MalariaWorld journal最新文献

Introduction: Malaria remains a significant health challenge in Laos, particularly in the southern provinces with dense forests and mobile populations. Despite progress in reducing cases, socio-environmental factors drive its persistence.

Materials and methods: Using data from 2016 to 2023, trends were analysed with P-trend analysis, and effects of long-lasting insecticidal nets (LLIN) and climate on malaria incidence were assessed via Poisson regression.

Results: During this period, malaria incidence decreased by 95.5%, underscoring the success of elimination strategies. LLIN distribution led to a 54.1% reduction in incidence (IRR=0.459; p 0.002). Climate factors did not significantly influence transmission rates (IRR=0.67; p 0.717).

Conclusions: The critical role of LLINs in reducing malaria incidence is evident. To support the national elimination goal for 2030, interventions must maintain consistent coverage and community engagement. Future research should focus on localised climatic data and address specific challenges in regions like Khammouane Province, enhancing the effectiveness of malaria control programmes and improving intervention strategies.

Background: Malaria remains a significant public health challenge in Mali, particularly in endemic areas such as the Kolondieba health district. This study aimed to analyse the geo-temporal dynamics of clinical malaria transmission, identifying high-risk periods, vulnerable age groups and associated environmental and health determinants.

Materials and methods: A historical cohort study was conducted from 2019 to 2021 across 21 health facilities in the Kolondieba district. Epidemiological, climatic, and demographic data were analysed using geospatial tools (QGIS) and statistical software (R). The non-parametric Wilcoxon and Kruskall-Wallis tests were used to compare two means and population malaria incidence distribution, respectively.

Results: The incidence of malaria exhibited seasonality influenced by precipitation and humidity, while elevated temperatures were associated with a decrease in malaria incidence. Periods of high transmission potential (HTP) last for 20-25 weeks annually (weeks 23-48) and peak around weeks 30-31. Malaria accounted for 53.71% of consultation reasons, with pronounced vulnerability observed in children aged 0-4 yrs, especially during high transmission periods. Spatial stratification revealed two risk levels: 5 health areas at moderate risk (incidence 251-450 cases/1000 inhabitants) and 16 at high risk (>450 cases/1000 inhabitants). Health center attendance was a more determining risk factor.

Conclusion: This study highlights the spatial and temporal heterogeneity of malaria transmission in southern Mali, emphasising the necessity to target interventions during weeks 23-48 (June through November), among children <5 yrs of age, in health areas with high health centre attendance. The integration of socio-economic factors in future studies could refine control strategies.

This paper examines why there was the necessity for prioritising sustainable malaria control in Palestine in 1922. It then follows by reviewing the method employed by the Zionists to achieve that goal. It also examines the difficulties encountered in organising education for the inhabitants and further examines evidence of the effectiveness of the education.

Background: Malaria remains a major global health challenge, disproportionately affecting pregnant women and children. In Nigeria, malaria in pregnancy contributes to 70.5% of maternal morbidity and 41.1% of maternal mortality. Recognising these risks, the World Health Organization recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) as a key strategy for malaria in pregnancy prevention. However, despite its proven effectiveness, pregnant women's uptake of IPTp-SP remains unacceptably low. This study presents participant-driven recommendations to enhance IPTp-SP uptake, structured within the socio-ecological framework.

Materials and methods: This study employed an exploratory descriptive qualitative approach to examine the community-level contextual factors influencing IPTp-SP uptake. Data were collected from 53 participants in two communities in Bayelsa, Nigeria. Individual interviews were conducted with 17 key stakeholders (spouses, mothers-in-law, religious leaders, community leaders, and traditional birth attendants) and 6 focus group discussions with 36 pregnant women. Data management and coding were conducted using NVivo 14 QSR International software, following an inductive-deductive thematic analysis approach.

Results: Participants proposed multi-level interventions to address barriers to IPTp-SP uptake at the individual, interpersonal, community, and healthcare system levels. Key recommendations include: Community-wide education campaigns to raise awareness of IPTp-SP's benefits; comprehensive training for healthcare providers to enhance their knowledge and prescription of IPTp-SP; integration of traditional birth attendants into the formal healthcare system; community-level distribution of IPTp-SP to improve access for pregnant women who do not attend antenatal care; government intervention to ensure the functionality of health centers; addressing workforce shortages, and guaranteeing a consistent supply of IPTp-SP.

