Malaria Eradication Program Research Articles

Global Fight against Malaria: Goals and Achievements 1900–2022

This article examines the historical and ongoing efforts to fight malaria, a parasitic disease caused by Plasmodium species and transmitted by Anopheles mosquitoes. Despite over a century of control efforts, malaria remains a major global health issue. In 2022, there were an estimated 249 million cases across 85 countries, leading to approximately 600,000 deaths. In the recently published Global Technical Strategy for Malaria 2016–2030, the World Health Organization (WHO) has prioritized malaria eradication. The main goals are to reduce malaria incidence and mortality by 90% by 2030 compared to 2015 levels. However, as of 2022, progress has been limited, with only a 2% reduction in incidence and a 6% reduction in mortality. This review traces the historical context of malaria, highlighting its ancient origins and the pivotal scientific discoveries in the late 19th century that paved the way for modern control measures. The Global Malaria Eradication Programme launched by the WHO in 1955 initially showed promise, largely due to the insecticide DDT, but ultimately failed to achieve its goals mainly due to logistical problems, vector resistance to DDT, and inadequate funding. Despite significant advances in the early 21st century, including the Roll Back Malaria initiative and increased international funding, malaria eradication remains a distant goal. Persistent challenges, such as weak healthcare systems, parasite and vector resistance to drugs and insecticides, and inadequate funding, continue to hamper global efforts. Therefore, this article underscores the need for a deeper understanding of malaria’s history and recent evolution to inform future strategies for eradication.

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

First Malaria Vaccine RTS, S: A Step toward the Eradication of Malaria

Malaria is a mosquito-borne life-threatening illness caused by the parasites, Plasmodium. Around 50% of the world’s population is at danger of this infectious disease. Antimalarial drug-Artemisinin, extracted from the plant Artemisia annua and has become a fundamental part of treatment regime for malaria across the world. The use of Artemisinin-based combination therapies (ACTs) against uncomplicated malaria has been endorsed by World Health Organization (WHO). As per the latest World malaria report (2022), around 247 million malaria cases were reported in 2021 from 84 malaria endemic nations (including the territory of French Guiana), a considerable upsurge from 245 million reported in the year 2020. One of the foremost reasons for this increase was linked with disturbance to services for prevention, diagnosis, and treatment measures during the recent COVID-19 pandemic. On 6th of October 2021, the WHO suggested RTS,S vaccine, the first malaria vaccine, for its use against Plasmodium falciparum malaria in children residing in areas with moderate to high transmission. In July 2022, WHO granted prequalification support for the RTS,S vaccine. One million plus children living in African countries (mainly Ghana, Kenya and Malawi) have got at least one dose of this groundbreaking malaria vaccine through programmes coordinated by WHO and international and country-level partners. RTS,S is a significant initial footstep in the path to production of other highly protective vaccines/multi-stage vaccines that may become a part of the malaria eradication programs in near future. Several malariologists are working on early clinical development or trial phases of first-generation and next-generation malaria vaccines, such as R21/Matrix-M, and malaria vaccine using mRNA technology.

Elimination of malaria from Sri Lanka and beyond; lessons for other countries in elimination phase

Elimination of malaria in 2012 was a major achievement in post-independent Sri Lanka. Sri Lanka missed a golden opportunity in 1963 when only 17 cases of malaria were reported in the country, but could not sustain the momentum resulting in a major resurgence in 1967/69. With the resurgence, the then malaria eradication programme was reverted back to a control programme that lasted for another 30 years. The WHO’s Roll Back Malaria Initiative launched in 1998 provided a renewed interest in malaria control and subsequent elimination. With targeted control activities, the burden of malaria started to decrease since year 2000. Although Sri Lanka had reached pre-elimination status as early as 2004, the ongoing separatist war at that time prevented a country-wide elimination drive being implemented. With cessation of hostilities in 2009 and Global Fund financing, both of which were crucial inputs, an elimination drive was launched in September 2009 which eventually eliminated indigenous malaria in November 2012 with malaria-free certification by WHO being obtained in September 2016. Since malaria elimination, the country forged on to the prevention of re-establishment phase primarily focusing on good public health practice that included intensified surveillance, both parasitological and entomological; quality assured diagnostic and treatment services; and advocacy at various levels including doctors. Despite these measures, an introduced case and a transfusion induced case of malaria have been reported. A new vector of urban malaria, Anopheles stephensi, was reported in December 2016. Prevention of re-establishment of malaria should be kept in the radar of public health until malaria is eradicated.

