Endemic Malaria Research Articles

Time to implement tailored interventions in Chhattisgarh, east-central India to reach malaria elimination.

Despite significant progress in malaria control throughout India, Chhattisgarh state continues to be a significant contributor to both malaria morbidity and mortality. This study aims to identify key factors associated with malaria endemicity, with a goal of focusing on these factors for malaria elimination by 2030. We employed an analysis and narrative review methodology to summarize the existing evidence on malaria epidemiology in Chhattisgarh. Data encompassing environmental conditions, dominant malaria vectors and their distribution, and the impact of previous interventions on malaria control, were extracted from published literature using PubMed and Google Scholar. This information was subsequently correlated with malaria incidence data using appropriate statistical and geographical methods. Much of the malaria burden in Chhattisgarh state is concentrated in a few specific districts. The primary malaria vectors in these regions are Anopheles culicifacies and An. fluviatilis. High transmission areas are found in tribal belts which are challenging to access and are characterized by densely forested areas that provide a conducive habitat for malaria vectors. Conducive environmental conditions characterized by high forest cover, community behavior, and insurgency, contribute to high malaria endemicity in the area. Challenges include insecticide resistance in malaria vectors and asymptomatic malaria. Allocating additional resources to high-endemic districts is crucial. Innovative and focused malaria control programs of the country, such as DAMAN and Malaria Mukt Abhiyan, hold immense importance.

TREATMENT FOR MALARIA PATIENTS IN PAKISTAN AND THE PREDOMINANCE OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD) DEFICIENCY

Even though it predisposes carriers to hemolysis, glucose-6-phosphate dehydrogenase (G6PD) deficiency is linked with malaria endemicity. This fact supports the malaria prevention theory. The objective of this paper to determine whether and how much there is a protective relationship between malaria and G6PD deficiency. Twelve databases were searched for studies describing any G6PD connection in malaria patients. 38 of the 50 included papers qualified for the review. Results indicated that there was no harmful association between G6PD deficiency and uncomplicated falciparum malaria in Even though it puts carriers at risk for hemolysis, glucose-6-phosphate dehydrogenase (G6PD) deficiency is widespread in areas of Pakistan where malaria is also prevalent. This data supports the malaria protection hypothesis. Pakistan's annual malaria burden is estimated to be 1.5 million cases. The government needs to execute a successful malaria control and eradication program, given the prevailing circumstances. Destroying Plasmodium falciparum gametocytes and eradicating Plasmodium vivax hypnozoite reservoirs are possible with primaquine. However, when using this medication, those who lack the enzyme glucose-6-phosphate (G6PD) experience hemolysis. The distribution of malaria and G6PD deficiency in Pakistan must be mapped to create an effective medication to suppress the disease. No significant reports of G6PD deficiency (G6PDd) in malaria patients have come from Pakistan. This review article seeks to establish the existence and magnitude of a protective connection between malaria and G6PD deficiency

Virtual Screening and Pharmacophore Modeling for discovery of Biologically Active Natural Products as Inhibitors of Odorant-binding Proteins

More than 100 nations in Africa, the Americas and the Eastern Mediterranean have endemic dengue and malaria, and these bites have the potential to have inflammatory or infectious local or systemic effects. The mosquito repellents from various sources were examined and plant repellents, researchers frequently exaggerate toxicity of the mentioned compound, alleging that it poses a threat to human health or even the environment and reported by recent studies. The aim of the research article, the historical developmental strategies of synthetics and natural and those acts on certain targets as repellent property, target discovery aims to identify and validate appropriate pharmacological targets for therapeutic interventions and establishment of correlations between the molecule and its potency as repellent using various physicochemical parameters and in silico studies. From this study proved that some of the natural compounds were potent in comparison with the some of the standard insect repellents and the paradigm offers a wide variety of prospects that will fasten the lead molecular modifications influences the novel targets and ultimately result in the optimization of the molecular properties by considering the all the methodologies leads to design novel molecules.

Naturally acquired immunity to Plasmodium pitheci in Bornean orangutans (Pongo pygmaeus).

