Endemic Malaria Research Articles

Plasmodium falciparum population structure inferred by msp1 amplicon sequencing of parasites collected from febrile patients in Kenya

BackgroundMultiplicity of infection (MOI) is an important measure of Plasmodium falciparum diversity, usually derived from the highly polymorphic genes, such as msp1, msp2 and glurp as well as microsatellites. Conventional methods of deriving MOI lack fine resolution needed to discriminate minor clones. This study used amplicon sequencing (AmpliSeq) of P. falciparum msp1 (Pfmsp1) to measure spatial and temporal genetic diversity of P. falciparum.Methods264 P. falciparum positive blood samples collected from areas of differing malaria endemicities between 2010 and 2019 were used. Pfmsp1 gene was amplified and amplicon libraries sequenced on Illumina MiSeq. Sequences were aligned against a reference sequence (NC_004330.2) and clustered to detect fragment length polymorphism and amino acid variations.ResultsChildren < 5 years had higher parasitaemia (median = 23.5 ± 5 SD, p = 0.03) than the > 5–14 (= 25.3 ± 5 SD), and those > 15 (= 25.1 ± 6 SD). Of the alleles detected, 553 (54.5%) were K1, 250 (24.7%) MAD20 and 211 (20.8%) RO33 that grouped into 19 K1 allelic families (108–270 bp), 14 MAD20 (108–216 bp) and one RO33 (153 bp). AmpliSeq revealed nucleotide polymorphisms in alleles that had similar sizes, thus increasing the K1 to 104, 58 for MAD20 and 14 for RO33. By AmpliSeq, the mean MOI was 4.8 (± 0.78, 95% CI) for the malaria endemic Lake Victoria region, 4.4 (± 1.03, 95% CI) for the epidemic prone Kisii Highland and 3.4 (± 0.62, 95% CI) for the seasonal malaria Semi-Arid region. MOI decreased with age: 4.5 (± 0.76, 95% CI) for children < 5 years, compared to 3.9 (± 0.70, 95% CI) for ages 5 to 14 and 2.7 (± 0.90, 95% CI) for those > 15. Females’ MOI (4.2 ± 0.66, 95% CI) was not different from males 4.0 (± 0.61, 95% CI). In all regions, the number of alleles were high in the 2014–2015 period, more so in the Lake Victoria and the seasonal transmission arid regions.ConclusionThese findings highlight the added advantages of AmpliSeq in haplotype discrimination and the associated improvement in unravelling complexity of P. falciparum population structure.

Outbreak of Locally Acquired Mosquito-Transmitted (Autochthonous) Malaria - Florida and Texas, May-July 2023.

Eight cases of locally acquired, mosquito-transmitted (i.e., autochthonous) Plasmodium vivax malaria, which has not been reported in the United States since 2003, were reported to CDC from state health departments in Florida and Texas during May 18-July 17, 2023. As of August 4, 2023, case surveillance, mosquito surveillance and control activities, and public outreach and education activities continue in both states. U.S. clinicians need to consider a malaria diagnosis in patients with unexplained fever, especially in areas where autochthonous malaria has been recently reported, although the risk for autochthonous malaria in the United States remains very low. Prompt diagnosis and treatment of malaria can prevent severe disease or death and limit ongoing transmission to local Anopheles mosquitoes and other persons. Preventing mosquito bites and controlling mosquitoes at home can prevent mosquitoborne diseases, including malaria. Before traveling internationally to areas with endemic malaria, travelers should consult with a health care provider regarding recommended malaria prevention measures, including potentially taking malaria prophylaxis. Malaria is a nationally notifiable disease; continued reporting of malaria cases to jurisdictional health departments and CDC will also help ensure robust surveillance to detect and prevent autochthonous malaria in the United States.

