High Prevalence Of Malaria Research Articles

Urinalysis, Malaria Random Diagnostic Methods and Clinical Symptoms in the Prediction of Malaria Parasitaemia among Pregnant Women in Umuahia and Ikwuano, Abia State, Nigeria

This study was targeted at assessing malaria prevalence, clinical symptoms and urine abnormalities associated with malaria in pregnancy. A cross-sectional study involving 250 pregnant women selected from five healthcare facilities in three local government areas of Abia state, was conducted. Data were collected using pre-tested structured questionnaires and patients’ blood and urine samples collected. Thick and thin blood films microscopy as well as malaria random kits were used to diagnose malaria. Medi-test combi 9 urine test strip was used to check urine abnormalities. Data were analysed using SPSS version 26. An overall malaria prevalence of 56% (95% CI: 0.42-0.60) was observed. Of the five centres, the highest prevalence was reported at PHC III in Umuahia North LGA with prevalence at 72% (95% CI: 0.51-0.98), while the lowest was reported at PHC IV in Umuahia North LGA with a prevalence of 36% (95% CI: 0.21-0.49). Pregnant women who had headache (OR=3.316, p=0.009, 95% CI: 1.288-7. 400), catarrh (OR=3.972, p=0.032, 95% CI: 1.028-15.352) and fever (OR=9.459, p<0.001, 95% CI: 3.767-23.753) had higher odds of malaria infection, compared to those without headache, catarrh and fever. Malaria was largely recorded among the primigravids 71% (53/75), followed by the secundigravidae 61% (43/70) and the least, observed among the multigravidae 43% (45/105). High malaria prevalence was observed among subjects who did not use preventive measures (100%) with the least observed among subjects, using window nets (22%). Malaria among subjects in this study is significantly prevalent. Proteinuria, bilirubinuria, urobilinogenuria as well as amber and clear urine macroscopy showed significant associations with malaria in pregnancy; thus, women with these clinical features should be further tested for malaria even in asymptomatic states to prevent the negative consequences of malaria in pregnancy.

Prevalence of asymptomatic malaria and associated factors among pregnant women in Ethiopia: systematic review and meta-analysis.

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023411385; identifier, CRD42023411385.

Malaria epidemiological characteristics and control in Guangzhou, China, 1950–2022

BackgroundMalaria was once widespread in Guangzhou, China. However, a series of control measures have succeeded in eliminating local malaria infections. Based on the analysis of the characteristics of malaria epidemics in Guangzhou, China, from 1950 to 2022, the changes and effectiveness of malaria control strategies and surveillance management in Guangzhou from 1950 to 2022 are described.MethodsData on malaria prevention and treatment in Guangzhou from 1950 to 2022 were collected, and descriptive epidemiological methods were used to analyse the prevalence of malaria, preventive and control measures taken, and the effectiveness of prevention and treatment in different periods. Data on malaria cases were obtained from the Guangzhou Centre for Disease Control and Prevention (CDC) and the China Communicable Disease Reporting System.ResultsThe development of the malaria control system in Guangzhou has gone through four periods: 1. High malaria prevalence (1950–1979), 2. Intensive prevention and control stage (1980–2000), 3. Consolidating gains in malaria control (2001–2008), and 4. Preventing reestablishment of transmission (2009–2022). During Period 1, only medical institutions at all levels and the local CDCs, the Guangzhou CDC participated in the malaria prevention and control system, establishing a three-tier health system on malaria prevention and control. During Period 2, other types of organizations, including the agricultural sector, schools and village committees, the construction department and street committee, are involved in the malaria control system. During Period 3, more and more organizations are joining forces to prevent and control malaria. A well-established multisectoral malaria control mechanism and an improved post-elimination surveillance management system are in place. Between 1950 and 2022, a total of 420,670 cases of malaria were reported. During Period 1, there was an epidemic of malaria in the early 1950s, with an annual incidence rate of more than 10,000/100,000, including a high rate of 2887.98/100,000 in 1954. In Period 2 malaria was gradually brought under control, with the average annual malaria incidence rate dropping to 3.14/100,000. During Period 3, the incidence rate was kept below 1/100,000, and by 2009 local malaria infections were eliminated.ConclusionFor decades, Guangzhou has adopted different malaria control strategies and measures at different epidemic stages. Increased collaboration among civil organizations in Guangzhou in malaria control has led to a significant decline in the number of malaria cases and the elimination of indigenous malaria infections by 2009.The experience of Guangzhou can guide the development of malaria control strategies in other cities experiencing similar malaria epidemics.

