Malaria Prevalence Rate Research Articles

Malaria Prevalence and Anemia Status of Children Attending a Health Facility in Yola

Background: Malaria and anemia among children especially those that are <5 years of age are still diseases of public health concern. This study was designed to determine the effect of malaria on the anaemia status of under five children attending a health facility in Yola, Adamawa state, Nigeria.
 Methods: Blood samples were collected from out-patient under five children reporting at the paediatric unit of the hospital. The blood samples were screened for the presence of malaria parasites by microscopy while their anaemia status was determined by checking their packed cell volume (PCV). The prevalence rate of malaria, anemia, and malaria-anemia was calculated. The level of significance was determined using chi-square (χ2) statistics.
 Results: Of the 200 samples, 124 (62%) were positive for malaria, with the prevalence being higher in males. 103 of the patients had PCV values below 33% giving an overall anaemia prevalence of 51.5% of anemia cases. The results obtained show that the three forms of anaemia – mild, moderate and severe were seen in the sampled population with moderate anaemia being the most prevalent (29.0%); the results also show that malaria parasite density has an effect on the PCV levels of the children at p= .0001, and patients with severe anaemia had the highest parasite loads.
 Conclusion: Malaria remains a common infection among under five children in this environment and predisposes them to having anaemia. Moderate malaria is also the most common form of anaemia seen in malaria positive children.

Assessing Prevalence and Transmission Rates of Malaria through Simultaneous Profiling of Antibody Responses against Plasmodium and Anopheles Antigens.

Reliably assessing exposure to mosquitoes carrying malaria parasites continues to be a challenge due to the lack of reliable, highly sensitive diagnostics with high-throughput potential. Here, we describe an approach that meets these requirements by simultaneously measuring immune responses to both disease vector and pathogen, using an electro-chemiluminescence-based multiplex assay platform. While using the same logistical steps as a classic ELISA, this platform allows for the multiplexing of up to ten antigens in a single well. This simple, reproducible, quantitative readout reports the magnitude, incidence, and prevalence of malaria infections in residents of malaria-endemic areas. By reporting exposure to both insect vectors and pathogen, the approach also provides insights into the efficacy of drugs and/or other countermeasures deployed against insect vectors aimed at reducing or eliminating arthropod-borne diseases. The high throughput of the assay enables the quick and efficient screening of sera from individuals for exposure to Plasmodium even if they are taking drug prophylaxis. We applied this assay to samples collected from controlled malaria infection studies, as well as those collected in field studies in malaria-endemic regions in Uganda and Kenya. The assay was sensitive to vector exposure, malaria infection, and endemicity, demonstrating its potential for use in malaria serosurveillance.

Geo-Climatic Factors of Malaria Morbidity in the Democratic Republic of Congo from 2001 to 2019.

Background: Environmentally related morbidity and mortality still remain high worldwide, although they have decreased significantly in recent decades. This study aims to forecast malaria epidemics taking into account climatic and spatio-temporal variations and therefore identify geo-climatic factors predictive of malaria prevalence from 2001 to 2019 in the Democratic Republic of Congo. Methods: This is a retrospective longitudinal ecological study. The database of the Directorate of Epidemiological Surveillance including all malaria cases registered in the surveillance system based on positive blood test results, either by microscopy or by a rapid diagnostic test for malaria was used to estimate malaria morbidity and mortality by province of the DRC from 2001 to 2019. The impact of climatic factors on malaria morbidity was modeled using the Generalized Poisson Regression, a predictive model with the dependent variable Y the count of the number of occurrences of malaria cases during a period of time adjusting for risk factors. Results: Our results show that the average prevalence rate of malaria in the last 19 years is 13,246 (1,178,383–1,417,483) cases per 100,000 people at risk. This prevalence increases significantly during the whole study period (p < 0.0001). The year 2002 was the most morbid with 2,913,799 (120,9451–3,830,456) cases per 100,000 persons at risk. Adjusting for other factors, a one-day in rainfall resulted in a 7% statistically significant increase in malaria cases (p < 0.0001). Malaria morbidity was also significantly associated with geographic location (western, central and northeastern region of the country), total evaporation under shelter, maximum daily temperature at a two-meter altitude and malaria morbidity (p < 0.0001). Conclusions: In this study, we have established the association between malaria morbidity and geo-climatic predictors such as geographical location, total evaporation under shelter and maximum daily temperature at a two-meter altitude. We show that the average number of malaria cases increased positively as a function of the average number of rainy days, the total quantity of rainfall and the average daily temperature. These findings are important building blocks to help the government of DRC to set up a warning system integrating the monitoring of rainfall and temperature trends and the early detection of anomalies in weather patterns in order to forecast potential large malaria morbidity events.