A Sensitivity Analysis of a Mathematical Model for the Transmission of Endemic Malaria under Periodic Climatic Conditions

We perform sensitivity analysis on a periodic mathematical model of endemic malaria transmission to determine the relative importance and impact of model parameters to disease transmission and prevalence. In this analysis, two sets of baseline parameter values are compiled: one for areas that exhibit high transmission rate and another one for areas with low transmission rates. Sensitivity indices for the basic reproductive number and the endemic equilibrium points are computed. The study established that in areas of low transmission, the reproductive number is most sensitive to the mosquito biting rate, but the equilibrium proportion of the infectious humans is most sensitive to the human recovery rate. Sensitivity analysis on all state variables was conducted. The results indicated that the most influential factors in the transmission and persistence of malaria in the society are those related to vectorial competence. These findings suggests that strategies that target the vector characteristics such as the mosquito biting rate and those that target the human recovery rate can be very successful in controlling malaria. These strategies include the use of insecticide-treated mosquito nets, indoor residual spraying, prompt diagnosis and treatment of infectious individuals. However, a combination of intervention strategies is more effective than application of a single intervention.

The question of the early diagnosis of asymptomatic and subpatent malaria in pregnancy: Implications for diagnostic tools in a malaria endemic area.

Malaria in pregnancy (MIP) is a major healthcare challenge in low-income countries with high malaria endemicity. Early but accurate diagnosis and appropriate treatment is the hallmark of preventing disease progression/adverse outcomes in the mother, foetus and neonates. We assessed the comparative diagnostic performance of Malaria Rapid Diagnostic Test (mRDT), microscopy and PCR for malaria diagnosis in pregnant women for early detection of asymptomatic malaria in pregnant women. Five hundred and twenty Pregnant women attending study clinics within Ikene and Remo North LGAs with gestational age between 16 and 29 weeks, willing and consented; were enrolled into the study. Blood samples collected via venepuncture were screened for malaria using microscopy, mRDTs kits, and PCR techniques on their first visit (V1) and at delivery. The parasite positivity rates, sensitivity and specificity were calculated and compared for each technique using PCR as the standard. Data was entered into REDCap® online database and analysis done using Stata and MedCalc®. Average age of enrolled women was 28.8 years and mean gestational age was 21.0 weeks. The parasite positivity rates were 4.3%, 8.8% and 25.0% for microscopy, mRDT and PCR at V1 and was 2.4%, 3.4% and 43.4% at delivery, respectively. Sensitivity for microscopy and mRDT was 11.2% and 30.3% respectively at V1, while specificity was 98.2% and 98.5%. At delivery, the sensitivity reduced to 1.6% and 4.9%; while specificity was 96.9% and 97.6% respectively. Only 2.3% cases correlated with all three diagnostic methods. Our data showed a decrease in sensitivity of the diagnostic methods as pregnancy progressed, which may be due to very low parasitaemia, but high specificity. Our study demonstrated a high rate of subpatent parasitaemia amongst pregnant women. This finding therefore raises the question of the effect of subpatent parasitaemia on the health of the mother and foetus.

Risk of imported malaria infections in Zanzibar: a cross-sectional study

BackgroundZanzibar has made substantial progress in malaria control with vector control, improved diagnosis, and artemisinin-based combination therapy. Parasite prevalence in the population has remained around 1% but imported infections from mainland Tanzania contribute to sustained local transmission. Understanding travel patterns between mainland Tanzania and Zanzibar, and the risk of malaria infection, may help to control malaria importation to Zanzibar.MethodsA rolling cross-sectional survey linked to routine reactive case detection of malaria was carried out in Zanzibar between May 2017 and October 2018. Households of patients diagnosed with malaria at health facilities were surveyed and household members were tested for malaria using rapid diagnostic tests and a sub-sample by quantitative PCR (qPCR). Interviews elicited a detailed travel history of all household members who had travelled within the past two months, including trips within and outside of Zanzibar. We estimated the association of malaria infection with travel destinations in pre-defined malaria endemicity categories, trip duration, and other co-variates using logistic regression.ResultsOf 17,891 survey participants, 1177 (7%) reported a recent trip, of which 769 (65%) visited mainland Tanzania. Among travellers to mainland Tanzania with travel destination details and a qPCR result available, 241/378 (64%) reported traveling to districts with a ‘high’ malaria endemicity and for 12% the highest endemicity category was ‘moderate’. Travelers to the mainland were more likely to be infected with malaria parasites (29%, 108/378) than those traveling within Zanzibar (8%, 16/206) or to other countries (6%, 2/17). Among travellers to mainland Tanzania, those visiting highly endemic districts had a higher odds of being qPCR-positive than those who travelled only to districts where malaria-endemicity was classified as low or very low (adjusted odd ratio = 7.0, 95% confidence interval: 1.9–25.5). Among travellers to the mainland, 110/378 (29%) never or only sometimes used a mosquito net during their travel.ConclusionsStrategies to reduce malaria importation to Zanzibar may benefit from identifying population groups traveling to highly endemic areas in mainland Tanzania. Targeted interventions to prevent and clear infections in these groups may be more feasible than attempting to screen and treat all travellers upon arrival in Zanzibar.