Naturally acquired immunity to the different types of malaria in humans occurs in areas of endemic transmission and results in asymptomatic infection of peripheral blood. The current study examined the possibility of naturally acquired immunity in Bornean orangutans, Pongo pygmaeus, exposed to endemic Plasmodium pitheci malaria. A total of 2140 peripheral blood samples were collected between January 2017 and December 2022 from a cohort of 135 orangutans housed at a natural forested Rescue and Rehabilitation Centre in West Kalimantan, Indonesia. Each individual was observed for an average of 4.3 years during the study period. Blood samples were examined by microscopy and polymerase chain reaction for the presence of plasmodial parasites. Infection rates and parasitaemia levels were measured among age groups and all 20 documented clinical malaria cases were reviewed to estimate the incidence of illness and risk ratios among age groups. A case group of all 17 individuals that had experienced clinical malaria and a control group of 34 individuals having an event of >2000 parasites μL−1 blood but with no outward or clinical sign of illness were studied. Immature orangutans had higher-grade and more frequent parasitaemia events, but mature individuals were more likely to suffer from clinical malaria than juveniles. The case orangutans having patent clinical malaria were 256 times more likely to have had no parasitaemia event in the prior year relative to asymptomatic control orangutans. The findings are consistent with rapidly acquired immunity to P. pitheci illness among orangutans that wanes without re-exposure to the pathogen.

Sporozoite infection and Entomological Inoculation Rate as a Measure of Endemic Malaria Transmission

The study was conducted in Kontagora town of Niger State, North Central Nigeria. Sporozoite Infection Rate (SR) and Entomological Inoculation Rate (EIR) was assessed in spatial order. Indoor resting mosquitoes were collected using Pyrethrum Spray Catch (PSC). Morphological identification was carried out using a trinocular dissecting microscope with the aid of standard Taxonomic keys. Mosquito Salivary glands were carefully dissected for determination of Sporozoite Infection Rate. The proportion of individual mosquitoes infected with Plasmodium sporozoites were noted as the sporozoite rate (SR) in percentage. Entomological inoculation rate (EIR) was calculated as a product of Sporozoite Rate (SR) and Human Biting Rate (HBR) and expressed as infective bite per person (ib/p. Annual Sporozoite Infection Rate of 63.8 % was recorded. No significant variation was reported (p>0.05) in Sporozoite Infection Rate between sampling locations. Annual Entomological Inoculation Rate (EIR) for Kontagora was calculated to be 1.84 infective bite per person (ib/p). A significant difference (P<0.05) was however observed in EIR of Anopheline mosquitoes between sampling locations. The results established high Sporozoite Infection and Entomological Inoculation Rate which are key indices that sustains malaria transmission in Kontagora. Anopheline mosquitoes were reported to be infective throughout the study area. Vector control intervention based on local entomological data is strongly recommended.

How COVID-19 and malaria are strikingly alike: A short review

COVID-19 is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, in late 2019 and has since spread globally, disrupting efforts to contain it. In Africa, the COVID-19 infection may be influenced by malaria coinfection. Global health is severely hampered by the co-infection of COVID-19 and malaria, especially in areas where both illnesses are endemic. Studies that have already been conducted indicate that those who have co-infection may have more severe symptoms and a higher risk of dying, even though there is little information on the prevalence and consequences of co-infection. More studies and focused initiatives are required to address this issue because of the difficulties in diagnosing the two diseases and the possibility that co-infection would worsen already existing health inequities. Methodology: This review follows the guidelines of PRISMA. In this article, we reviewed published articles from 2019 to May 2023 on COVID-19 and malaria co-infection that might influence the ontology of COVID-19. Results: Sub-Saharan African countries have fewer COVID-19 cases due to factors like young populations, warm weather, lack of proper diagnosis, malaria history, and antimalarial drug use. Population genetics also influence COVID-19 dynamics. Clinical and pathological similarities between malaria and COVID-19 have confused diagnosis and treatment in Africa. Conclusion: Understanding the dynamics of COVID-19 infection in Sub-Saharan Africa and how another endemic disease like malaria shapes it can provide insights into how to tailor successful diagnostic, intervention, and control plans that lower disease morbidity and mortality. Coinfection with COVID-19 and malaria is related to expanded all-cause in-hospital mortality compared to mono-infection with serious acute respiratory disorder coronavirus 2 (SARS-CoV-2).

Compliance of blood donors in Germany with non-sexual deferral criteria.