Ex vivo and in vitro antiplasmodial activity and toxicity of Caesalpinia decapetala (Roth) Alston (Fabaceae)

Ethnopharmacological relevanceMalaria is among the most prevalent and devastating parasitic diseases globally with most cases reported in Sub-Saharan Africa. One of the major reasons for the high malaria prevalence is the ever-increasing emergence of resistant strains of malaria-causing parasites to the currently used antimalarial drugs. This, therefore, calls for the search for antimalarial compounds with alternative modes of action. Plants used in traditional medicine for the treatment of malaria offer possible sources of such compounds. Caesalpinia decapetala has been used traditionally for the treatment of various diseases including malaria. However, the antiplasmodial activity of the plant has never been reported. Aim of the studyTo determine the ex vivo and in vitro antiplasmodial activities of the extracts of the roots, stem bark and leaves of Caesalpinia decapetala. MethodologyThe roots, stem bark and leaves of Caesalpinia decapetala (Roth) Alston (Caesalpiniaceae) were collected and air-dried under a shade then extracted consecutively with dichloromethane and methanol (1:1 (v/v) (4 × 0.8 L). The extracts were tested for antiplasmodial activities against four strains of Plasmodium falciparum (W2, DD2, 3D7, and D6) and fresh P. falciparum field isolates using the SYBR green I assay. The mean fifty percent inhibition concentration (IC50) was determined for each assay. An acute oral toxicity test was done based on the Organization for Economic Cooperation and Development (OECD 425) guidelines using Swiss albino mice. ResultsThe leaves and stem bark extracts showed good antiplasmodial activities with IC50 values of 4.54 and 4.86 μg/mL, respectively, when tested against the fresh field isolates ex vivo. Similarly, the roots extract showed an IC50 value of 6.49 μg/mL when tested against field isolates ex vivo. The roots extract showed the highest antiplasmodial activities among the samples when tested against W2 (IC50 = 6.12 μg/mL), DD2 (IC50 = 8.17 μg/mL), and D6 (IC50 = 16.02 μg/mL) strains of P. falciparum whereas the leaves showed the highest activity (IC50 = 9.3 μg/mL) when tested against the 3D7 strain of P. falciparum. No mortality was observed for the mice treated with 2000 mg/kg of the leaves and stem bark extracts. The mouse treated with 2000 mg/kg of the roots extracts regained weight by day 12 of the observation period. ConclusionCaesalpinia decapetala has the potential to suppress the growth of P. falciparum thereby contributing to combating the recurrent emergence of antimalarial drug resistance.

Therapeutic Potentials of Neem Against Malaria Parasite: A Review

Malaria presents a significant public health threat, affecting both developed and developing nations. The rise of drug resistance in regions with high malaria prevalence has posed challenges in effectively managing the disease. Azadirachta Indica, commonly known as the neem plant, has long been recognized as a medicinal plant in Asia and Africa, with historical usage in treating malaria parasites. The neem plant contains various bioactive compounds, making it a popular ingredient in traditional remedies. This study aimed to assess the effectiveness of neem leaf and seed extracts in combating malaria parasites. The information used in this review was obtained from previously published studies sourced from various journals. The findings suggest that neem (Azadirachta indica) seeds or leaves show promise as a potential treatment for inhibiting the malaria parasite. However, further research is required to ascertain the antimalarial potency of the neem plant before confidently recommending it as a treatment for malaria parasites.

Comparison of deforestation and forest land use factors for malaria elimination in Myanmar

ObjectivesWithin the remote region of Ann Township in Myanmar's Rakhine State, malaria prevalence has remained steady at ∼10% of the population from 2016-2019. Previous studies have linked areas of higher malaria prevalence in the region to heavily forested areas, however, little is known about how people live, work, and move through these areas. This work aims to disentangle landscape from land use in regard to malaria exposure. MethodsWe investigated the roles of forest cover, forest loss, and land use activities with malaria prevalence through the combined use of land use surveys, malaria surveillance, and satellite earth observations. ResultsOur results confirm previous research that linked areas of high forest cover with high malaria prevalence. However, areas experiencing high levels of deforestation were not associated with malaria prevalence. The land use factors that contribute most significantly to increased malaria risk remained those which put people in direct contact with forests, including conducting forest chores, having an outdoor job, and having a primary occupation in the logging and/or plantation industry. ConclusionMalaria prevention methods in Myanmar should focus on anyone who lives near forests or engages in land use activities that bring them within proximity of forested landscapes, whether through occupation or chores.

