively sampled interviews (n = 7) and key informant interviews (n = 3) and analyzed thematically.

Results: The prevalence of ITN utilization was 55.6% (95% CI: 51.9%-59.3%) and was significantly associated with perceived severity (AOR = 1.74; 95% CI: 1.27-2.39), LLINs-to-family size ratio (AOR = 2.09; 95% CI: 1.51-2.91), and occupation specifically, being a government employee (AOR = 3.45; 95% CI: 1.57-7.58). The mixed methods design therefore provided a more comprehensive understanding by revealing behavioral and contextual factors that were not captured through quantitative data alone. Qualitative findings complemented the quantitative results by explaining why LLIN utilization remained low, highlighting misconceptions about net safety, doubts about effectiveness, discomfort due to heat, and structural barriers such as lack of space for hanging nets.

Conclusion: LLIN utilization in Gondar Zuria District fell below the national target (100%). Misconceptions and misinformation contribute to irregular use and reduced trust. Beyond distribution and health education, community-based behavior changes strategies such as household follow-ups by health workers and integrating LLIN promotion into local forums alongside routine net condition monitoring are essential to improve consistent use and advance malaria elimination efforts.

Background: Malaria continues to pose a serious public health challenge in Zamfara State, Nigeria, disproportionately affecting women and children due to socio-economic barriers. This study aimed to develop a Composite Gender-Sensitive Malaria Vulnerability Index (CGMVI) to identify areas of heightened malaria vulnerability and support informed targeted interventions.

Methods: Malaria incidence and mortality data from the Malaria Atlas Project, and population data from WorldPop, were integrated with indicators of Insecticide-Treated Net (ITN) access and usage, maternal education, and household wealth. A Pentagonal Fuzzy Analytic Hierarchy Process was used to compute the CGMVI, while Getis-Ord Gi* hotspot analysis identified spatial patterns of vulnerability across Zamfara State.

Results: The CGMVI revealed a west-to-east gradient of malaria vulnerability across Zamfara State, with hotspots in Gummi (3.86) and Bukkuyum (3.62), characterized by low ITN usage (82-85%), high maternal education deficits (89-91%), and household poverty (85-90%). Moderate vulnerability was observed in central Local Government Areas (LGAs) such as Anka and Bungudu, while northern and eastern LGAs, including Shinkafi, Zurmi, and Tsafe, exhibited low vulnerability with higher ITN coverage (≈92%) and better socio-economic profiles. Hotspot analysis using Getis-Ord Gi* confirmed statistically significant clustering in western LGAs (z-scores 2.11-4.89 at 99% confidence), while coldspots in the north and east had z-scores from - 1.69 to - 3.39. These patterns reflect intersections of socio-economic barriers, ITN access, and maternal education, highlighting areas where women and children face elevated malaria risk.

Conclusion: The study offers a spatial framework for understanding how epidemiological, socio-economic, and gender-related factors shape malaria vulnerability in Zamfara State. By identifying areas where women and children may face elevated risk, the findings can inform gender-sensitive ITN distribution, community malaria literacy initiatives, and socio-economic support strategies. The CGMVI provides a tool to guide evidence-informed planning and better integrate gender considerations into malaria control efforts in the state.

The measurement of glucose-6-phosphate dehydrogenase (G6PD) activity was currently used laboratory method for the diagnosis of G6PD deficiency (G6PDd). This study evaluated the analytical and diagnostic performance of a fully-automated method for the one-time quantitative measurement of G6PD activity normalized per unit of hemoglobin (G6PDH) on the Mindray BS-2800M analyzer, using 1561 whole blood samples. For analytical performance, the G6PDH (U/g Hb) showed more stable repeatability performance with coefficient of variation (CV) of 4.48% ± 3.86%, compared with the relatively large CVs in G6PD and Hb detection alone. G6PDH exhibited linearity from 0.37 to 20.86 U/g Hb, which could almost cover the known very low level and very high level, with a carryover rate of less than 1%. The minimum applicable level of Hb for blood sample was at 200 g/L, in which the G6PDH automated method results were not be interfered significantly compared with manual method. Sample stability studies indicated that G6PDH results remained stable for up to 4 h at room temperature and 48 h at 4 °C, but were significantly reduced after storage at - 20 °C (P < 0.05). To evaluate the diagnostic performance of G6PDH, the reference intervals in 806 non-neonates were established as < 2.31 U/g Hb for deficient males/females, 2.31-6.17 U/g Hb for intermediate females. For neonates, they were < 4.14 and 4.14-11.03 U/g Hb respectively based on 122 samples. Comparison of genetic results from 185 samples revealed that G6PDH achieved accuracy of 91.35%, surpassing conventional G6PD single enzymatic method (77.30%) and G6PD/6PGD (82.70%). The kappa coefficient and chi-square analysis indicated that G6PDH phenotypic classifications and genetic results had significant correlation. Furthermore, in 64 of heterozygous females, G6PDH had higher positively detection rate (87.50%) than G6PD single enzymatic method (39.06%) and G6PD/6PGD (51.56%). In summary, the automated G6PDH method offered a valuable approach for clinical laboratory, as it not only had favorable analytical performance for improving testing efficiency, but also provided reliable diagnostic performance for G6PDd, especially holding significant value in precise screening female heterozygotes, early prevention of G6PDd and guiding safe clinical medication.

Background: Malaria transmission is highly sensitive to climatic variability, as changes in temperatures and rainfall, directly influence mosquito breeding, survival, and parasite development. Extreme climatic events, such as flooding, further exacerbate malaria risk by disrupting access to preventive, diagnostic and treatment services. However, there is limited evidence on how communities in malaria-endemic settings perceive and respond to the health impacts of climate variability and change. This study explored community knowledge, perceptions, and practices related to the relationship between climate variability and malaria transmission in south-eastern Tanzania.

Methods: An explanatory mixed-methods cross-sectional study was conducted in malaria-endemic villages in south-eastern Tanzania. Quantitative data were collected through structured questionnaires administered to 384 community members, while qualitative data were obtained through 11 key informant interviews and 12 focus group discussions involving 72 participants. Survey data were analysed descriptively, and qualitative data were analysed thematically.

Results: Among survey respondents, 86% reported experiencing climate-related changes, including altered cropping seasons, increased flooding, and a perceived rise in vector-borne diseases. Approximately two-thirds (67.5%) recognized a link between climate change and malaria transmission. Perceived vulnerability was high, with 59.5% reporting increased risk of vector-borne diseases and 70% indicating higher malaria occurrence during the rainy season compared to the dry season. Access to timely climate and health information was limited, as only 26.6% regularly received updates, despite 96.6% expressing a desire for such information. Findings from focus group discussions and key informant interviews corroborated these perceptions and highlighted the need for targeted community awareness and education on climate-related malaria risks.

Conclusions: Community members demonstrated awareness of climate change and its perceived impacts on malaria and livelihoods. These findings highlight the importance of integrating community perspectives and local knowledge into climate-adaptation and malaria-control strategies to enhance locally relevant and community-centered resilience.