EFFECT OF MALARIA ON VISUAL ACUITY (V.A)

The study was carried out to determine the prevalence and effect of malaria on visual acuity (V.A) in relation to age, sex and the level of parasitaemia in patients visiting the University of Benin Health Centre. The research was accomplished by examination of blood films of the patients for presence of malaria and measuring the visual acuity (V.A) and palpebral apertures of the patients. A total of 1,000 patients were examined to determine their visual acuity and palpebral aperture after confirmation of malaria parasite in their blood films. Both parameters were again measured after a two-week- recovery period and on a confirmation of the absence of malaria parasite in the blood film of the patient. Five hundred (500) patients served as control. The result showed a malaria prevalence rate of 32% with no sex predilection. Malaria had a statistically significant effect on visual acuity (t=21.22, p&lt;0.05). The result also revealed that the effect of malaria on the patient‘s visual acuity was dependent on the age (r=0.373, p&lt;0.05) and the sex of the subject (t=3.41, p&lt;0.05). Also the level of parasitaemia had a significant effect on the patient‘s V.A (rs=0.485, p&lt;0.05). There was also a statistically significant effect of malaria on the palpebral aperture (t=3.15, p&lt;0.05). The study demonstrated clearly that poor visual acuity is a symptom of malaria disease and deteriorates with increase in parasitaemia and increase in age of the subject and also that the males are more affected than the females

Individual-level variations in malaria susceptibility and acquisition of clinical protection

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparum develop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort’s limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual’s risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.

Cross-sectional study of asymptomatic malaria and seroepidemiological surveillance of seven districts in Gia Lai province, Vietnam

BackgroundMalaria elimination by 2030 is an aim of many countries in the Greater Mekong Sub-region, including Vietnam. However, to achieve this goal and accelerate towards malaria elimination, countries need to determine the extent and prevalence of asymptomatic malaria as a potential reservoir for malaria transmission and the intensity of malaria transmission. The purpose of this study was to determine the prevalence of asymptomatic malaria and seropositivity rate in several districts of Gia Lai province in the Central Highlands of Vietnam.MethodsA cross-sectional survey of asymptomatic malaria and serological testing was conducted in 3283 people living at 14 communes across seven districts in Gia Lai province in December 2016 to January 2017. Finger prick capillary blood samples were tested for malaria using rapid diagnostic testing and polymerase chain reaction (PCR), as well as detecting antibodies against 3 Plasmodium falciparum and 4 Plasmodium vivax antigens by indirect enzyme-linked immunosorbent assay (ELISA). Age-seroprevalence curves were fitted using reverse catalytic models with maximum likelihood.ResultsThe study population was predominantly male (65.9%, 2165/3283), adults (88.7%, 2911/3283) and of a minority ethnicity (72.2%, 2371/3283), with most participants being farmers and outdoor government workers (90.2%, 2960/3283). Using a small volume of blood (≈ 10 µL) the PCR assay revealed that 1.74% (57/3283) of the participants had asymptomatic malaria (P. falciparum 1.07%, P. vivax 0.40%, Plasmodium malariae 0.15% and mixed infections 0.12%). In contrast, the annual malaria prevalence rates for clinical malaria in the communities where the participants lived were 0.12% (108/90,395) in 2016 and 0.22% (201/93,184) in 2017. Seropositivity for at least one P. falciparum or one P. vivax antigen was 38.5% (1257/3262) and 31.1% (1022/3282), respectively. Age-dependent trends in the proportion of seropositive individuals in five of the districts discriminated the three districts with sustained low malaria prevalence from the two districts with higher transmission.ConclusionsAsymptomatic Plasmodium carriers were found to be substantially more prevalent than clinical cases in seven districts of Gia Lai province, and a third of the population had serological evidence of previous malaria exposure. The findings add knowledge on the extent of asymptomatic malaria and transmission for developing malaria elimination strategies for Vietnam.

