Decrease In Malaria Cases Research Articles

Malaria cases and its trend among the outpatients who attended some hospitals and health centres in four towns in Ekiti State, Nigeria

Monitoring the trend of malaria cases over a period of time is very useful to evaluate successes of malaria control programme in the endemic area. This study evaluated the trend of malaria cases from 2013 to 2022 from four major towns in Ekiti State, Nigeria. Clinical data involving malaria cases of outpatient visits to some hospitals and health centres from 2013 to 2022 in the four towns of Ekiti State were collected for statistical analysis. Data were analyzed with SPSS version 29 with probability value of < 0.05 as significant. Results showed that 162,077 outpatients visited the selected hospitals and health centres of the four towns from 2013 to 2022. The overall percentage of malaria cases in the study area was 21.3 % with no significant difference (P = 0.001) from the four towns. There was a gradual decrease in malaria cases from 2013 to 2021 among outpatients who were not pregnant women. Malaria cases among pregnant women however showed a slight increase from 2013 to 2022. If the control measures that caused a decline of malaria cases in this study area is sustained for a good period of time, there is tendency that malaria is eliminated from the area and possibly in the whole Ekiti State.

Malaria elimination: situation analysis of cases in India, the state of Madhya Pradesh in central India, and district Mandla of Madhya Pradesh.

India contributed approximately 66% of the malaria cases in the WHO South-East Asia region in 2022. In India, approximately 44% of cases have been reported to be disproportionately contributed by approximately 27 districts. A comparative analysis of reported malaria cases between January 2017 and December 2022 was performed in Mandla district, which is the site of a model malaria elimination demonstration project (MEDP) in Madhya Pradesh (MP), India. Compared to 2017, the decrease in malaria cases in Mandla from 2018 to 2022 was higher than MP and the rest of the country. The reduction of cases was significant in 2018, 2019, and 2021 (p < 0.01) (Mandla vs. MP) and was highly significant during 2018-2022 (p < 0.001) (Mandla vs. India). Robust surveillance and real-time data-based decisions accompanied by appropriate management, operational controls, and independent reviews, all designed for resource optimisation, were the reasons for eliminating indigenous malaria in Mandla district. The increase in infection rates during the months immediately following rains suggests that surveillance, vector control, and case management efforts should be specifically intensified for eliminating imported and indigenous cases in the near-elimination districts to work towards achieving the national elimination goal of 2030.

Assessing climate change impacts on public health in Haiti: a comprehensive study of disease distribution, modeling, and adaptation strategies

This study examines the relationship between climate change and public health in Haiti, a country already facing socioeconomic challenges. The well-being of Haiti’s vulnerable population is expected to be further affected by climate change, leading to an increase in vector-borne, water-borne, and heat-related diseases. As one of the most vulnerable countries to climate change effects, Haiti is currently experiencing an increase in vector-borne diseases such as malaria, dengue, and chikungunya, as well as water-borne diseases and emerging zoonotic outbreaks. This study aims to improve planning, decision-making, and responses to public health challenges by utilizing health data, climatic information, and impact models. The methodology involves the creation of a comprehensive climate and health database to uncover detailed spatial-temporal relationships on a national scale. By evaluating disease indicators from historical periods (1950-2014) and future projections (2015-2100) using the Shared Socio-Economic Pathways (SSPs) from the multi-model ensemble mean of the CMIP6 models, target diseases, including malaria, meningitis, dengue, and heat-sensitive chronic diseases are assessed. Our results highlight a decrease in rainfall and a strong increase in temperatures, especially within western Haiti under the extreme SSP585 scenario. The ability of the impact models to simulate the seasonality and spatial distribution of malaria incidence, dengue and heatwaves was performed. The analysis of risks related to climate-sensitive diseases’ climatic parameters shows that Haiti’s west and central regions are mostly exposed to vector-borne and water-borne diseases. Models predict a decrease in malaria cases due to climate change with hot temperatures and a decline in rainfall, while dengue transmission patterns may undergo changes. These findings will inform the implementation of context-specific early-warning systems and adaptation strategies for climate-sensitive diseases while acknowledging the challenges of integrating climate-altered data into health policies.