High-Throughput Antibody Profiling Identifies Targets of Protective Immunity against P. falciparum Malaria in Thailand.

Malaria poses a significant global health challenge, resulting in approximately 600,000 deaths each year. Individuals living in regions with endemic malaria have the potential to develop partial immunity, thanks in part to the presence of anti-plasmodium antibodies. As efforts are made to optimize and implement strategies to reduce malaria transmission and ultimately eliminate the disease, it is crucial to understand how these interventions impact naturally acquired protective immunity. To shed light on this, our study focused on assessing antibody responses to a carefully curated library of P. falciparum recombinant proteins (n = 691) using samples collected from individuals residing in a low-malaria-transmission region of Thailand. We conducted the antibody assays using the AlphaScreen system, a high-throughput homogeneous proximity-based bead assay that detects protein interactions. We observed that out of the 691 variable surface and merozoite stage proteins included in the library, antibodies to 268 antigens significantly correlated with the absence of symptomatic malaria in an univariate analysis. Notably, the most prominent antigens identified were P. falciparum erythrocyte membrane protein 1 (PfEMP1) domains. These results align with our previous research conducted in Uganda, suggesting that similar antigens like PfEMP1s might play a pivotal role in determining infection outcomes in diverse populations. To further our understanding, it remains critical to conduct functional characterization of these identified proteins, exploring their potential as correlates of protection or as targets for vaccine development.

A malaria risk model for the Mediterranean in antiquity based on the historical Carta della Malaria dell’Italia

ABSTRACT Growing interest in the health burden of malaria in ancient times is complimented by recent DNA confirmation of its presence at several archaeological sites in the Mediterranean. This study presents a model of ancient malaria risk for the region with utility for synthesis and application. The GIS-based model combines malaria risk factors that can be reasonably known for pre-modern times. Calibration, verification, and validation of the model is possible through use of a detailed map of pre-eradication malaria endemicity in Italy, the 1882 Carta della Malaria dell’Italia. The model provides a cross-disciplinary tool by bringing technical GIS capabilities to the evaluation of textual sources having potential malarial connections. The study’s main product is an open access relative malaria risk layer for GIS use and application to historical reconstruction. Example maps using model output and potential use are presented.

Understanding disease pathogenesis and host response of endemic malaria in previously exposed individuals compared to naïve individuals

Plasmodium falciparum and Plasmodium vivax are two major species of malaria that can establish a focus of infection in millions of individuals per year. Principally, this occurs in the tropical and subtropical regions of the world where malaria is endemic due to the ubiquity of the disease vector, the Anopheles mosquitos. Malaria takes the lives of thousands of infected individuals as the progression of disease symptoms having fatal consequences. This disease mainly affects children and pregnant women which poses a great public health concern. It is also a global economic burden from the millions of international dollars are aliquoted for research yearly. This review looks to discuss the pathogenesis of malaria, various host immune responses, the development of clinical immunity in reinfected individuals, and the effects that the presence of one species may have on the pathogenesis and disease outcome of another malarial species in co-infected individuals. Overall, this manuscript aims to provide an understanding of malarial infection and the differing host immune mechanisms of previously exposed individuals compared to those of naïve individuals in environments where malaria is of high prevalence. These highlights indicate a need for further research in order to better understand host-species and species-species interactions so that proper therapeutics and vaccinations may be developed as to not inhibit the beneficial effects species may have on one another in mixed species interactions as well as to aid in the development of clinical immunity.