Knowledge, Attitude, and Practice towards Malaria among People Attending Mekaneeyesus Primary Hospital, South Gondar, Northwestern Ethiopia: A Cross-Sectional Study.

Background Malaria is one of the most severe public health problems worldwide. It is a leading cause of suffering, death, and socioeconomic problem, especially in many developing countries like Ethiopia. To introduce appropriate preventive and control measures, assessment of community's levels of knowledge, attitude, and preventative practices regarding malaria is crucial. This study was aimed at assessing the knowledge, attitude, and practice (KAP) towards malaria and its preventive and control methods among people attending Mekaneeyesus primary hospital, South Gondar, northwestern Ethiopia. Methods A hospital-based cross-sectional study was conducted from September 2017 to April 2018. A structured questionnaire was administered to collect data on sociodemographic characteristics and KAP of 390 randomly selected individuals. The data collecting tool was pretested before commencing the actual data collection. The data were analyzed using the SPSS version 21 software. P values less than 0.05 were considered statistically significant. Results The overall prevalence rate of malaria in the study area was 8.5%. Nearly two-third of the participants had good knowledge (63.1%) and positive attitude (62.6%) scores towards malaria while only half of the participants had (50.8%) good practice score towards malaria prevention and control measures. Sex, age category, family monthly income, residence, and occupational and educational status of the participants were significantly associated with knowledge and practice scores (P < 0.05). The odds of malaria were 26.93 (CI = 3.67‐197.47, P = 0.001) and 13.09 (CI = 0.93‐183.47, P = 0.036) times higher among individuals who had poor knowledge and poor practice towards malaria, respectively, as compared to individuals who were knowledgeable and had good practice score towards malaria. Conclusion The overall knowledge score, attitude, and practice level of respondents towards malaria was relatively good. However, significant proportion of the participants still have misconception about the cause, sign and symptoms, modes of transmission, and practices towards prevention methods of malaria. Thus, health education which is aimed at raising community's awareness about the disease is necessary to address the gaps identified by this study.

Interfacing vector-borne disease dynamics with climate change: Implications for the attainment of SDGs in Masvingo city, Zimbabwe.

This study used a mixed-methods research design to examine the sensitivity of vector-borne disease (VBD) patterns to the changes in rainfall and temperature trends. The research focused on malaria in Masvingo Province, Zimbabwe. The study interfaced the climate action, health and sustainable cities and communities with sustainable development goals (SDGs). Historical climate and epidemiological data were used to compute the correlations and determine the possible modifications of disease patterns. Clustered random and chain-referral sampling approaches were used to select study sites and respondents. Primary data were gathered through a questionnaire survey (n = 191), interviews and focus group discussions, with Mann–Kendal trend tests performed using XLSTAT 2020. The results show a positive correlation between malaria prevalence rates and temperature-related variables. A decline in precipitation-related variables, specifically mean monthly precipitation (MMP), was associated with an increase in malaria prevalence. These observations were confirmed by the views of the respondents, which show that climate change has a bearing on malaria spatial and temporal dynamics in Masvingo Province. The study concludes that climate change plays a contributory role in VBD dynamics, thereby impeding the attainment of the 2030 Agenda for Sustainable Development, especially SDG 3, which deals with health. The study recommends further research into appropriate adaptation mechanisms to increase the resilience of rural and urban communities against the negative transmutations associated with weather and climatic pressures.

