MalariaWorld journal最新文献

During the first World War (1914-1918), the British Army found itself confronting enemy armies in several countries in which malaria potentially hampered its ability to engage with the enemy. This article contrasts how it dealt with malaria on two of these fronts, the Macedonia front and the Palestine front. One front resulted in a failure of the Army to protect itself against the disease, with the other front resulting in successful protection of its troops, enabling those troops to create a decisive victory. The paper briefly explains the major differences between the two fronts, including the different attempts to deal with the disease, and draws lessons for contemporary malaria elimination efforts.

Background: Malaria is a major global public health issue that disproportionately affects pregnant women in sub-Saharan Africa. The World Health Organization recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) for its control. Despite its proven efficacy, drug uptake remains low. Sulphadoxine-pyrimethamine (SP) safety concerns have been cited as one of several reasons for this low uptake.

Methods: We conducted a scoping review using the Arksey and O'Malley framework and the health belief model to investigate perceptions of SP use among pregnant women in sub-Saharan Africa. We looked for peer-reviewed publications in five international databases.

Results: The review included 19 articles out of a total of 246. It showed that pregnant women in sub-Saharan Africa have a good understanding of malaria and its consequences, but this does not necessarily translate into increased IPTp-SP uptake. It is worrisome to know that some pregnant women (from 2 studies) did not believe that SP use is beneficial, and several participants (from 4 studies) were unsure or did not see the drug as an effective intervention. Many pregnant women believe SP harms them, their partners, or their unborn children.

Conclusions: Healthcare professionals should continue prescribing and encouraging pregnant women to use SP for malaria prevention until a better substitute becomes available.

A century ago, Dr. I. Kligler, a Jewish Zionist in Palestine, initiated the first start anywhere in the world of a successful national malaria elimination campaign. It is little realised today that Palestine back then was drenched in malaria, rendering it uninhabitable in many areas, leaving it a country almost empty. Kligler recognised in his quest for malaria elimination firstly the need to demonstrate that malaria elimination was in fact possible. Secondly, he noted that the old colonial attitudes which then prevailed around the world towards subject populations also existed in Palestine. He realised that to be effective in educating anyone to assist with malaria elimination in such a colonial environment, that person would need to be educated, and such education had to be conducted with 'dignity and respect'. Such an attitude is something that was (and still is in many places) sadly missing within former colonies. Kligler knew the Zionist dream of a Jewish homeland in Palestine would in all probability be an impossibility unless malaria could be defeated there. He accordingly set out to initially demonstrate on a very small scale what could be achieved by way of malaria control. With dignity and respect, he engaged with all the inhabitants, both Arabs and Jews, sometimes even individually if necessary, to educate about the disease and to explain why his anti-malarial works were necessary, thereby enlisting the inhabitants effective assistance in these works. The result was enthusiastic co-operation by the inhabitants for over twenty years which was eventually rewarded with malaria elimination. Unfortunately, the example shown by Kligler is little known to the rest of the world today, and unless communities suffering from the disease learn from such examples, the task of malaria elimination elsewhere around the world will continue to be fraught with great difficulty, and more than likely to result in failure.

Background: Malaria in pregnancy is a significant public health concern in Nigeria. It threatens pregnant women and their unborn babies and undermines the achievement of Sustainable Development Goal 3. The World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine [IPTp-SP] for its control, but there are challenges to its access and uptake.

Methods: Using the Arksey and O'Malley framework and the cascade of care model, we conducted a scoping review to investigate barriers and facilitators of IPTp-SP access and uptake, including their influence on pregnant women's health-seeking behaviour for the control of malaria in pregnancy in Nigeria. We searched seven scientific databases for papers published from 2005 to date.

Results: We included a total of 31 out of 2149 articles in the review. Poor provider knowledge of the IPTp-SP protocol and lack of essential commodities for sulphadoxine-pyrimethamine administration in clinics are significant barriers to IPTp-SP use. Staff shortages and poor remuneration of health care professionals are obstacles to IPTp-SP utilisation.

