Malaria Prevention Methods Research Articles

Low levels of Plasmodium falciparum parasitaemia among patients receiving antiretroviral therapy at the treatment centre of the Regional Hospital Bamenda, Northwest Cameroon.

Malaria and HIV are leading causes of death in Africa, including Cameroon. Antiretroviral therapy (ART) is expected to boost immunity and reduce vulnerability to opportunistic infections. Reports on comorbidities including malaria are common in Cameroon. To determine the prevalence of malaria parasitaemia, clinical manifestations, treatment related factors and prevention methods associated with malaria parasitaemia as well as parasite density among HIV patients on ART. It was a cross-sectional study among HIV patients on ART at the Regional Hospital Bamenda. A pre-tested questionnaire was used to collect data on participants' socio-demographic characteristics, clinical manifestations, history of HIV treatment and malaria prevention methods. Microscopy was used for malaria parasite diagnosis and to determine white blood cell (WBC) count. Data was analysed using SPSS version 20. The study included 181 participants. The overall prevalence of malaria parasitaemia was 9.4%. Although there were no significant statistical differences, the following trends were observed in the results: 55-71 year old age group (14%) was most infected with malaria parasite with the highest prevalence among those on the 8A first-line ART (10.3%, 14/122); (χ2=1.03, p=0.96), only participants in the 8A and 12A ART protocols were infected; parasite prevalence was higher in patients with detectable viral load (14.3%, 3/21), (OR=.0.57 (CI: 0.15-2.2), p=0.41), while GMPD varied from 45.7-53.3-±23.1/μl of blood. Low malaria parasite prevalence and density were detected amongst HIV patients receiving ART. A systematic malaria test could be helpful to avert morbidity and improve the general health of patients on ART.

CONTRIBUTING FACTORS FOR INCREASING INCIDENCE OF MALARIA IN Talata asher VILLAGE, TESSENEY DISTRICT, GASH BARKA, ERITREA 2023

Abstract Background: The expansion of new malaria vector knows to call An. stephensi in Sub-Saharan-Africa (SSA) is another challenge in malaria elimination .The use of long lasting insecticidal net(LLINs) ,indoor residual spraying (IRS) and environmental management targeted to eliminating mosquitoes breeding sites is the main malaria prevention strategies. This study aimed at assessing the factors for increasing incidence of malaria in talataasher village, teseney district gash barka region of Eritrea. Methods: The quantitative descriptive cross sectional & qualitative study was conducted in Talata Asher village, Tesseney district, Gash barka, Eritrea which is found in gash barka, Eritrea in border with Sudan. A total of 102 households interviewed, 10 households for indoor breeding site assessment, 10 outdoor breeding habitat for outdoor breeding assessment and also twelve participants for focus group discussion. Data was collected using a standard structured questionnaire, standard entomological forms and analyzed using SPSS version 2025. Results: Of the 102 households assessed 92.2% of the households own at least one LLINs, 73.2% two or more LLINs. Only about 23% of all households had sufficient numbers of LLINs to meet the desired target in the household. Nearly 87.2 % of household members were used the net for sleeping under, but only 52.9% slept under LLINs during the previous night. The majority of the house holds 40.4 % were slept under LLINs after ten pm. Out of the total 60% of the households mentioned only one environmental management campaign performed through the whole year in the area. With regards to the total morphologically identified Anopheles from the artificial and natural breeding habitat, 34.3% and 27.9% were An.stephensi which is the new emerging malaria vector respectively. Conclusions: The low bed net utilization and practice of environmental management targeted to malaria prevention results the increasing malaria incidence in study site. In addition, to that the presence of new emerging malaria vector An. Stephensi in the study area also the cause increased incidence. Therefore there is a need to a special attention on the behavior of the new vector and a need to promote the whole population on the core malaria prevention methods.

Impacts of COVID-19 on malaria elimination strategies in Asia: A scoping review.

