Malaria Endemic Areas Research Articles

Knowledge, attitudes, and practices about malaria in travelers to risk areas in Peru.

Travelers from international airports who travel to endemic countries know the knowledge, attitudes, and practices (KAP) about malaria; however, it is still unknown to interprovincial travelers who go to the endemic regions of Peru. The objective is to determine the level of KAP about malaria among Peruvian travelers to risk areas. This are an analytical cross-sectional study of 277 passengers from a bus station in a low-risk area of malaria in Peru, whose destination was an intermediate/high-risk area during February-March 2018. Absolute and relative frequencies of personal variables associated with the trip and KAP were estimated. Less than 50% know the main symptoms of malaria and at what time of day there is a greater risk of becoming infected. Five out of ten people knew which practices were preventive against contagion, and four out of ten answered that the treatment can be given in a health establishment, pharmacy, or by some healer. Travelers to malaria endemic areas have a low level of knowledge and practice (39.7%) as well as an inadequate preventive attitude (35.4%) against malaria.

On the potential for discontinuing atovaquone-proguanil (AP) ad-hoc post-exposure and other abbreviated AP-regimens: Pharmacology, pharmacokinetics and perspectives.

According to current guidelines, atovaquone-proguanil (AP) malaria chemoprophylaxis should be taken once daily starting one day before travel and continued for seven days post-exposure. However, drug-sparing regimens, including discontinuing AP after leaving malaria-endemic areas are cost-saving and probably more attractive to travelers, and may thus enhance adherence. AP has causal prophylactic effects, killing malaria parasites during the hepatic stage. If early hepatic stages were already targeted by AP, AP could possibly be discontinued upon return. Pharmacokinetic data and studies on drug-sparing AP regimens suggest this to be the case. Nevertheless, the evidence is weak and considered insufficient to modify current recommendations. Field trials require large numbers of travelers and inherently suffer from the lack of a control group. Safely-designed controlled human malaria infection trials could significantly reduce study participant numbers and safely establish an effective AP abbreviated regimen which we propose as the optimal trial design to test this concept.

Correlation between Knowledge, Attitude and Practice towards Malaria in Endemic Areas: A Cross-Sectional Study

Objective: To find a correlation between knowledge, attitude and practice of malaria in endemic areas and to identify any significant factors associated with them.
 Study Design: Cross-sectional study.
 Place and Duration of the Study: Pathology Department, Combined Military Hospital, Khuzdar, from Nov 2019 to Oct 2020.
 Methodology: People admitted with malaria from Khuzdar district, and surrounding areas were included in the study.Patients with the communication barrier were excluded. Patients with debilitating illness or pregnant ladies and those allergic to the drugs were also excluded from the study.
 Results: Total 203 people with a confirmed malarial diagnosis were enrolled. The age of participants ranged from 20-48 years,with a mean of 30.49±6.45 years. All the study participants had heard about malaria and had adequate knowledge about its mode of transmission. 84.3% patients had a positive attitude towards understanding disease as potentially life-threatening.70.9% patients had good practices about using anti-mosquito sprays, and 71.9% had good practices about using personal protective clothing. Our study showed that malaria prevention practice was significantly associated with endemic areas (p<0.001).
 Conclusions: All the patients had adequate knowledge about malaria. Targeted interventions towards malaria prevention in endemic areas should be enhanced.

Factors associated with delay in seeking healthcare for imported malaria: a retrospective study in a French hospital.

