Bed Nets Research Articles

Advances and Challenges for the Malaria Vaccine: A Review

Malaria remains a leading cause of morbidity and mortality worldwide, particularly in sub-Saharan Africa and Southeast Asia, where transmission rates are highest. Traditional control measures, such as insecticide-treated bed nets and antimalarial drugs, have helped reduce the disease’s impact, but challenges such as drug and insecticide resistance continue to undermine these efforts. A highly effective malaria vaccine represents a crucial step towards achieving long-term control and eventual eradication. This review explores recent advances in malaria vaccine development, including the RTS, S/AS01 and R21/Matrix-M vaccines, while highlighting their limitations related to efficacy, immunity duration, and accessibility in resource-poor regions. Additionally, it addresses the challenges in developing multivalent vaccines, targeting different strains of Plasmodium, and the need for integrated approaches combining vaccination with existing control strategies. Looking ahead, the review discusses the potential of next-generation vaccines, mRNA platforms, and hybrid strategies that could enhance global malaria control efforts. Keywords: Malaria vaccine, RTS, S/AS01, R21/Matrix-M, transmission-blocking vaccines, malaria control.

Mass Distribution of Insecticide-Treated Nets: A Qualitative Study on Sumba Island

Background: The distribution of insecticide-treated nets (ITNs) is one of the main forms of malaria control intervention in Sumba Island. Although it has been running for more than a decade, there are still some gaps in the planning and implementation of this program. Aims: This study aims to obtain an overview of the planning and implementation of the mass distribution of ITNs running on Sumba Island, Indonesia. Methods: This study is qualitative research conducted in 2019 in all districts on Sumba Island. Data were collected by conducting in-depth interviews with 53 informants, including those in charge of the program, cross-sectors, and communities selected based on the researcher's considerations. Thematic analysis was used to produce the findings. Results: The study showed a gap between the number of ITNs and the real target, the sources of data on ITNs targets are different, and cross-sector involvement is limited to socialization activities, not maximizing the socialization and education of ITNs to the community. Conclusion: The planning and implementation of the mass distribution of ITNs on Sumba Island have not run optimally at the stages of socialization, logistics management, and distribution to the community. Modification of socialization methods and strengthening of distribution strategies to the community is needed.

Innovative Approaches and Opportunities in Malaria Eradication in East Africa

Malaria remains a significant public health issue in East Africa, with countries such as Kenya, Tanzania, Uganda, Rwanda, Burundi, and Ethiopia experiencing high transmission rates despite ongoing control efforts. Traditional methods like insecticide-treated nets (ITNs), indoor residual spraying (IRS), and anti-malarial medications face challenges due to insecticide and drug resistance, environmental changes, and socio-economic barriers. This review explores innovative approaches and opportunities in malaria eradication, focusing on novel vector control methods, advancements in diagnostic tools, new drug developments, and community-based interventions. The review was conducted by analyzing recent scientific literature and advancements in malaria research. Integrating these innovative strategies with existing control measures holds promise for achieving significant progress toward malaria eradication in East Africa, ultimately improving public health outcomes in the region. Keywords: Malaria Eradication, Vector Control, Genetic Modification, Diagnostic Tools, Community-Based Interventions

Mosquitoes: The Long-term Effects of Malaria Eradication in West Africa

Malaria has been a critical public health issue in West Africa for centuries, resulting in widespread morbidity and mortality, especially among vulnerable groups like children and pregnant women. Recent eradication efforts, bolstered by insecticide-treated bed nets (ITNs), indoor residual spraying (IRS), and antimalarial drugs, have significantly reduced the disease burden. This review examines the long-term socio-economic impacts of malaria eradication in West Africa, including improved public health, enhanced productivity, economic growth, and better access to healthcare. The reduction of malaria-related healthcare costs has led to increased investments in education, infrastructure, and other essential services. However, challenges persist, such as insecticide resistance among mosquitoes, financial constraints, and emerging public health concerns. Ecological effects of mosquito eradication, including impacts on biodiversity and the evolution of insecticide-resistant mosquitoes, raise important considerations for future control strategies. The role of climate change in shaping mosquito ecology and malaria transmission dynamics is also explored. This review underscores the need for sustained political and financial commitment, regional collaboration, and innovation to ensure the continued success of malaria eradication in West Africa. Integrating these efforts with broader Sustainable Development Goals (SDGs) and addressing ecological sustainability are essential for achieving long-term health and socio-economic benefits. Keywords: Malaria eradication, West Africa, public health, insecticide resistance, socio-economic impact, mosquito ecology.