The association between malaria prevalence and COVID-19 mortality

BackgroundThe number of persons infected with COVID-19 continues to increase with deaths reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria prevalence and COVID-19 mortality.MethodsAn ecological study was conducted with data from 195 countries. Spearman’s correlation was used to test the association between the population variables and COVID-19 mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 mortality.ResultsThere was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 mortality while malaria prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 mortality. Malaria prevalence, life expectancy and mortality rate were significant on multivariate regression analysis.ConclusionThe results of this study support the hypotheses that there are reduced COVID-19 deaths in malaria endemic countries, although the results need to be proved further by clinical trials.

Individual-level variations in malaria susceptibility and acquisition of clinical protection.

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparumdevelop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort's limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual's risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.

Individual-level variations in malaria susceptibility and acquisition of clinical protection

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparum develop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort’s limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual’s risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.

A Review of Ethnomedicinal Plant Resources in Southern Nigeria

Background: The inadequate programs established to eradicate numerous health problems in Nigeria have led to little improvement in the health status, especially in southern Nigeria. Southern Nigeria has a high prevalence rate of malaria, typhoid, fevers, colds and chills, catarrh, flu, river blindness, respiratory disorders, eye problems and skin infections. The strain caused by the dire need to provide a financial health coverage for the family, a poorly developed health care systems and functional surveillance has led to the exploration of alternative medicine by the indigenes of southern Nigeria.This study aims at documenting information on the common plant resources employed in the ethnomedicinal practices of the indigenous people of the Southern Nigeria, and to explore ways of sensitizing genuine conservation efforts in the face of threat of genetic erosion posed to these resources due to anthropogenic activities. Materials and methods: Onsite ethnomedicinal survey in the study area was carried out between September 2019 and November 2020 to document an indigenous medicinal plant traditional knowledge. Interviews were conducted with the aid of a local language interpreter. Data were obtained using 300 semi-structured questionnaires. Consultations were made on all available information about traditional medicinal plants and ethnomedicinal surveys in Southern Nigeria. Online electronic databases including Google scholar, Research Gate, SciFinder, ScienceDirect and Open Thesis were used to search for relevant literature. Ethnomedicinal data were analyzed using the Relative frequency of citation (RFC), Fidelity level (FL), Relative popularity level (RPL), Use value (UV) and Informant Consensus Factor (ICF). Results: A total of 236 species belonging to 80 families were reported by this study. Fabaceae was the most represented family having thirty (30) plant species. The three (3) regions had varying frequencies of occurring plants species. South-Western Nigeria represented the region with the highest plant occurrence (47%) followed by South–South (31%). Leaves (42.32%) were the most common parts used in the preparation of herbal remedies. Decoctions (48.89%) were the most common method of plant preparation used in herbal remedies. Regional distribution and occurrence of ethnomedicinal plant resources of Southern Nigeria is reported here for the first time. Conclusion: Medicinal plants play crucial role in the treatment of various ailments by the indigenous people in Southern Nigeria. This study highlights the level of species richness as well as biodiversity in the study area. Bioactivity and toxicity by in vitro and in vivo standard tests should be made on herbal drug extracts of the presented species for isolation and possible identification of potentially active compounds

Prevalence of malaria and quantification of cytokine levels during infection in East Nile locality, Khartoum State: a cross-sectional study.

Background: The cytokines interferon gamma (IFN-γ), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF- α) play an important role in malaria infection. The aim of this study was to determine the prevalence of malaria and to evaluate cytokine responses to malaria infection in patients from the East Nile locality of Khartoum State. Methods: This study was carried out from May to July 2018 in the East Nile Locality, Khartoum State. Blood samples were collected from 384 randomly selected patients for blood film analysis. Of these, 39 were selected for cytokine level analysis (10 control and 29 patient samples), determined using enzyme-linked immunosorbent assays. Results: The malaria prevalence rate among 384 patients was 18.5%. Plasmodium falciparum was the most prevalent (13%), while the prevalence of Plasmodium vivax was 4.6%. The rate of mixed infection was 0.8%. There was a higher prevalence rate (22.7%) in males than females (15.6%). However, we found no significant correlation between cytokine levels and parasitemia in the study group. Nevertheless, our study demonstrated a significant correlation between cytokine levels and recurrent infections. Conclusions: Together, our data show that malaria remains a public health problem in East Nile locality with a high prevalence. Additionally,serum levels of IFN- γ and TNF- α were significantly higher in malaria-infected individuals compared to non-infecting individuals and cytokine levels were found to be correlated with recurrent malaria infection.