Evolutionary outlook on the impending endgame of malaria

Malaria is a highly debilitating vector-borne parasitic infection which has been known to be mortal and morbid to human beings for centuries now. As of today, the success rate of effective control strategies is less; however there have been several riveting developments. These include: 1. A global incidence of decrease in malaria cases; 2. The development of several non-malaria transmissible transgenic mosquitoes and 3. The launch of the vaccine has been a game changer as it is now being given to children with the success rate being high. In this review, we discuss if the current control strategies in place and the launch of the vaccine and its speculated success in children has become/been a game changer. Our take on the coevolution of parasites and vector can be the answer to the questions above. We highlight that parasites and vectors have evolved together for millions of years now, and to break this liaison will not be as easy.

Should anti-malarial chemoprophylaxis be reimbursed in France? A cost-effectiveness analysis of different reimbursement strategies

ObjectivesFrance is the Western country with the highest number of imported malaria cases. This study evaluates the cost and effectiveness of the potential reimbursement of drugs for malaria chemoprophylaxis (CP). It targets travelers with medical insurance in France who are heading to endemic regions in sub-Saharan Africa (SSA), the cost of which is currently fully borne by these travelers. Patients and methodsA decision-tree model was built to assess the cost-effectiveness of three CP reimbursement strategies compared to the current strategy of non-reimbursement from the French National Health Insurance (NHI) perspective. The three strategies targeted either (1) all travelers to SSA (2) travelers of African origin traveling to visit friends and relatives (VFR) and (3) all travelers to West and Central Africa (WCA). Base-case analysis is complemented with deterministic and probabilistic sensitivity analyses (PSA). ResultsReimbursement of CP would lead to a decrease in malaria cases. The base-case incremental cost per additional malaria case prevented (ICER) for strategies 1, 2 and 3 is estimated at € 34,623, € 15,136 and € 23,640, respectively. PSA confirms our results, showing that reimbursement has a very high probability of being cost-effective, especially under strategies 2 and 3. ConclusionReimbursement of malaria CP by the French NHI could be cost-effective and have a positive effect on malaria prevention in France. Restricting reimbursement to VFRs allows lower ICERs but does not seem feasible in the current French context, while targeting travelers to WCA, who are at higher risk for malaria, could be a reasonably efficient policy.

A brief review of malaria epidemiological trend in Kermanshah province, Iran, 1986-2014.

Malaria is the most severe protozoan disease in the world. As a result of strict malaria control programs, malaria's epidemiological model has changed. Knowing this epidemiological model and its effects will help us predict and prevent a new epidemic. This research was conducted to review the epidemiological trend of malaria in the Kermanshah province of Iran and some of its effective factors. Data were extracted from the registers in the disease control unit of the province, national population census, and annual rainfall report. The data was processed by SPSS16. There has been an evident decrease in malaria cases over the last 30 years in Kermanshah. This decreasing trend began especially after 1994, and since then, just 6% of all cases have happened. Between 1990 to 1997, an epidemic occurred, and more than 80% of positive cases were registered in these years. P. vivax malaria was the most common type (99.32%), and P. falciparum malaria was the second, with a very egregious difference (0.68%). The average age was 23.1 years, and men were infected twice more than women. There was a positive relation between annual rainfall level and positive malaria cases in these cities. After the major changes in malaria control programs in Kermanshah province, the number of positive cases fell noticeably, and now it is in the elimination stage. All cases of malaria were imported in the last years, and no resistance type was ever seen.

Conserved Plasmodium Protein (PF3D7_0406000) of Unknown Function: In-silico Analysis and Cellular Localization.

In spite of a decrease in malaria cases, the threat of malaria due to Plasmodium falciparum still prevails. The sequencing of Plasmodium falciparum reveals that approximately 60% of the Plasmodium genes code for hypothetical/putative proteins. Here we report an in silico characterization and localization of one such protein. This was encoded by one of the hub genes, in a weighted gene co-expression based systems network, from in-vivo samples of patients suffering from uncomplicated malaria or complicated malaria disease like jaundice and jaundice with renal failure. Interestingly, the protein PF3D7_0406000 (PFD0300w) is classified as a conserved protein of unknown function and shows no identity with any protein from the human host. The transcriptomic data shows up-regulation of transcripts in cases of malaria induced disease complications. PFD0300w peptide antibody based immunolocalization studies using a, gametocyte producing P. falciparum strain RKL-9, shows presence of the protein in the cytoplasm of both asexual and sexual stage parasites.

Malaria during pregnancy and newborn outcome in an unstable transmission area in Brazil: A population-based record linkage study.