The global malaria program has faced setbacks due to disruptions in health services caused by COVID-19 pandemic. Despite these challenges, Asia that primarily comprised of low and middle-income countries (LMICs), continues to make strides towards malaria elimination. This scoping review explored the impact of the COVID-19 pandemic on malaria control programs in Asian countries with varying levels of malaria endemicity. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was applied to search for articles published between January 2020 and May 2024 that examined the impact of COVID-19 on malaria control programs in Asia on six databases (PubMed, Scopus, Google Scholar, WHO COVID-19 Research Database, Garuda and Sinta). The findings of these articles were organized into five themes: epidemiology and surveillance, case management (including diagnosis and coinfection), vector control, prevention, and program management. Overall, 54 articles from countries with various endemicity levels were included. These studies focused on malaria epidemiology, surveillance, and case management, with few studies on vector control. The COVID-19 pandemic has affected malaria control differently in different regions. In malaria-free, low-, and high-endemic countries, malaria cases were reduced mainly due to strict public health measures such as travel restrictions, quarantines, and COVID-19-related stigma, which reduced clinic attendance. Conversely, increased malaria cases owing to increased imports, relapses of malaria cases triggered by COVID-19, social conflicts, and underreporting have contributed to this surge. The priority shift to COVID-19 has affected malaria centers, resulting in personnel shortages, budget limits, and an increased number of malaria cases and outbreaks. The pandemic has also spurred innovative malaria prevention methods, such as using social media to raise awareness in China. The COVID-19 pandemic has had a mixed impact on the number of malarial cases reported across Asia. The three main factors were travel restrictions, COVID-19-related stigma, and shifting priorities to COVID-19. Integrating malaria control and COVID-19 strategies, strengthening the healthcare system, developing flexible malaria control strategies during crises, and developing innovative solutions could mitigate these impacts.

Examining Barriers to the Utilization of Malaria Control and Prevention Services in the South West Region, Cameroon

Purpose: The purpose of this study is to examine the barriers to the utilisation of malaria control and prevention services in the southwest region of Cameroon precisely in the Fako division. Cultural beliefs and practices significantly influence health-seeking behaviours in communities, even when faced with life-threatening diseases like malaria. Methodology: Qualitative data were collected through structured interviews to understand the preferred treatment methods for malaria, the rationale behind the disease's continuous prevalence within the community, and the low usage of prevention methods prescribed in the hospitals. The data were analysed using a thematic technique, and presented following the themes that were elicited during the in-depth interviews and focus group discussions. Findings: This study found that herbal medical practices are deeply rooted in the community's culture and need to be more quickly supplanted by modern medical practices. The study found that the resistance to malaria prevention methods was fueled by a lack of awareness about the importance of malaria prevention and control, contributing to the high malaria prevalence rate in the community. Also, the study found that the current healthcare system needs to be culturally sensitive, potentially leading to a lack of trust and confidence among community members. Additionally, financial constraints significantly impact the utilisation of preventive and treatment measures like mosquito nets, health centres, and community health workers. Unique Contribution to Theory, Practice and Policy: These findings aligned with the Health Belief Theory (HBT), which explains that individuals' beliefs and attitudes towards malaria prevention in these communities constitute a significant barrier to malaria eradication. Community members perceive malaria as a severe disease and believe they are at risk of contracting it, leading to action due to susceptibility. However, traditional remedies are preferred due to perceived barriers to mosquito nets, such as cost, lack of access, and perceived ineffectiveness of the mosquitoes’ nets. The study concluded that a culturally sensitive approach to malaria treatment and prevention, built on the community's beliefs and practices, can improve health outcomes. Therefore, organisations in charge of malaria prevention must adapt their approach to align better with the community's cultural values. The study further recommended that education and awareness campaigns about malaria prevention and control should be tailored to the community's cultural realities.

Usability of a digital tool to support long-lasting insecticide net distribution in Northern Bahr el Ghazal State, South Sudan.

Long-lasting insecticidal nets (LLINs) have been a widely used malaria prevention method for decades. In South Sudan, LLINs are typically distributed by volunteers who use paper-based systems to collect distribution data. Paper-based systems are simple to use but have a higher occurrence of data inaccuracies and can hinder the timely use of data for decision-making. In 2022, a digital tool was introduced to collect data during the LLIN campaign in Northern Bahr el Ghazal (NBeG). The tool aimed to improve the accuracy of data entry and enable data to be used in real-time for decision making during the campaign. The digital tool was developed with offline functionality and interoperability with DHIS2 tracker version 2.8 in DHIS2 version 2.38. This study assessed the usability of the tool according to user perspectives. A questionnaire containing open- and closed-ended questions was conducted with users of the digital tool, supervisors and other key stakeholders in five counties of NBeG. The questionnaire was administered using Malaria Consortium's Projects Results System Android mobile application. Usability was determined through a modified and validated System Usability Scale (SUS) approach. A total of 93 participants responded to the usability questionnaire. The mean (± standard deviation) usability score across 10 SUS-scoring items was60.91 (12.87), indicating a modest level of usability. The majority of users agreed the tool was useful for managing the LLIN distribution workflow, was easy to use, reduced workload, and supported stock management and real-time campaign monitoring. There was no significant difference in the usability scores across genders, roles, and counties. Respondents with experience of both paper-based and the digital tool tended to express a preference for the digital tool over paper-based systems. The majority of respondents also reported they would recommend the digital tool to colleagues. Digital tools are perceived to improve data collection during LLIN campaigns, even in remote areas where network coverage is challenging. Additional improvements can be implemented to overcome operational challenges and improve usability of the tool. Further study is needed to assess the impact of the digital tool on data quality and real-time data use.

