MalariaWorld journal最新文献

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.

Background: Malaria continues to be a major cause of morbidity and mortality in Cameroon. With all efforts being made to eliminate malaria, it is imperative to describe the epidemiology of the disease in different parts of the country in order to inform control policies. This study aimed to present the differences in the prevalence and intensity of malaria and the anaemic status of children living in different areas of the North West region of Cameroon.

Materials and methods: This study was carried out from April 2016-July 2017. Blood samples were collected from children via finger pricking. Stained thick and thin blood films were examined through microscopy (x100) to detect the presence of parasites and to estimate the geometric mean parasite density (GMPD). Packed cell volume (PCV) values were determined by micro-centrifugation. Data was analysed using SPSS to determine proportions and test for significance levels between these.

Results: Overall prevalence of malaria was 45.3%. Awing and Obang recorded the highest prevalence while Mankon and Nkwen recorded the lowest (p=0.01). The GMPD of infection was highly heterogeneous between the different localities (p=0.03). Age significantly affected the prevalence of malaria (p=0.02). Sex did not affect the prevalence nor the GMPD of malaria infection (p>0.05). Overall mean PCV value was 32.9±3.9. Localities in urban settings recorded the highest mean PCV values compared to those in rural settings (p=0.68). Sex and age did not affect mean PCV values (p>0.05).

Conclusion: Malaria still remains a major problem in the North West region of Cameroon. Malaria control interventions should therefore be based on evident spatial and temporal heterogeneity of Plasmodium species in a particular area so as not to waste resources that would only be of limited effectiveness and value to the populations at risk.

Transmission of malaria by anopheline mosquitoes had been established by 1897, and in 1922, the first start of a successful national malaria elimination campaign began. Until then, only malaria control had been considered anywhere as a feasible project, such malaria control having been conducted primarily through larval source management. From 1922 onwards, in Palestine, by ensuring the breeding sites remained destroyed continuously over years and years, malaria elimination was eventually achieved. However, in order to achieve such continuous destruction, transmission of the disease had to be imaginatively and sensitively explained to all the inhabitants who thereupon willingly accepted the task of ensuring the breeding sites remained destroyed. Without that education, the inhabitants would not have provided the continuous work required, and Palestine would have remained in its severe malarious state.

Arachidonic acid (AA or ARA) is an extremely important fatty acid involved in cell regulation. It is a polyunsaturated fatty acid (20:4n6) covalently bound in esterified form in membrane phospholipids of most body cells. Following irritation or injury, arachidonic acid is released and oxygenated by enzyme systems leading to the formation of an important group of inflammatory mediators, to the prostaglandins (PGE₂) by the cyclooxygenase enzyme. This paper describes the positive health effects of arachidonic acid on malaria and other tropical diseases.

Background: Over the past decade, Cambodia has seen a significant decline in its malaria burden. The government has established the goal of eliminating malaria in the country by 2025. With PMI/USAID support, Cambodia is implementing a package of interventions as part of its efforts. This assessment aimed to describe the cost of malaria elimination activities in Sampov Loun Operational District (OD) between July 2015 and March 2018, to describe the cost per malaria case detected under PMI programming, and to estimate the incremental cost-effectiveness of the elimination programme per Plasmodium falciparum (Pf) or P. vivax (Pv)/Pf mixed case averted under the Cambodia Malaria Elimination Programme (CMEP) and the U.S. President's Malaria Initiative. Opportunity costs of government workers were also assessed to understand the theoretical cost of sustaining this programme through government efforts alone.

Materials and methods: We conducted an empirical micro-costing analysis based on elimination activities alone using CMEP internal project implementation data and corresponding epidemiologic data from July 2015 to March 2018 and empirical findings from implementation to date. We then constructed a cost model in Microsoft Excel using empirical data and used a cost-effectiveness decision tree to describe programme effectiveness in the first three years of implementation and to estimate efficacy for the subsequent year.

Results: The total cost of malaria elimination activities in Sampov Loun OD from July 2015 to March 2018 was $883,096. The cost per case of malaria detected in 2017 was $1,304. Including opportunity costs for government staff from July 2015 to March 2018, the total cost was $926,000. Under continued CMEP implementation, the projected future total cost of the program would be about $110,000 per year, or $0.64 per Sampov Loun resident. The incremental cost-effectiveness of the elimination programme was $28 for every additional Pf or Pv/Pf mix malaria case averted, compared to the no-CMEP proxy.

Conclusion: CMEP activities are cost effective compared to the no-CMEP proxy, as shown through an incremental cost-effectiveness of $28 for every additional Pf or Pv/Pf mix malaria case averted. The total cost of the project is 0.93% of the total per capita spending on health in Cambodia and about 5% of all government health expenditure. Continuing investments in malaria will be needed at national level for stewardship and governance and at local level for ensuring programme readiness in case of malaria outbreaks.