BackgroundMalaria in pregnancy (MiP) is one of the major causes of mortality and morbidity in tropical regions, causing maternal anemia, intrauterine growth retardation, preterm birth, and low birth weight (LBW). The integration of the information systems on pregnancy and malaria could prove to be a useful method of improved decision making for better maternal-child health.MethodsA population-based observational study acquired information retrospectively from all live births that occurred between 2006 and 2014 in Cruzeiro do Sul (Acre, Brazil). Social and clinical data of the mother and newborn was extracted from the Information System of Live Births. Malaria episodes information was obtained from the Brazilian Epidemiological Surveillance Information System Malaria. A deterministic record linkage was performed to assess malaria impact on pregnancy.ResultsThe studied population presented a malaria incidence of 8.9% (1283 pregnant women infected), of which 63.9% infected by Plasmodium (P.) vivax. Reduction of newborn birth weight at term (small for gestational age (SGA) and LBW) has been found associated with P. vivax infection during pregnancy (SGA—OR 1.24, 95% CI 1.02–1.52, p = 0.035; term LBW—OR 1.39, 95% CI 1.03–1.88, p = 0.033). Additionally, P. falciparum infection during pregnancy has been found to be associated with preterm births (OR 1.54, 95% CI 1.09–2.18, p = 0.016), which is related with late preterm births (OR 1.59, 95% CI 1.11–2.27, p = 0.011).ConclusionsDespite the decrease of malaria cases during the evaluation period and regardless of Plasmodium species, we present evidence of the deleterious effects of MiP in a low transmission area in the Amazonian region.

Malaria Surveillance - United States, 2015.

Malaria Surveillance - United States, 2015.

Journey of dengue in Rajasthan in the last 15 years (2001-2015) with special reference to 2015

Introduction: Dengue is an underestimated and under-reported disease. We have analyzed the last 15 years data of dengue reported in Rajasthan with special reference to the year 2015 to assess the trends. Materials and Methods: This observational, descriptive study was conducted during January 2016-August 2016. Secondary data were collected from Integrated Disease Surveillance Programme (IDSP) Cell, Directorate, Medical and Health, Jaipur, the website of National Vector Borne Disease Control Programme, Census 2011. Reports of P form and L form and line listing of dengue cases of 2015 were collected. Results: Rajasthan had 1452 laboratory-confirmed cases in 2001 and 1850 in 2006 after a gap of 6 years. The next surge came only after 3 years gap. Recently, there was a fourfold increase (>4000 cases/year) during 2013 and 2015. There were substantial dengue deaths till 2009, but thereafter, it never crossed the figure of 10. Surprisingly five districts, i.e., Bhilwara, Chittorgarh, Jhalawar, Pali, and Sirohi, did not report a single case of dengue during 2015. There was fourfold increase in dengue cases but paradoxically fourfold decrease in malaria cases in the last 5 years. Conclusion: Dengue was the new emerging disease with 1452 confirmed cases in Rajasthan in 2001. Thereafter, there was a constant high load of dengue; however, case-fatality rate is below one after 2010. Recently, there was a fourfold increase (>4000 cases/year) during 2013 and 2015. Zero reporting of dengue in a few districts indicates the need for improvement in IDSP reporting in these districts.

Mathematical Analysis of Malaria-Schistosomiasis Coinfection Model

We formulated and analysed a mathematical model to explore the cointeraction between malaria and schistosomiasis. Qualitative and comprehensive mathematical techniques have been applied to analyse the model. The local stability of the disease-free and endemic equilibrium was analysed, respectively. However, the main theorem shows that if RMS&lt;1, then the disease-free equilibrium is locally asymptotically stable and the phase will vanish out of the host and if RMS&gt;1, a unique endemic equilibrium is also locally asymptotically stable and the disease persists at the endemic steady state. The impact of schistosomiasis and its treatment on malaria dynamics is also investigated. Numerical simulations using a set of reasonable parameter values show that the two epidemics coexist whenever their reproduction numbers exceed unity. Further, results of the full malaria-schistosomiasis model also suggest that an increase in the number of individuals infected with schistosomiasis in the presence of treatment results in a decrease in malaria cases. Sensitivity analysis was further carried out to investigate the influence of the model parameters on the transmission and spread of malaria-schistosomiasis coinfection. Numerical simulations were carried out to confirm our theoretical findings.