The prevalence and density of asymptomatic plasmodium infections among children in a rural community of South- Western Nigeria.

Asymptomatic malaria is highly prevalent in endem ic areas of Africa and it is a new challenge for the malaria elimination agenda. In recent years, the number of hospitalizations due to malaria cases in sub-Saharan Africa has steadily decreased. However, there are indications that this positive trend could suffer a setback due to asymptomatic malaria cases, which may serve as reservoir of infections for vulnerable populations. This cross-sectional study examined the prevalence of asymptomatic malaria in school-aged children living in a rural community in South- West, Nigeria. The study was conducted from August to September 2020, involving 300 randomly selected school children. Histidine rich protein II rapid diagnostic test kits (HRP2) were used to screen participants for malaria. All blood samples were further examined microscopically using 3% Giemsa-stained blood smears for confirmation, speciation, and parasites. The anaemia status of the children was quantification of malaria determined by measuring the haematocrit. Statistical analysis of the data was done using the chi-square test, student t-test, Mann Whitney U test and Kruskal-Wallis rank sum tests to determine the association between variables and the difference in mean/median with a significance level p≤ 0.05. The results showed a high prevalence of asymptomatic malaria of 41% by microscopy. The prevalence of asymptomatic malaria was statistically significantly higher among children aged 6 to 11 years (52%), compared to children >12years (37%), and < 5years old (13%), (p=0.00001). Plasmodium falciparum was responsible for 96% of the infection while the remaining 4% had multiple infections with Plasmodium falciparum and Plasmodium ovale. This study confirms that the prevalence of asymptomatic cases of malaria among children in malaria endemic areas is high and they will benefit from malaria chemoprophylaxis.

Molecular investigation of malaria-infected patients in Djibouti city (2018–2021)

BackgroundThe Republic of Djibouti is a malaria endemic country that was in pre-elimination phase in 2006–2012. From 2013, however, malaria has re-emerged in the country, and its prevalence has been increasing every year. Given the co-circulation of several infectious agents in the country, the assessment of malaria infection based on microscopy or histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDT) has shown its limitations. This study, therefore, aimed to assess the prevalence of malaria among febrile patients in Djibouti city using more robust molecular tools.MethodsAll suspected malaria cases reported to be microscopy-positive were randomly sampled (n = 1113) and included in four health structures in Djibouti city over a 4-year period (2018–2021), mainly during the malaria transmission season (January–May). Socio-demographic information was collected, and RDT was performed in most of the included patients. The diagnosis was confirmed by species-specific nested polymerase chain reaction (PCR). Data were analysed using Fisher’s exact test and kappa statistics.ResultsIn total, 1113 patients with suspected malaria and available blood samples were included. PCR confirmed that 788/1113 (70.8%) were positive for malaria. Among PCR-positive samples, 656 (83.2%) were due to Plasmodium falciparum, 88 (11.2%) Plasmodium vivax, and 44 (5.6%) P. falciparum/P. vivax mixed infections. In 2020, P. falciparum infections were confirmed by PCR in 50% (144/288) of negative RDTs. After the change of RDT in 2021, this percentage decreased to 17%. False negative RDT results were found more frequently (P < 0.05) in four districts of Djibouti city (Balbala, Quartier 7, Quartier 6, and Arhiba). Malaria occurred less frequently in regular bed net users than in non-users (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.42–0.92).ConclusionsThe present study confirmed the high prevalence of falciparum malaria and, to a lesser extent, vivax malaria. Nevertheless, 29% of suspected malaria cases were misdiagnosed by microscopy and/or RDT. There is a need to strengthen the capacity for diagnosis by microscopy and to evaluate the possible role of P. falciparum hrp2 gene deletion, which leads to false negative cases of P. falciparum.