Delayed treatment is associated with a higher risk of severe malaria. In malaria-endemic areas, the main factors associated with delay in seeking healthcare are low educational level and traditional beliefs. In imported malaria, determinants of delay in seeking healthcare are currently unknown. We studied all patients presenting with malaria, from 1 January 2017 to 14 February 2022, in the hospital of Melun, France. Demographic and medical data were recorded for all patients, and socio-professional data were recorded for a subgroup of hospitalized adults. Relative-risks and 95% confidence intervals were determined using univariate analysis by cross-tabulation. There were 234 patients included, all travelling from Africa. Among them, 218 (93%) were infected with P. falciparum, 77 (33%) had severe malaria, 26 (11%) were <18years old and 81 were included during the SARS-CoV-2 pandemic. There were 135 hospitalized adults (58% of all patients). The median time to hospital admission (THA) , defined by the period from onset of symptoms to arrival at hospital, was 3days (IQR = 2-5). A THA ≥3days tended to be more frequent in travellers visiting friends and relatives (VFR; RR = 1.44, 95% CI = [1.0-2.05], P = 0.06), while it was less frequent in children and teenagers (RR = 0.58, 95% CI = [0.39-0.84], P = 0.01). Gender, African background, unemployment, living alone and absence of referring physician were not associated with delay in seeking healthcare. Consulting during the SARS-CoV-2 pandemic was neither associated with a longer THA nor with a higher rate of severe malaria. In contrast to an endemic area, socio-economic factors did not impact on delay in seeking healthcare in imported malaria. Prevention should focus on VFR subjects, who tend to consult later than other travellers.

The Conventional Diagnostic Techniques of Malaria in Endemic Areas: A Review of the Approaches with Focus on Newly Noninvasive Methods

The Conventional Diagnostic Techniques of Malaria in Endemic Areas: A Review of the Approaches with Focus on Newly Noninvasive Methods

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.

Diagnosis of cerebral malaria: Tools to reduce Plasmodium falciparum associated mortality.

Cerebral malaria (CM) is a major cause of mortality in Plasmodium falciparum (Pf) infection and is associated with the sequestration of parasitised erythrocytes in the microvasculature of the host's vital organs. Prompt diagnosis and treatment are key to a positive outcome in CM. However, current diagnostic tools remain inadequate to assess the degree of brain dysfunction associated with CM before the window for effective treatment closes. Several host and parasite factor-based biomarkers have been suggested as rapid diagnostic tools with potential for early CM diagnosis, however, no specific biomarker signature has been validated. Here, we provide an updated review on promising CM biomarker candidates and evaluate their applicability as point-of-care tools in malaria-endemic areas.

Malaria in Children: Updates on Management and Prevention.

Malaria in Children: Updates on Management and Prevention.

Effect of large-scale mass drug administration for malaria on mortality and morbidity in Angumu health zone, Ituri, Democratic Republic of Congo

BackgroundAngumu health zone in Ituri, Democratic Republic of Congo, is a highly malaria-endemic area with an overburdened health system and hosting internally displaced persons (IDP). The World Health Organization recommends mass drug administration (MDA) for malaria in complex emergencies. Therefore, three MDA rounds were implemented by Ministry of Public Health and Médecins sans Frontières from September 2020 to January 2021 in four health areas selected for epidemiological (high malaria incidence) and logistic reasons. Reported mortality and morbidity were compared in locations where MDA has been performed and locations where it has not.MethodsA non-randomized controlled population-based retrospective mortality survey was conducted in March 2021. Two-stage cluster sampling was used in villages; all IDP sites were surveyed with systematic random sampling. The main (mortality rates) and secondary (morbidity) outcomes were estimated and compared between locations where MDA had been conducted and where it had not, using mixed Poisson and binomial regression models respectively.ResultsData was collected for 2554 households and 15470 individuals, of whom 721 died in the 18-month recall period. The under-five mortality rate (U5MR) decreased in the locations where MDA had been implemented from 2.32 [1.48–3.16] “before” the MDA to 1.10 [0.5–1.71] deaths/10,000 children under 5 years/day “after”, whereas it remained stable from 2.74 [2.08–3.40] to 2.67 [1.84–3.50] deaths/10,000 children/day in the same time periods in locations where MDA had not been implemented. The U5MR and malaria-specific mortality was significantly higher in non-MDA locations after MDA was implemented (aRR = 2.17 [1.36–3.49] and 2.60 [1.56–4.33], respectively, for all-cause and malaria-specific mortality among children < 5 years). Morbidity (all age and < 5 years, all cause or malaria-specific) appeared lower in MDA locations 2.5 months after last round: reported malaria-specific morbidity was 14.7% [11–18] and 25.0% [19–31] in villages and IDP sites where MDA had been implemented, while it was 30.4% [27–33] and 49.3% [45–54] in villages and IDP sites with no MDA.ConclusionsDespite traditional limitations associated with non-randomized controlled retrospective surveys, the documented sharp decrease of under-5 mortality and morbidity shows that MDA has the potential to become an important malaria-control tool in emergency settings. Based on these results, new MDA rounds, along with indoor residual spraying campaigns, have been planned in the health zone in 2022. A set of surveys will be conducted before, during and after these rounds to confirm the effect observed in 2021 and assess its duration.