Malaria Prevention Strategies in Kalimantan, Indonesia: A Secondary Analysis of 2018 Basic Health Research Data

Background: Kalimantan remains malaria-endemic, particularly in rural areas, where prevention efforts face challenges such as insecticide resistance and limited healthcare access. Despite available measures like insecticide-treated nets, gaps in understanding individual and household prevention practices persist, especially in relation to demographics and effectiveness in reducing malaria transmission.Purpose: This study aimed to examine the individual and household-level malaria prevention strategies utilized in rural Kalimantan and evaluate their effectiveness in reducing malaria incidence.Methods: The study is a secondary analysis of the 2018 Basic Health Research. A total of 67,155 respondents in Kalimantan were analyzed including respondent characteristics, memories of malaria infection, and individual and household malaria prevention efforts. Bivariate regression and multivariable logistic regression were used in data analysis.Results: Older participants were less likely to report having malaria, although self-reported malaria rates were higher among older respondents compared to younger ones. Women reported lower malaria rates than men, especially in South Kalimantan. Agricultural workers showed a higher likelihood of reporting malaria than the jobless, though not statistically significant. In West Kalimantan, the use of bed nets was associated with higher self-reported malaria rates (OR=1.838, 95% CI:1.147–2.943). Short-term use of Insecticide Treated Nets showed varying odds across provinces: Central Kalimantan (OR = 3.659, 95% CI 1.378–9.717), South Kalimantan (OR = 10.811, 95% CI 3.649–32.030), East Kalimantan (OR = 2.615, 95% CI 1.041–6.567), and West Kalimantan (OR = 2.428, 95% CI 1.446–4.078). In all provinces, preventive measures such as coils or electric mats reduced self-reported malaria cases. The use of mosquito screens was effective in South Kalimantan (OR = 0.208, 95% CI 0.027–1.598), Central Kalimantan (OR = 0.365, 95% CI 0.120–2.181), and North Kalimantan (OR = 0.000, 95% CI 0.000–0.000). The multivariate model highlighted mosquito nets as the most effective household-scale prevention in nearly all Kalimantan provinces, except North Kalimantan.Conclusion: This study shows that individuals aged 25 and over, women, non-farmers, and those using insecticide-treated nets (ITNs) and other preventive measures, especially in rural areas, were less likely to report malaria, emphasizing the need for targeted interventions from local health authorities

Risk Factors Affecting The Incident of Malaria in The Working Area of The Malaimsimsa Public Health Center Sorong City

Background: Malaria is an infectious disease caused by Plasmodium sp, a single-celled living creature that belongs to the group of the genus Protozoa which is parasitic. The purpose of this study was to determine the influence of environmental factors and behavioral factors on the incidence of malaria in the working area of the Malaimsimsa Community Health Center, Sorong City.Methods: This research is an observational study using a case-control study . The case group in this study included people with malaria as indicated by positive malaria blood test results. Examination of malaria is carried out by means of microscopic examination by making thick and thin blood preparations, stained using Giemsa stain, then identified using a microscope. The control group includes people who are not sick with negative blood test results.Result: The results of this study indicate that all malaria infections that occur are caused by infection with the type of Plasmodium vivax. The risk factors that influence the incidence of malaria are behavioral factors, namely the use of body armor and the use of insect repellent. While the risk factors that do not affect the incidence of malaria are the presence of puddles, temperature and use of mosquito nets.Conclusion : From the results of this study it can be concluded that the factors of stagnant water, temperature and use of mosquito nets are not related to the incidence of malaria, on the contrary the use of body armor and the use of insect repellent have a relationship with the incidence of malaria.

Evaluation of Anopheline Diversity and Abundance across Outdoor Collection Schemes Utilizing CDC Light Traps in Nchelenge District, Zambia.