Sustaining control: lessons from the Lubombo spatial development initiative in southern Africa

BackgroundThe Lubombo Spatial Development Initiative (LSDI) was a tri-country project between South Africa, Swaziland and Mozambique with the aim of accelerating socio-economic development in the region. The malaria component of the project was introduced to decrease the transmission of malaria in the region. This goal was met but with termination of this project resulted in an upsurge of malaria cases in the sub-region mainly as a result of migration from high transmission areas to low transmission ones. The movement of people across borders in southern Africa remains a challenge in sustaining malaria control and elimination.MethodsMalaria case data for Swaziland and South Africa were obtained from their respective national Malaria Information Systems. Data for Mozambique was obtained from the Mozambican Ministry of Health. Data obtained during the course of the LSDI project was compared to the case data post the termination of the LSDI.ResultsThe 12-year period of the LSDI showed a substantial decrease in disease burden amongst the three countries involved when compared to the baseline year of 2000. The decrease in malaria cases was 99 % in South Africa and 98 % in Swaziland. Malaria prevalence in Mozambique decreased by 85 % over the same period. However, after the LSDI ended, between 2012 and 2014, there was an upward trend in case data that was counter to the goal of elimination.ConclusionSouth Africa and Swaziland benefitted from the LSDI and were able to sustain malaria control and progress to the stage of elimination. Mozambique could not sustain the gains made during the LSDI and case numbers increased. Technical and financial resources are key challenges for malaria control and elimination interventions.

Sharp decline of malaria cases in the Burie Zuria, Dembia, and Mecha districts, Amhara Region, Ethiopia, 2012-2014: descriptive analysis of surveillance data.

BackgroundIn the Amhara Region of Ethiopia, a steep decline of malaria cases was seen in early 2014. This study verified the decrease of the malaria cases along with the positivity rates among acute febrile illness patients, from late 2012 through 2014 in selected districts of the Amhara Region of Federal Republic of Ethiopia.MethodsDescriptive epidemiological analysis was conducted on the routine malaria surveillance data from the World Health Organization epidemiological week 28 of 2012 to week 52 of 2014 in three districts: Burie Zuria, Dembia and Mecha, the Amhara Region in Ethiopia. The authors visited the three district health offices, and health centres, when necessary, and collected the surveillance data on malaria for that period.ResultsThe study found that the malaria cases, along with the positivity rates, decreased from late 2012 to early 2014 in all three districts. Though the situation had slightly reverted in late 2014, the numbers of cases were much smaller than in late 2012 in all three districts. Despite the different diagnostic techniques used at health centres (malaria microscopy) and health posts (rapid diagnostic tests), moderate to high correlations were found, suggesting that the trends were real and not caused by a defect in the reagent, differences in the technicians’ skills for microscopy, or a change of the health workers’ attitudes toward cases with acute febrile illness. The decrease in malaria cases in early 2014 may have resulted from successful implementation of the three pillars of malaria control—case management, indoor residual spraying and insecticide-treated nets—in the districts where a high percentage of households were protected by indoor residual spraying and/or insecticide-treated nets.ConclusionWhile the current efforts for malaria control should be strengthened and maintained, the review of malaria surveillance data should also be used to verify the malaria trend in the region.

Malaria prevention—keep it simple and logical

Due to various activities—including those by the World Bank and the Bill & Melinda Gates Foundation—we are happy to see a global decrease in malaria cases. But too many still suffer and die from malaria so malaria prevention or at least to prevent deaths by malaria is of paramount importance, still. And this is not true for the indigenous population only but for travellers as well. Balancing the risk of disease with that of possible side effects of chemoprophylaxis is a difficult task which mostly leads to split decisions even in experts (as was shown in a thrilling Pro-Con debate at the CISTM14 in Quebec in May 2015). This lack of guidance left and still leaves many colleagues (including qualified travel medicine practitioners) quite puzzled—not to talk about those on target—i.e. the travellers. For sustainable guidance my deep believe is: KEEP IT SIMPLE—otherwise counselling doctors (not all of whom are experts in tropical medicine or malariology) as well as travellers will get lost in confusion for sure1 (‘The compliance is inversely proportional to the complexity of the prescription’—Haynes and Sackett 1976). Insect bite precautions (IBP) from dusk until dawn are the mainstay of malaria prophylaxis—so this is of paramount importance for each traveller going to malaria endemic areas no matter how high the risk actually is. The first crucial decision of the binary decision tree is the definition of high risk of exposure (but may consider high risk of complications in vulnerable travellers as well). Whereas some sources say that there is no method of quantifying the risk2 in other sources high risk is defined by a risk …