Elimination of malaria from Sri Lanka and beyond; lessons for other countries in elimination phase.

Elimination of malaria in 2012 was a major achievement in post-independent Sri Lanka. Sri Lanka missed a golden opportunity in 1963 when only 17 cases of malaria were reported in the country, but could not sustain the momentum resulting in a major resurgence in 1967/69. With the resurgence, the then malaria eradication programme was reverted back to a control programme that lasted for another 30 years. The WHO's Roll Back Malaria Initiative launched in 1998 provided a renewed interest in malaria control and subsequent elimination. With targeted control activities, the burden of malaria started to decrease since year 2000. Although Sri Lanka had reached pre-elimination status as early as 2004, the ongoing separatist war at that time prevented a country-wide elimination drive being implemented. With cessation of hostilities in 2009 and Global Fund financing, both of which were crucial inputs, an elimination drive was launched in September 2009 which eventually eliminated indigenous malaria in November 2012 with malaria-free certification by WHO being obtained in September 2016. Since malaria elimination, the country forged on to the prevention of re-establishment phase primarily focusing on good public practice that included intensified surveillance, both parasitological and entomological; quality assured diagnostic and treatment services; and advocacy at various level including doctors. Despite these measures, an introduced case and an induced case of malaria have been reported. A new vector of urban malaria, Anopheles stephensi, was reported in December 2016. Prevention of re-establishment of malaria should be kept in the radar of public health until malaria is eradicated.

Settler Sensibilities and Environmental Change

Malaria eradication arrived in Nepal in the 1950s as part of a global initiative to make malarial landscapes available for land reclamation and universal settlement. This article situates period reports from World Health Organization personnel involved in the Nepal Malaria Eradication Organization alongside testimonies from two malaria eradication workers from the country's Farwestern Tarai region to disentangle the socioecological and political effects of Nepal's malaria eradication project in its formative years. By concentrating on the labor of malaria eradication—focused on geographic reconnaissance and indoor residual spraying and the employment of laborers of diverse caste and ethnic backgrounds—the author argues that the project helped generate a settler sensibility toward the Nepal Tarai, transforming the forests and grasslands into a domesticated, development-ready village landscape. Applying insights from settler studies to a formally non-colonized nation-state, Nepal, the article highlights settlerism as a practice extending beyond the geography of European-American imperialism and embeds Nepal's malaria eradication program within the colonial landscape of Northern South Asia.

Assessing The Impact of Medical Treatment and Fumigation on The Superinfection of Malaria: A Study of Sensitivity Analysis

Malaria is a disease caused by the parasite Plasmodium, transmitted by the bite of an infected female Anopheles. In general, five species of Plasmodium that can cause malaria. Of the five species, Plasmodium falciparum and Plasmodium vivax are two species of Plasmodium that can allow malaria superinfection in the human body. Typically, the popular intervention for malaria eradication is the use of fumigation to control the vector population and provide good medical services for malaria patients. Here in this article, we formulate a mathematical model based on a host-vector interaction. Our model considering two types of plasmodium in the infection process and the use of medical treatment and fumigation for the eradication program. Our analytical result succeeds in proving the existence of all equilibrium points and how their existence and local stability criteria depend not only on the control reproduction number but also in the invasive reproduction number. This invasive reproduction number represent how one plasmodium can dominate other plasmodium. Our sensitivity analysis shows that fumigation is the most influential parameter in determining all control reproduction numbers. Furthermore, we find that the order in which numerous intervention measures are taken will be very crucial to determine the level of success of our malaria eradication program.