A Review of Major Patents on Potential Malaria Vaccine Targets.

Malaria is a parasitic infection that is a great public health concern and is responsible for high mortality rates worldwide. Different strategies have been employed to improve disease control, demonstrating the ineffectiveness of controlling vectors, and parasite resistance to antimalarial drugs requires the development of an effective preventive vaccine. There are countless challenges to the development of such a vaccine directly related to the parasite's complex life cycle. After more than four decades of basic research and clinical trials, the World Health Organization (WHO) has recommended the pre-erythrocytic Plasmodium falciparum (RTS, S) malaria vaccine for widespread use among children living in malaria-endemic areas. However, there is a consensus that major improvements are needed to develop a vaccine with a greater epidemiological impact in endemic areas. This review discusses novel strategies for malaria vaccine design taking the target stages within the parasite cycle into account. The design of the multi-component vaccine shows considerable potential, especially as it involves transmission-blocking vaccines (TBVs) that eliminate the parasite's replication towards sporozoite stage parasites during a blood meal of female anopheline mosquitoes. Significant improvements have been made but additional efforts to achieve an efficient vaccine are required to improve control measures. Different strategies have been employed, thus demonstrating the ineffectiveness in controlling vectors, and parasite resistance to antimalarial drugs requires the development of a preventive vaccine. Despite having a vaccine in an advanced stage of development, such as the RTS, S malaria vaccine, the search for an effective vaccine against malaria is far from over. This review discusses novel strategies for malaria vaccine design taking into account the target stages within the parasite's life cycle.

Optimizing Routine Malaria Surveillance Data in Urban Environments: A Case Study in Maputo City, Mozambique.

In urban settings in malaria-endemic countries, malaria incidence is not well characterized and assumed to be typically very low and consisting largely of imported infections. In such contexts, surveillance systems should adapt to ensure that data are of sufficient spatial and temporal resolution to inform appropriate programmatic interventions. The aim of this research was to 1) assess spatial and temporal trends in reported malaria cases in Maputo City, Mozambique, using an expanded case notification form and 2) to determine how malaria surveillance can be optimized to characterize the local epidemiological context, which can then be used to inform targeted entomological investigations and guide implementation of localized malaria responses. This study took place in all six health facilities of KaMavota District in Maputo City, Mozambique. A questionnaire was administered to all confirmed cases from November 2019 to August 2021. Households of cases were retrospectively geolocated using local landmarks as reference. Overall, 2,380 malaria cases were reported, with the majority being uncomplicated (97.7%) and a median age of 21 years; 70.8% of cases had reported traveling outside the city in the past month with nine reporting traveling internationally. Maps of the 1,314 malaria cases that were geolocated showed distinct spatial patterns. The expanded case notification form enables a more granular overview of the malaria epidemiology in Maputo City; the geolocation data clearly show the areas where endemic transmission is likely, thus informing where resources should be prioritized. As urbanization is rapidly increasing in malaria endemic areas, identifying systems and key variables to collect ensures an operational way to characterize urban malaria through optimization of routine data to inform decision-making.

Higher antigen occupancy of high avidity CSP serum antibodies associates with protection against human malaria.