Conclusion: These evidence-based, participant-driven recommendations offer a holistic and scalable strategy to improve pregnant women's uptake of IPTp-SP in Nigeria and other malaria-endemic regions. Implementing these recommendations can strengthen malaria prevention efforts, improve maternal and child health outcomes, and support broader public health initiatives.

Introduction: HIV and malaria coexist in individuals across sub-Saharan Africa, a region profoundly impacted by both diseases. Plasmodium falciparum exhibits significant genetic diversity in high-transmission areas, which may further complicate the clinical outcomes of people living with HIV (PLWH). This study investigates the genetic diversity of P. falciparum among PLWH in Ogbomoso, Nigeria.

Materials and methods: A total of 254 blood samples were collected from HIV-positive patients attending clinics at LAUTECH Teaching Hospital and BOWEN Teaching Hospital in Ogbomoso, Oyo State, Nigeria. Malaria infection was diagnosed using a rapid diagnostic test (RDT), microscopy, and nested polymerase chain reaction (nPCR). Genotyping of msp-1, msp-2, and glurp genes was performed to assess genetic diversity. The distribution of allelic families was analysed descriptively using SPSS v.27, and a p-value≤ 0.05 was considered statistically significant.

Results: Among the 254 samples, females (72.8%; mean age 40.7 years) were the most predominant. The prevalence of P. falciparum was 5.9%, 55.1%, and 40.6% by RDT, microscopy, and nPCR, respectively. The msp-1 geno-typing identified 170 distinct variants, with the K1, MAD20, and RO33 families detected at frequencies of 34.7%, 30.0%, and 35.3%, respectively. The msp-2 genotyping revealed 56 alleles, predominantly from the FC27 family (73.2%). The multiplicity of infection (MOI) for msp-1, msp-2, and glurp genes was 2.02, 1.13, and 1.00, respectively, while the expected heterozygosity (H_E) values were 0.86, 0.52, and 0.10, respectively. Most msp-1 (68.5%) and glurp (31.1%) samples exhibited polyclonality, whereas msp-2 samples were predominantly monoclonal (22.1%). .

Conclusions: Despite the high malaria transmission intensity in the region, P. falciparum isolates from PLWH exhibited relatively low genetic diversity, suggesting a potential reduction in malaria transmission and signalling the effectiveness of malaria control strategies. Further studies are needed to explore the underlying factors leading to reduced transmission and low genetic variations in this population and their potential impact on malaria transmission and treatment outcomes in PLWH.

When the Asian tiger mosquito (Aedes albopictus) was discovered in the EU for the first time, in a kindergarten in Genua (Italy) in 1990, it was followed initially by a call for action to stop its spread, but gradually turned into a 'study object', resulting in hundreds of research papers since, but very little action in terms of actually trying to eliminate it. Europe is now facing the grave consequences of this lack of action, with dengue, Chikungunya, and West Nile virus already creating problems around the Mediterranean, and aided by climate change both the mosquito and these diseases will move farther north in years to come, posing a risk to millions of people. This history is now repeating itself in the Horn of Africa. It's been thirteen years since Anopheles stephensi, an Asian malaria vector, invaded Djibouti, and has not had much going against it since. And like in Europe, stephensi has become 'the new kid on the block' for academics, and paper after paper (87 in the last 3 years) is coming online, always calling for action in the final paragraphs, but forgetting that mosquitoes don't care about papers and happily continue to conquer more terrain as we sit down to read another paper. Research should focus exclusively on four things: where is the mosquito (surveillance), what works to kill it (control), how do we free areas of it (implementation strategy) and how can we prevent re-invasion of cleared areas. In two of these areas we're almost clueless: strategic area-wide vector elimination and preventing re-invasion. Action in these areas is therefore critical if Africa is to prevent repeating Europe's mistake. And should start with garnering unwavering support and resources from governments of affected countries, regional organisations, and global players. The stephensi problem will not be solved with a dipper searching for larvae in the field. It should start by knocking on politicians' doors, intense lobbying, and succeeding in having the problem addressed with utmost priority. Only then will the means and resources become available to attempt elimination of this invasive vector. Critically, these resources should not affect any ongoing malaria control efforts but should be freed specifically for this purpose. On a more positive note, going aggressively after stephensi would concurrently teach us ways to go after indigenous African vectors in an area-wide fashion, notably through larval source management. Inertia will merely push us all decades backwards in terms of hoping to eliminate malaria in Africa one day.