Empowering rural communities for effective larval source management: A small-scale field evaluation of a community-led larviciding approach to control malaria in south-eastern Tanzania

IntroductionLarval source management, particularly larviciding, is mainly implemented in urban settings to control malaria and other mosquito-borne diseases. In Tanzania, the government has recently expanded larviciding to rural settings across the country, but implementation faces multiple challenges, notably inadequate resources and limited know-how by technical staff. This study evaluated the potential of training community members to identify, characterize and target larval habitats of Anopheles funestus mosquitoes, the dominant vector of malaria transmission in south-eastern Tanzania. MethodsA mixed-methods study was used. First, interviewer-administered questionnaires were employed to assess knowledge, awareness, and perceptions of community members towards larviciding (N = 300). Secondly community-based volunteers were trained to identify and characterize aquatic habitats of dominant malaria vector species, after which they treated the most productive habitats with a locally-manufactured formulation of the biolarvicide, Bacillus thuringiensis var. israelensis. Longitudinal surveys of mosquito adults and larvae were used to assess impacts of the community-led larviciding programme in two villages in rural south-eastern Tanzania. ResultsAt the beginning of the program, the majority of village residents were unaware of larviciding as a potential malaria prevention method, and about 20 % thought that larvicides could be harmful to the environment and other insects. The trained community volunteers identified and characterized 360 aquatic habitats, of which 45.6 % had Anopheles funestus, the dominant malaria vector in the area. The preferred larval habitats for An. funestus were deep and had either slow- or fast-moving waters. Application of biolarvicides reduced the abundance of adult An. funestus and Culex spp. species inside human houses in the same villages, by 46.3 % and 35.4 % respectively. Abundance of late-stage instar larvae of the same taxa was also reduced by 74 % and 42 %, respectively. ConclusionThis study demonstrates that training community members to identify, characterize, and target larval habitats of the dominant malaria vectors can be effective for larval source management in rural Tanzania. Community-led larviciding reduced the densities of adult and late-stage instar larvae of An. funestus and Culex spp. inside houses, suggesting that this approach may have potential for malaria control in rural settings. However, efforts are still needed to increase awareness of larviciding in the relevant communities.

A qualitative look at bed net access and use in Burkina Faso, Mozambique, Nigeria, and Rwanda following piloted distributions of dual-active ingredient insecticide-treated nets

BackgroundUniversal coverage with insecticide-treated nets (ITNs) is important for malaria control and elimination. The emergence and intensification of insecticide resistance threatens progress made through the deployment of these interventions and has required the development of newer, more expensive ITN types. Understanding malaria prevention behaviour, including barriers and facilitators to net access and use, can support effective decision-making for the promotion and distribution of ITNs.MethodsIn-depth interviews and focus group discussions were conducted in 3 to 4 villages per district, in 13 districts across Burkina Faso, Mozambique, Nigeria and Rwanda from 2019 to 2022. Interviews were conducted in the local language, translated and transcribed in English, French or Portuguese. Transcripts were coded and analysed using Nvivo and ATLAS.ti.ResultsITNs were obtained from mass distribution campaigns, antenatal care and immunization visits, and purchased on the private market in some locations. While there were divergent perspectives in whether the number of distributed nets were adequate, participants consistently expressed concerns of bias, discrimination, and a lack of transparency with the distribution process. ITNs were frequently used alongside other malaria prevention methods. The primary motivation for use was malaria prevention. While some participants reported using nets nightly throughout the year, other participants reported seasonal use, both due to the perceived higher density of mosquitoes and discomfort of sleeping under a net in the increased heat. Other barriers to consistent net use included activities that take place away from the home, sleeping patterns and arrangements, and sensitivity to the insecticides on the nets.ConclusionsITNs remain an important malaria control intervention. To ensure adequate and increased net access, distribution campaigns should consider family structures, available sleeping spaces, and other bed sharing preferences when identifying the number of nets needed for distribution. In addition, campaigns should allow for multiple options for net distribution points and timing to accommodate households remote to health services. Continuous distribution channels and complimentary distribution through the private sector could help fill gaps in coverage. Solutions are needed for outdoor malaria transmission, including alternative designs for ITNs, and improving access to complementary personal protective measures.