In addition to mandatory testing of blood donations, the deferral of donors in the case of various sexual and non-sexual risk exposures ensures the safety of blood products in Germany. The study aimed to quantify non-disclosure of non-sexual risk exposures, as no data are available so far. We conducted an anonymous online survey among whole-blood donors with successful donations between January and March 2020. Data on travel to countries with endemic malaria, recent mild or febrile infections, tattoos or piercings and drug use were collected. We analysed non-compliance in relation to donor demographics by multivariable analyses. Altogether, 5.4% of the donors were non-compliant. Non-disclosure was highest for mild infection with 3.3% of donors, followed by febrile infections (1.4%), travel to malaria endemic countries (0.7%) and body modifications (0.5%). Intravenous drug use was negligible in our study population. Age was a predictor for all investigated risks, with higher prevalence in younger age groups. Prevalence ratios for non-disclosure of body modifications and mild infection were higher in females than males. Donation in blood establishments with mobile services was associated with higher non-disclosure of mild infections. The considerable degree of non-compliance in some donor groups reflects the prevalence of risk factors in the underlying population (e.g., body modification) as well as probable tendency to socially desirable responding. Donor education should not focus exclusively on sexual risk behaviour, as undisclosed non-sexual exposures may bear risks for recipients and donors.

Clinicohematological and drug prescription details in children affected with malaria: A retrospective study from a tertiary hospital of an endemic region in India

Malaria is a life threatening plasmodial infection transmitted by infected female Anopheles mosquitoes. It infects mainly the reticulo-endothelial system and causes derangement in the hematological parameters. This study was undertaken to study the Clinicohematological and audit of drug prescription in children affected with malaria attending a tertiary care hospital at Mangalore in Karnataka state of India.This was a retrospective study conducted in a tertiary care hospital among paediatric patients (<18 years of age) who were diagnosed with malaria during the study period. All the clinical details and other laboratory parameters were collected from the medical records and the lab parameters compared with control group, and statistical analysis was done. The mean, standard deviation was done for all the parameters and compared with control cases, using ANOVA /Kruskal Wallis test. The p value < 0.05 were considered as significant.: A total of 290 children (males 182: females 108, 2:1) were included in the study, 204 (70.3%) patients had , mixed malaria 71 (24.5%) and 15 (5.2%) had . The Majority of the patients (179, 61.72%) belonged to the age group of 11-16 years (Table 1). Among the 290 children diagnosed with malaria, all had fever. Vomiting (89, 30.7%) was second most common symptom. The haemoglobin, and total leucocyte count was reduced in all patients, whereas the Erythrocyte Sedimentation Rate (ESR) was significantly higher in the infected cases. There was significant thrombocytopenia seen mainly in falciparum group. The liver and renal functions were deranged in infected cases. Among the 204 vivax group of patients, chloroquine (187, 91.67%) was the most frequently administered drug. All patients with and mixed group were treated with Artemether. Anti-hypnozoites drug, i.e. Primaquine were administrated to all vivax and mixed malarial patients as per guidelines for 14 days.The study area is a well document endemic region forvivax malaria and our results agreed to previous reports in this study with the paediatric age group. The audit of drug prescriptions suggests that the drugs prescribed were as per guidelines in majority of the children.

Dengue and Malaria Co-infection in a Young Adult with Atypical Feature

As an endemic zone, malaria and dengue coinfection can be expected in Bangladesh, although there have not been enough case reports of such coinfection. We describe a previously healthy 22-year-old male from Dhaka, with a history of travelling to Coxs-Bazar 3 weeks ago, presented with fever with chills and rigors, generalized weakness and cough for 2 weeks. Clinical examination showed tachycardia, hypotension, subconjunctival haemorrhage and positive tourniquet test. Lab reports showed NS1-Ag positive, thrombocytopenia, progressive anaemia, mild hyperbilirubinemia. He was treated initially for dengue haemorrhagic fever. His laboratory parameters started improving; however, he had persistent fever with chills and rigors daily and persistent coughing. Peripheral smear for Malaria showed schizonts and trophozoites of Plasmodium falciparum and ICT for malaria was positive. He recovered following treatment with IV fluids and oral artesunate. The presence of fever even in a critical phase of dengue, the typical rise of temperature daily, progressive anaemia, mild jaundice and specific travelling history gave a clue of coinfection with Malaria. On follow-up, after 2 weeks, he had no symptoms, and all the laboratory parameters were normal. challenge was the atypical features like dry cough and exertional dyspnoea. The timely diagnosis and appropriate treatment were crucial for prognosis of this patient. Bangladesh J Medicine 2024; 35(1): 38-41