R21, a next generation malaria vaccine candidate, demonstrated 74-77% efficacy among children living in a malaria endemic area. In a phase IIa controlled human malaria infection (CHMI) study, R21 demonstrated 48.6% to 78.2% vaccine efficacy. The immune mechanisms responsible for protection by the R21 immunogen are unknown. We hypothesized that both magnitude and avidity of R21-induced polyclonal antibodies (pAbs) contribute to protection status. The biophysical properties of plasmodium falciparum (Pf) circumsporozoite protein (CSP) specific pAbs of participants from CHMI study were measured by Biolayer Interferometry, including antigen binding response and dissociation rate constant (kd) when binding to recombinant CSP, central repeat-peptides (NANP)6 and (NPNA)3, and the virus like particle R21 vaccine immunogen presenting 19 repeats of NANP motif, with the C-terminal region of CSP fused to the hepatitis B surface antigen. An innovative polyclonal antibodies avidity resolution tool (PAART) was used to derive kd values reflecting different avidities of pAbs and the fraction of their contribution to total binding (antigen occupancy). We found that protected vaccinees from all groups combined displayed higher median binding response (p<0.05 for R21, CSP and (NPNA)3, Mann-Whitney U test) and slower median kd values (p<0.01 for (NANP)6 and (NPNA)3, Mann-Whitney U test) compared to non-protected vaccinees. For the majority of participants, further dissecting the heterogeneity of avidities of the R21 immunogen-induced antibodies revealed two kd components, 10−4 s−1 (higher avidity component) and >10−2 s−1 (lower avidity component). Interestingly, the median antigen occupancy of higher avidity component for CSP, (NANP)6 and (NPNA)3 binding, i.e., the dominant fraction (82-99% occupancy, mean value 95%), was greater in the protected than non-protected vaccinees. These results suggest that high magnitude and avidity pAbs contribute to the R21 vaccine protection against Pf sporozoite infection.

Patient-level performance evaluation of a smartphone-based malaria diagnostic application

BackgroundMicroscopic examination is commonly used for malaria diagnosis in the field. However, the lack of well-trained microscopists in malaria-endemic areas impacted the most by the disease is a severe problem. Besides, the examination process is time-consuming and prone to human error. Automated diagnostic systems based on machine learning offer great potential to overcome these problems. This study aims to evaluate Malaria Screener, a smartphone-based application for malaria diagnosis.MethodsA total of 190 patients were recruited at two sites in rural areas near Khartoum, Sudan. The Malaria Screener mobile application was deployed to screen Giemsa-stained blood smears. Both expert microscopy and nested PCR were performed to use as reference standards. First, Malaria Screener was evaluated using the two reference standards. Then, during post-study experiments, the evaluation was repeated for a newly developed algorithm, PlasmodiumVF-Net.ResultsMalaria Screener reached 74.1% (95% CI 63.5–83.0) accuracy in detecting Plasmodium falciparum malaria using expert microscopy as the reference after a threshold calibration. It reached 71.8% (95% CI 61.0–81.0) accuracy when compared with PCR. The achieved accuracies meet the WHO Level 3 requirement for parasite detection. The processing time for each smear varies from 5 to 15 min, depending on the concentration of white blood cells (WBCs). In the post-study experiment, Malaria Screener reached 91.8% (95% CI 83.8–96.6) accuracy when patient-level results were calculated with a different method. This accuracy meets the WHO Level 1 requirement for parasite detection. In addition, PlasmodiumVF-Net, a newly developed algorithm, reached 83.1% (95% CI 77.0–88.1) accuracy when compared with expert microscopy and 81.0% (95% CI 74.6–86.3) accuracy when compared with PCR, reaching the WHO Level 2 requirement for detecting both Plasmodium falciparum and Plasmodium vivax malaria, without using the testing sites data for training or calibration. Results reported for both Malaria Screener and PlasmodiumVF-Net used thick smears for diagnosis. In this paper, both systems were not assessed in species identification and parasite counting, which are still under development.ConclusionMalaria Screener showed the potential to be deployed in resource-limited areas to facilitate routine malaria screening. It is the first smartphone-based system for malaria diagnosis evaluated on the patient-level in a natural field environment. Thus, the results in the field reported here can serve as a reference for future studies.

Neurobehavioral and biochemical responses to artemisinin-based drug and aflatoxin B1 co-exposure in rats.