Introduction: Seasonal malaria chemoprevention (SMC) is an effective malaria preventive intervention in sub-Saharan Africa. As with other drug-based interventions, large-scale deployment increases drug pressure, which may result in drug-resistant parasite strains thereby jeopardising the impact of the intervention. Mutations in Pfdhps and Pfdhfr genes are known to be associated with resistance to sulfadoxine and pyrimethamine, respectively, making the surveillance of molecular markers crucial in settings where SMC is widely applied. This study aimed at assessing the distribution of Pfdhfr and Pfdhps alleles before and after the 2021 annual campaign of SMC in the health district of Nanoro in Burkina Faso.

Materials and methods: Randomly selected dried blood spots collected prior (n=100) and after (n=100) the 2021 SMC campaign were used for the detection of mutation in codons 51, 59 and 108 of the Pfdhfr gene and in codons 437 and 540 of Pfdhps gene using a nested PCR with restriction fragment length polymorphism approach.

Results: The prevalence of Pfdhfr and Pfdhps mutant alleles were very high before and after SMC, ranging from 88.42% to 97.98%. However, no significant change in the prevalence of Pfdhfr and Pfdhps mutant alleles was observed in the period before and after SMC campaign (p>0.05). No mutation was observed in Pfdhps codon 540. In addition, the prevalence of the Pfdhfr triple mutant and Pfhfr-dhps quadruple mutant was higher in the study area but with no significant variation before and after SMC campaign (p>0.05). .

Conclusions: The prevalence of Pfdhfr and Pfdhps mutant alleles were higher either in pre or post SMC. However, no significant variation in the prevalence of these alleles was observed following the SMC campaign suggesting that these high mutation frequencies may be the result of continuous use of SMC in Burkina Faso since 2014.

Introduction: The genetic diversity of Plasmodium falciparum correlates with its pathogenicity, therefore design of evidence-based intervention strategies to eradicate malaria requires genetic diversity surveillance. This study characterised the allelic frequencies and genetic diversity of P. falciparum parasites isolated from Awka, Nigeria.

Materials and methods: Genomic DNA was extracted from 177 P. falciparum isolates and the polymorphic regions of the msp2 and glurp genes were genotyped by nested polymerase chain reaction (PCR).

Results: Two msp2 alleles (3D7 and FC27) were analysed. The 3D7 (93.55%) msp2 allelic family was predominant in msp2 positivie isolates. Polyclonal msp2 infection was observed in 24 (38.71%) isolates. Twenty-one distinct msp2 alleles were detected, with fragment sizes ranging from 200 bp to 1200 bp. The 300 bp allelic fragment (26.83%) was predominant for the 3D7 allele, while the 400 bp allelic fragment (29.54%) was predominant for the FC27 allele. The multiplicity of infection (MoI) in msp2 was 2.03, and the expected Heterozygosity (He) was 0.34. Sixty-nine isolates (38.98%) were positive for the RII repeat region of the glurp gene. For the glurp gene, nine alleles were detected for fragment sizes ranging from 200 bp to 1150 bp, and the most prevalent allelic fragment was 200 bp (19%). The MoI and He for the glurp gene were 0.45 and 0.98, respectively.

Conclusions: The high level of polyclonal infections with P. falciparum parasites observed in this study indicates extensive genetic diversity in the study area. The data provide important baseline information that can be implemented in developing malaria control strategies and elimination in the study area and Nigeria.

For malaria control to be successful, experience has shown that success is more likely where all involved feel the attempt must not be allowed to fail, and that success can be the only acceptable outcome. Importantly, all those at the top must have such commitment, and, in particular, this should also include the funder, the source of finance of the attempt. That would be malaria control treated as a priority. If not treated as such, experience has shown the outcome of such attempts to be disappointing.