DDT Resistance Korean Body Lice and Development of Insecticide Resistance Knowledge during Korean War.

DDT exemplifies success and failure of modern science and technology. Once it was heralded as technological wonder that will deliver human from misery of insect-borne infectious disease. However DDT took dramatic downturn after failure in global malaria eradication program initiated by World Health Organization, with advent of DDT-resistant strain of mosquitoes. Although insecticide resistance has been know since late 19th century, the definitions and mythologies for finding resistance has not been settled until 1950s. This paper argues that discovery of DDT-resistant strain of body lice in prisoners of war camp in Korea during the Korean War provided essential knowledge and opportunity for advancing insecticide resistance studies. Since 1945 to the end of Korean War, US Army sprayed thousands of tonnes of DDT on Korean body and soil. DDT was only went into wide field application since 1943, was still a very new technology. The ways to deliver and utilize DDT was still under the investigation. And Korea, especially during the War, was ideal place to construct such knowledge and place it in the application. The main focus was to control public health threats, such as louse-borne typhus fever. Korean soldiers and prisoners of war exposed to regular dose of DDT, which soon gave rise to DDT-resistant strain of body lice. It was the first major outbreak of insecticide-resistance appeared in insect that has major public health importance. Until early 1950s, mechanisms of resistance, or even definition of insecticide resistance was unclear. Researchers in US Army and Department of Agriculture rushed to find the ways to quantify insecticide resistance. Network of laboratories, connecting Korea-Japan-US, had to devise new laboratory methods to rear, and test body lice. These body lice later migrate to laboratories in US, providing valuable asset for future insecticide resistance research in US. At the same time, laboratory methods of testing resistance in body louse became a standard across the globe, setting new research agenda through World Health Organization. This shows flow of knowledge, along with migration of body louse, during the Korean War. At the same time, this case show who new knowledge is constructed through the expense of involvement of minority populations, such as natives, soldiers, and prisoners of war.

Detection of Antimalarial Resistance-Associated Mutations in Plasmodium falciparum via a Platform of Allele-Specific PCR Combined with a Gold Nanoparticle-Based Lateral Flow Assay.

Since single nucleotide polymorphisms (SNPs) have attracted attention, there have been many explorations and improvements in screening and detection methods for SNPs. Traditional methods are complex and time-consuming and rely on expensive instruments. Therefore, there is an urgent need for a low-cost, simple, and accurate method that is convenient for use in resource-poor areas. Thus, a platform based on allele-specific PCR (AS-PCR) and a gold nanoparticle-based lateral flow assay (LFA) was developed, optimized, and used to detect the SNPs of the drug resistance gene pfmdr1. Subsequently, the system was assessed on clinical isolates and compared with nested PCR followed by Sanger sequencing. The sensitivity and specificity of the AS-PCR-LFA platform were up to 99.43% and 100%, respectively, based on the clinical isolates. The limit of detection is approximately 150 fg/μL for plasmid DNA as the template and 50 parasites/μL for dried filter blood spots from clinical isolates. The established and optimized AS-PCR-LFA system is more adaptable and rapidly translated to SNP analysis of other drug resistance genes and genetic diseases. In addition, while actively responding to the point-of-care testing policy, it also contributes to the Global Malaria Eradication Program. IMPORTANCE Rapid detection of single nucleotide polymorphisms (SNPs) is essential for malaria treatment. Based on the techniques of allele-specific PCR (AS-PCR) and lateral flow assay (LFA), an accurate and powerful platform for SNP detection of pfmdr1 was developed and evaluated with plasmid and clinical isolates. It offers a useful tool to identify antimalarial drug resistance and can support the effort to eliminate malaria globally.