In the global fight against malaria, standard vector control methods such as indoor residual spraying (IRS) and insecticide-treated nets (ITNs) are intended to protect inside residential structures and sleeping spaces. However, these methods can still leave individuals vulnerable to residual transmission from vectors that they may be exposed to outdoors. Nchelenge District in northern Zambia experiences persistently high malaria transmission even with ITNs and IRS in place. However, very few studies have examined outdoor vector activity. To assess the diversity and abundance of outdoor foraging female anopheline mosquitoes, CDC light traps were used as proxy measures for mosquito host-seeking, set in three outdoor trapping schemes randomly assigned on different nights: (1) locations where people congregate at night outside of the house within the peri-domestic space, (2) animal pens or shelters, and (3) high-human-traffic areas, such as paths to latrines, where traps were baited with BG-Lure®. A total of 1087 total female anophelines were collected over a total of 74 trap nights. Anopheles funestus s.s. comprised the majority of the collection (86%), with An. gambiae s.s. (2%) and a highly diverse sampling of other anophelines (12%) making up the remainder. Plasmodium falciparum parasites were only detected in An. funestus (1%). No significant difference in species diversity or female anopheline abundance was detected between trapping schemes. Outdoor foraging anopheline mosquitoes, including a number of infectious An. funestus, may partially explain the difficulty of controlling malaria transmission in Nchelenge District, where vector control is only targeted indoors. BG-Lure® shows some promise as an alternative to human-baited landing catch collections in this resource-poor setting.

The Impact of Long Lasting Insecticidal-Treated Nets on Malaria Parasitaemia among out Patients in Shonga, Edu Local Government Area, Kwara State

The Impact of Long Lasting Insecticidal-Treated Nets on Malaria Parasitaemia among out Patients in Shonga, Edu Local Government Area, Kwara State

Long-lasting insecticidal nets use and the prevalence of Plasmodium falciparum infection among pregnant women attending antenatal care at the Bonassama District Hospital, Littoral Region of Cameroon: a cross-sectional study

BackgroundMalaria during pregnancy continues to be a significant cause of morbidity and mortality for both infants and mothers, particularly in sub-Saharan African (SSA) countries, despite increased efforts to control it. The utilization of long-lasting insecticide-treated nets (LLINs) during pregnancy is a well-established strategy to reduce the prevalence of malaria. Nonetheless, inadequate adherence remains a persistent challenge in certain regions with high malaria endemicity. This research aimed to assess the effectiveness of long-lasting insecticidal nets in preventing asymptomatic malaria infections among pregnant women attending antenatal care at the Bonassama District Hospital in the Littoral Region of Cameroon.MethodsA hospital-based cross-sectional study was conducted from March to June 2022. Data on sociodemographic characteristics and LLIN usage were collected through a structured questionnaire, while asymptomatic malaria infections were identified using a PfHRP2/pLDH malaria qualitative rapid diagnostic kit. The relationship between categorical variables was analyzed using the chi-square test and logistic regression at a significance level of 5%.ResultsOut of the 411 pregnant women included in the study, 35.4% were diagnosed with malaria. The LLIN utilization rate was 65.1%. The risk of malaria infection was 2.7 times higher (AOR = 2.75, 95% CI = 1.83–4.14, p < 0.001) among women who did not consistently use LLINs compared to those who did. Pregnant women in their first trimester (AOR = 3.40, 95% CI = 1.24–4.64, p = 0.010) and second trimester (AOR = 1.90, 95%CI = 0.99–3.62, p = 0.055) were more likely to sleep under net when compared to those in the third trimester. Younger women 20–29 years (71.4%), those in the first trimester (69.6%) and those who had the nets before pregnancy (68.9%) were amongst those who frequently used use the nets. Among the reasons reported for not frequently using LLINs were heat (55.2%), suffocation (13.6%) and the smell of nets (8.4%).ConclusionThe use of LLIN was moderately high among the participants in this study, though still below national target. Age group, religion and gestation period were the major factors determining the use of LLINs. Considering the proven effectiveness of LLINs in reducing malaria morbidity and mortality, it is imperative for the National Malaria Control Programme (NMCP) to remain focused in promoting both LLIN ownership and utilization to achieve the national target of 100% and 80%, respectively.