The wealth gradient in diarrhoea, acute respiratory infections, and malaria in childhood over time: A descriptive analysis using DHS and MICS from Western and Central Africa between 1995 and 2017.

BackgroundWhile the prevalence of childhood diseases and related mortality have been decreasing over the past decades, progress has been unequally distributed. The poorest households often carry the highest disease burden. As morbidity and mortality also decline most slowly among children of the poorest households, socioeconomic status may become a more relevant risk factor for childhood diseases.MethodsWe analysed the association between socioeconomic status and highly prevalent childhood diseases, specifically diarrhoea, acute respiratory infections (ARI), and malaria, and how this association changed over time. For this observational study, we used repeated cross-sectional data, namely all available Demographic and Health Surveys as well as Multi-Indicator Cluster Surveys from Western and Central Africa between 1995 and 2017. We estimated the predicted prevalence of each disease for the entire region in three time periods. We repeated the analysis separately for each country to highlight heterogeneity between countries.ResultsA notable wealth gradient can be seen in the prevalence rates of diarrhoea, ARI, and malaria in Western and Central Africa. Children in the poorest quartile have a much higher morbidity than children in the richest quartile and have experienced a considerably slower decline in prevalence rates. In the period 2010-2017, predicted prevalence of diarrhoea was 17.5% for children in the poorest quartile and 12.5% for children in the richest quartile. Similarly, the predicted prevalence was 11.1% and 8.6% for ARI, and 54.1% and 24.4% for malaria in endemic countries. The pattern does not differ between boys and girls. While exact prevalence rates vary between countries, only few countries have seen a decline in the wealth gradient for childhood diseases.ConclusionsThe increasing wealth gradient in health raises concerns of increasing inequality that goes beyond wealth. It suggests a need to further improve targeting of health programmes. Moreover, these programmes should be adapted to address the interlinked challenges which burden the poorest households.

Blood Lead Levels and Subsequence Risk of Malaria in the African Population: A Systematic Review and Meta-Analysis.

Previous epidemiological studies showed that blood lead level (BLL) was associated with malaria infection and severity. Therefore, the present study aimed to qualitatively and quantitatively synthesize the evidence on the association between BLL and risk of malaria infection and severity using the systematic review and meta-analysis approach. Potentially relevant studies were identified from three databases using a combination of search terms. The quality of the included studies was assessed using the checklist for the cross-sectional studies developed by the Joanna Briggs Institute. The qualitative synthesis of the risk or odds of malaria infection in patients with BLL was performed as the outcome of each included study could not be pooled. The pooled mean BLL and prevalence of malaria infection of the included studies was estimated using a random-effect model. The heterogeneity of the outcomes among the included studies was assessed using the Cochran Q test and I2 statistics. The subgroup analysis of the study sites and participants was performed to explore the source(s) of heterogeneity of the outcomes. Publication bias was assessed in the case of more than 10 studies used for pooling of the same outcome. Among 114 potentially relevant studies identified from the databases, 6 eligible studies were included for qualitative and quantitative syntheses. The results showed that the pooled mean BLLs were 7.33 μg/dL in children (95% confidence interval (95%CI), 4.08–10.58; I2, 98.2%), 7.94 μg/dL in children with BLL > 45 mg/dL before chelation (95%CI, 7.87–8.01), 7.41 μg/dL in infants (95%CI, 7.34–7.48 μg/dL), 9.20 μg/dL in children with malaria (95%CI, 9.16–9.24 μg/ dL), and 36.37 μg/dL in pregnant women (95%CI, 34.43–38.31 μg/dL). The prevalence rates of malaria among participants (2381 participants, 803 malaria-positive patients) were 53% in children (95%CI, 50–57%; I2, 99.8%), 24% in children with BLL > 45 mg/dL before chelation (95%CI, 21–27%), 12% in infants (95%CI, 8–18%), and 21% in pregnant women (95%CI, 18–26%). The subgroup analysis of countries demonstrated that the prevalence rates of malaria among participants was 17% in Benin (95%CI, 13–21%; I2, 98.8%) and 36% in Nigeria (95%CI, 10–63%; I2, 99.4%). BLL associated with decreased risk of malaria was demonstrated by two studies conducted in Benin and Nigeria, while BLL associated with increased risk of malaria was demonstrated by a study conducted in Nigeria. BLL was associated with the risk of severe malaria, involving severe neurological features and severe anemia. In conclusion, the present systematic review and meta-analysis determined the current status of the studies on BLL and risk of malaria in African countries. Further studies are needed to investigate the impact of BLL on patients with malaria to help the clinician determine the risk of severity, such as the development of neurological features or severe anemia, among patients exposed to lead.