Facilitators and barriers to integrated malaria prevention in Wakiso district, Uganda: A photovoice study.

Malaria continues to cause significant morbidity and mortality globally, particularly in sub-Saharan Africa. Appropriate combinations of non-chemical and chemical methods of malaria vector control in the context of integrated vector management have been recommended by the World Health Organization. The aim of the study was to explore facilitators and barriers to using integrated malaria prevention in Wakiso district, Uganda. This qualitative study employed photovoice among 20 community members in Kasanje Town Council, Wakiso District. The photos taken by participants for 5 months using smartphones were discussed during monthly meetings with the researchers. The discussions were audio-recorded, and resulting data analysed using thematic analysis with the support of NVivo (2020) QSR International. Findings indicated that various conventional and non-conventional measures were being used for preventing malaria such as: insecticide treated nets; clearing overgrown vegetation; draining stagnant water; mosquito coils; smouldering of cow dung; spraying insecticides; plant repellents near houses; eating of prophylactic herbs; as well as closing doors and windows on houses early in the evening. Facilitators supporting the use of several malaria prevention methods holistically included: low cost and accessibility of some methods such as slashing overgrown vegetation; and support provided for certain methods such as receiving free mosquito nets from the government. Barriers to using several malaria prevention methods holistically included: inadequate knowledge of some methods such as housing improvement; allergic reactions to chemical-based methods such as insecticide treated nets; unaffordability of some methods such as insecticide sprays; and inaccessibility of certain methods such as body repellents. These barriers to integrated malaria prevention need to be addressed to achieve greater impact from the combination of methods in endemic communities.

Impact of Malaria on Hematocrit Levels in HIV-Infected Individuals: A Comprehensive Review

His comprehensive review explores the intricate relationship between malaria infection and hematocrit levels in individuals co-infected with HIV. Malaria and HIV, both prevalent in resource-limited regions, exhibit a synergistic impact on the immune system, leading to exacerbated anemia and subsequent reductions in hematocrit levels. The interplay between these infections involves complex immune responses, compromising the ability to combat anemia effectively. Accurate diagnosis presents challenges due to overlapping symptoms, necessitating integrated diagnostic approaches. Treatment strategies, including antiretroviral therapy and antimalarial drugs, must be carefully chosen to avoid adverse interactions. Preventive measures, such as malaria prevention methods and nutritional interventions, play a crucial role in mitigating the risk of co-infection and anemia. The review emphasizes the need for a multidimensional approach in both diagnosis and treatment to enhance the overall well-being of individuals facing the complex challenge of malaria and HIV co-infection.

Assessment of malaria prevention knowledge, attitude, and practice and associated factors among households living in rural malaria-endemic areas in the Afar Pastoral Region of Ethiopia.

Malaria morbidity has reduced significantly in most regions of Ethiopia, but it is still a serious issue in the northeast, particularly in the Afar region. The study aimed to evaluate household heads' knowledge, attitudes, and practices toward malaria prevention and its associated factors in rural Ada'ar woreda district in the Afar region. A community-based cross-sectional study was conducted among 422 households living in Ada'ar woreda district. A systematic sampling technique was used to select households. A pre-tested, structured questionnaire was used to interview randomly selected adult household heads. Frequency and percentage were computed. Logistic regression was used to determine the association between independent and dependent variables. Statistical significance was considered to be a p-value <0.05. Nearly two-thirds (64.2%) of household heads had good knowledge of malaria prevention, and 46.9% had a positive attitude toward it. About 17.3 and 56.9% of study participants had good malaria prevention practices and good healthcare seeking behaviors, respectively. Illiterate (AOR = 2.62, 95% CI: 1.49-4.63) and low-income (AOR = 2.6, 95% CI: 1.2-5.6) participants were more likely to have poor knowledge of malaria prevention (malaria signs and symptoms, malaria transmissions, and malaria prevention methods). Married participants (AOR = 2.52, 95% CI: 1.02-6.29) and illiterates (AOR = 2.83, 95% CI: 1.69-4.73) had negative attitudes toward malaria prevention. Household heads with poor knowledge of malaria prevention had 85% higher rates of practicing poor malaria prevention methods (regular bed nets used; AOR = 1.85, 95% CI: 1.2-2.8). Young adults (18-25 years) were more likely to have poor healthcare seeking behaviors (AOR = 3.5, 95% CI: 1.73-7.1), while pastoralists had a lower likelihood (AOR = 0.46, 95% CI: 0.28-0.8). Knowledge, attitude, and practices toward malaria prevention remain a problem in malaria-endemic rural areas of the Afar region of Ethiopia. There is a need for the implementation of interventions that will focus on increasing knowledge of malaria prevention and encouraging positive attitudes toward it, as well as promoting regular bed net usage and healthcare seeking behaviors.