Knowledge and practice of malaria vector control of the residents in Chu RCam commune, Krong Pa district, Gia Lai province, in 2023

Cross - sectional descriptive study with the aim of describing the knowledge and practices of malaria vector control among people in the area where malaria is still prevalent in Chu RCam commune from September to December 2023. The results of interviews with 300 people showed that the average ratio of people/net in the village was 1.5 people/net, while the ratio in the field was 2 people/net. 47.4% of people did not know the cause of malaria infection; 36.3% of people did not know the harmful effects of malaria, and 12.7% of people did not know how to sleep under a mosquito net to prevent malaria. 5.8% of people in the village and 3.3% of people in the field did not sleep under a mosquito net. 74.7% of people chose mosquito nets to prevent mosquitoes. Therefore, it is proposed to continue providing mosquito nets to households lacking mosquito nets.

Effectiveness of Insecticide Treated Mosquito Nets on the Death of Anopheles subpictus Mosquitoes

The prevalence of malaria in East Nusa Tenggara based on positive diagnosis results containing malaria parasites and symptoms in the 2013 - 2015 period decreased but has not yet reached the National Strategic Plan target, namely in 2013 it was 21 per 1,000 population (o/oo), in 2014 it was 14 o/oo, and in 2015 it became 8 o/oo (NTT Health Office, 2016). In 2017 there was a spike in malaria cases to 211,409 cases (API = 44.96 o/oo). Kupang Regency with 1,108 cases (API = 24.87 o/oo). Malaria cases in the Tarus Community Health Center work area are the eighth highest, namely 7 cases. This study aims to analyze the effectiveness of insecticide-treated bed nets on the death of Anopheles subpictus mosquitoes. The variables observed were the length of time the mosquito net was used, the frequency of washing the mosquito net, the method of washing the mosquito net, and the percentage of Anopheles subpictus mosquito deaths. The effectiveness of insecticide-treated bed nets on the death of Anophles subpictus mosquitoes with usage time &lt; 3 years (100%), usage time 3 – 5 years (70%) and usage time &gt; 5 years (40%). The effectiveness of insecticide-treated bed nets that have never been washed reaches 100% mortality within 24 hours of observation. Meanwhile, mosquito nets with a washing frequency of 1 – 10 times (70%) kill mosquitoes, and a washing frequency of &gt; 10 times (50%). The method of washing mosquito nets carried out by the community in the Puskesmas Working Area is 100% using detergent. In the control group that used mosquito nets that did not contain insecticide, no Anopheles subpictus mosquito deaths occurred (0%). Suggestions for health workers to increase education regarding the correct use of mosquito nets, so that a higher level of effectiveness of mosquito nets is obtained as a means of personal protection in avoiding mosquito bites.

Impact of mass media campaigns on knowledge of malaria prevention measures among pregnant mothers in Uganda: a propensity score-matched analysis

BackgroundUganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women’s knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda.MethodsSecondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018–2019 was used for this analysis. Women aged 15–49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures.ResultsThe study revealed that 39% [95% CI 34.0–44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035–0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0–71.8] followed by interpersonal communication [45.0, 95% CI 37.6–52.6], community health workers [38.8, 95% CI 29.6–48.8], community events [21.4, 95% CI 15.8–28.3], and social mobilization [18.3, 95% CI 12.7–25.8].ConclusionResults highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.

Advancing spatial repellents for malaria control: effectiveness and cost-effectiveness of a spatial repellent under operational use in Northern Uganda—study protocol for a cluster randomized controlled trial