Disease Eradication, Infant Mortality, and Fertility Response: Evidence from Malaria Eradication in India

Using a massive malaria eradication program in India during the 1950s as a natural experiment, we examine the effects of disease environment on child health outcomes and fertility. We harmonise a rich dataset on malaria endemicity with fertility histories of women to exploit the cohort level variation in exposure to the program. We find that the program leads to a significant decline in infant and neonatal mortality and leads to a significant increase in the probability of birth during adolescent years in high malaria endemic regions. We confirm that a fall in the mother’s age at first birth in the post-eradication period drives the fertility response.

BIOORGANOMETALLIC FERROQUINE AND RELATED COMPOUNDS AS ANTIMALARIAL CHEMOTHERAPEUTIC AGENTS: A SHORT REVIEW

Drug resistant Plasmodium falciparum is a major threat to global health. Eradicating the parasite in endemic regions, especially sub-Saharan Africa is daunting. Milestones and a general target of 2030 have been set for this. However, funding and disruptions due to Ebola virus disease epidemic and COVID-19 pandemic are some of the cog in the wheel of the malaria eradication program. The recent WHO approval of the first malaria vaccine is a hope raiser and is expected to merely catalyze the eradication effort. Chemoprevention is a key malaria eradication strategy. Ferroquine, an organometallic chloroquine-ferrocene conjugate with effective antimalarial properties is capable of overcoming resistant strains and restoring chloroquine antimalarial properties. It has a novel mechanism of action. Like chloroquine, it forms complex with Fe(III)PPIX, strongly inhibit ß-hematin formation and drug accumulation in the acidic digestive vacuole. ferroquine is more lipophilic at cytosolic pH and cannot be pumped out of digestive vacuole thereby evading the chloroquine resistance mechanism. Clinical trials showed the drug candidate to be safe and tolerable. The ferroquine molecule can be conveniently synthesized via a reductive amination reaction involving a condensation of 7-chloroquinolin-4-amine and amino ferrocenyl aldehyde in a single stage procedure. It is well characterized. Studies revealed that covalently bonded chloroquine-ferrocene is responsible for the molecule's efficacy against P. falciparum. The pure chloroquine or ferrocene moieties are less active. Structural adjustments in amino group side chain, changes in position of the ferrocenyl organometallic group, substituting the Fe with other bioactive metals (Ru, Rh, Os) and substituting chloroquine for other organic molecules with antimalarial properties, all resulted in analogues with potent antimalarial properties similar to or better than chloroquine but not as effective as ferroquine.

Transition of Malaria Control to Malaria Elimination in India

India achieved spectacular gains in malaria control during the ‘Eradication Era’ in the 1950s till the mid-1960s. The Global Malaria Eradication Programme of WHO launched in the 1950s was a huge success in India with the incidence dropping from an estimated 75 million cases and 8,00,000 deaths in 1947 to just 49,151 cases and no deaths in 1961 and malaria was thought to be on the verge of eradication. Thus, since the early 1950s, the malaria program in India has produced a number of successes, and has faced some setbacks also which have led to malaria resurgences. Recently, India envisages eliminating malaria by 2030 in line with the Global Technical Strategy (2016-2030). The National Framework for Malaria Elimination was launched in 2016 and National Strategic Plan 2017-2022 in 2017, provide a phased approach to elimination and outline priority areas and activities required to be implemented based on district-level stratification of burden. Malaria program is now moving away from “One Fit Size to All”. States and districts are classified in four categories to eliminate malaria in a phased manner. In 2019, India recorded a 60% reduction in reported cases compared with 2017 and a 46% reduction compared with 2018. India’s progress for drastic reduction of malaria incidences have also mentioned in World Malaria Report 2018, 2019 and 2020. However, there are challenges for the country to sustain the progress made so far and to accelerate further malaria activities to achieve the goal for malaria elimination by 2030. Since the discovery of malaria transmission was made in India by Sir Ronald Ross in 1897, an intensive works was carried on malaria control in India. There were different phases for malaria control in the country to moving from control towards eradication and elimination. The paper gives a brief history of malaria control in India and analyses the present malaria situation.