Distribution, survivability and susceptibility status of Anopheles mosquitoes in Kamamaung Township, Kayin State in Myanmar

Malaria endemicity is remaining in hard to reach and insurgent areas in Myanmar, where high density of primary and secondary vectors are available. Present study was determined the distribution, survivability and insecticides susceptibility status of vectors and non-vectors of malaria in Katinehtit village Kamamaung Township, Kayin State from July 2020 to June 2021. Mosquitoes were collected by Kanda net for animal bait and CDC light traps for indoor and outdoor collection from 18:00 to 00:06 hour. Survivability rate of An. dirus, An. minimu, An. aconitus, An. philippinensis, An. vagus and An. culicifacies were measured under the group of banana plants and susceptibility of collected mosquitoes were tested with WHO recommended insecteds. A total of 2207 mosquitoes consist of 13 Anopheles mosquito adult were collected by different collection methods by Cattle bate 1581(71.64%), Light trap indoor 174(7.88%), Light trap outdoor 297(13.46%), Morning Resting 43(1.95%) and Near the resting plant 112(5.07). Main vector An. dirus and An. minimus were mostly collected in Rainey season in high density and An. dirus was disappeared in hot season. Main vector An. minimus and secondary vector as An. philippinensis, An. culicifacies, An. maculatus, An. aconitus and nan vector An. barbirostris and An. hyrcanus were collected in all seasons. An. philippinensis, An. barbirostris and An. hyrcanus were abundantly collected. The highest survivability rate was found An. dirus and An. vagus for 8 days (10%) followed by An. culicifacies (20%), An. philippinensis (10%), An. minimus (20%) for 7 days and lowest was found An. aconitus for 6 days (20%). High density of An. dirus larvae were collected from rock pools and An. minimus was collected in sand pools, rice fields water, bed of Yonsalin creeks and water pools. All the collected mosquitoes were susceptible to Deltamethrin 0.05%, Permethrin 0.75% and Cyfuthris 0.15%. In conclusion, high density of main malaria vectors and secondary vectors were collected from Katinehtit village is a high risk area of malaria. Although all the collected main and secondary vectors were susceptible to WHO recommended insecticides. Therefore, Long Lasting Insecticide impregnated nets can be preventing the transmission of malaria in this area.

Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya.

While many studies have characterized mobility patterns and disease dynamics of settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the variability of their environments, reduce their access to health care, and limit the number of intervention strategies suitable for their lifestyles. Quantifying the movements and their associated disease risks will be key to developing interventions more suitable for mobile populations. Turkana, Kenya is an ideal setting to characterize these relationships. While the vast, semi-arid county has a large mobile population (>60%) and was recently shown to have endemic malaria, the relationship between mobility and malaria risk in this region has not yet been defined. Here, we worked with 250 semi-nomadic households from four communities in Central Turkana to 1) characterize mobility patterns of travelers and 2) test the hypothesis that semi-nomadic individuals are at greater risk of malaria exposure when migrating with their herds than when staying at their semi-permanent settlements. Participants provided medical and travel histories, demographics, and a dried blood spot for malaria testing before and after the travel period. Further, a subset of travelers was given GPS loggers to document their routes. Four travel patterns emerged from the logger data, Long Term, Transient, Day trip, and Static, with only Long Term and Transient trips being associated with malaria cases detected in individuals who carried GPS devices. After completing their trips, travelers had a higher prevalence of malaria than those who remained at the household (9.2% vs 4.4%), regardless of gender and age. These findings highlight the need to develop intervention strategies amenable to mobile lifestyles that can ultimately help prevent the transmission of malaria.

Clinico-epidemiological profiles & outcome of severe malaria in children under-five in the tribal area of Kalahandi, Odisha.