BackgroundSpatial repellents (SRs) have been widely used for the prevention of mosquito bites, and preliminary findings suggest efficacy against both malaria (1) and Aedes-borne viruses (2) but their effectiveness in reducing mosquito-borne diseases under operational use has never been evaluated. SRs have the potential of being critical tools in the prevention of mosquito-borne diseases in contexts where typical vector control strategies, such as insecticide-treated nets (ITNs) and indoor residual spraying, are inaccessible or underutilized such as among displaced persons or in emergency relief settings.MethodsChildren will be enrolled in 3 separate cohorts to establish the effectiveness of SRs in reducing malaria infection in different distribution channels. One cohort will estimate the direct effect of the SR distributed through a reference channel (study personnel distribution). The two remaining cohorts will estimate the protection of the SR distributed through a voucher channel and the Village Health Team channel. Cohorts will be followed twice a month (approximately every 15 days): during the first scheduled household visit in the month, a blood sample will be taken for malaria rapid diagnostic test (Monthly Visit #1); and, during the second scheduled household visit, a blood sample will only be taken if the participant has a recent history of fever (Monthly Visit #2). The incidence of malaria in each cohort will be estimated and compared to the reference cohort to determine the benefit of using a SR in an area with high, year-round transmission of malaria.DiscussionThis study will address the knowledge gap of whether or not SRs are effective in reducing human malaria disease in humanitarian assistance and emergency response settings in sub-Saharan Africa where underlying transmission rates are historically high and ITNs may or may not be widely deployed. This research will inform policy makers on whether to recommend SRs as a means to further reduce malaria transmission for such operational programs.Trial registrationClinicalTrials.gov NCT06122142. Registered on November 8, 2023.

Clinical Manifestations and Health Impact of Malaria in Pregnant Women

Malaria during pregnancy poses significant health risks, both to mothers and their unborn children, due to the unique physiological and immunological changes occurring during this period. This review provides a comprehensive examination of the clinical manifestations and health impacts of malaria in pregnant women, highlighting the severity of the disease across different trimesters and its implications for maternal and fetal health. Malaria during pregnancy can cause symptoms like fever, anemia, headaches, fatigue, and nausea, with complications varying by trimester. In the first trimester, malaria can lead to early pregnancy loss and congenital anomalies, while in the second trimester, it can exacerbate maternal anemia and affect fetal growth. The third trimester is associated with an increased risk of preterm labor and adverse fetal outcomes. Placental malaria, characterized by parasite accumulation in the placenta, impairs nutrient and oxygen transfer to the fetus, leading to intrauterine growth restriction, low birth weight, and increased stillbirth risk. Maternal complications include severe anemia, acute respiratory distress syndrome, and potential long-term health effects. HIV infection further complicates malaria during pregnancy, increasing risks for both mother and fetus. Age-related variations and socioeconomic factors also impact malaria severity and management. Effective management strategies include intermittent preventive treatment, insecticide-treated nets, and indoor residual spraying. Addressing malaria during pregnancy requires a multifaceted approach, including enhancing diagnostic tools, improving preventive measures, and ensuring equitable healthcare access. Keywords: Clinical Manifestations, Health, Malaria, Pregnant Women

A Machine Learning-Based Prediction of Malaria Occurrence in Kenya

For many years’ malaria has been a health public concern in Kenya as well as many parts of Africa and other parts of the world. The purpose of this study is to develop and evaluate a supervised machine learning model to predict malaria occurrence (final malaria test results) in Kenya. The study investigated twelve predictor variables on the outcome variable (malaria test results), where five machine learning models namely; k-nearest neighbors, support vector machines, random forest, tree bagging, and boosting, were estimated. During the model evaluation, random forest emerged as the best overall model in the classification and prediction of final malaria test results. The model attained a higher classification accuracy of 97.33%, sensitivity of 71.1%, specificity of 98.4%, balanced accuracy of 84.7% and an area under the curve of 98.3%. From the final model, the presence of plasmodium falciparum emerged most important feature, followed by region, endemic zone and anemic level. The feature with the least importance in predicting final malaria test results was having mosquito nets. In conclusion, employing Machine learning algorithms enhances early detection, optimizing resource allocation for interventions, and ultimately reducing the incidence and impact of malaria in the Kenya. The study recommends allocation of resources and funds to areas with the presence of plasmodium falciparum, region susceptible to malaria, endemic zones and anemic prone areas.