Evaluation of the factors that contribute to high prevalence of malaria in HIV Patients in Bushenyi District, Uganda

Malaria remains the single main cause of ill health and death among HIV/AIDS patients in resource-poor countries worldwide. Malaria still remains a challenging infection affecting the lives of several HIV-infected persons in Uganda. Statistics from the Ministry of Health show that malaria is still the leading cause of death in Uganda, accounting for over 27% of deaths. Malaria prevalence in HIV-positive patients in Kyamuhunga Health Centre III is thought to be at 7.8% of the HIV-positive patients attending the clinic on a daily basis. This study therefore aimed at assessing the factors contributing to the high prevalence of malaria among HIVpositive patients attending the HIV Clinic at Kyamuhunga Health Centre III in Bushenyi District. The study covered a sample of eighty (80) respondents to gather primary data. A simple random sampling method was used to gather responses from patients. Questionnaires and an interview guide were used as data collection tools. Results indicated that the majority of the participants were female patients and malaria was dominant among HIV-positive patients aged 38-47 years. It was noted that the odds of having malaria also increased among patients with lower levels of education. It was also noted that more odds of having malaria were found among the majority of patients who were farmers and unemployed participants. Malaria infection was acquired with repeated exposure to malaria parasites especially for patients who did not use insecticide treated mosquito nets. It is noted that HIV-positive patients with malaria greatly acquired unbalanced immunity with relatively low CD4+ cell count and unbalanced hemoglobin levels, greatly affected by body pain and weakness, fever, headache, and variety issues of vomiting. Paracetamol, use of treated mosquito nets, clinical examination, and patient follow-up was shown to provide a beneficial effect in preventing malaria infection among HIV-positive patients. In conclusion, malaria infection is acquired from repeated exposure to malaria parasites especially for patients who did not use Treated mosquito nets which increased the susceptibility to new malaria infections among HIVpositive patients. The researcher, therefore, recommends that comprehensive health education, antiretroviral therapy, and malaria preventive materials such as insecticidetreated bed nets should be provided to reduce the prevalence of malaria among HIV-positive patients. Keywords: Malaria, HIV patients, Treated mosquito nets, Antiretroviral therapy.

High prevalence of malaria in pregnancy among women attending antenatal care at a large referral hospital in northwestern Uganda: A cross-sectional study.

Malaria in pregnancy contributes to substantial morbidity and mortality among women in Uganda. However, there is limited information on the prevalence and factors associated with malaria in pregnancy among women in Arua district, northwestern Uganda. We, therefore, assessed the prevalence and factors associated with malaria in pregnancy among women attending routine antenatal care (ANC) clinics at Arua regional referral hospital in north-western Uganda. We conducted an analytic cross-sectional study between October and December 2021. We used a paper-based structured questionnaire to collect data on maternal socio-demographic and obstetric factors and malaria preventive measures. Malaria in pregnancy was defined as a positive rapid malarial antigen test during ANC visits. We performed a modified Poisson regression analysis with robust standard errors to determine factors independently associated with malaria in pregnancy, reported as adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). We studied 238 pregnant women with a mean age of 25.32±5.79 years that attended the ANC clinic, all without symptomatic malaria. Of the participants, 173 (72.7%) were in their second or third trimester, 117 (49.2%) were first or second-time pregnant women, and 212 (89.1%) reported sleeping under insecticide-treated bednets (ITNs) every day. The prevalence of malaria in pregnancy was 26.1% (62/238) by rapid diagnostic testing (RDT), with the independently associated factors being daily use of insecticide-treated bednets (aPR 0.41, 95% CI 0.28, 0.62), first ANC visit after 12 weeks of gestation (aPR1.78, 95% CI 1.05, 3.03), and being in the second or third trimester (aPR 0.45, 95% CI 0.26, 0.76). The prevalence of malaria in pregnancy among women attending ANC in this setting is high. We recommend the provision of insecticide-treated bednets to all pregnant women and early ANC attendance to enable access to malaria preventive therapy and related interventions.

Analysis of Factors Influencing the Incidence of Malaria in the Work Area of Public Health Centers

The purpose of this research is to determine what aspects of the Sidodadi Public Health Center's surrounding environment in Asahan District contribute to the high prevalence of malaria there. The survey, conducted in August and September 2022 at the Sidodadi Health Center in the Asahan Province, was quantitative in nature, taking the form of a cross-sectional study. Purposive selection was used to select a total of 88 participants for the study. Chi-square and logistic regression tests were used to evaluate the data. The bulk of the 88 respondents (35 or 39.7%) were business owners (48 or 54.5%), high school graduates (54.5%), and aged 36–45 (39.4%). The bivariate analysis revealed a significant relationship between community awareness and malaria prevalence (p=0.000). The multivariate analysis revealed that in the service region of the Sidodadi Public Health Center in the Asahan District, education was the most important factor in reducing the prevalence of malaria (p=0.000, OR=8.480). This study found that the knowledge variable was the most influential out of the six examined, which included attitudes, economic capacity, information media, living environment, and support from health workers in the catchment area of the Sidodadi Health Center in the Asahan Regency, where malaria cases were studied.