Populations in malaria endemic areas are frequently exposed to mycotoxin-contaminated diets. The possible toxicological outcome of co-exposure to dietary aflatoxin B1 (AFB1) and artemisinin-based combination therapy warrants investigation to ascertain amplification or attenuation of cellular injury. Here, we investigated the neurobehavioral and biochemical responses associated with co-exposure to anti-malarial drug coartem, an artemether-lumefantrine combination (5mg/kg body weight, twice a day and 3days per week) and AFB1 (35 and 70µg/kg body weight) in rats. Motor deficits, locomotor incompetence, and anxiogenic-like behavior induced by low AFB1 dose were significantly (p < 0.05) assuaged by coartem but failed to rescue these behavioral abnormalities in high AFB1-dosed group. Coartem administration did not alter exploratory deficits typified by reduced track plot densities and greater heat map intensity in high AFB1-dosed animals. Furthermore, the reduction in cerebral and cerebellar acetylcholinesterase activity, anti-oxidant enzyme activities, and glutathione and thiol levels were markedly assuaged by coartem administration in low AFB1 group but not in high AFB1-dosed animals. The significant attenuation of cerebral and cerebellar oxidative stress indices namely reactive oxygen and nitrogen species, xanthine oxidase activity, and lipid peroxidation by coartem administration was evident in low AFB1 group but not high AFB1 dose. Although coartem administration abated nitric oxide level, activities of myeloperoxidase, caspase-9, and caspase-3 in animals exposed to both doses of AFB1, these indices were significantly higher than the control. Coartem administration ameliorated histopathological and mophometrical changes due to low AFB1 exposure but not in high AFB1 exposure. In conclusion, contrary to AFB1 alone, behavioral and biochemical responses were not altered in animals singly exposed to coartem. Co-exposure to coartem and AFB1 elicited no additional risk but partially lessened neurotoxicity associated with AFB1 exposure.

A novel multiplex qPCR assay for clinical diagnosis of non-human malaria parasites-Plasmodium knowlesi and Plasmodium cynomolgi.

The imminent risk of zoonoses of non-human malaria parasites is not far from reality in India, as has been observed in the case of Plasmodium knowlesi (Pk), and so is possible with P. cynomolgi (Pc), already reported from South East Asian countries. Therefore, a novel multiplex qPCR assay was developed and evaluated for detection of non-human malaria parasites- Pk and Pc in populations at risk. The qPCR primers were designed in-house with fluorescence labeled probes (HEX for Pk and FAM for Pc). DNA samples of Pk and Pc were used as templates and further the qPCR assay was evaluated in 250 symptomatic and asymptomatic suspected human blood samples from malaria endemic areas of North Eastern states of India. The qPCR assay successfully amplified the target 18S rRNA gene segment from Pk and Pc and was highly specific for Pk and Pc parasites only, as no cross reactivity was observed with P. falciparum (Pf), P. vivax (Pv), P. malariae (Pm), and P. ovale (Po). Standard curves were generated to estimate the limit of detection (LOD) of Pk and Pc parasites DNA (0.00275 & 0.075 ng/μl, respectively). Due to COVID-19 pandemic situation during 2020-21, the sample accessibility was difficult, however, we managed to collect 250 samples. The samples were tested for Pf and Pv using conventional PCR- 14 Pf and 11 Pv infections were observed, but no Pk and Pc infections were detected. For Pk infections, previously reported conventional PCR was also performed, but no Pk infection was detected. The multiplex qPCR assay was observed to be robust, quick, cost-effective and highly sensitive as compared to the currently available conventional PCR methods. Further validation of the multiplex qPCR assay in field setting is desirable, especially from the high-risk populations. We anticipate that the multiplex qPCR assay would prove to be a useful tool in mass screening and surveillance programs for detection of non-human malaria parasites toward the control and elimination of malaria from India by 2030.

Using Malarial Retinopathy to Improve the Diagnosis of Pediatric Cerebral Malaria.