Manifestações clínicas e o manejo da infecção congênita pelo Zika Vírus: Uma revisão sistemática

Objective: The general objective of the present study is to analyze the scientific production on Congenital Zika Virus Infection, seeking to identify the main clinical manifestations, as well as the main methods used in the treatment of this pathology. Methodology: It is a systematic review focused on understanding the main aspects of Congenital Zika Virus Infection. The research was guided by the question: "What are the main signs and symptoms of congenital Zika virus infection in the pediatric population, as well as what are the therapeutic resources used in clinical practice?" . To find answers, searches were performed in the PubMed database using three descriptors combined with the Boolean term "AND". This resulted in 010 articles. 12 articles were selected for analysis. Results: Congenital Zika syndrome (CZS) emerges as a complex and multifaceted challenge whose implications go beyond the boundaries of public health. Babies exposed to the Zika virus during pregnancy face a range of clinical manifestations, from microcephaly to eye anomalies and neurological disorders. Prevention, therefore, takes on a crucial role: educating pregnant women about the risks and promoting protective measures, such as the use of repellents and mosquito nets, is imperative. Conclusion: Although we do not yet have a licensed Zika vaccine, research efforts continue to explore this possibility. In addition, long-term surveillance is essential to fully understand the effects of the virus. In this scenario, awareness, interdisciplinary collaboration, and a commitment to the well-being of future generations are our best allies in the fight against this potentially devastating syndrome.

Longitudinal survey of insecticide resistance in a village of central region of Burkina Faso reveals co-occurrence of 1014F, 1014S and 402L mutations in Anopheles coluzzii and Anopheles arabiensis

BackgroundPyrethroid resistance is one of the major threats for effectiveness of insecticide-treated bed nets (ITNs) in malaria vector control. Genotyping of mutations in the voltage gated sodium channel (VGSC) gene is widely used to easily assess the evolution and spread of pyrethroid target-site resistance among malaria vectors. L1014F and L1014S substitutions are the most common and best characterized VGSC mutations in major African malaria vector species of the Anopheles gambiae complex. Recently, an additional substitution involved in pyrethroid resistance, i.e. V402L, has been detected in Anopheles coluzzii from West Africa lacking any other resistance alleles at locus 1014. The evolution of target-site resistance mutations L1014F/S and V402L was monitored in An. coluzzii and Anopheles arabiensis specimens from a Burkina Faso village over a 10-year range after the massive ITN scale-up started in 2010.MethodsAnopheles coluzzii (N = 300) and An. arabiensis (N = 362) specimens collected both indoors and outdoors by different methods (pyrethrum spray catch, sticky resting box and human landing collections) in 2011, 2015 and 2020 at Goden village were genotyped by TaqMan assays and sequencing for the three target site resistance mutations; allele frequencies were statistically investigated over the years.ResultsA divergent trend in resistant allele frequencies was observed in the two species: 1014F decreased in An. coluzzii (from 0.76 to 0.52) but increased in An. arabiensis (from 0.18 to 0.70); 1014S occurred only in An. arabiensis and slightly decreased over time (from 0.33 to 0.23); 402L increased in An. coluzzii (from 0.15 to 0.48) and was found for the first time in one An. arabiensis specimen. In 2020 the co-occurrence of different resistance alleles reached 43% in An. coluzzii (alleles 410L and 1014F) and 32% in An. arabiensis (alleles 1014F and 1014S).ConclusionsOverall, an increasing level of target-site resistance was observed among the populations with only 1% of the two malaria vector species being wild type at both loci, 1014 and 402, in 2020. This, together with the co-occurrence of different mutations in the same specimens, calls for future investigations on the possible synergism between resistance alleles and their phenotype to implement local tailored intervention strategies.