International border malaria transmission in the Ethiopian district of Lare, Gambella region: implications for malaria spread into South Sudan

BackgroundDespite notable progress in the control and prevention of malaria in the Horn of Africa, the disease continues to cause significant morbidity and mortality in various regions of Ethiopia, and elsewhere in the region. The transmission of malaria is affected by genetic, sociocultural, and ecological factors. Lare is an Ethiopian district adjacent to the Ethio-South Sudan border, in Gambella region. The region currently has the highest prevalence of malaria in Ethiopia. This study assesses the burden and spatiotemporal patterns of disease transmission, including the effect of climatic factors on the occurrence of malaria, across an international border crossing. This understanding can assist in crafting informed programmatic and policy decisions for interventions.MethodsThis study was conducted in Lare district, Southwest Ethiopia, a temperate zone. A retrospective descriptive analysis was conducted using clinical service data collected between 2011 and 2021 from the 9 health facilities of the district. Both clinically diagnosed patients and those identified using microscopy and rapid diagnostic testing (RDT) were included in the study. Additionally, climate data was incorporated into analyses. Examples of analyses include malaria burden, positivity rate, incidence, species frequency, and an ANOVA to assess inter-annual case number and meteorological factor variation.ResultsBetween 2011 and 2021, a total of 96,616 suspected malaria cases were tested by microscopy or RDT, and 39,428 (40.8%) of these cases were reported as positive. There were 1276 patients admitted with 22 deaths recorded. There were further more significant fluctuations in positivity rates across years, the highest being 74.5% in 2021. Incidence varied from 18.0% in 2011 to 151.6% in 2016. The malaria parasite species most detected was Plasmodium falciparum, followed by a smaller proportion of Plasmodium vivax. The greatest proportions of P. falciparum cases were observed in 2018 and 2019, at 97.4% and 97.0% prevalence, respectively. There was significant seasonal variation in case number, the highest observed in July through September of each year. Climatic conditions of annual rainfall, temperature and humidity favored the increment of malaria cases from June until October.ConclusionThe study shows that the burden, i.e. morbidity and mortality (with fluctuating patterns) of malaria are still significant public health problems and can pose serious consequences in the district. This has implication for cross-border malaria transmission risk due to considerable border crossings. The predominant cause of the disease is P. falciparum, which causes severe complications in patients. The district has to prepare to deal with such complications for better patient care and outcomes.

The discovery of human Plasmodium among domestic animals in West Sumba and Fakfak, Indonesia

Background: In Indonesia, malaria incidence is at a high rate despite maximum preventive efforts. Therefore, this study aims to determine the possibility of a Plasmodium reservoir among domestic animals in malaria-endemic areas. Methods: Animal blood was collected using EDTA tubes, then smeared and stained with Giemsa for Plasmodium microscopic identification. About 10 µl of blood was dropped on to a filter paper to capture Plasmodium DNA. Nested PCR was used for parasite molecular detection, while Plasmodium species were identified using the sequenced DNA. Results: A total of 208 and 62 animal blood samples were collected from Gaura village, West Sumba and Fakfak village, West Papua, Indonesia respectively. In total, 32 samples from Gaura contained P. falciparum or P. vivax, while the Plasmodium percentage in buffalo, horse, goat, and dogs were 20.7%, 14.3%, 5.8%, 16.7%, respectively. P. knowlesi was not found in any of the samples, and no other species were detected in 18 pig blood samples. Conclusion: Human Plasmodium existence among domestic animals in Indonesia partly explains the high prevalence and persistence of malaria in some endemic areas due to a reservoir host presence. Therefore, future studies need to ascertain the cause.

Prevalence of malaria and associated clinical manifestations and myeloperoxidase amongst populations living in different altitudes of Mezam division, North West Region, Cameroon