Knowledge, Attitudes and Practices Among Adult Malaria Patients Co-Infected with Opportunistic Intestinal Coccidian Parasites in Fundong Health District, Northwest, Cameroon: A Cross Section Study Design

Introduction: Malaria and intestinal coccidian parasitic co-infections, are becoming a public health emergency affecting millions of people around the world. They are among the leading cause of socio-economic problems, long suffering and death especially in developing countries like Cameroon. Introducing new appropriate preventive and control measures to the population requires thorough assessment of community and patient-based knowledge, attitude and preventive practices towards malaria and pathogenic intestinal coccidian parasites is crucial. Our study aimed to describe knowledge, attitudes, and practices and the risk factors among adult malaria patients co-infected with intestinal parasitic infections in the Fundong Health District, a locality in the Northwest Region of Cameroon. Methods: This was a cross-sectional study carried out between February and December, 2022 involving sixteen (16) health facilities in Fundong Health district. A total number of 330 patients participated in the study. Normal saline wet mount and formol-ether concentration techniques were employed in coccidian parasitic detection. Blood samples were subjected to Giemsa stained and viewed microscopically to detect the Plasmodium parasites. Pretested structured questionnaires were administered to collect information on patient’s socio-demographic factors and determine patients’ knowledge, attitudes and practices towards malaria and intestinal coccidian parasites, as well as their prevention and control. The Pearson’s Chi-Square (χ2) and Student T-test were performed a part of the statistical analysis to check for associations between malaria, infection and between malaria-coccidian co-infection and demographic factors. Statistical significance was set a P-value&lt;0.05. Results: Participants main sources of information on malaria were: Television (TV) and radio 111/330 (34%), community health workers 109/330 (33%), and Hospitals (37%). Participants had good knowledge of mosquito bite as the malaria transmission route, 296/330 (90%), night time is the frequent biting time for the mosquito 296/330(90%), dark corners 229 (69%) and dirty areas 175(53%) as mosquito resting places. Knowledge score was also good on cleaning of the house surroundings, 281/330(85%), clearing the bushes 180/330(55%), poor knowledge score on drainage of stagnant water113/330 (34%) as ways to prevent the mosquito from multiplying. Participants had good knowledge of insecticide treated bed nets 295/330 (89%) as the best way to prevent mosquito bites. However, participants also expressed poor knowledge on edges of the river or streams 7(20%), and animal shed 20/330 (6%) as mosquito hiding places, and Plasmodium specie as malaria causative agent 8/330 (2%) (P-value=0.011). Poor scores were recorded on knowledge of opportunistic intestinal coccidian parasites (19.4%) (P=0.427), and was significantly low on unsafe water (47.2%) (P-value=0.036) as possible transmission routes for coccidian parasites. The knowledge score was also low on the at-risk population for malaria and intestinal coccidian infection (31.9%) P-value=0.009. Participants who had poor knowledge about coccidian transmission routes were less likely to drink from protected water source with an odds of 0.713(95% CI: 0.297-1.711) P value=0.449, compared to those who were more knowledgeable and who were 2.981(95% CI: 1.367-6.115) P value=0.005, more likely to use protected source of drinking water. Participants who had hand washing facility in the household were 3.488 (1.760-6.912) value=0.001 times more likely have better knowledge of coccidian transmission routes compared to those who did not have 0.748 (95% CI: 0.406-1.376) P value=0.350. Poor knowledge score of poor hygiene as major cause of coccidian infection significantly associated with poor practice score of sometime or not at all disinfecting animal shed to prevent coccidian infection among study participants (P =0.039). Conclusion: The overall knowledge scores, attitude and practices level of participants towards malaria and opportunistic intestinal coccidian parasites were relatively good. A significant proportion of the participants still have misconceptions about cause, modes of transmission and practices towards malaria and coccidian prevention methods. A combined health education programmes for malaria and intestinal coccidian parasites aimed at raising community awareness needs to be evidence based and requires innovative approaches, to address the gaps identified in the study.

Using routine health data to evaluate the impact of indoor residual spraying on malaria transmission in Madagascar

IntroductionIndoor residual spraying (IRS) and insecticide-treated bed nets (ITNs) are cornerstone malaria prevention methods in Madagascar. This retrospective observational study uses routine data to evaluate the impacts of IRS overall,...