Conclusions: To improve IPTp-SP access and uptake, the government should ensure a continuous supply to clinics and support the employment of additional health care professionals who should be well paid and trained on using the IPTp-SP protocol.

Background: Recent reports suggest that pregnant women living in holoendemic regions of sub-Sahara Africa die in great numbers annually due to malaria disease resulting from their higher susceptibility, reduced immunity and demographic associated factors. This work investigated the prevalence of Plasmodium falciparum in pregnant women attending antenatal care (ANC) in selected private hospitals in Onitsha metropolis South East Nigeria.

Methods: Venous blood samples were collected from 270 pregnant women during ANC visits between October 2016 and December 2017. A questionnaire was used to collect demographic data, gestational age, knowledge of malaria and preventive measures while clinical presentations and symptoms were extracted from the physician's clerking form. Laboratory diagnosis was done using microscopy. The effect of the demographic variables and other associated factors on prevalence and parasite densities was studied using Chi-square and ANOVA tests.

Results: The overall P. falciparum prevalence was 42.6%. Prevalence varied with the maternal age, gestational age, preventive measures adopted by the pregnant women and clinical presentations. 27.8 % of the infected women were highly parasitized (>5000 parasites/μl); 67% had a moderate parasite density (1,000-4,999 parasites/μl) and 5.2% showed a low parasite density (1-999 parasites/μl). We observed that 35.2%, 30%, 18.9% and 5.2% of the study cohorts preferred and used treated bed nets, insecticides, windows and door screening and non-treated bed nets respectively as malaria preventive measures. 5.9% did not use any protection.

Conclusions: The findings of this study revealed high prevalence of malaria among pregnant women living in Onitsha metropolis with high mean parasite densities despite strong adherence to use of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment in pregnancy (IPTp) and other malaria preventive measures.

The role of Robert Koch in the early discoveries of the malaria lifecycle and the complex of diseases, the development of immunity, quinine prophylaxis and the mosquito theory has fallen into oblivion. As a mature and famous hygienist, Koch had travelled the Old World, where malaria was endemic. His first studies took place in Tanganyika, German East Africa (now Tanzania) in 1898 and thereafter in Italy and the East Asian archipelago. As malaria in Germany did not offer a sufficiently endemic situation, he chose the Istrian island of Brioni (Kroatia) to eliminate malaria. Because virtually all of Koch's publications are in German, his achievements on malaria never settled in the common memory of tropical medicine. Around the turn of the century the race to elucidate the transmission pathway through mosquitoes took place and though he hardly yielded any honour of priority, his research certainly determined the speed by which British and Italian contenders made their ways. His exertion and interference led to the awarding of the 2^nd Nobel Prize in Medicine to Ronald Ross only, leaving Giovanni Battista Grassi to draw the blank. Proof of this intervention in the otherwise well-known quarrel at the start of modern malaria research shows once more how personal characters may clash or join forces.

This paper begins with a brief examination of the first start made anywhere of a successful national malaria-elimination campaign. This start was made in 1922 in Palestine. The paper examines the essential education that was required to make the campaign so successful, thereby ensuring all inhabitants treated all aspects of the malaria-elimination as an absolute priority. Such priority led to the vital cooperation required for the necessary steps in the malaria-elimination method. But the paper also highlights a criticism of the campaign by the League of Nations in 1925 when the League sent its Malaria Commission to Palestine to investigate the campaign which it had heard about. The author tends to conclude that the education of all the inhabitants, of both Arabs and Jews, and which resulted in the inhabitants' very strong cooperation, was actually contrary to, or in conflict with, the natural inclination of the members of the Malaria Commission whose governments were mainly still, in 1925, colonial powers. The paper then moves on to present times and concludes the lack of success in malaria-elimination in many areas throughout the world is greatly due to the failure to provide that same personal education to the inhabitants that was provided in Palestine 100 years ago, principally because the governments in many malarious countries have not moved on from colonial times. The author's personal conclusion, impression and opinion is that there appears to be hardly any sense of priority for the various malaria-elimination campaigns being presently conducted around the world, and where involved governments are probably still retaining old colonial attitudes when dealing with their respective populations.