Severe malaria is a cause of excess mortality and morbidity in children in malaria-endemic areas where indigenous people live. Currently, available reports are all from secondary or tertiary care hospitals across India and some African countries. The objective of this study was to assess the clinical and epidemiological profiles of children under five years in two primary care health centres located in tribal-dominant Thuamul Rampur Block of Kalahandi district, Odisha. The outcome of management of severe malaria in these children was also assessed. A retrospective review of case records of children under five years of age diagnosed and admitted with severe malaria in two non-governmental primary care facilities between 2017 and 2022, was undertaken. There was a declining trend in malaria cases documented in primary care health facilities between January 2017 and June 2022. Of the 4858 cases recorded, 242 (4.9%) had severe malaria, of whom 70.7 per cent (n=171) were children under 5 yr. The median age of the study children was 24 months (16-36). Children aged 1-2 yr had a significantly higher risk of malaria. The majority were tribals (87%), more than half the children presented with neurological manifestations (64.4%), and 49.6 per cent had respiratory manifestations, while 20.5 per cent had severe anaemia (Hb <5 g/dl). Most, 167 (97.7%) severe malaria was due to Plasmodium falciparum. Thirty-two percent of children were severely wasted (WHZ < -3 SD) and 28 per cent were moderately wasted (WHZ <-2 SD). There was no fatality among the 171 children who were managed for severe malaria in the two primary care facilities. In high endemic areas severe malaria is predominantly a disease of under-five children and is caused by P. falciparum. Clinical manifestations of severe malaria in children can be varied and life-threatening. Primary health facilities can manage severe malaria successfully, thereby reducing child mortality. Effective collaboration between malaria control and nutrition intervention programmes is essential for appropriate case management.

Treatment-seeking behavior for malaria among communities in Indonesia: A systematic review.

Indonesia stands as one of the nine malaria-endemic countries in Southeast Asia with a total of 443,530 cases in 2022. Eastern Indonesia is listed as an area with high malaria endemicity and the Indonesian government has set a target of eliminating malaria by 2030. From 2010 to 2014, the number of malaria cases decreased but stagnated until 2020 and have continued to increase. Stagnation may occur as a result of many non-medical treatment-seeking behaviors. The aim of this systematic review was to provide a summary and overview of malaria treatment-seeking behavior among communities in several regions in Indonesia. The searches were conducted through four databases (Cochrane, PubMed, Google Scholar, and ScienceDirect) using medical subject headings (MeSH) "treatment-seeking behavior" OR "health-seeking behavior" AND "malaria" AND "Indonesia". This systematic review was limited to studies conducted in Indonesia that were published between 2013 and 2023 using either a quantitative or qualitative approach. Out of 2831 studies, a total of thirteen studies were included. The pattern of seeking malaria treatment varied between doing nothing or no action, self-treatment (purchasing drugs at pharmacies and consuming leftover medicines), traditional medicine, and medical treatment (public health facilities or malaria control clinics). Those behaviors are attributed to education level, socioeconomic level, occupation, distance from home to health facilities, geographical conditions, and people's perceptions of malaria and antimalarial medicines. There is still a range of malaria treatment-seeking behavior outside of recommended medical treatment in communities in several regions in Indonesia. The phenomenon of medical pluralism and syncretism requires approaches from various sectors in order to achieve a malaria-free Indonesia by 2030.

Evaluation of Total Protein in Malaria Parasitaemia

Malaria endemicity is most common in the tropical region, continuous transmission still occurs in about 85 countries and regions. The liver is very essential in overall body physiology and it plays a very important role in the life cycle of malaria and its function may be altered due to malaria parasitaemia. This cross sectional study was aimed at evaluating the level of total protein in malaria parasitaemia among children attending Braithwaite Memorial Specialist Hospital, Palmars, Omega Children Hospital, Early Breed Group of Schools, St Francis Nursery and Primary school and Staff Nursery and Primary school in Port Harcourt, Rivers state Nigeria. Of the 1000 subjects within 1-10 years, 694 subjects had malaria parasitaemia while 306 subjects had no malaria and thus made up the control group. Venipuncture technique was used to collect samples for estimation of malaria parasite density and total protein (TP) using biuret method. The results showed low (873.8±30.44), moderate (3248±109.31) and high malaria (24813.8±877.22) densities with TP values of 42.70±0.50g/l, 43.21±0.60g/l and 39.64±0.60g/l respectively. There was a significant difference (P-value&lt;0.05) in total protein (TP) levels among various groups of malaria densities. This study has shown that the impact of malaria on the liver health vary depending on the level of the infestation.