Malaria surveillance, outbreak investigation, response and its determinant factors in Waghemra Zone, Northeast Ethiopia: unmatched case–control study

Malaria is a major global public health concern, with around half of the world's population at risk of infection. It is one of the most common epidemic-prone diseases, resulting in on-going epidemics and significant public health problems. On September 12, 2022, Waghemra Zone malaria monitoring data revealed that the district was suffering an unusually high number of malaria cases. Therefore, the aim of this study was to assess the occurrence of malaria outbreaks and investigate contracting factors in Waghemra Zone, Northeast Ethiopia. A community-based case–control study with a 1:1 ratio was employed at Waghemra Zone from September 14 to November 27, 2022. A total of 260 individuals (130 cases and 130 controls) were included in the study. A structured questionnaire was used to collect the data. Malaria cases were confirmed by either microscopy or malaria rapid diagnostic tests. The magnitude of the outbreak was described by place, person, and time. A multivariable logistic regression analysis was conducted to identify malaria risk factors. A total of 13,136 confirmed cases of malaria were detected in the Waghemra zone, with an overall attack rate of 26.5 per 1000 and slide positivity rate was 43.0%. The predominant species was Plasmodium falciparum accounting for 66.1%. Children under five years old (AOR = 5.1; 95% CI 2.6–23.0), the presence of artificial water-holding bodies (AOR: 2.7; 95% CI 1.340–5.420), intermittent rivers closer to the living house (AOR = 4.9; 95% CI 2.51–9.62), sleeping outside a home (AOR = 4.9; 95% CI 2.51–9.62), and a lack of knowledge about malaria transmission and prevention (AOR: 9.7; 95% CI 4.459–20.930) were factors associated with malaria contraction. The overall attack rate for malaria during this outbreak was high. Children less than five years, the presence of mosquito breeding sites, staying outdoors overnight, and a lack of knowledge on malaria transmission and prevention were predictors of malaria. Early management of local vector breeding places, as well as adequate health education on malaria transmission and prevention methods, should be provided to the community to prevent such outbreaks in the future.

Towards malaria elimination: analysis of travel history and case forecasting using the SARIMA model in Limpopo Province

Despite various efforts and policy implementation aimed at controlling and eliminating malaria, imported malaria remains a major factor posing challenges in places that have made progress in malaria elimination. The persistence of malaria in Limpopo Province has largely been attributed to imported cases, thus reducing the pace of achieving the malaria-free target by 2025. Data from the Limpopo Malaria Surveillance Database System (2010–2020) was analyzed, and a seasonal auto-regressive integrated moving average (SARIMA) model was developed to forecast malaria incidence based on the incidence data’s temporal autocorrelation. The study found that out of 57,288 people that were tested, 51,819 (90.5%) cases were local while 5469 (9.5%) cases were imported. Mozambique (44.9%), Zimbabwe (35.7%), and Ethiopia (8.5%) were the highest contributors of imported cases. The month of January recorded the highest incidence of cases while the least was in August. Analysis of the yearly figures showed an increasing trend and seasonal variation of recorded malaria cases. The SARIMA (3,1,1) X (3,1,0) [12] model used in predicting expected malaria case incidences for three consecutive years showed a decline in malaria incidences. The study demonstrated that imported malaria accounted for 9.5% of all cases. There is a need to re-focus on health education campaigns on malaria prevention methods and strengthening of indoor residual spray programs. Bodies collaborating toward malaria elimination in the Southern Africa region need to ensure a practical delivery of the objectives.

Integrated malaria prevention in low- and middle-income countries: a systematic review

BackgroundAs many countries aim to eliminate malaria, use of comprehensive approaches targeting the mosquito vector and environment are needed. Integrated malaria prevention advocates the use of several malaria prevention measures holistically at households and in the community. The aim of this systematic review was to collate and summarize the impact of integrated malaria prevention in low- and middle-income countries on malaria burden.MethodsLiterature on integrated malaria prevention, defined as the use of two or more malaria prevention methods holistically, was searched from 1st January 2001 to 31st July 2021. The primary outcome variables were malaria incidence and prevalence, while the secondary outcome measures were human biting and entomological inoculation rates, and mosquito mortality.ResultsA total of 10,931 studies were identified by the search strategy. After screening, 57 articles were included in the review. Studies included cluster randomized controlled trials, longitudinal studies, programme evaluations, experimental hut/houses, and field trials. Various interventions were used, mainly combinations of two or three malaria prevention methods including insecticide-treated nets (ITNs), indoor residual spraying (IRS), topical repellents, insecticide sprays, microbial larvicides, and house improvements including screening, insecticide-treated wall hangings, and screening of eaves. The most common methods used in integrated malaria prevention were ITNs and IRS, followed by ITNs and topical repellents. There was reduced incidence and prevalence of malaria when multiple malaria prevention methods were used compared to single methods. Mosquito human biting and entomological inoculation rates were significantly reduced, and mosquito mortality increased in use of multiple methods compared to single interventions. However, a few studies showed mixed results or no benefits of using multiple methods to prevent malaria.ConclusionUse of multiple malaria prevention methods was effective in reducing malaria infection and mosquito density in comparison with single methods. Results from this systematic review can be used to inform future research, practice, policy and programming for malaria control in endemic countries.