Superoxide dismutase activity levels in parturients on intermittent preventive treatment with sulphadoxine pyrimethamine and their controls at current confinements

Malaria prevention in pregnancy especially in endemic areas has been greatly emphasized. This is especially so during the antenatal periods. Malaria prevention is important for reducing the problems of malaria in pregnancy. Early trimester miscarriages, preterm labours, anaemia in pregnancy, small for date babies and increased admissions into special care baby units are some of the problems encountered that are traceable to malaria infection. It is also noteworthy that some favourable antioxidants have been noted to help pregnant women enjoy and cope with their pregnancies. In that same way, it has also been noted that optimal levels of superoxide dismutase is equally necessary to help pregnant women enjoy uneventful pregnancies as well as stay free from some problems associated with malaria in pregnancy. Objectives: We have comparatively and objectively assessed the plasma Levels of superoxide dismutase in Parturients on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine and their Controls at Current Confinements. Method: This comparative study was conducted at the Obstetrics and Gynaecology Department of the Federal Medical Centre (FMC) Owerri, South East Nigeria. Owerri is widely known for its heavy malaria endemicity. Prior to participant recruitment, appropriate ethical clearance was applied for and obtained from the ethics committee of FMC Owerri. This enabled the commencement of the longitudinal recruitment of participants after due counseling and adequate informed consent involving both study groups. This bench-based research and cross-sectional descriptive study involved two hundred and ninety-six (296) consented participants. The participants were made to understand clearly the study protocol as well as satisfy the inclusion criteria for either the study (case) or control groups. Upon recruitment, participants were then followed up all throughout their entire antenatal course culminating in the delivery. The follow up enabled the collection of blood samples for the estimation of Superoxide Dimutase (SOD) plasma levels at delivery. The SOD levels were estimated using the Misra and Fridovich method, 1972. The ability of superoxide dismutase to inhibit the auto oxidation of adrenaline at pH 10.2 makes this reaction a basis for the SOD assay. Superoxide anion (O2) generated by the xanthine oxidase reaction is known to cause the oxidation of adrenaline to adrenochrome. The yield of adrenochrome produced per superoxide anion introduced increased with increasing pH and also with increasing concentration of adrenaline. These led to the proposal that auto oxidation of adrenaline proceeds by at least two distinct pathways, one of which is a free radical chain reaction involving superoxide radical and hence could be inhibited by SOD. Data analysis: Data computation and analysis were done using the computer Software Package for Social Science (SPSS) version 20.0 (SPSS, Inc, 2007, Chicago). Important descriptive statistics (mean, standard deviation, range, percentages etc) were determined for continuous variables. P-value less than (&lt;0.05) at 95% confidence interval was considered statistically significant. Result: The mean serum level of superoxide dismutase (SOD) in the study group was 12.61 U/ml ± 3.105 while the minimum and maximum serum superoxide dismutase were 7 and 20 U/ml respectively. For their controls, the mean serum level of superoxide dismutase was 11.69 U/ml ± 2. 969. However, the minimum and maximum serum superoxide dismutase were 7 and 20 U/ml respectively. The difference was found to be statistically significant (p= 0.011) with odds ratio 1.12 (CI of 95% 1.024-1.193).

Sickle Cell Disease in Pregnancy: Obstetrician’s Nightmare in Resource-Poor Countries!

Sickle Cell Disease in Pregnancy: Obstetrician’s Nightmare in Resource-Poor Countries!

Spontaneous Rupture of the Spleen Due To Malaria A Case Report

Malaria is of the commonest diseases in Sudan and a major cause of morbidity and mortality. Its transmitted by Anopheles mosquito bite. It has well described and common complications that most of the clinicians in Sudan are familiar with its presentation and how to deal with it. However, Malarial splenic rupture (MSR) is uncommon even in highly endemic areas Malaria and is a dramatic complication demanding prompt recognitions and surgical treatment.