Commodifying Vaccines to Curtail Antibiotic Resistance Impact in Malaria Endemic Countries

Commodifying Vaccines to Curtail Antibiotic Resistance Impact in Malaria Endemic Countries

Adherence to Anti-Malarial Treatment in Malaria Endemic Areas of Bangladesh.

Ensuring adherence to antimalarial treatment is crucial for achieving a radical cure and elimination of malaria, especially in hard-to-reach areas. We conducted this study to assess the current scenario of drug adherence in four endemic sub-districts of Bangladesh. Among 110 enrolled participants, 70% were mono-infected with Plasmodium falciparum and the remaining 30% with P. vivax. The overall treatment adherence frequency was 92.7% (95% CI: 83.0-96.3%). A total of eight participants were found to be nonadherent to treatment and all of them were from Bandarban. Level of nonadherence was equally observed in two age groups: 11-17 and 18+ years. However, male participants (n = 6) were found to be more nonadherent than females (n = 2). Among 7.3% with nonadherence to treatment, a single participant with P. falciparum mono-infection refused to take medication and became nonadherent. Remaining participants stated that they were feeling well and going to work, thus leaving treatment course uncompleted. Although overall compliance with malaria medication seems good, a gradual increase in noncompliance to P. vivax malaria treatment suggests that the National Malaria Elimination Program must be enhanced and monitored to fulfil the projected malaria elimination goal before 2030 from Bangladesh.

Advocating for PCR-RFLP as molecular tool within malaria programs in low endemic areas and low resource settings.

The road to malaria elimination for low- and middle-income countries is paved with obstacles, including the complexity and high costs of advanced molecular methods for genomic analysis. The usefulness of PCR-RFLP as less complex and affordable molecular surveillance tool in low-endemic malaria regions was assessed in a cross-sectional study conducted in Suriname, currently striving for malaria elimination, but plagued by recent P. vivax outbreaks. Molecular analysis of two highly polymorphic genes Pvmsp-1 F2 and Pvmsp-3α was performed for 49 samples, collected during October 2019 through September 2021 from four different regions with varying malaria transmission risks. RFLP-profiling revealed that outbreak samples from three indigenous villages, almost exclusively, harbored a single clonal type, matching the "Palumeu" lineage previously described in 2019, despite multiple relapses and drug pressure exerted by mass drug administration events, suggesting a limited P. vivax hypnozoite reservoir in Suriname. In contrast, isolates originating from Sophie, a mining area in neighboring French Guiana displayed a highly heterogeneous parasite population consistent with its endemic malaria status, demonstrating the differentiating capacity and thus the usefulness of PCR-RFLP for P. vivax genetic diversity studies. Outbreak reconstruction emphasized the impact of undetected human movement and relapses on reintroduction and resurgence of P. vivax malaria and PCR-RFLP monitoring of circulating parasites guided the roll-out of targeted interventions. PCR-RFLP seems a suitable molecular alternative in low-endemic areas with restricted resources for outbreak analysis, for monitoring the spread or containment of circulating strains and for identification of imported cases or potential foci.

Prevalence of Plasmodium species in Badr Governorate, Madinah Province, Saudi Arabia using microscopy and rapid diagnostic test.