Is there evidence of sustained human-mosquito-human transmission of the zoonotic malaria Plasmodium knowlesi? A systematic literature review

BackgroundThe zoonotic malaria parasite Plasmodium knowlesi has emerged across Southeast Asia and is now the main cause of malaria in humans in Malaysia. A critical priority for P. knowlesi surveillance and control is understanding whether transmission is entirely zoonotic or is also occurring through human-mosquito-human transmission.MethodsA systematic literature review was performed to evaluate existing evidence which refutes or supports the occurrence of sustained human-mosquito-human transmission of P. knowlesi. Possible evidence categories and study types which would support or refute non-zoonotic transmission were identified and ranked. A literature search was conducted on Medline, EMBASE and Web of Science using a broad search strategy to identify any possible published literature. Results were synthesized using the Synthesis Without Meta-analysis (SWiM) framework, using vote counting to combine the evidence within specific categories.ResultsOf an initial 7,299 studies screened, 131 studies were included within this review: 87 studies of P. knowlesi prevalence in humans, 14 studies in non-human primates, 13 studies in mosquitoes, and 29 studies with direct evidence refuting or supporting non-zoonotic transmission. Overall, the evidence showed that human-mosquito-human transmission is biologically possible, but there is limited evidence of widespread occurrence in endemic areas. Specific areas of research were identified that require further attention, notably quantitative analyses of potential transmission dynamics, epidemiological and entomological surveys, and ecological studies into the sylvatic cycle of the disease.ConclusionThere are key questions about P. knowlesi that remain within the areas of research that require more attention. These questions have significant implications for malaria elimination and eradication programs. This paper considers limited but varied research and provides a methodological framework for assessing the likelihood of different transmission patterns for emerging zoonotic diseases.

Challenging Experience with Severe Complicated Malaria in the City of Dhaka

Malaria is a vector-borne febrile illness that requires an association of three factors- parasite, vector, andhost- to continue its life cycle. The physical and cultural environments, as rainfall, humidity, and temperaturepermitted Bangladesh to be a malaria-endemic area, where Plasmodium falciparum is the dominantparasite and accounts for 93% of the malaria cases in the country. Due to the high degree of severity of thedisease and about 15% of total annual deaths in Bangladesh, in the year of 1961, Malaria EradicationProgram (MEP) was introduced. NMEP caused a significant reduction in total malaria incidences, severityand deaths. Still 33.6% of the total population in Bangladesh is at risk of malaria and the majority of casesare reported in 13 endemic areas of 64 districts in the country. Above all, resurgence of malaria andtreatment resistant cases have become a burning issue to think about in recent years. Here, we presenttwo severe falciparum malaria cases that challenged us with the complicated nature of the disease inDhaka city, which is not listed as a malaria endemic zone of Bangladesh. J MEDICINE 2022; 23: 87-95

Spatio-temporal variability of malaria infection in Chahbahar County, Iran: association with the ENSO and rainfall variability.

Malaria is one of the most widespread communicable diseases in the southeast regions of Iran, particularly the Chabahar County. Although the outbreak of this disease is a climate-related phenomenon, a comprehensive analysis of the malaria-climate relationship has not yet been investigated in Iran. The aims of this study are as follows: a) analyzing the seasonal characteristics of the various species of the infection; b) differentiating between number of patients during El Niño and La Niña and also during the wet and dry years. The monthly malaria statistics collected from twelve health centers were firstly averaged into seasonal scale and then composited with the corresponding data of the ground-based meteorological records, Southern Oscillation Index (SOI), and the satellite-based rainfall data. The proper statistical tests were used to detect differences in the number of patients between El Niño and La Niña and also between the adopted wet and dry episodes. Infection rate from the highest to the lowest was associated with summer, autumn, spring, and winter, respectively. Plasmodium falciparum, P. vivax, and the other species were responsible for 22%, 75%, and 3% of the sickness, respectively. The outbreak of P. falciparum/P. vivax occurs during autumn/summer. Due to the malaria eradication programs in urban areas, infection statistics collected from the rural areas were found to be more climate-related than that of urban regions. For rural/urban areas, the infection statistics exhibited a significant decline/increase during El Niño episodes. In autumn, spring, and winter, the patient number has significantly increased/decreased during the dry/wet years, respectively. These relationships were, however, reversed in summer.