BackgroundMalaria is a growing problem in Africa, with prevalence varies from areas to areas due to several factors including the altitude. This study aimed to investigate the malaria distribution and its relationship with level of some blood parameters and plasma myeloperoxidase (MPO) in population of three localities with different altitudes.MethodsA total of 150 participants were recruited in each locality and facial body temperature of each was measured using a forehead digital thermometer. Blood samples were collected and used diagnose malaria parasite using the rapid test followed by Giemsa stain microscopy and have the full blood count and MPO level using a colorimetric method.ResultsThe overall prevalence of falciparum malaria was 34.7%, with no difference between the three communities, but Bambili of high altitude had the highest prevalence (70.7%). A majority of the infected persons had mild malaria, with most cases being asymptomatic (temperature < 37.5 ºC). Patients had significant increase of geometric mean malaria parasite density (GMPD) in Bambili (1755 ± 216 parasites/µL) and Bamenda (1060 ± 2515 parasites/µL of blood) than patients in Santa (737 ± 799 parasites/µL). There was a significant risk to have malaria infection in Bambili (OR = 33.367, p = 0.021) than in Santa (OR = 2.309, p = 0.362). Bambili’ participants of 6–10 years showed a high prevalence of malaria (85.7%). GMPD was significantly different between males (p = 0.010) as well as females (p = 0.000). Participants from Santa (11.2 ± 3.2 g/dL) and Bambili (12.6 ± 2.4 g/dL) had a high haemoglobin concentration than those from Bamenda (10.6 ± 2.1 g/dL). There was a significant difference in the WBC counts and platelet counts among infected participants in the study areas. MPO level had an increasing trend among infected participants in Santa (2.378 ± 0.250), Bambili (2.582 ± 0.482) and Bamenda (2.635 ± 0.466).ConclusionThe results of the present study demonstrated that altitudinal variations significant impact the risk of population to have malaria with high parasitaemia and may contribute to the malaria prevalence and severity by affecting the haemoglobin concentration, WBC and platelet level and plasma MPO in population.

Molecular Detection of the Effect of Malaria Infection on Nutritional Status in Paediatrics Attending Primary Health Care Hospitals (PHC) Around Sokoto Metropolitan, Sokoto, Nigeria

Molecular diagnosis is now considered to be the most efficient and reliable method for detection of malaria parasites; hence the present research was designed to access the effect of malaria infection on the nutritional status of the pediatrics attending PHC in Sokoto, 400 children were recruited randomly, nutritional status was determined using mid-upper armed circumference (MUAC) tape, blood samples was collected then subjected to Nested Polymerase Chain Reaction (nPCR) test. Out of 400 samples analyzed, 199/400 (49.75%) were acutely malnourished, 117/400 (44.25%) were normal and 84/400 (21.00%) were severely malnourished. Although 237 (59.25%,) were found positive for Plasmodium falciparum, those that are severely malnourished had the highest infection rate [78/84 (92.86%)] followed by those that are normal [124/199 (62.31%)] than those that were acutely malnourished [35/84 (41.67%)], a significant association was reported for those that are severely malnourished based on parent’s occupation (P=0.001), place of living (P=0.000), and sleeping under nets (P=0.012), there was also significant relationship in those that are normally based on gender (P=0.001), and sleeping under nets (P=0.021) only while those that were normal showed significant relationship based on sleeping under nets (P=0.001) and parents occupation (P=0.000). The high prevalence of malaria in the study demonstrates high sensitivity and specificity of molecular diagnosis. There is a need to embark on massive community campaigns and adoption of mosquito control measures in the study area.

COVID lockdown and malaria incidence: A note from the tropical endemic area

Dear Editor, Malaria is an important mosquito-borne infection. The pathogenic Plasmodium parasite is the causative agent of malaria and it is presently seen at many tropical countries around the world. In tropical Asia, the disease is highly prevalent and there is an extremely high prevalence of drug-resistant malaria along Myanmar–Thailand border area.[1] Children are an important group affected by malaria.[1] At the border area, the school children are the main group that gets malaria and it can affect school performance, therefore, many school-based malaria control programs have been implemented.[2] Due to the present emerging COVID-19 crisis, the impact on malaria control is an interesting issue.[3] The interruption of the malaria control program during the COVID-19 pandemic is possible.[4] Here, the author would like to share the local data from the area that there is a co-endemicity between COVID-19 and malaria in Indochina. This area is the local rural province locating at Thailand–Myanmar border. The most updated data on June 2020 showed that there are already 9 COVID-19 cases and 265 malaria cases in this remote forestry area in 2020. All of the pediatric patients are school students and the primary presentation of all cases is high fever. In the country, COVID-19 started in January 2020 and the lockdown started in March 2020. The data on the incidence of COVID-19 and malaria in this area before and after the COVID-19 lockdown are presented in Table 1. Based on this data, the COVID-19 lockdown, that includes school closure, transportation blockage, and international border closure, can effectively reduce the incidence of COVID-19 in this malaria-endemic area. However, after the lockdown, the incidence of malaria significantly increases.Table 1: The incidence of COVID-19 and malariaIn fact, although the study area is a forestry area with high malaria prevalence, the problem of COVID-19 can still be seen. In fact, the rural forestry area does not guarantee for absence of COVID -19 cases and disease might be imported by outside.[5] The blockage of transportation and school closure seems to effectively control COVID-19. However, the lockdown does not have a positive control effect on malaria. Indeed, the difficulty in malaria control due to the COVID-19 lockdown is proposed and the present observation is good clinical evidence to support that hypothesis.[4] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Prevalence of Malaria Among Children Attending AlFaw Teaching Hospital, El-Gedaref State, Sudan