Overview of Malaria in Pregnancy: Challenges and Strategies for Effective Prevention

Malaria in pregnancy is a significant public health issue in sub-Saharan Africa, with 30 million pregnancies at risk each year. Pregnant women are particularly vulnerable due to immunological changes and the placental environment that facilitates parasite sequestration. The predominant malaria parasite, Plasmodium falciparum, is associated with significant maternal and fetal complications. Effective malaria prevention strategies include insecticide-treated nets (ITNs) and intermittent preventive treatment (IPTp) with Sulfadoxine-pyrimethamine. However, adherence to preventive chemotherapy is challenging due to side effects and socioeconomic barriers. Health education programs are crucial for increasing awareness and promoting preventive behaviors. Early diagnosis and prompt treatment are critical for managing severe malaria cases. Environmental and vector control measures, such as indoor residual spraying and larval source management, are vital for reducing mosquito populations and transmission. Nutritional interventions support immune function and overall health. Access to healthcare services, innovative technologies, and cultural and socioeconomic factors are essential for overcoming barriers to malaria prevention and treatment. Continuous monitoring and evaluation are crucial for refining interventions and improving health outcomes. Keywords: Malaria, Pregnancy, Challenges, Strategies, Effective Prevention

Factors Associated with Indoor Residual Spraying Programme Effectiveness in Mutare City, Manicaland Province, Zimbabwe

Introduction: Malaria is a mosquito-borne disease causing fever, chills, and flu-like symptoms. If untreated, it can lead to severe complications and death (CDC, 2016). Recently, Mutare city recorded malaria cases after local transmission was confirmed in 2017. Indoor Residual Spraying (IRS) was implemented, but coverage decreased during the 2018/2019 IRS season, prompting a study in ten randomly selected locations. The study aimed to identify knowledge gaps, preferred alternatives to IRS, the influence of competing events, and household ownership on IRS. Methods: A descriptive cross-sectional study with 260 participants was conducted using proportional allocation for the study locations. Data were collected via interviewer-administered questionnaires, interviews with key informants, and focus group discussions. Results: Participants were mostly female (67%) and aged 31-60 years (50%), with vending being the top livelihood (52%). Only 38% always used bed nets, 24% owned houses, and 76% were tenants. IRS reservations included time consumption (11%), preference for other interventions (9%), landlord objections (22%), livelihood pressures (14%), labour intensity (15%), exposure of secrets and poverty (12%), distrust of the team (8%), and property damage (9%). Bed nets were preferred over IRS. Conclusion: Challenges in conducting IRS included knowledge gaps needing health education sessions, which faced attendance issues due to competing events. More strategic health education and bed net deployment were recommended.

Pooled prevalence of malaria and associated factors among vulnerable populations in Ethiopia: a systematic review and meta-analysis

BackgroundMalaria is a serious, fatal disease, and a high-risk determinant for human health globally. Children, pregnant women, and migrants are vulnerable groups for malaria infection in African regions. Recently, malaria is an endemic disease in Ethiopia.ObjectivesThis study aimed to determine the pooled prevalence of malaria and its determinant factors among the most vulnerable populations in Ethiopia.MethodsElectronic databases, including PubMed, Google Scholar, Web of Science, Semantic Scholar, and Scopus were used for searching articles published since the 2020 Gregorian calendar and onwards. All peer-reviewed Ethiopian journals, health institutions, and Universities were considered for article searching. A PRISMA flow chart and Endnote software were used for article screening, and to remove duplications, respectively. The modified version of the Newcastle–Ottawa Scale was used for potential risk of bias assessments. The heterogeneity among the included studies was evaluated using the indicator of heterogeneity (I2). Egger’s test and funnel plot were used to examine the possible publication bias. A random-effects analysis was used to assess the pooled prevalence of malaria, and its determinant factors with a 95% CI. The screening process, data extraction, and quality assessment were done independently, and any disagreements were resolved through discussions.ResultsA total of twelve studies were included in this study. The pooled malaria prevalence was 11.10% (95% CI: 6.10, 16.11). Stagnant water (AOR: 4.19, 95% CI: 2.47, 7.11), no insecticide-treated net utilization (AOR: 3.15, 95% CI: 1.73, 5.73), and staying outdoors at night (AOR: 5.19, 95% CI: 2.08, 12.94) were the pooled estimated statistically risk factors for malaria prevalence. Whereas, insecticide-treated bed net utilization (AOR: 1.59, 95% CI: 0.23, 10.95) reduces the risk of malaria infection.ConclusionsThe pooled prevalence of malaria is high among vulnerable populations. Creating awareness regarding utilization of insecticide-treated bed nets, and draining stagnant water from the environment are possible interventions to reduce the prevalence of malaria.