The Role of Nutrient Intake and Social Determinants in Anemia among Pregnant Women at Lampung Malaria Endemic Areas

Anemia in pregnancy is a health problem, associated with an increased risk of morbidity and mortality during childbirth. The study’s purpose was to determine the role of nutrient intake and social determinants on anemia in pregnancy in the Pesawaran district. This study was an analytic observational study using a cross-sectional design, conducted in malaria-endemic areas, Pesawaran district, Lampung, from June to Desember 2021. The sample was 75 pregnant women in second trimester, taken by purposive sampling technique. Anemia was measured by examining haemogobins, data on education, family income, age, and parity were obtained from interviews, maternal knowledge using questionnaires, and food intake using a 2x24-hour food recall questionnaire. Data were analyzed univariate, bivariate, and multivariate. The results showed that anemia in pregnancy was 42,7%. Most of the pregnant women are poorly educated (50,7%), have poor knowledge (64%), sufficient income (53,3%), multiparous (68%), good age (64%), inadequate energy intake (72%), inadequate protein intake (58,7%), and inadequate iron intake (56%). The results showed that education (p=0.003), knowledge (p=0.015), income (p=0.009), parity (p=0.004), age (p=0.004), energy intake (p=0.02), protein intake (p = 0.025), and iron intake (p=0,031) has a role on anemia in pregnancy. The factors that most play a role are education, income, parity, and iron intake.

Quantitative Polymerase Chain Reaction from Malaria Rapid Diagnostic Tests to Detect Borrelia crocidurae, the Agent of Tick-Borne Relapsing Fever, in Febrile Patients in Senegal.

In endemic malaria areas, Plasmodium is currently diagnosed mainly through the use of rapid diagnostic tests (RDTs). However, in Senegal, many causes of fever remain unknown. Tick-borne relapsing fever, an often-neglected public health problem, is the main cause of consultation for acute febrile illness after malaria and flu in rural areas. Our objective was to test the feasibility of extracting and amplifying DNA fragments by quantitative polymerase chain reaction (qPCR) from malaria-negative RDTs for Plasmodium falciparum (malaria Neg RDTs P.f) to detect Borrelia spp. and other bacteria. Between January and December 2019, malaria Neg RDTs P.f were collected on a quarterly basis in 12 health facilities in four regions of Senegal. The DNA extracted from the malaria Neg RDTs P.f was tested using qPCR and the results were confirmed by standard PCR and sequencing. Only Borrelia crocidurae DNA was detected in 7.22% (159/2,202) of RDTs. The prevalence of B. crocidurae DNA was higher in July (16.47%, 43/261) and August (11.21%, 50/446). The annual prevalence was 9.2% (47/512) and 5.0% (12/241) in Ngayokhem and Nema-Nding, respectively, health facilities in the Fatick region. Our study confirms that B. crocidurae infection is a frequent cause of fever in Senegal, with a high prevalence of cases in health facilities in the regions of Fatick and Kaffrine. Malaria Neg RDTs P.f are potentially a good source of pathogen sampling for the molecular identification of other causes of fever of unknown origin, even in the most remote areas.

Perceived Health System Challenges of Implementing Cross-Border Malaria Preventive Measures at Ports of Entry in KwaZulu-Natal.