Introduction: In Sudan, malaria is still a major cause of death and the primary cause of death for children. A strategy for reducing and eradicating malaria may be developed with the help of knowledge regarding the prevalence of the disease among children. The goal of this study was to examine the prevalence of malaria in children at the AlFaw Teaching Hospital, as well as the risk factors and contributing factors. Methods: In this study, questionnaires were used to gather socioeconomic, demographic, and vector control data from the families of children aged 1 day to 17 years in order to detect Plasmodium falciparum and other spp. Age, gender, place of residence, usage of a vector control intervention, and mother’s educational degree are all associated with malaria positivity. Results: During June through July 2022, 400 children who visited AlFaw teaching hospital participated in a facility-based crosssectional survey. P. falciparum species made up 279 of the Plasmodium species (70%), and other species consisted of 121 (30%). Children who regularly spend the night outside and those who live in homes with stagnant water in the complex had higher probabilities of contracting malaria than those who regularly sleep under long-lasting insecticide-treated nets. Malaria diagnoses were more common in children of mothers with no formal education than in children of mothers with secondary education. Conclusion: Children who were patients at AlFaw teaching hospital had a significant malaria prevalence. In this study, a higher proportion of moderate parasitemia was also detected, and those with the highest prevalence of malaria were in the age group of 0–17 years. The main correlations with malaria were irregular usage of bed nets, night-out times, and parents not receiving malaria health education. To reduce the impact of malaria, the local government and other concerned organizations should put more emphasis on routine insecticide-treated net (ITN) use, infections linked to nighttime exposure to the outdoors, environmental management, and modification of attitudes toward malaria prevention and control through health education. Other actions that can be taken to decrease this impact include improving health management and planning, redistributing resources (including consultants) at the central and regional levels, and implementing appropriate training programs on the management of severe malaria at all levels.

A community based study on haemoglobinopathies and G6PD deficiency among particularly vulnerable tribal groups in hard-to-reach malaria endemic areas of Odisha, India: implications on malaria control

BackgroundHaemoglobinopathies and G6PD deficiency are inherited disorders found mostly in malaria-endemic areas among different tribal groups of India. However, epidemiological data specific to Particularly Vulnerable Tribal Groups (PVTGs), important for planning and implementing malaria programmes, is limited. Therefore, the present community-based study aimed to assess the prevalence of haemoglobinopathies and G6PD deficiency among the 13 PVTGs found in the state of Odisha, reporting the maximum malaria cases in the country.MethodsThis cross-sectional study was conducted from July 2018 to February 2019 in 12 districts, home to all 13 PVTGs, in an estimated sample size of 1461, selected two-stage sampling method. Detection of haemoglobinopathies was done by the variant analyser. Screening of G6PD deficiency was carried out using DPIP method followed by quantification using spectrophotometry. The PCR–RFLP technology was used to determine variant of G6PD deficiency and haplotype analysis of sickle cell, while ARMS-PCR and GAP-PCR was used for detecting the mutation pattern in β-thalassaemia and α-thalassaemia respectively. The diagnosis of malaria was done by Pf-PAN RDT as point of care, followed by nPCR for confirmation and Plasmodium species identification.ResultsThe prevalence of sickle cell heterozygotes (AS) was 3.4%, sickle cell homozygous (SS) 0.1%, β-thalassaemia heterozygotes 0.3%, HbS/β-thalassaemia compound heterozygote 0.07%, HbS-α-thalassaemia 2.1%, G6PD deficiency 3.2% and malaria 8.1%. Molecular characterization of βS revealed the presence of Arab-Indian haplotype in all HbS cases and IVS 1–5 G → C mutation in all β-thalassaemia cases. In case of α-thal, αα/α-3.7 gene deletion was most frequent (38%), followed by αα/α-4.2 (18%) and α-3.7/α-3.7 (4%). The frequency of G6PD Orissa (131C → G) mutation was found to be 97.9% and G6PD Mediterranean (563C → T) 2.1%. Around 57.4% of G6PD deficient individuals and 16% of the AS were found to be malaria positive.ConclusionThe present study reveals wide spread prevalence of sickle cell anaemia, α-thalassaemia, G6PD deficiency and malaria in the studied population. Moderate to high prevalence of G6PD deficiency and malaria warrants G6PD testing before treating with primaquine (PQ) for radical cure of Plasmodium vivax. Screening and counselling for HbS is required for the PVTGs of Odisha.