Malaria Among Pregnant Women in Bossaso City, Somalia: Cross Sectional Study Design

Malaria is a protozoan-caused parasitic infection of the genus Plasmodium. Approximately 25 million pregnant women in sub-Saharan Africa live at risk of Malaria. This study aims to address the prevalence of Malaria and its associated factors among pregnant women in Bossaso, Somalia. A health institution-based cross-sectional study was conducted among 422 pregnant women in Bossaso General Hospital (BGH) using an interview-administered questionnaire and malaria diagnosis confirmation, which was done on microscope-based laboratory techniques. The collected data were analyzed. Bivariate and multivariate logistic regression models were employed to identify factors associated with Malaria. The overall prevalence of Malaria was found to be 20.9% [95%CI (15.9%, 25.9%)]. Of these, 64 (75.3%), 19 (22.4%), and 2 (2.4%) were caused by Plasmodium falciparum, Plasmodium vivax, and mixed infection, respectively. The factors like the presence of water pond sites around the house or vicinity [AOR= 6.5, 95% CI (1.6, 20.5)] and always using insecticide-treated bed nets (ITNs) [AOR=0.1, 95%CI (0.01, 0.88)] were found to be significantly associated with Malaria during pregnancy. The prevalence of Malaria among pregnant women in the study area was found to be high; Thus, this study emphasized the need to provide health education and consultation to pregnant women on the appropriate malaria preventive methods and continue strengthening other interventions.

Assessment of the Knowledge, Prevalence, and Control Strategies of Malaria Among Households in Sunyani Municipality, Bono Region, Ghana.

Malaria remains a global public health concern for centuries. The study assessed the knowledge, prevalence and control strategies of malaria among households in the Sunyani Municipality, Bono Region, Ghana. A simple random sampling method was used to administer semi-structured questionnaires to the respondents (n = 422). STATA version 14.0 was used to analyse the data and the results were presented in charts, graphs, and tables. The study shows that the knowledge level of malaria, its vector of transmission and mosquitoes breeding sites among the respondents was quite high. Among the respondents, 43% reported to have been infected by malaria once in a year and 94% indicated that, their relatives have been infected with malaria parasites previously. Also, majority, 65% of the respondents selected environmental management and sanitation (EMS), followed by settlement (building houses) away from wetlands, 20.0% as alternative vector control methods to be employed to supplement the core vector control methods in the Municipality. Further, majority, 69% of the respondents indicated that enforcement of environmental sanitation bye-laws will compel residents to clean their environment, and this is likely to eliminate most mosquito breeding sites, whiles 46% called on Government to support, and employ more Environmental Health Officers and Sanitary Labourers, and adequately resource them to work effectively. Health authorities in the Sunyani Municipality must intensified education on malaria at all levels with the aim to influence the attitudes of households towards its prevention and control. Central and Local Government must employ more Environmental Health Officers, and empower and adequately resourced them to strictly enforce the environmental sanitation bye-laws. Malaria control authorities in the study area must consider employing environmental management and sanitation (EMS) and application of larvicides for mosquito larval control as alternative/supplementary malaria prevention and control methods to compliments the current core vector control methods.