In malaria endemic areas, a high proportion of children have detectable parasitemia but show no clinical symptoms. When comatose from a cause other than malaria, this group confounds the cerebral malaria (CM) definition, making accurate diagnosis challenging. One important biomarker of CM is malarial retinopathy, a set of specific features visible in the ocular fundus. In this study, we quantified the contribution of malarial retinopathy in discriminating malaria-caused coma from non-malaria-caused coma. We estimated that 10% of our study cohort of N = 1,192 patients who met the WHO clinical definition of CM in Malawi had non-malarial coma based on a Gaussian mixture model using the parasite protein Plasmodium falciparum histidine-rich protein-2. A classification based on platelets, white blood cells, and retinopathy significantly improved the discriminative power of a previously established model including only platelets plus white blood cells (area under the receiver operating characteristic curve: 0.89 versus 0.75, P value < 0.001). We conclude that malarial retinopathy is highly predictive of malaria-caused versus non-malaria-caused coma and recommend that an ocular funduscopic examination to determine malarial retinopathy status be included in the assessment of parasitemic comatose African children.

Vector Bionomics of Anopheline Fauna in Malaria Endemic Areas (Three Sentinel Sites) of Bangladesh

Background: The three Hill Tract Districts are highly malaria transmission areas in Bangladesh and intensified coverage of LLINs to reduce the number of malaria cases. Information of the bionomics of disease vectors and biting behavior is more essential to take appropriate vector control measures. The bionomics study was carried out after approximately 10 years back (2005-2006), if there any changes in vector behavior after introducing the long lasting insecticidal nets (LLINs) in malaria endemic areas. Method: Three sites were selected based on the number of last several years reported cases and malariogenic potentials including geographical condition, altitude, latitude, presence of vectors, availability of breeding sources, favorable temperature, humidity, rainfall and other possible risk factors. Mosquitoes were collected through the human and animal landing from outdoor and indoor, Pythrum Spray sheet collection, morning resting collection form human dwelling and cattle shed. Results: Mosquitoes were collected through the hand aspirator and Pyrethrum spray sheet collection during day and night time. A total of 8078 Anopheles mosquitoes, 20 specie were collected, out of that 3858 (47.76 %) are An. vagus is the most abundant followed by An. willmori 965 (11.95), An. nigerrimus 848 (10.50%), An. kochi 734 (9.09%), An. barbirostris 444 (5.50%), An. jamesii 367 (4.54 %), An. philippinensis 182 (2.25), A subpictus 163 (2.02%), An. annularis 135 (1.67%), the most virulent vector An baimaii 72(0.89), An culicifacies 51 (0.64%), An. minimus 26 (0.32%). Conclusion: The main malaria vectors A baimaii (=dirus) has been collected from 19.18 to 02.30 hrs and the pick biting period is identified 20.30 to 21.30 hrs and 21.30 to 22.30 The early biting of the An baimai indicate its behavioural changes. A vagus prevalence was higher among the collected anopheline populations in all three places.

Evaluation of Experimental Cerebral Malaria of Curcumin and Kaempferol in Plasmodium berghei ANKA-Infected Mice

Background: Cerebral malaria (CM) is one of the most severe complications of Plasmodium falciparum infection and the leading cause of death from malaria in endemic areas. Natural products with antioxidant and anti-inflammatory activities have become valuable alternative therapeutic options in CM treatment. Therefore, this study aimed to investigate the neuroprotective effects of curcumin and kaempferol in experimental cerebral malaria (ECM) in mice infected with Plasmodium berghei ANKA (PbA). Methods: After PbA infection, mice were divided into 9 groups, namely Group I (negative control (NC)) with 0.5% HPMC, Group II received chloroquine 20 mg/kg, Group III (normal) with aquadest, Groups IV, V, and VI received curcumin at doses of 20, 40, and 80 mg/kg, respectively, Groups VII, VIII, and IX received kaempferol at doses of 20, 40, and 80 mg/kg, respectively. The antimalarial activity was evaluated using Peter's four-day suppressive test. This was conducted to determine the % parasitemia, survival rate, AST and ALT, blood-brain barrier (BBB) leakage, and neurobehavioral disorders in mice with CM. Results: The results showed that all treatments had significant antimalarial activity, with the % suppression depending on the dose. It also indicates that PbA-infected mice had a survival rate of 11-19 days after infection, which was higher than those in the NC group. This suggested that curcumin and kaempferol have a protective effect on the survival of PbA-infected mice. Furthermore, they significantly reduced the AST and ALT concentrations in the sample compared to the NC group. The same was observed in cerebral vessel extravasation, where the Evans Blue stain assay showed significantly less dye extravasation in the brains of PbA-infected mice treated with curcumin and kaempferol. This indicated better-protected integrity of the BBB. Additionally, the results also demonstrated a decrease in neurological disorders arising during ECM in the group treated with curcumin and kaempferol. Conclusion: Considering these results, it is concluded that treatments with curcumin and kaempferol could improve animal survival, prevent AST and ALT elevations, as well as protect the BBB and neurobehavioral disorders associated with CM in PbA-infected mice.