Spatial Modelling of Risk Factors for Malaria Prevalence in SNNP Regional State, Ethiopia.

Malaria is one of the most severe public health problems worldwide with 300 to 500 million cases and about one million deaths reported to date of which 90% were from world health organization (WHO) Sub Saharan Africa (SSA) countries. The purpose of this study was to explore the spatial distribution of malaria parasite prevalence (MPP) among districts of Southern Nations Nationalities and Peoples Regional State (SNNRS) in Ethiopia by using 2011 malaria indicator survey (MIS) data collected for 76 districts and to model its relationship with different covariates. Exploratory spatial data analysis (ESDA) was conducted followed by implementation of spatial lag model (SLM) and spatial error model (SEM) in GeoDa software. Queen contiguity second order type of spatial weight matrix was applied in order to formalize spatial interaction among districts. From ESDA, we found positive spatial autocorrelation in malaria prevalence rate. Hot spot areas for MPP were found in the eastern and southeast parts of the region. Relying on specification diagnostics and measures of fit, SLM was found to be the best model for explaining the geographical variation of MPP. SLM analysis demonstrated that proportion of households living in earth/local dung plastered floor house, proportion of households living under thatched roof house, average number of rooms/person in a given district, proportion of households who used anti-malaria spray in the last 12 months before the survey, percentage household using mosquito nets and average number of mosquito nets/person in a given district have positive and statistically significant effect on spatial distribution of MPP across districts of SNNPRS. Percentage of households living without access to radio and television has negative and statistically significant effect on spatial distribution of MPP across districts of MPP. Malaria is spatially clustered in space. The implication of the spatial clustering is that, in cases where the decisions on how to allocate funds for interventions needs to have spatial dimension.

People behavior and anopheles mosquitous bionomic and its correlation with malaria parasite prevalence and case fatality rate (CFR) in West Seram Regency

WHO mentions that 300-500 million of people in the world are infected with malaria every year, 110 million of people perform the symptoms, and 2.7 million are even died. In 2005, malaria patients in West Seram Regency were 7.760 people. The research design was Survey and Case control in order to investigate the behavior of local society, Anopheles mosquito bionomic, malaria prevalence and case fatality rate (CFR). Purposive sampling was taken from the people of 2 villages in 3 districts with the highest numbers of patients. 30 people were taken from each village so total sample was 180 respondents. Anopheles bionomics involved habitat and breeding. Malaria cases in 2012-2016 obtained from public health center, health department office and public hospitals. Data analysis was done by using Pearson correlation test. The results showed that people behavior strongly agreed in overcoming the spread of Anopheles mosquitoes and malaria. Natural breeding habitat in swamps area where mangrove trees grow and sago trees at trenches, rice fields, ponds and water on the boat. Anopheles larvae species encountered was Anopheles sundaicus that actively bite all night inside and outside the house with peak activity at 02.00-03.00 a.m. Average larval density was 5.00, 9.00 and Average density of Anopheles mosquitoes was 5.09 - 9.85. The Prevalence Rate of Malaria is still high and Case Fatality Rate (CFR) is low. There is a significant correlation between people behavior and prevalence rate and no correlation with Case Fatality Rate (CFR)