Microbiomes associated with avian malaria survival differ between susceptible Hawaiian honeycreepers and sympatric malaria-resistant introduced birds.

Of the estimated 55 Hawaiian honeycreepers (subfamily Carduelinae) only 17 species remain, nine of which the International Union for Conservation of Nature considers endangered. Among the most pressing threats to honeycreeper survival is avian malaria, caused by the introduced blood parasite Plasmodium relictum, which is increasing in distribution in Hawai'i as a result of climate change. Preventing further honeycreeper decline will require innovative conservation strategies that confront malaria from multiple angles. Research on mammals has revealed strong connections between gut microbiome composition and malaria susceptibility, illuminating a potential novel approach to malaria control through the manipulation of gut microbiota. One honeycreeper species, Hawai'i 'amakihi (Chlorodrepanis virens), persists in areas of high malaria prevalence, indicating they have acquired some level of immunity. To investigate if avian host-specific microbes may be associated with malaria survival, we characterized cloacal microbiomes and malaria infection for 174 'amakihi and 172 malaria-resistant warbling white-eyes (Zosterops japonicus) from Hawai'i Island using 16S rRNA gene metabarcoding and quantitative polymerase chain reaction. Neither microbial alpha nor beta diversity covaried with infection, but 149 microbes showed positive associations with malaria survivors. Among these were Escherichia and Lactobacillus spp., which appear to mitigate malaria severity in mammalian hosts, revealing promising candidates for future probiotic research for augmenting malaria immunity in sensitive endangered species.

Malaria diagnostic and treatment practices for febrile children under 5 years at two general hospitals in Karamoja, a high transmission setting in Uganda

BackgroundMalaria is one of the leading causes of morbidity and mortality among children under 5 years of age in Uganda. Although Karamoja sub-region has the highest prevalence of malaria, and one of the highest case fatality rates in children under 5 years, information on malaria case management for the sub-region is scarce. The study evaluated the malaria diagnostic and treatment practices, as well as the factors associated with inappropriate care for children under 5 years of age presenting with fever in two public hospitals within the sub-region.MethodsA cross-sectional study was conducted amongst 857 children under 5 years of age who presented with fever at Abim and Kaabong general hospitals between February and March 2020. A questionnaire was administered to the primary caregiver during exit/bedside interviews to collect socio-demographic information. The participant clinical notes were reviewed to capture information on laboratory tests conducted, diagnosis given, and treatment prescribed. In addition, a health facility assessment was conducted and information on healthcare workers was collected. The healthcare worker and facility data was linked to the participant’s hospital visit. Main outcome measures were malaria diagnostic and treatment practices.ResultsOf the 857 children enrolled, 820 (95.7%) had a malaria diagnostic test done and 623 (76.0%) tested positive for malaria. All test positive children received anti-malarial treatment, however, only 424/623 (68.1%) received the recommended anti-malarial drug and 376/424 (88.7%) received the right dose of the treatment. Inappropriate diagnosis/treatment was in 321 (37.5%) of the enrolled participants. Factors associated with inappropriate diagnosis/treatment included: lack of recommended anti-malarials on the day of the visit (Prevalence Ratio [PR] = 2.1, 95% confidence interval [CI] 1.8–2.4), hospital where care was sought (PR = 0.4, 95% CI 0.3–0.5), being managed by a recently supervised health worker (PR = 0.5, 95% CI 0.2–0.9), and health worker cadre (PR = 0.8, 95% CI 0.7–0.9).ConclusionThe prevalence of inappropriate malaria diagnosis and treatment in the Karamoja sub-region was high with approximately one in every three children receiving inappropriate care. This was majorly influenced by health system factors, which if improved upon may reduce malaria-related mortalities in the sub-region a vital step in meeting the country’s target of zero deaths from malaria by 2030.