Malaria infection still represents a notable public health risk in Saudi Arabia. This cross-sectional study aimed to determine the prevalence of Plasmodium species among clinically suspected cases who presented at Badr General Hospital and healthcare facilities in selected regions of Badr Governorate, Madinah Province, Saudi Arabia between January 2021 and January 2022. A total of 493 suspected patients were recruited from Badr Governorate, investigated for malaria infection using CBFME and rapid diagnostic test- CareStart Malaria Pf/PAN (HRP2/pLDH) Ag Combo rapid diagnostic tests. The results showed that malaria infection was 34 (6.89%) cases among 493 suspected patients using microscopic examination as reference test. Moreover, subjects aged 31 to 40 years and those aged 51 to 60 years had the highest (50%) and lowest (8.82%) percentages of malaria cases. Plasmodium vivax (19/34, 55.88%) was higher than P falciparum (15/34, 44.1%) as the causative agents of malaria cases. The majority of malaria cases (29/34, 80.9%) among non-Saudi mainly from Sudan (15/34, 44.1%), Pakistan (5/34, 14.7%), Bangladesh (5/34, 14.7%) and India (4/34, 11.76%) whereas malaria cases among Saudis (5/34, 14.7%). In addition, the majority of malaria cases (32/34, 94.11%) among male subjects while (2/34, 5.88%) among females. The current study revealed that malaria transmission is still active in Badr Governorate, Madinah Province, Saudi Arabia and represents a public health concern. Further screening implements and continuous epidemiological monitor of the status of malaria infection in Kingdom of Saudi Arabia are thus warranted to improve its controlling activities and eradicate malaria endemicity in the country.

Malaria endemicity: A survey of antimalarial herbal products in Ijebu Ode, Nigeria

Empirical evidence has shown that approximately 80% of the global population uses herbal medicines as primary care, especially in developing nations, particularly Nigeria. Despite this, an estimated 95% of global cases of malaria occur in Africa, with Nigeria accounting for approximately 27%. Therefore, the current study investigated the prevalence of antimalarial herbal medicinal products in Ijebu-Ode for the fight against malaria endemicity. It explored their regulatory registration and active plant components, considering the documented evidence of their use for treating malaria. A cross-sectional study was adopted in the collection of empirical data and analyzed in SPSS (version 23.0), while spatial data were analyzed in ARC-GIS, and the results were graphically presented using pictorial variables. The results revealed the availability of approximately 18 different antimalarial herbal products, of which 72.2% were registered with regulatory agencies. Similarly, the herbal products were shown to contain more than one plant species as their active component (Azadirachta indica (83.3%), Nauclea latifolia (55.6%), and Enantia chlorantia (44.4%), which may be responsible for multiple indications (typhoid (83.3%), yellow fever (38.9%), and cold (33.3%). The results of this study provide valuable insights for developing evidence-based policies to standardize and regulate herbal remedies, particularly for combating malaria and other endemic conditions. These findings have implications for public health and the development of effective strategies to address the challenges posed by malaria in Nigeria and other similar regions.

One size does not fit all: an application of stochastic modeling to estimating primary healthcare needs in Ethiopia at the sub-national level

BackgroundPrimary healthcare systems require adequate staffing to meet the needs of their local population. Guidelines typically use population ratio targets for healthcare workers, such as Ethiopia’s goal of two health extension workers for every five thousand people. However, fixed ratios do not reflect local demographics, fertility rates, disease burden (e.g., malaria endemicity), or trends in these values. Recognizing this, we set out to estimate the clinical workload to meet the primary healthcare needs in Ethiopia by region.MethodsWe utilize the open-source R package PACE-HRH for our analysis, which is a stochastic Monte Carlo simulation model that estimates workload for a specified service package and population. Assumptions and data inputs for region-specific fertility, mortality, disease burden were drawn from literature, DHS, and WorldPop. We project workload until 2035 for seven regions and two charted cities of Ethiopia.ResultsAll regions and charted cities are expected to experience increased workload between 2021 and 2035 for a starting catchment of five thousand people. The expected (mean) annual clinical workload varied from 2,930 h (Addis) to 3,752 h (Gambela) and increased by 19–28% over fifteen years. This results from a decline in per capita workload (due to declines in fertility and infectious diseases), overpowered by total population growth. Pregnancy, non-communicable diseases, sick child care, and nutrition remain the largest service categories, but their priority shifts substantially in some regions by 2035. Sensitivity analysis shows that fertility assumptions have major implications for workload. We incorporate seasonality and estimate monthly variation of up to 8.9% (Somali), though most services with high variability are declining.ConclusionsRegional variation in demographics, fertility, seasonality, and disease trends all affect the workload estimates. This results in differences in expected clinical workload, the level of uncertainty in those estimates, and relative priorities between service categories. By showing these differences, we demonstrate the inadequacy of a fixed population ratio for staffing allocation. Policy-makers and regulators need to consider these factors in designing their healthcare systems, or they risk sub-optimally allocating workforce and creating inequitable access to care.