Individual-level variations in malaria susceptibility and acquisition of clinical protection

After decades of research, our understanding of when and why individuals infected with Plasmodium falciparumdevelop clinical malaria is still limited. Correlates of immune protection are often sought through prospective cohort studies, where measured host factors are correlated against the incidence of clinical disease over a set period of time. However, robustly inferring individual-level protection from these population-level findings has proved difficult due to small effect sizes and high levels of variance underlying such data. In order to better understand the nature of these inter-individual variations, we analysed the long-term malaria epidemiology of children ≤12 years old growing up under seasonal exposure to the parasite in the sub-location of Junju, Kenya. Despite the cohort's limited geographic expanse (ca. 3km x 10km), our data reveal a high degree of spatial and temporal variability in malaria prevalence and incidence rates, causing individuals to experience varying levels of exposure to the parasite at different times during their life. Analysing individual-level infection histories further reveal an unexpectedly high variability in the rate at which children experience clinical malaria episodes. Besides exposure to the parasite, measured as disease prevalence in the surrounding area, we find that the birth time of year has an independent effect on the individual's risk of experiencing a clinical episode. Furthermore, our analyses reveal that those children with a history of an above average number of episodes are more likely to experience further episodes during the upcoming transmission season. These findings are indicative of phenotypic differences in the rates by which children acquire clinical protection to malaria and offer important insights into the natural variability underlying malaria epidemiology.

Malaria infection and associated risk factors in pregnant women attending antenatal care clinics in Al Jabalian Locality, White Nile state, Sudan.

Pregnant women are more susceptible to malaria which is associated with adverse effects on pregnancy. It is one of the leading causes of maternal mortality in Sudan. The main aim of this study was to determine the prevalence rate of malaria in pregnant women. This cross sectional descriptive study was carried out in Al Jabalian and Kenana hospitals, White Nile State, Sudan. The data of the present study has been collected from 400 Sudanese pregnant women, during a period extending from 16th July 2018 to 25th October 2018. The overall the prevalence of malaria was 38.5% (154), Plasmodium falciparum was only malaria parasite observed in all samples. From 154 pregnant women infected with malaria, the third trimester had higher prevalence 53.9% (83), followed by the second trimester 31.8% (49) and the first trimester was 14.3% (22), P<0.0001. The multigravida had high infection with prevalence of 54.5% (84), secondgravida was 24.7% (38) and primigravida was 20.8% (32), P<0.0001. Significant association was noticed between the malaria parasite infection and occupation, ANC attendance and utility of mosquito net, P-value 0.05, 0.0024, 0.0010, respectively. However, no significant association was observed with education level and malaria infection. The study was recommended to promote diagnosis during pregnancy, take anti-malarial medicine as routine care to pregnant women and improve environmental sanitation.

Can we use local climate zones for predicting malaria prevalence across sub-Saharan African cities?

Malaria burden is increasing in sub-Saharan cities because of rapid and uncontrolled urbanization. Yet very few studies have studied the interactions between urban environments and malaria. Additionally, no standardized urban land-use/land-cover has been defined for urban malaria studies. Here, we demonstrate the potential of local climate zones (LCZs) for modeling malaria prevalence rate (PfPR) and studying malaria prevalence in urban settings across nine sub-Saharan African cities. Using a random forest classification algorithm over a set of 365 malaria surveys we: (i) identify a suitable set of covariates derived from open-source earth observations; and (ii) depict the best buffer size at which to aggregate them for modeling PfPR.Our results demonstrate that geographical models can learn from LCZ over a set of cities and be transferred over a city of choice that has few or no malaria surveys. In particular, we find that urban areas systematically have lower PfPR (5%–30%) than rural areas (15%–40%). The PfPR urban-to-rural gradient is dependent on the climatic environment in which the city is located. Further, LCZs show that more open urban environments located close to wetlands have higher PfPR. Informal settlements—represented by the LCZ 7 (lightweight lowrise)—have higher malaria prevalence than other densely built-up residential areas with a mean prevalence of 11.11%. Overall, we suggest the applicability of LCZs for more exploratory modeling in urban malaria studies.