Comparative Insecticidal Effects of Dry Ocimum Gratissium (Scent Leaves) and Rambo™ Paper on Mosquitoes in Jos, Nigeria

Insecticides are chemicals or biological substances that are used to kill or disable insects. Blood feeding mosquitoes are responsible for the intolerable biting nuisance and transmission of large number of diseases such as malaria, yellow fever, dengue fever, filarias is amongst others, causing serious health problems to humans and obstacles to socioeconomic development of developing nations like Nigeria. The insecticidal effect of scent leaves (Ocimum gratissum) and Rambo™ paper on mosquitoes was investigated. The study is aimed at comparing the insecticidal effects of Ocimum gratissimum and Rambo™ paper on mosquitoes in Jos. 100 mosquitoes were exposed to dried Ocimum gratissum and Rambo™ paper at different time intervals of 5, 10 and 12 min. Results obtained showed a time dependent insecticidal effect on mosquitoes, which was 54.2%, 54.0% and 55.6% total mortality of mosquitoes at respective time intervals on exposures to both Rambo™ paper insecticide and Osimum gratissum, indicating that there was a significant difference in the lethal effect of Rambo™ paper insecticide and scent leave on mosquitoes at (p<0.05). In comparing the lethal effect of Rambo™ paper insecticide and Ocimum grasstisimum on mosquitoes at differnt locations in Jos, at Dogon Karfe, after 10 min of treatment, Rambo™ paper had the highest lethal effect of 21 (84.0%) compared to scent leaves 6 (24.0%) and at Abattoir Jos, after 12 min of treatment, Rambo™ paper had the highest lethal effect of 17 (94.4%) compared to Ocimum grasstisimum 3 (16.7%). These comparisons were significant at p 0.05. This study provides evidence that Ocimum grasstisimum has a mosquitocidal effect. However, the Rambo™ paper gave a better mosquitocidal effect than Ocimum grasstisimum. There is a need to discover better additive or extract options that could give Ocimum grasstisimum a better effect as a natural product available in Africa towards the malaria eradication programme.

Passive Surveillance of Malaria in Pregnant Women, Non-pregnant Women and Children Under 5 Years of Age in Bannu District, Khyber Pakhtunkhwa Pakistan.

Background: Malaria among pregnant women is one of the major causes of maternal and infant mortality and morbidity, especially in high-risk areas. Therefore, our study identified the burden of malaria for pregnant women, non-pregnant women, and children under 5 years of age, and malaria service health facilities in Bannu district, Khyber Pakhtunkhwa, Pakistan.Methods: A cross-sectional study was conducted. In this survey, 15,650 individuals were surveyed, and 1,283 were malaria-positive detected. The data were collected from 80 different healthcare centers. SPSS version 23 was used for data analysis. ArcGIS version 10.8 was used for study area mapping.Results: Malaria was detected in 23.3% of children under five, 4.4% of pregnant women, and 72.3% of non-pregnant women, respectively. Moreover, P. falciparum, P. vivax, and mixed infection had a prevalence of 2.1, 96.8, and 1.1%. The most often used and effective medications to treat malaria were chloroquine (29.7%) and primaquine (69.4%).Conclusion: This study's findings depict that malaria's prevalence in the non-pregnant women's group was high. Additionally, P. vivax infection was found to be more prevalent than other types of malaria infection. Due to the scarcity of healthcare facilities in this endemic region, special attention should be directed to strengthening the malaria surveillance and eradication programs.