Cross-border movements, especially from a malaria-endemic neighbour, contribute to importation of malaria, as they provide favourable conditions for malaria transmission in the receiving country. In the KwaZulu-Natal (KZN) province of South Africa (SA), the uMkhanyakude district is one of the endemic malaria areas where the borders are characterised by frequent cross-border movements of travellers coming into the province, mostly from Mozambique. Many studies have suggested that regional efforts through the implementation of cross-border measures are needed in both the high- and low-endemic countries to effectively address imported malaria. The implementation of cross-border measures to prevent imported malaria has led to a significant decline in malaria cases in KZN and SA; however, those measures are subjected to various challenges. This study sought to determine the health system challenges of implementing cross-border preventive measures for imported malaria at the Kosi Bay, Kwaphuza and Golela ports of entry in KZN. This inquiry consisted of a mixed methods approach, of which the qualitative component is reported here. In-depth interviews were conducted with four purposively selected health officers working at the legal and illegal ports of entry of the KZN province. Data were coded manually and then analysed using thematic data and descriptive analyses. This study identified operational and prevention challenges. The related operational challenges included travellers' non-disclosure and refusal, uncontrolled cross-border movements and poor coverage as well as shortage of staff. The prevention challenges included lack of novelty in the existing cross-border preventive measures, insecurity and illegal migration. Concerning travellers' non-disclosure and refusal to cooperate, these issues occur at the legal ports of entry of Kosi Bay and Golela, where travellers were less cooperative in disclosing their health-related information to health border officers. They were more eager to cross and attend to their business. The findings revealed a lack of new ideas in the existing cross-border measures for the prevention of imported malaria, which some scientists considered as the reason for the failure of the elimination efforts in SA. Because of the porous borders and the shortage of staff to cover all the uncontrolled entries, travellers constantly crossed without any hindrances. Porous borders exposed the people living at the border areas and travellers to insecurity, promoted criminal activities and encouraged illegal migration. Cross-border malaria preventive measures are meant to contribute to decreased travel-related disease. Failure to attain this purpose must be carefully examined and mitigation strategies implemented. The study revealed the challenges of implementing cross-border measures at the KZN ports of entry of Kosi Bay, Kwaphuza and Golela. The challenges occurred at the operational and prevention levels, which, if not effectively addressed, could impede the decrease of imported malaria in the malaria-endemic district of KZN and SA in general.

Malaria endemicity in sub-Saharan Africa: Past and present issues in public health

Malaria endemicity in sub-Saharan Africa: Past and present issues in public health

Survey in Iranian Malaria Blood Donation Deferral: Laboratory Evaluation in Malaria Blood Donation Deferral in the Iranian Blood Centers

Introduction: Transfusion-transmitted malaria (TTM), from a malaria infected donor, is an accidental Plasmodium infection, which is one of the concerns of blood transfusion issue in the world. Countries have adopted different strategies for donor selection and improving criteria to overcome these concerns, In the Iranian Blood Transfusion Organization (IBTO), donors who refer to blood transfusion centers after registration are screened by the physicians based on interview and examination. This prevention due to the possibility of malaria infection is called malaria donor deferral strategy.&#x0D; Methods: In this study 248 malaria blood donation deferral samples were selected and evaluated by microscopic, serological and molecular methods, after completing the questionnaire.&#x0D; Results: The results of the survey of the questionnaires showed that 30 cases were deferred from donating blood due to having a history of malaria infection. In microscopic examination, Plasmodium ring was observed in 2 samples and 2 samples were also reported as suspicious. In serological examination, 23 cases (9.27%) were reported positive. All cases were reported negative for the presence of malaria parasite DNA.&#x0D; Conclusions: The adoption of TTM prevention strategies depends on the malaria endemicity of the geographical area. According to the IBTO instructions, donors are examined and interviewed by a blood transfusion physician’s and owning to traveling or residency in endemic area or malaria infection, deferred temporary or permanently.&#x0D; Recent study reveal that the strategy of donor selection and deferral in the IBTO, with little residual risk of malaria transmitting, is sufficient to prevent the occurrence of TTM in Iran.

Prevalence of Antimalaria-Drug-Resistant-Plasmodium-falciparum Mutant Genes in Out-Patients from a Malaria Endemic Region in Southwest, Nigeria