Background: Cambodia has made significant progress in controlling malaria in the past decade. It now aims to eliminate malaria from the country by 2025. It launched the Malaria Elimination Action Framework (MEAF 2016-2020) in 2015 with strong political commitment targeting appropriate interventions on high-risk populations, particularly mobile and migrant groups.

Methods: In 2020, the household-level Cambodia Malaria Survey 2020 (CMS 2020) was conducted with the objective to assess the performance of malaria control activities using the indicators outlined in MEAF 2016-2020. The survey used a cross-sectional probability proportional to size approach drawing 4,000 households from 100 villages across the malaria-endemic districts of the country.

Results: A total of 3,996 households with 17,415 inhabitants were interviewed. Of the surveyed households, 98.4% owned a long-lasting insecticide-treated bednet or hammock (LLIN/LLIHN). However, only 79.5% of these reported sleeping under a net the previous night, with only 45.7% sleeping under an insecticide treated net (ITN). Given that forest visitors are at the highest risk of getting malaria, the survey also targeted this group. Of the forest visitor respondents, 89.3% brought an ITN along and 88.9% reported to have used a net during their forest stay. About 10.8% of forest goers had received a forest kit for malaria prevention from mobile malaria workers the last time they went to the forest. Knowledge about mosquito repellents was high among forest goers (62.5%) but the actual use thereof during the last visit to the forest was low (22%). While awareness about malaria prevention with LLINs remained high among most respondents, knowledge about malaria diagnosis and treatment was not universal. Source of malaria knowledge and its treatment was usually from a household member, followed by a village malaria worker or a primary health care center staff. Of those who had fever during the previous two weeks, 93.6% sought advice or treatment outside the home, and the most commonly reported source for advice or treatment was private providers (39.4%) followed by health center/district hospital (31.3%).

Conclusions: ITN distribution and other malaria prevention interventions have largely benefited the high-risk groups including the forest visitors. Comparing the CMS 2020 results with the 2017 CMS results, it is clear that forest visitors' use of LLIN/LLIHN has improved considerably. However, more needs to be done to ensure forest visitors be protected either through using LLINs or repellents while working and staying in the forest areas. Also, given that sleeping under LLINs has decreased over the past several years among the at-risk populations, the programme will have to develop strategies to ensure that the communities do not lower their guard against malaria as cases further dwindle in malaria prone areas. Heightened a

Background: Rapid Diagnostic Testing (RDT), a point-of-care, qualitative test for Plasmodium antigen, has been a catalyst in the diagnosis of patients in malaria-endemic regions. While blood-smear microscopy remains the gold standard, RDT allows for swift diagnosis in resource-poor settings. Our study sought to utilize RDT to quantify local malaria prevalence in the Rorya district of Tanzania.

Materials and methods: Two field clinics were established and 1,032 patients were screened. Those that described malaria symptoms were tested via RDT. The percentage of positive tests was compared to national data from the World Health Organization's 2019 World Malaria report and the President's Malaria Initiative Report for Tanzania. Intake data (sex, age, heart rate (HR), and temperature) were compared between the malaria-positive and malaria-negative groups.

Results: 772 patients received RDT of whom 487 tested positive. There was a statistically significant difference in the percentage of positive patients between the two sites (52.0% vs 38.2%). Sixty percent of malaria-positives were female and the median age of this group was 10 yrs (range 5-15 yrs). Intake data showed a notable difference in median heart rates between malaria-positive and malaria-negative persons, 84.0 (72-100) and 72.0 (74-84) beats per minute (bpm), respectively.

Conclusions: The prevalence of malaria in Rorya was significantly higher than the reported Tanzanian average. Additionally, children were at a statistically higher risk of contracting malaria. Our data indicates that RDT offers enhanced insight into the local malarial burden that may be valuable to (governmental) health providers for the disbursement of resources in malaria-endemic regions.