Malaria at Forest Areas in South Kalimantan, Indonesia: Risk Factors and Strategies for Elimination

BACKGROUND: South Kalimantan is one of province in Indonesia which has endemic area, mainly in the villages at forest area. Understanding the risk factors which can increase the risk of malaria in individuals at forest area will enable more effective use for controlling the disease. The identification of risk factors will provide information about local malaria epidemiology and usefull for making appropriate and effective malaria eradication program policies in this area. AIM: To know the risk factors of malaria prevalence in endemic forest areas in South Kalimantan, Indonesia. METHODS: This cross-sectional study was conducted on 107 adult people who lived in Batu Bulan Village and Batu Paha Village, South Kalimantan. Blood samples for malaria microscopy and rapid diagnostic test is taken from cubital vein. Household factors and demographic data were obtained. Chi-square and logistic regression were performed to analyze the factors associated with malaria prevalence in South Kalimantan. This research didn’t do vector survey, only on the prevalence of malaria and risk factor in human and environment. RESULTS: The prevalence of malaria based RDT examination was 35.5% with 23.68% Plasmodium falciparum, 21.05% Plasmodium vivax, and 55.27% mixed infection. The prevalence malaria based on microscopic examination was 17.75% with 47.36% P. falciparum, 26.32% P. vivax, and 26.32% mix infection. Demographic factors influencing the prevalence of malaria were aged below 25-years-old (p = 0.01, 95% CI, OR = 2.289), villages in Batu Paha (p = 0.048, 95% CI, OR = 3.55), and occupation as a forest worker (p = 0.022, 95% CI, OR = 6.38). House factors that influence the prevalence of malaria were the condition of the walls that are open or not tight (p = 0.048 95% CI, OR = 5.205), the roof is made of plastic (p = 0.015 95% CI, OR = 2.831), and the presence of animal cage around the house (p = 0.015 95% CI, OR = 6.292). CONCLUSIONS: Malaria incidence remains occurs with high prevalence in the pupolation in remote forest areas.

Malaria, Race, and Inequality: Evidence from the Early 1900s U.S. South

This study investigates the impact of malaria eradication programs on Black-white economic disparities in the early 1900s U.S. South. Malaria eradication was widespread and improved health across races. Yet, only white men experienced economic benefits. Using matched census records, we find that increased exposure to the program was associated with higher schooling attainment and income for whites but not for Blacks. Blacks exposed to malaria eradication were more likely to be farm laborers, and both Blacks and whites were more likely to migrate out of state. Our findings suggest that malaria eradication, a broadly applied intervention, widened racial gaps.

Kala-azar Burden in Bangladesh- An Overview

Kala-azar is one of the major public health problems in Bangladesh and the disease is endemic for many decades. In SEA Region, VL is reported from 109 contiguous districts bordering Bangladesh, India and Nepal. Approx. 147 million people at risk in these three countries with an estimated 50,000 new cases each year. Kala-azar or Leishmaniasis is a disease caused by protozoan parasites of the Leishmania genus. It is transmitted by the sand fly named Phlebotomus argentipes and affects largely the socially marginalized and the poorest communities. The parasite migrates to the internal organs such as liver, spleen and bone marrow and if left untreated, will almost always result in the death of the host. Signs and symptoms include fever, weight loss, fatigue, anemia, and substantial swelling of the spleen and occasionally liver. In Bangladesh, kala-azar cases were reported from 45 of 64 districts, >90% of cases were reported from just 10 districts. Mymensingh accounted for more than 50% of the total kala-azar cases reported in Bangladesh. Research in recent years has demonstrated the utility of non-invasive diagnostic modalities such as the direct agglutination test and rapid tests based on the immune response to the rK39 antigen. Primary kala-azar now can be easily recognized and effective treatment is available. Clinical trials in Bangladesh have reported encouraging results with amphotericin B (recommended as a third-line drug by the National Malaria Eradication Programme). Until a safe and effective vaccine is developed, a combination of sandfly control, detection and treatment of patients and prevention of drug resistance is the best approach for controlling kala-azar.
 CBMJ 2020 January: Vol. 09 No. 01 P: 43-50