The research identified, ipso facto, Pfcrt gene SNP at codons 72&amp;76 and Pfmdr1 gene SNPs at codons 86 &amp;184 and 1034,1042 &amp;1246 from malaria patients in Ifedore Local Government Area (LGA) in Ondo State, Nigeria. Thick blood film microscopy was used to examine blood samples from 2,063 febrile malaria patients within the study area. Four hundred positive samples were used to make Dry Blood Spots (DBS) on Whatman No.3 paper. The parasite DNAwas extracted from the DBS samples using spin column-based DNA purification kit. Identification and genotyping of the Pfcrt and Pfmdr1 mutant genes of the parasite were done using Nested PCR method. Molecular analysis of the 400 positive samples yielded 352 positive results after testing with various plasmodia markers with only Plasmodium falciparum detected in the study area. Results obtained from genotyping the mutant genes showed that of all the 352 P. falciparum isolates examined, Pfmdr1 SNP at codons 86&amp;184 recorded the highest prevalence (11.08%), followed by Pfmdr1 SNP at codon 1034,1042&amp;1246 (7.95%) while Pfcrt SNPat codon 72&amp;76 recorded the lowest prevalence (3.41%). A prevalence of 19.32% coexistence of the three SNPs of the mutant genes was observed among the study population (p&lt;0.05). The existence of the Pfcrt and Pfmdr1 mutant genes suggests resistance of P. falciparum to most malaria drugs used in the treatment of malaria in the study area. Therefore, it is important to monitor resistance to treatment regimens and therapeutics to aid the management of malaria in endemic areas.

Distinctive Kaposi Sarcoma-Associated Herpesvirus Serological Profile during Acute Plasmodium falciparum Malaria Episodes.

The seroprevalence of Kaposi sarcoma-associated herpesvirus (KSHV) and the incidence of endemic Kaposi sarcoma (KS) overlap with regions of malaria endemicity in sub-Saharan Africa. Multiple studies have shown an increased risk of KSHV seroconversion in children from high malaria compared to low malaria regions; however, the impact of acute episodes of Plasmodium falciparum (P. falciparum) malaria on KSHV's biphasic life cycle and lytic reactivation has not been determined. Here, we examined KSHV serological profiles and viral loads in 134 children with acute malaria and 221 healthy children from high malaria regions in Kisumu, as well as 77 healthy children from low malaria regions in Nandi. We assayed KSHV, Epstein-Barr virus (EBV), and P. falciparum malaria antibody responses in these three by multiplexed Luminex assay. We confirmed that KSHV seroprevalence was significantly associated with malaria endemicity (OR = 1.95, 1.18-3.24 95% CI, p = 0.01) with 71-77% seropositivity in high-malaria (Kisumu) compared to 28% in low-malaria (Nandi) regions. Furthermore, KSHV serological profiles during acute malaria episodes were distinct from age-matched non-malaria-infected children from the same region. Paired IgG levels also varied after malaria treatment, with significantly higher anti-ORF59 at day 0 but elevated ORF38, ORF73, and K8.1 at day 3. Acute malaria episodes is characterized by perturbation of KSHV latency in seropositive children, providing further evidence that malaria endemicity contributes to the observed increase in endemic KS incidence in sub-Saharan Africa.

Environmental and Behavioral Factors in Malaria Endemic and Non- Endemic Villages of Jampea Island Districts, Selayar Island Regency Indonesia

Jampea Island is included in the malaria intermediate endemic area, but this area is interested to study because there are 3 villages without malaria cases for the last three years. The aims of the study were to determine the difference in the physical environment and social behavior of malaria endemic and non-endemic villages in Jampea Island, Selayar Island Regency. This study was observational with cross sectional study design. The study was conducted in the village with endemic status, Bontobaru village and non-endemic, Ujung village. Respondents were 110 households. Data were analyzed proportional discrepancy test and logistic regression. The result of proportional discrepancy test identified the value of variables of water puddle, shrubs, ceiling, wall type, floor type, the use of wire netting, and evenings go out habit was p&lt;0.05 which indicated a difference between malaria endemic and non-endemic villages in the Jampea Island. Based on logistic regression test, in endemic areas p-value of puddle variable was p&lt;0,05, and in non-endemic areas evenings out behavior variables was p&lt;0,05. Anopheles sp. larvae species found on the Jampea island were An. vagus, An. supbictus, An. indefinitus, and An. barbirostis. This study concluded that there were differences, the presence of puddle and shrubs was the most influential factors in endemic areas, while in non-endemic areas the behavior factor of going out at night was the most influential.

Endemicity of malaria in the human population of district Kech, Balochistan

Endemicity of malaria in the human population of district Kech, Balochistan