Simultaneous detection of G6PD mutations using SNPscan in a multiethnic minority area of Southwestern China.

Objectives: Baise, a multiethnic inhabited area of southwestern China, is a historical malaria-endemic area with a high prevalence of G6PD deficiency. However, few studies of G6PD deficiency have been conducted in this region. Therefore, we performed a genetic analysis of G6PD deficiency in the Baise population from January 2020 to June 2021. Methods: A SNPscan assay was developed to simultaneously detect 33 common Chinese G6PD mutations. 30 G6PD-deficient samples were used for the method's validation. Then, a total of 709 suspected G6PD-deficient samples collated from the Baise population were evaluated for G6PD status, type of mutation and effect of mutations. Results: The SNPscan test had a sensitivity of 100% [95% confidence interval (CI): 94.87%-100%] and a specificity of 100% (95% CI: 87.66%-100%) for identifying G6PD mutations. A total of fifteen mutations were identified from 76.72% (544/709) of the samples. The most common mutation was discovered to be G6PD Kaiping (24.12%), followed by G6PD Canton (17.91%), and G6PD Gaohe (11.28%). We compared the G6PD mutation spectrum among Zhuang, Han and other Southeast Asian populations, and the Zhuang population's mutation distribution was quite similar to that in the Han population. Conclusion: This study provided a detailed G6PD mutation spectrum in Baise of southwestern China and will be valuable for the diagnosis and research of G6PD deficiency in this area. Furthermore, the SNPscan assay could be used to quickly diagnose these G6PD mutations accurately.

Effect of Malaria Parasite on Hepatic Parameters in People Living in Aba Metropolis

Purpose: In Nigeria, malaria continues to be a huge public health problem. Incidentally, malaria is caused by either Plasmodium falciparum or Plasmodium vivax. Malaria associated deaths in Metropolis area is mainly due to Plasmodium falciparum. Plasmodium parasite is primarily transmitted by the bite of an infected female anopheles mosquito during blood meal though this can also occur through exposure to infected blood products (blood transfusion) and by congenital transmission. This study therefore aimed at investigating the effect of malaria parasite on hepatocytes by monitoring enzyme activities such as the transaminases and the excretory function of the liver (bilirubin).&#x0D; Methodology: This study was a cross-sectional study where hundred adults participated. A total of 50 patients' samples (adults) both male and female were collected from the same geographic location and fifty were selected as control and another fifty for the test. Examination of a thick blood film stained with Giemsa was done to confirm the presence of plasmodium and its absence as control. The activities of Aspartate transaminase, Alanine transaminase and bilirubin level was determined using Redox enzymatic kit Standard methods. Data obtained were statistically analyzed using students t-test where P&lt;0.05 was considered significant.&#x0D; Findings: There was a positive relationship between the enzyme activities and the level of parasitemia (P&lt;90.05). Derangement in AST (13.30±4.48U/L), ALT (13.9±4.52U/L), TB (3.92± 1.30U/L), CB (0.56 ±0.28U/L) levels for the infected subjects were higher when compared with controls .This study has demonstrated that the invasion of the hepatocytes by the malaria parasite causes the liberation of the transaminase into the blood serum and equally, the excretory function through elevation of bilirubin of the liver was affected.&#x0D; Recommendation: This study recommend transaminases and bilirubin to be assessed to assist in disease detection, prompt diagnosis and intervention especially in endemic malaria area. &#x0D;