Controlling malaria in Niger with bednets: how to take the Big Picture

Results and discussion During the first year of follow-up, vector dynamics showed an overall decrease in malaria transmission, but this was highly variable from village to village. Indeed, the second year of survey showed a return to transmission levels close to the pre-intervention period. A study of microsatellite markers showed no modification of the genetic structure in the two malaria vectors An. gambiae and An. arabiensis. However, a clear increase of the resistant allele of the kdr gene resistence to the pyrethroid insecticide used in the bed nets was observed. This clearly demonstrated that the main target vectors were reached. As measured by ovarian tracheoles observation, the parity rate of vectors was not significantly decreased. However, the index sporozoite decreased in the first year and remained low in the second year. Indeed, the parasite prevalence and the gametocyte carriage were shown decreasing in the children under five. This continued in 2007 as the National Malaria Control Program provided free artemisinin-based combination therapies as first line treatment for malaria in children under five. The national survey network showed a decrease in malaria cases, as confirmed in our sentinelle sites. However the biological confirmation of cases by HRP2 plasmodial antigen research has increased during the two years of follow-up. This could be explained by the more accurate diagnosis by peripheral health personal with the help of rapid diagnostic tests.

Socioecological Perspectives of Malaria in India: A Review

P-522 Introduction: Malaria is a major health problem in India and every year it claims the lives of thousands of people and infects millions. Although nearly eradicated, it is significantly on the rise. According to the WHO, in 2003, there were approximately 2.8 million reported cases of malaria in India. There are several opinions regarding the resurgence of malaria and majority of them blame the operational aspect, which are often too simplistic and far from the reality. The present study has tried to establish the complex social and ecological perspective of malaria occurrence in various geographical locations in the country. Methods: Data for the malaria study was retrieved from the Central Bureau of Health Intelligence (CBHI) of India for the years 1994 to 2001. The study also analyzed socio-ecological perspectives of epidemics derived from several secondary sources. The majority of the secondary data on epidemics was collected from online searches (Pub med, google scholar) and unpublished government reports. We also linked the malaria outbreak with the dynamics of recent ecological change due to human interactions. Results: Our analysis led to the identification of states and areas of the county yielding high number of malaria cases in the past decade and to those regions in which there was an increased rate in malaria cases during the same period. State level data analysis identified Orissa, Madhya Pradesh, and Karnataka among the states with high number of malaria cases. Furthermore, we recognized that the states such as Gujarat and Chandigarh were showing a decrease in malaria cases. Falciparum malaria continues to exist in remote tribal forest areas in central and eastern part of the country where health service is very poor. The appearance of vectors in several hilly areas indicates the possible role of global warming and population mobility from endemic areas. Investment and priority in malaria eradication program was found to be linked with recent epidemics. Irrational medication and improper insecticide spray resulted in resistance of parasites and vectors respectively, hence more malaria incidence and fatality. Discussion and Conclusion: This study clearly recognizes a need for better disease and vector surveillance, rational treatment and proper vector control for effective eradication of malaria in India. There is a requirement of micro and macro level analysis on demographics, population behavior and movement, irrigation, deforestation and environment change in order to implement a need based control approach.

Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa.

BackgroundBetween 1995 and 2000, KwaZulu–Natal province, South Africa, experienced a marked increase in Plasmodium falciparum malaria, fuelled by pyrethroid and sulfadoxine-pyrimethamine resistance. In response, vector control was strengthened and artemether-lumefantrine (AL) was deployed in the first Ministry of Health artemisinin-based combination treatment policy in Africa. In South Africa, effective vector and parasite control had historically ensured low-intensity malaria transmission. Malaria is diagnosed definitively and treatment is provided free of charge in reasonably accessible public-sector health-care facilities.Methods and FindingsWe reviewed four years of malaria morbidity and mortality data at four sentinel health-care facilities within KwaZulu–Natal's malaria-endemic area. In the year following improved vector control and implementation of AL treatment, malaria-related admissions and deaths both declined by 89%, and outpatient visits decreased by 85% at the sentinel facilities. By 2003, malaria-related outpatient cases and admissions had fallen by 99%, and malaria-related deaths had decreased by 97%. There was a concomitant marked and sustained decline in notified malaria throughout the province. No serious adverse events were associated causally with AL treatment in an active sentinel pharmacovigilance survey. In a prospective study with 42 d follow up, AL cured 97/98 (99%) and prevented gametocyte developing in all patients. Consistent with the findings of focus group discussions, a household survey found self-reported adherence to the six-dose AL regimen was 96%.ConclusionTogether with concurrent strengthening of vector control measures, the antimalarial treatment policy change to AL in KwaZulu–Natal contributed to a marked and sustained decrease in malaria cases, admissions, and deaths, by greatly improving clinical and parasitological cure rates and reducing gametocyte carriage.