Knowledge, Attitude, And Practices (KAP) Of Malaria Prevention Amongst Medical Students of Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

Background: Malaria remains one of the foremost causes of morbidity in the world. Practices of preventive measures have been linked to factors including educational status. Students of health-related sciences are expected to possess a high-level knowledge of the disease and translate this into the better practice of preventive measures. Hence, this study was conducted to assess the knowledge attitude and practice of malaria prevention among medical students of Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. Methods: Data for this cross-sectional study was collected from 253 consenting medical students using an online group-designed Google Form questionnaire and analyzed using Microsoft excel. Results: Although 47.83% of respondents think malaria is a deadly disease and 98.81% affirmed it is preventable, almost all (≥98.42%) reported female anopheles’ mosquito and plasmodium as vector and causative agent, respectively. Moreover, 65.22% were very willing to use one or a combination of malaria preventive methods. Insecticides usage were most common among the respondents, with 84.58% having used them in the last year. In contrast, only 12.25% and 35.97% had used Indoor Residual Spray (IRS) and insecticide-treated mosquito net (ITN), respectively. Conclusion: This study revealed good knowledge and attitude amongst the medical students. However, this did not translate to practice, especially with the most advanced vector control practices such as ITN usage and IRS. Hence, a review of the public/community health curricula and related course modules to provide more information about IRS is recommended. Also, and there is a need for the government to make ITNs more readily available and affordable.

Prevention of Malaria in Pregnancy: What Do the Pregnant Women of Nigeria Know and Do about It?

We assessed knowledge, attitude, and practice regarding two malaria prevention measures (long-lasting impregnated mosquito nets, LLINs, and intermittent preventative therapy with sulphadoxine-pyrimethamine (IPTp-SP)) among pregnant women in Nigeria. Pregnant women selected from among the four communities of Nnewi were interviewed by using a semistructured, interviewer-administered questionnaire on the respondents' demography, knowledge of the cause, consequences, and malaria prevention methods. Also, a total of 48 focused group discussions, 24 key informant interviews, and 24 in-depth interviews were held among women leaders, village heads, pregnant women, community health workers, husbands of pregnant wives, and drug and insecticide-treated net sellers. A total of 384 women (88.0% third trimester, 90.0% literate, and 41.1% primigravidae) participated. About 80.0% suffered from malaria during their current pregnancy. The majority was aware of the cause of malaria, local name of malaria, mode of transmission, risk of malaria among pregnant women, etc. However, their knowledge and attitude were inadequate regarding the symptomatology and complications of malaria in pregnancy, benefits of sleeping under the net or taking chemoprophylactic doses, or the concurrent use of both. About 80.0% had LLINs, yet only 41.5% slept under it the previous night. Only 31.0% had IPTp-SP doses under direct observation. Only 35.9% had a good understanding of IPTp-SP during pregnancy. Our work presents important practice gaps associated with the prevention of malaria during pregnancy. The pregnant women seemed to be aware of the basic concepts related to malaria but that does not translate into adequate attitude and practice necessary for malaria reduction.

Prevalence and diversity of Plasmodium species in pregnant women attending antenatal clinics in selected health centers of Kakamega County, Western Kenya

Malaria remains a major public health concern around the world with tropical and sub-tropical regions bearing the greatest brunt despite up-scaling of control strategies. Despite the provisioning of insecticidal nets to expectant women attending antenatal care facilities, Plasmodium infections was a recurrent problem in Kakamega County. We hypothesized that socioeconomic factors were risk factors for the high prevalence levels of asymptomatic Plasmodium infections (API) among pregnant women in the County. A prospective cohort of 304 asymptomatic pregnant women aged 18 years and older was identified to assess the association between patient characteristics and risk of API using a cross-sectional study design. The study was conducted across four representative antenatal clinics (ANC) in the region. A pre-structured and pre-tested questionnaire was used to obtain the socio-demographic characteristics, residence, and knowledge of malaria. The questionnaire was followed by a face-to-face interview. Each participant provided a fingerprick blood sample for a thick and thion blood smear for parasite studies at Masinde Muliro University Science and Technology. The slides were examined at ×100 oil immersion. Plasmodium and the developmental stages were checked, quantified, and recorded. The data were analyzed using SPSS ver 16. Differences in parasite densities for various parameters was assessed using Mann Whitney U and Kruskal Wallis non-parametric tests. Ordinary linear squares (OLS) regression was used to uncover any significant associations at 95% CI and p-value ≤ 0.05. The majority of the women had a post-primary education (75%), were married (60.9%), multigravidae (50%), in their second trimester (41.4%), residing in rural areas (62.2%), used ITNs (77%), and did not practice IRS (67.8%) as a malaria prevention method. Plasmodium species infection prevalence was (24.34%; 95% CI, 19.52–29.16) P. falciparum (82.4%; 95% CI 73.72–91.08) accounting for the majority of infections. The parity and gestation status of the pregnant women were found to have a significant association with API. This study showed that a significant number of women in Kakamega County attending ANCs were asymptomatic for Plasmodium malaria. We propose that malaria screening through microscopy and treatment should be incorporated into maternal health within the county.